Revised on: April 19, 2021

ABD Applicant Referrals

1. Eligibility staff (PBS/WPS) determine financial eligibility for ABD cash applicants.

   1. PBS/WPS finalize applications for financially eligible applicants age 65 or older. (See CSD Procedures Handbook: Pending an Application or Eligibility Review)

2. Eligibility staff (PBS/WPS) refer financially eligible applicants to the Disability Specialist (DS). (See CSD Procedures Handbook: Information and Referrals)

   1. PBS/WPS complete a DSHS 14-084 (Social Service Referral) at the time each applicant has been determined financially eligible.

3. The Disability Specialist (DS) receives and responds to ABD referrals. (See CSD Procedures Handbook: ABD Applicant Referrals and CSD Procedures Handbook: ABD Aged Referrals)

   1. If an applicant is eligible for ABD based on non-SEP criteria described in Disability Determination - Non SEP Approvals, the DS approves ABD prior to completing a Social Services Intake.

4. The DS reviews and follows any existing Equal Access (EA) Plan for each referred applicant.

Social Services Intake

1. The DS completes the Social Services Intake in ICMS. (See CSD Procedures Handbook: Social Services Intake)

   1. It is a best practice to complete a Social Services Intake for all ABD applicants however it is not required to determine program eligibility.

   2. The DS does not deny an applicant based on the lack of a Social Services Intake.

2. The DS creates a new EA Plan or updates an existing EA Plan for the applicant when needed. (See EA-Z Manual: Equal Access and CSD Procedures Handbook: Equal Access)

3. The DS obtains a signed Interim Assistance Reimbursement Authorization (IARA) when the applicant has a current pending SSI application.

Related Procedures (Staff Only)

• Pending an Application or Eligibility Review
• Information and Referrals
• ABD Referrals
• ABD Aged Referrals
• Social Services ABD Intake
• Equal Access (Screening)

Revised on: December 11, 2023

Purpose 

Individuals residing in Eastern or Western State Hospital are potentially eligible for the Aged, Blind, or Disabled (ABD) program if they meet all other eligibility criteria per WAC 388-400-0060. If ABD is approved, individuals are eligible for a clothing, personal maintenance, and necessary incidentals (CPI) monthly grant up to $41.62. 

At Admission: Eastern and Western State Hospital staff help patients submit ABD cash applications after their admission. Hospital staff will only submit ABD applications for patients who are civilly committed or “not guilty by reason of insanity.” HCS and DDA staff process ABD applications (and recertifications) for patients age 20 or under and age 65 and over (Title 19). CSD staff process applications (and recertifications) for patients age 21-64.  

At Discharge or transfer: Eastern and Western State Hospital staff help patients submit food/cash applications at discharge. HCS and DDA staff process discharge applications (and ABD recertifications) for patients discharging to their services/care. Remaining discharge applications (and ABD recertifications) are processed by CSD staff.

See the following WACs for additional information:

• WAC 388-400-0060: Who is eligible for aged, blind or disabled (ABD) cash assistance?   

• WAC 388-400-0070: Who is eligible for referral to the housing and essential needs (HEN) program?  

• WAC 388-434-0005: How often does the department review my eligibility for benefits?  

• WAC 388-449-0001: What are the disability requirements for the aged, blind, or disabled (ABD) program?  

• WAC 388-449-0150: When does my eligibility for aged, blind, or disabled (ABD) cash benefits end?

• WAC 388-449-0200: Am I eligible for cash assistance for aged, blind, or disabled (ABD) while waiting for supplemental security income (SSI)?  

• WAC 388-452-0005: Do I have to be interviewed in order to get cash and basic food benefits? 

• WAC 388-478-0006: The clothing, personal maintenance, and necessary incidentals (CPI) payment standard for cash assistance.  

• WAC 388-478-0033: What are the payment standards for aged, blind, or disabled (ABD) cash assistance?  

Clarifying Information 

WAC 388-400-0060: Who is eligible for aged, blind, or disabled (ABD) cash assistance?

1. You may be eligible for ABD if you reside in Eastern or Western State Hospital and meet all other eligibility requirements.
2. You are not eligible for ABD if you are in the custody of or confined in a public correctional facility such as a state prison, or city, county or tribal jail, including placement in a work release program.
3. Forensic patients are individuals who have been admitted to Eastern or Western State Hospitals through the criminal justice system. 
   1. Patients who have been determined “not guilty by reason of insanity” (NGRI) have had their competency restored, completed their court process, pleaded NGRI and have been adjudicated. These patients are potentially eligible for ABD. 
   2. Competency evaluation and restoration patients are committed under RCW 10.77. Competency is the ability of the person to understand and participate in the court process. This population have not had their crimes adjudicated and are considered in custody of or confined to a public correctional facility. These individuals are not eligible for ABD. 
4. The following chart shows which Eastern and Western State Hospital “legal authorities” are potentially eligible for ABD. 

WAC 388-434-0005: How often does the department review my eligibility for benefits?  

1. Eligibility staff review financial eligibility for ABD recipients residing in Eastern or Western State Hospital every 24 months and at discharge. See CSD Procedures Handbook: ABD Inpatient Discharging from a State Hospital.

WAC 388-449-0001: What are the disability requirements for the aged, blind, or disabled (ABD) program?  

1. We consider civilly committed Eastern or Western State Hospital patients as likely to be disabled. Initial civil commitment requires that a person has been determined to be an imminent danger to themselves, to others or meets the criteria for grave disability under RCW 71.05. BHA evaluates civil commitments at 90 and 180 days. 
2. We consider Eastern or Western State Hospital patients who have been determined “not guilty by reason of insanity” (NGRI) as likely to be disabled. NGRI patients have had their competency restored, completed their court process, pleaded NGRI and have been adjudicated.
3. Eligibility staff finalize applications for these patients without a disability determination from social services staff. See CSD Procedures Handbook: ABD for Inpatient Customers at State Hospitals.

WAC 388-449-0150: When does my eligibility for aged, blind, or disabled (ABD) cash benefits end?

1. We review ABD financial and social services eligibility for recipients discharging from Eastern or Western State Hospital. Eligibility staff complete an early eligibility review. Social Services staff complete a disability determination. 
   1. Eligibility staff complete an early eligibility review. See CSD Procedures Handbook: ABD Inpatient Discharging from a State Hospital.
   2. Social Services staff complete a disability determination. See CSD Procedures Handbook:  ABD Referrals and Documents for Customers Discharging from Eastern or Western State Hospital.

WAC 388-449-0200: Am I eligible for cash assistance for aged, blind, or disabled (ABD) while waiting for supplemental security income (SSI)?

1. ABD recipients who reside in Eastern or Western State Hospital are not required to sign an interim assistance reimbursement authorization.
2. ABD recipients who reside in Eastern or Western State Hospital are not required to file an application for SSI.
3. If the client remains eligible for ABD after discharge, social services staff work with the client to meet the above requirements at that time.

WAC 388-452-0005: Do I have to be interviewed in order to get cash and basic food benefits?

1. Eligibility staff waive interviews for ABD cash applicants and recipients who reside in a public institution at application and eligibility review (ER). See CSD Procedures Handbook: ABD for Inpatient Customers at State Hospitals.
2. Eligibility staff complete an ABD ER at discharge. See CSD Procedures Handbook: ABD Inpatient Discharging from a State Hospital.

Points of Contact (Staff Only)

Related Procedures (Staff Only) 

• ABD Inpatient Discharging from a State Hospital
• ABD for Inpatient Customers at State Hospitals
• ABD Referrals and Documents for Customers Discharging from Eastern or Western State Hospital
• ABD Referrals and Documents for Inpatient Customers at Eastern or Western State Hospital
• ABD Documents from Eastern or Western State Hospital Received by Non-Designated Social Services Specialists

Revised December 30, 2013

Purpose:

Provide a basic overview of alcohol/substance abuse system and guidelines to assist in determining if a client is in need of alcohol or substance abuse treatment.

Guidelines

The department recognizes that identification and treatment of alcohol and substance abuse issues are of paramount importance in assisting clients to attain self-sufficiency. The Division of Behavioral Health and Recover (DBHR) contracts with local treatment centers which provide alcohol and substance abuse evaluations and treatment.

Evaluation and treatment services are provided for clients receiving services under the following programs:     

• WorkFirst;
• ABD cash assistance;
• HEN Referral; and 
• Medicaid.

Under certain circumstances, other persons in low-income status may also receive evaluation and treatment services.

Alcohol dependency and chemical dependency are addictive diseases that include the following four symptoms:

• Craving: A strong need or urge to use alcohol or other substances
• Loss of Control: Not being able to stop drinking or using once the drinking or use has begun
• Physical Dependence: Withdrawal symptoms, such as nausea, sweating, shakiness, or anxiety
• Tolerance: The need to drink or use greater amounts of alcohol or other substances to achieve the effects.

Alcohol and Substance Abuse

Alcohol or substance abuse can be just as harmful as an addiction or dependency. Some of the problems associate with alcohol and substance abuse include:

• The inability to fulfill work, school, or family obligations;
• Involvement in legal issues such as drunk driving arrests or violence;
• Increased social and inter-personal problems, including family violence, child neglect and abuse;
• Increased occurrence of accidents; and,
• Health concerns, such as harm caused by the use of alcohol or substances during pregnancy, and increases in the risk of other medical disorders.

Worker Responsibilities

WorkFirst Clients

All WorkFirst applicants are screened using the Alcohol / Substance Abuse Screening Tool in e-JAS. If the alcohol / substance abuse screening indicates the likelihood of abuse use the e-JAS alcohol / substance abuse evaluation to determine if you should refer the client to the local Certified Chemical Dependency Counselor for a full assessment.

More information is in the WorkFirst Handbook - 6.7 Resolving Issues - Substance Abuse.

ABD/HEN Referral/PWA

Recipients are required to complete an assessment if there is an indication of substance abuse or chemical dependency. If assessed as in need of treatment, the recipient must follow through with all recommended treatment activities as a condition of eligibility.

Links

• Behavioral Health and Service Integration
• www.samhsa.gov (Federal Substance Abuse & Mental Health Services Administration)
• www.niaaa.nih.gov  (National Institution of Alcohol Abuse and Alcoholism)

Purpose:

This category describes the information collected by a case worker in an assessment, the skills the case worker needs to conduct an effective assessment and where to find information about assessments designed for specific programs.

Clarifying Information

1. An assessment is a brief or extended compilation of client information including:
   1. Risk factors,       
   2. Mental / physical conditions,
   3. Family interaction,
   4. Employment support network,
   5. Needs,
   6. Strengths,
   7. Barriers, and
   8. Other significant information as presented by the client or observed by the case worker.
2. During the assessment the case worker and the client work together to identify the resources available to the client through the CSO, other agencies or community-based organizations.
3. To conduct an effective assessment the case worker needs the skill and ability to:
   1. Create an environment in which the client feels safe to discuss sensitive and personal issues.
   2. Establish rapport with the client.
   3. Apply active listening skills.
   4. Identify the client's interests, skills, abilities, obstacles, strengths, needs for services, and personal resources.
   5. Help the client develop and set realistic goals and action plans.
   6. Use professional expertise to observe and note the client's physical appearance, body language, eye contact, affect, dress, personal hygiene, speech patterns and cognitive abilities.
   7. Gather and incorporate other medical / psychological reports, tests and information, as needed to complete the assessment.
4. The case worker and other program staff use the information collected through the assessment to develop an action plan, or other plans for service delivery.
5. There are several assessment / evaluation tools available to case workers, they include:
6. e-JAS automated assessment
7. Intensive Services Assessment
8. Teen Living Assessment
9. ABD cash - Sequential Evaluation Process
10. MCS/ HEN- Progressive Evaluation Process
11. SSI Facilitation
12. Good Cause Determination
13. Necessary Supplemental Accommodations
14. Learning Needs Screening Tool

This chart shows the assessment types, what form or system is used to collect the information required for the assessment and purpose of the assessment in relation to the specific program in which it is used.

Worker Responsibilities

1. Receive referral for assessment from the WorkFirst case manager, Public Benefit Specialist, or through statewide and local office procedures via the e-JAS system or hard copy paper referral.
2.  Determine the type of assessment required.
3. Conduct the assessment in a safe and confidential environment.
4. Document the results of the assessment in the appropriate automated system.
5. Provide feedback to the referring worker regarding the results of the assessment and the recommendations for further services and participation.
6. Make appropriate referrals to community service providers when necessary.
7. Develop an IRP that addresses the needs discovered in the assessment.
8. Provide assistance and support services to the client to help them meet the goals established on their IRP.

Purpose:

This category describes the case review process used by the Disability Specialist Supervisor.

Worker Responsibilities

The supervisor:

1. Informs workers when cases are due for review.
2. Once the review is complete, provides the program specialist with a copy of the completed audit for the case.
3. Follows regional or CSO procedures for documenting the review conclusions, and
4. Monitors cases identified for corrective action.

Revised on: January 23, 2024

WAC 388-447-0120 -How does substance use affect my eligibility for referral to the housing and essential needs (HEN) program?

WAC 388-449-0220 -How does substance use affect my eligibility for the ABD cash and pregnant women assistance programs?

Clarifying Information 

1. When we have current objective information that indicates an ABD or HEN Referral recipient may have a substance use disorder that is material to the client’s incapacitating or disabling condition(s), ABD and HEN Referral recipients must complete a substance use assessment as a condition of eligibility. Indications of a substance use disorder include, but are not limited to:
   
   1. A diagnosis of a substance use disorder;
   2. Signs of intoxication noted by a medical provider;
   3. Medical or mental health chart notes indicating overuse or misuse of prescribed medication;
   4. Recent legal problems associated with substance use (e.g. as reported by the client or documented via medical records); or
   5. Statement from the client that their substance use is a barrier to employment
2. When we have current objective information that indicates a PWA recipient may have a substance use disorder, PWA recipients must complete a substance use assessment as a condition of eligibility.
3. If a current substance assessment from a substance use disorder professional indicates a need for treatment, ABD, HEN Referral, and PWA recipients must participate in recommended treatment unless the recipient has good cause.
   
   1. Substance use assessments are valid for 6 months. Once a client is engaged in substance use treatment, it is not necessary to obtain a new substance use assessment unless otherwise recommended by the client’s treatment provider.
4. Good cause for not completing a substance use assessment or treatment includes, but is not limited to, the following reasons:
   
   1. We determine that the recipient’s physical or mental impairment(s) prevent them from participating based on a review of available objective medical evidence;
   2. The outpatient substance use disorder treatment the recipient needs is not available in the county where they live;
   3. The inpatient substance use disorder treatment the recipient needs is not available at a location the recipient can reasonably access; or
   4. The recipient is a parent or other relative personally providing care for a minor child or an incapacitated individual living in their household, child care or day care is necessary for the recipient to participate in substance use disorder treatment, and such care is not available.

Note: If there are other good cause reasons not listed in 4 (a-d), staff the case with your supervisor to determine good cause. Clearly document the case actions.

5. When a client's ABD, HEN Referral, or PWA assistance is closed due to not completing an assessment or participating in treatment without good cause, the client remains ineligible until they take necessary steps (within their power) to participate.
6. Disability Specialists support assessment and treatment requirements for ABD and HEN Referral clients. (See CSD Procedures Handbook: Substance Use Disorder Assessment and Treatment- ABD/ HEN Referral)
7. WorkFirst Social Services Specialists support substance use requirements for PWA clients. (See CSD Procedures Handbook: Substance Use Assessment and Treatment- PWA)

Related Procedures (Staff Only)

• Substance Use Assessment and Treatment

Purpose:

This category provides general information regarding crisis intervention including but not limited to, planning, implementation and available resources that may be able to assist a client in a crisis situation.

Clarifying Information

Definition of a Crisis: A disruption or breakdown in a person’s or family’s normal or usual pattern of functioning. A crisis cannot be resolved by a person’s customary problem-solving resources/skills.

A crisis may be different from a problem or an emergency

• While a problem may create stress and be difficult to solve, the family or individual is capable of finding a solution. Consequently, a problem that can be resolved by an individual or a family without outside intervention is not a crisis. Oftentimes, a problem may seem like a crisis to a family or individual under stress and not thinking clearly. Interventions that establish trust and provide reassurance, advice or a referral by the case worker may resolve such a problem.
• An emergency is a sudden, pressing necessity, such as when a life is in danger because of an accident, a suicide attempt, or family violence. It requires immediate attention by law enforcement, CPS, or other professionals trained to respond to life-threatening events. If a situation can wait 24 to 72 hours for a response, without placing an individual or a family in jeopardy, it is a crisis and not an emergency.
• Three basic elements of a crisis are: A stressful situation, difficulty in coping, and the timing of intervention. Each crisis situation is unique and will require a flexible approach to the client and situation.

Situations Which Can Lead to a Crisis

Everyone has experiences that make them feel upset, disappointed, or fatigued. When these types of feelings are combined with certain life events or situations, they often lead to mounting tension and stress. Five types of situations have been identified that may produce stress and, in turn, contribute to a state of crisis. Types of client crisis situations presented in the CSO are typically related to the following:

• Family Situations - a child abuse investigation, spouse abuse, an unplanned pregnancy, a parent’s desertion, a chronically ill family member, and lack of social supports are examples of family situations that can create stress and crises.
• Economic Situations - sudden or chronic financial strain is responsible for many family crises, such as loss of employment, eviction, no food, a theft of household cash or belongings, high medical expenses, missed child support payments, repossession of a car, utilities cut off from service, money “lost” to gambling or drug addiction, and poverty.
• Community Situations - neighborhood violence, inadequate housing, a lack of community resources, and inadequate educational programs illustrate some ways the community may contribute to family crises.
• Significant Life Events - events that most view as happy, such as a marriage, the birth of a child, a job promotion, or retirement, can trigger a crisis in a family; a child enrolling in school, the behaviors of an adolescent, a grown child leaving the home, the onset of menopause, or the death of a loved one can also be very stressful life events.
• Natural Elements -crises are created by disasters such as floods, hurricanes, fires, and earth quakes, or even extended periods of high heat and humidity, or gloomy or excessively cold weather.

Worker Responsibilities

1. CSO case workers and disability program specialists can have a major lasting impact on their clients' lives and assist other CSO staff by responding appropriately and promptly to client crises. CSO Financial Workers and WorkFirst Case Managers are to attempt to resolve crisis issues that relate to the assigned caseloads and programs. If necessary, CSO staff my consult with case workers and disability program specialists to resolve client-related crisis situations.
2. The successful resolution of an emergent situation can do much to strengthen the case worker's bond of trust with their client, and set the stage for a cooperative and productive future relationship. When confronted with a client emergency, case workers and disability program specialists respond by doing the following:
   1. Take a quick inventory of the situation;
   2. Identify the type of crisis;
   3. Take action;
   4. Attempt to defuse situation and/or reassure the client;
3. Once the situation is calm:
   1. Identify and contact available community resources in your area that can assist the client through the crisis
   2. Document events to the extent possible, maintaining confidentiality when required.
4. Maintain your professional skills and resources:
   1. Identify and post information about available community resources. Keep that information available to all clients and staff.
   2. Seek additional training opportunities when available. Additional resources for Crisis Intervention Training include:

DSHS

DOP - www.hr.wa.gov,

UW School of Social Work - http://socialwork.uw.edu/

Crisis Clinic of Thurston and Mason Counties - www.crisis-clinic.org.

Revised on: April 17, 2024

WAC 388-449-0001 What are the disability requirements for the Aged, Blind, or Disabled (ABD) program?

WAC 388-447-0001 What are the incapacity requirements for referral the Housing and Essential Needs (HEN) program?

Clarifying Information

1. Under the concurrent disability/incapacity determination (CDID) process, the Department first attempts to obtain medical evidence necessary to determine eligibility for ABD cash assistance identified in WAC 388-449-0015.                                                                                                                                                   
2. If an applicant does not meet ABD disability criteria outlined in WAC 388-449-0001 or does not provide medical evidence necessary for the Department to determine ABD eligibility within the forty-five (45) day standard of promptness, the Department considers eligibility for the HEN Referral program.
   1. Incapacity criteria for the HEN Referral program is outlined in WAC 388-447-0001.
3. See Disability Determination - Review of Disability and Incapacity Determination - Review of Incapacity for ABD/HEN Referral Review information.

Related Procedures (Staff Only):

Determining ABD Eligibility after a Final Disability Determination

Disability and Incapacity Reviews

Determining a New or Worsening Condition after an ABD Termination

Revised on: April 5, 2024

WAC 388-422-0020 What if you are afraid that cooperating with the division of child support (DCS) may be dangerous for you or the child in your care?

Purpose

This chapter provides the department’s policy and procedures for determining if a custodial parent has “Good Cause” (GC) for non-cooperation with TANF/SFA program requirements.

The Division of Child Support (DCS) helps families with a variety of services including the collection and disbursement of child support. Parent/caretakers receiving TANF/SFA for themselves and/or their child(ren) are required to cooperate with DCS to help establish paternity, set a child support order, and enforce child support.

"Child Support" includes health insurance coverage, medical expenses, birth costs, and child care or special child rearing expenses. Either or both parents are required to provide health insurance for the children, and both parents are required to contribute to uninsured medical expenses, regardless of whether the children received medical assistance.

The DCS cooperation requirement is waived if you determine that establishing and/or enforcing child support may result in serious physical or emotional harm to the child or parent/caretaker. This requirement may also be waived in instances of rape (including rape of a child), incest, or when an adoption discussion is taking place. See WAC 388-422-0020 and the EA-Z Manual - Child Support for more information.

Clarifying Information

DCS Good Cause Referrals

1. All requests for DCS Good Cause due to threat of serious physical or emotional harm to the child or parent/caretaker are referred by the Public Benefits Specialist (PBS) or Case Planning and Support Specialist (Case Planner) to the WorkFirst Social Service Specialist (SSS). The SSS can see a list of cases pending Good Cause on the discrepancy reports in the Barcode Good Cause system.  The SSS reviews any documents associated with the referral including but not limited to:
   
   1. The parent’s/caretaker’s signed sworn statement, which could be the DSHS 18-334(X) Your Options for Child Support Collection, outlining their fears and concerns; and
   2.  The DSHS 18-334 includes boxes that parents/caregivers can check that will indicate the level and specific nature of their fears and concerns,
   3. Any additional documents, statements or other types of verification that has been gathered to support the parent's/caretaker's Good Cause request. Even without other documentation, you must accept a sworn statement in support of the good cause claim.

Parent Interview

Whenever possible, interview the parent/caretaker on the same day you receive the Good Cause referral. If the interview is not done the same day the referral is received, schedule the interview as soon as possible allowing for adequate notice, but no longer than 30 days.

 During the interview, the WorkFirst Social Service Specialist:

1. Finds out why the parent/caretaker does not want to pursue Child Support.
   
   1. Asks if there are current issues around Family Violence, rape, incest or pending adoption.
   2. Reviews eJAS for possible Family Violence.
   3. Reviews address to determine if the parent/caretaker is enrolled in the Address Confidentiality Program (ACP).
   4. If the parent, caretaker, or child(ren) share they are in danger, or at risk of serious harm, seek assistance from an on-site or community-based domestic violence advocate. A referral to a community based domestic violence advocate can be made for ongoing services and support.
2. Talks with the parent/caretaker about what they view as the pros and cons of establishing paternity and/or collecting Child Support. If you feel the parent/caretaker is misinformed about a child's rights to resources, benefits, or entitlements, help the parent to seek advice from appropriate resources. Resources may include legal advocacy, DCS staff located in the CSO, the local DCS office, a family violence advocate, etc.
3. Informs the parent/caretaker:
   
   1. About the advantages and disadvantages of pursuing Child Support.
   2. About their choice between Good Cause Level A and Level B options and document their decision. (See Section 7 for more information about Level A and B)
   3. They have the option to change the level of Good Cause claimed by communicating with their SSS to make the update. 
   4. If Good Cause is approved now, but later withdrawn, DCS will begin necessary actions to establish paternity and/or to establish and enforce both past and current child support from the NCP. It is important that a victim of family violence understand this if there are any continuing safety risks at the time DCS action begins.
   5. If cash assistance closes after Good Cause Level A approval, the Good Cause claim will not close. It will remain open through the next review period.
4. If there is more than one noncustodial parent (NCP) for the children in the assistance unit, the parent/caretaker must be given the option of claiming Good Cause for each NCP. When possible, the parent needs to complete and sign an individual DSHS 18-334(X) form, with the separate NCP and child in common, when filing the Good Cause claim.
5. Once a support order is established, the NCP has an obligation to pay child support for the child. Granting either level of Good Cause does not cancel the support obligation or any existing child support order. However when Good Cause Level A is approved, DCS closes the case and does not take any action to establish paternity or to establish/ enforce a child support order against that NCP until the Good Cause claim is withdrawn or the parent/caretaker applies for non-assistance support enforcement services. This makes it important to obtain and maintain accurate information about the basis for the Good Cause exemption.
6. If Good Cause Level A is approved and has not been denied or withdrawn at the time the parent/caretakers cash assistance is terminated, DCS will not reopen the case at that time. DCS will reopen the case only if the parent/caretaker applies for TANF again without claiming Good Cause, or submits a non-assistance support enforcement application to DCS.
7. If the NCP is in another state or country, DCS may need to ask the other state or/ country to help. DCS may be required to provide the parent/caretaker address to the other state and rely on that state to keep it confidential.

8. Asks the parent/caretaker for verification. Discuss with the parent/caretaker the types of verification that can be used to substantiate the Good Cause claim. Document which type of documentation was used to make the determination. The parent/caretaker has 20 days to provide verification of Good Cause, however they can request more time and help getting proof. Verification may include one the following, but the department can use the signed sworn statement (DSHS 18-334 form) as good cause verification:

   1. A signed, sworn statement which could be the completed 18-334(X) or other signed statement from the survivor themselves, outlining their fears and concerns (see the CSD Procedures Handbook section - Determining Good Cause for Non Collection of Child Support);
   2. A statement from clergy, friends, relatives, neighbors or co-workers.

9. Offers a referral to the on-site or community based domestic violence advocate, if available.  For households where the custodial parent/caretaker is not on WorkFirst, provide the National Domestic Violence Hotline number (1-800-799- SAFE or 1-800-799-7133).
10. Withdraws the request if the parent/caretaker does not want to proceed with the Good Cause claim.
    
    1. Remind the parent that they may request Good Cause at any time if their circumstances change. Document the parent's request to withdraw the claim.
    2. Send a DSHS 18-444 (X), Good Cause Decision, to the parent/caretaker and DCS, marked withdrawn. If you choose central print, a copy will automatically be sent to the parent/caretaker and DCS.  An alert will auto generate for financial staff to update 3G. 
    3. If the parent/caretaker has questions or fears about issues related to custody, visitation or paternity, refer the parent/caretaker to the legal services CLEAR line (1-888-201-1014).

11. Makes third party contacts with the knowledge and consent of the parent/caretaker. Inform the parent/caretaker of each specific contact.

When the decision is based upon phone verification, document the date, phone number, and the person you talked with, along with the information you received.

If the parent/caretaker needs help getting verification and consents to your helping them, have the parent/caretaker complete and sign the DSHS 14-012 - Authorization to Release Information.

If the parent/caretaker does not consent to department assistance, talk with the parent/caretaker in order to identify other ways to get the verification.

Offer the parent/caretaker the opportunity to obtain the information on their own.

1. Document more time is needed to obtain the information.

12. Explains to the parent/caretaker that the parent/caretaker has the opportunity to decide what level of Good Cause protection is necessary and document their decision. There are two levels:

• Level A:

  • DCS will not pursue the establishment of paternity, establishment of a support order, or enforcement/collection of child support or from the NCP because any contact with the NCP poses a risk of serious harm to the child or parent/caretaker.

  • DCS closes the child support case, takes no actions on the child support case and the parent/caretaker will not receive child support. Even though DCS closes the child support case, any child support owed under an existing child support order continues to accumulate each month that it is not paid.

  • In the future, if the Good Cause claim is withdrawn or if the parent/caretaker files an application for DCS non-assistance services, DCS will reopen the case and collect both current and past due child support

• Level B:

  • DCS will pursue the establishment of a support order and collect child support without the parent/caretakers cooperation.

  • DCS keeps the parent/caretaker advised of case actions, but the parent/caretaker is not required to cooperate with DCS; they may elect to cooperate or not. Generally, paternity establishment is not pursued in Level B cases because these proceedings require the cooperation and involvement of the child and custodial parent.

Claim Determination and Processing

1. The department is required to make an initial determination within 30 days. WorkFirst Social Service Specialists (SSS) are required to use the Barcode Good Cause program for claim determination and processing. Good Cause is found if the parent or caretaker’s written statement outlining their fears and concerns, or other verification, indicates that the likelihood of harm (physical or emotional) to the parent/caretaker or child(ren) is too great to safely seek collection of child support. When verification has been received and/or the review of the verification is completed, a determination can be made. Document the verification that was used to make the decision.
2. If the Good Cause is an approval, set the review date for twelve months or shorter if circumstances warrant.
3. If TANF/SFA benefits are provided to the parent, who requested Good Cause due to serious physical or emotional harm to the child or parent/caretaker but TANF assistance is terminated while the claim is still pending, the SSS must complete the Good Cause determination. DCS must be informed to know if further action concerning the child support case is necessary.
   
   1. If a determination cannot be made, because of loss of contact or some other reason, the default decision is approval of the Good Cause claim.
   2. If the parent reapplies for cash assistance after a default approval decision, Good Cause must be re-determined according to the standard process.
   3. If the parents/caretakers cash is terminated before the Good Cause decision is made, a determination must be completed.
4. Supervisory approval is required on all Good Cause claims before the decision letter can be generated. The supervisor approves the DSHS 18-444(X) - Good Cause Decision by checking the 'reviewed by Supervisor' box in the Barcode Good Cause system.
5. Notify the parent/caretaker of the final decision on the DSHS 18-444(X) - Good Cause Decision. Once the letter is saved, a copy will be mailed from central print to the parent/caregiver and DCS. A Barcode tickle will automatically generate to alert eligibility staff for an entry in 3G.

6. If Good Cause is denied, advise the parent/caretaker that:

   1. They have a right to an Administrative Hearing. See (EA-Z Manual - Administrative Hearings).
   2. If circumstances change, the parent/caretaker may, at any time, request another Good Cause determination due to serious physical or emotional harm to the child or parent/caretaker by completing and signing another Your Options for Child Support Collection (DSHS 18-334(X)).
   3. On-site or community based domestic violence advocates are available for support.

7. Document essential case information in the appropriate confidential notes section (Barcode Good Cause Program and eJAS if the parent/caretaker is on TANF). The notes should include for which noncustodial parent the parent/caretaker is requesting Good Cause, if Good Cause was granted, verification provided to verify Good Cause, what level of Good Cause was chosen, and when the next review will need to be completed. The notes may be needed in the future to:

   1. Support the decision;
   2. Aid at review; and
   3. Inform the Administrative Hearing process.

Reviewing Good Cause Determinations

Review Good Cause determinations at intervals consistent with the family circumstances. WorkFirst Social Service Specialists are required to use the Barcode Good Cause program for reviewing Good Cause determinations.

1. If Good Cause is approved because the child was conceived as a result of rape or incest, it is not necessary to review the Good Cause decision. The review date can be set for the child's eighteenth birthday. However, advise the parent/caretaker that they can withdraw their claim of Good Cause at any time if they wishes to do so.
2. If Good Cause is approved based on any other circumstance (e.g. physical or emotional harm to the child or parent/caretaker or adoption discussions or proceedings), Good Cause will be reviewed periodically, usually every twelve months.
3. At the time of review:
   
   1. Review the documents in the case record. Determine if contact with the parent/caretaker is necessary to make the determination to continue Good Cause.
      
      1. If there is sufficient verification in the record to continue the Good Cause determination without contacting the parent/caretaker such as the previously signed sworn statement such as the DSHS 18-334(X), authorize continued Good Cause and establish a new review date at an appropriate time in the future.
   2. If contact is necessary due to missing verification in the case record:
      
      1. Reach out to the parent/caretaker to determine if the circumstances have changed since the last Good Cause determination. If additional verification is available and necessary to make a re-determination, review
      2. The provided verification and make a new Good Cause determination.
   3. Complete a DSHS 18-444(X), Good Cause Decision:
      
      1. Mark the box to indicate it is a re-determination; and
      2. Once the letter is saved, a copy will be mailed from central print to the parent/caregiver and DCS. A Barcode tickle will automatically generate to alert eligibility staff for an entry into ACES 3G.
4. If cash assistance is closed, deny Good Cause to close out the Good Cause claim. DCS will not pursue the establishment of a support order unless the parent/caretaker files an application for non-assistance child support services through DCS. 
   1. In the Barcode Good Cause program, take the following steps:
      
      1. Check "Review Claim"
      2. "Good Cause Established?" - check "No"
      3. "Reason for Good Cause Decision" - Select "No Proof of Good Cause"
      4. Enter Close Date - End date of current review
      5. "Reason" - Select "Financial Assistance Closed"

Referrals and Resources

1. If the parent is a WorkFirst participant, the SSS will do the following:
   1. Offer the parent/needy caretaker a referral to the on-site or community-based domestic violence advocate who may be able to help them address the circumstances creating the need for the Good Cause claim.
   2. Create and document the referral in eJAS to the local contracted domestic violence advocate, if available in the local office. Document the note in eJAS under note type, Family Violence Special Records.
   3. Document the family violence related referral in the Barcode Good Cause program

2. For TANF parents/caretakers, not participating in WorkFirst, provide resources to the parent/needy caretaker to a community-based domestic violence agency for support.
3. Explain the use of Washington Apple Health to obtain health care coverage for the family. Ask the parent/caretaker if they need any special accommodations to seek or access health care coverage services. Tell the parent/caretaker that receiving Medicaid or other state-funded health care coverage will not automatically result in a DCS case, but that they can apply for DCS services if they wish to do so.
4. Give the parent/caretaker available informational brochures related to DCS or Good Cause due to serious physical or emotional harm to the child or parent/caretaker and discuss any other pertinent issues related to the parents/caretakers situation.
5. Encourage the parent/caretaker at risk of family violence to determine if enrolling in a community support group, counseling activities or contacting legal services (CLEAR 1-888-201-1014) is in their best interest.
6. If the parent would like more information about DCS support enforcement services, have the client call 1-800-442-KIDS.
7. Some parents/caretakers may be participating in the Address Confidentiality Program (ACP) through the Office of the Secretary of State. The ACP protects the release of the physical address, the work address of the parent/caretakers, and the school address of the child(ren) who fled or are hiding from -an abuser. ACP participants use a substitute address in place of their actual physical address. See the EA-Z Manual if the parent is participating in, or you would like more information about the Address Confidentiality Program.

Forms

Revised on January 30, 2023

Purpose

The Community Services Division (CSD) and DVR collaborate to improve employment outcomes for our mutual clients and reduce poverty statewide. We work toward these goals by providing seamless and consistent service delivery statewide.

Related WACs

WAC 388-400-0060: Who is eligible for aged, blind, or disabled (ABD) cash assistance?

WAC 388-449-0225: Am I required to participate in vocational rehabilitation services if I receive ABD cash grant?

The Warm Handoff

CSD social services and WorkFirst staff use the processes and procedures outlined in the CSD Procedures Handbook when referring CSD cash assistance clients to DVR.

DVR Referral Guidelines

To refer to DVR, the client must:

1.  Express that they want to work and are available to participate in work related activities;
2.  State that they may have a physical, sensory, or mental disability that constitutes a significant ongoing barrier to their employment; and
3. Agree to the referral and, if determined eligible by DVR, be willing to participate fully in DVR’s Individualized Plan for Employment (IPE).

Before making a referral to DVR, CSD social services or WorkFirst staff provide the client with information and a brief orientation regarding DVR services. CSD staff can access client orientation materials on the CSD DVR Partnership SharePoint site and DVR’s website.

• Considering if DVR is the Choice for You: Employ Your Abilities
• What Services are Available to Me?
• Frequently Asked Questions

Aged, Blind, or Disabled (ABD) and Housing and Essential Needs (HEN) Referral Clients

1. The Disability Specialist discusses the benefits of DVR services with all ABD/HEN Referral clients.
2. When an ABD/HEN Referral recipient is determined eligible for DVR services, the Disability Specialist incorporates IPE requirements into the client’s ABD/HEN Referral Case Plan. The client is required to report their DVR participation to their ABD/HEN Referral Disability Specialist.
3. The Disability Specialist terminates ABD or HEN Referral benefits for clients who fail to participate in the DVR portion of their ABD/HEN Referral Case Plan without good cause (RCW 74.04.655). When determining good cause, the Disability Specialist consults with DVR staff and the client (when available) to determine why the client is not participating in DVR services. The Disability Specialist and DVR staff discuss what steps can be taken to support the client’s participation.
4. The Disability Specialist reviews an ABD/HEN Referral recipient’s progress, at a minimum, when the client:
   • Becomes employed;
   •  Is not making satisfactory progress;
   • Experiences significant improvement or deterioration of their disability;
   • Is unable or refuses to participate; or
   • Completes their IPE.

WorkFirst Clients

1. When a participant chooses a referral to DVR, WorkFirst staff updates their IRP to include DVR participation.
2. WorkFirst staff reviews the need for support services, to support DVR participation.
3. While DVR is determining eligibility for vocational rehabilitation services, WorkFirst staff engages the participant in other appropriate WorkFirst components.
4. WorkFirst staff include DVR in employment case planning for mutual clients.
5. A DVR IPE is the DVR participation requirement documented in a participant’s IRP.
6. WorkFirst staff reviews the participant’s progress with DVR on a monthly basis and updates their IRP when the participant:
   • Becomes employed;
   • Is not making satisfactory progress;
   • Experiences significant improvement or deterioration of their disability;
   • Is unable or refuses to participate; or
   • Completes their IPE.
7. If a participant fails or refuses to engage with DVR, WorkFirst staff determines whether the participant has good cause. When determining good cause, WorkFirst staff consults with DVR staff and the participant (when available) to determine why the participant is not following through with DVR services. WorkFirst and DVR staff discuss what steps can be taken to support the participant’s engagement.
   
   1. When WorkFirst staff determines that the participant did not have good cause, they follow the WorkFirst sanction process for failure to participate in required activities.
8. When verifying and reporting hours of participation in a participant’s IRP, WorkFirst staff:
   
   1. Enters the start and end date of each IRP activity into eJAS, not to exceed 12 months;
   2. Uses the XD component for activities verified by DVR;
      
      1. The DVR Vocational Rehabilitation Counselor (VRC) may excuse absences if the participant has a good reason for missing scheduled activities
   3. For activities not under the XD component, uses the eJAS code that best describes the activity; and
   4. Uses the DVR Actual Hours Reporting Table available on the CSD DVR Partnership SharePoint site as needed to accurately record participation hours.
9. When an individual who is an existing DVR client becomes eligible for TANF/WorkFirst, DVR and WorkFirst staff conduct a joint case staffing with the participant to determine the appropriate activities as follows:
10. If the participant expresses desire to work, the IRP and IPE assists the participant with obtaining employment while continuing DVR training or education services.
11. If the participant is unable to work, the IRP reflects work preparation activities outlined in the IPE.
12. WorkFirst staff informs the participant of TANF program time limits and the goal of obtaining employment while on TANF.

Refugee Cash Assistance (RCA) Clients

1. CSD social services staff discusses the benefits of DVR services with any RCA client who has a significant disability-related barrier to employment, and refers interested clients through the Warm Handoff process.

Guidelines for Collaboration and Coordination

1. CSD and DVR both identify and maintain liaisons for every local CSD Community Service Office (CSO) and for every local DVR office.

a. The current CSD and DVR liaison lists are on the CSD & DVR Partnership SharePoint site.

b. Liaison Roles and Responsibilities are detailed on the CSD & DVR Partnership SharePoint site.

2. CSD and DVR fund services based on the following:

a. DVR funds:

i. Diagnostic and vocational assessment services required for DVR eligibility determination or IPE development; and

ii. Foreign language or sign language interpreters needed by an individual to participate in DVR services.

b. (For WorkFirst participants) WorkFirst funds available support services to complete the DVR eligibility determination and support the client’s IPE.

3. DVR may include any WorkFirst employment activities in an IPE.

Related Procedures (Staff Only)

 CSD Procedures Handbook 

CSD & DVR Partnership SharePoint site.

Revised on: June 1, 2020

Purpose

Title 2 of the Americans with Disabilities Act (ADA) prohibits discrimination on the basis of disability in all services, programs, and activities provided by the department.

Chapter 388-472 WAC broadly supports Title 2 of the ADA and outlines the following:

• WAC 388-472-0005 What are my rights and responsibilities?
• WAC 388-472-0010 What are necessary supplemental accommodation (NSA) services?
• WAC 388-472-0020 How does the department decide if I am eligible for NSA services?
• WAC 388-472-0030 How can I get NSA services?
• WAC 388-472-0040 What are the department’s responsibilities in giving NSA services to me?
• WAC 388-472-0050 What if I don’t accept or follow through with program requirements because I’m not able to or don’t understand them?

*Visit the Equal Access page in the EA-Z Manual for clarifying information*

Purpose:

To provide Family Planning guidelines to Community Services Office (CSO) staff for providing educational, medical and social services to all Washington Apple Health eligible men and women, helping them become self-sufficient and avoid unintended pregnancy by planning and spacing the birth of their children.

WAC 182-532-100 - FAMILY PLANNING SERVICES

Guidelines

CSO workers are not expected to be Family Planning medical experts. CSO staff provide individuals with needs assessment and information about family planning services.

Individuals can access the WithinReach website for additional information about family planning services, such as pregnancy testing and birth control.

Family Planning Program Objectives

1. Reduce unintended pregnancies using state and local partnerships.
2. Provide all eligible and potentially eligible men and women with information about, and linkage to, available family planning services per WAC 182-532-100.
3. Reduce publicly funded maternity costs from unintended pregnancies.
4. Educate men and women about:
   • Available family planning health services,
   • The variety of birth control methods to help plan, if or when, to have another child,
   • The cost of raising children,
   • Barriers that unintended pregnancies create in becoming self-sufficient, and
   • The best use of TANF and Washington Apple Health resources.

Family Planning Services

1. Services are provided at local Family Planning clinics or other medical provider agencies.
2. Services may be covered under
   1. Washington Apple Health, or
   2. The Take Charge Family Planning program.
   3. Information about services is offered by any CSO or Customer Service Center staff, with social service case workers as the lead experts in motivating and educating men and women to access services. The social service case worker may help ensure the individual is linked to a Family Planning Provider via WithinReach.

Upfront Screening

1. The CSO case managers and Customer Service Center staff play a critical role in providing individuals with information and links to Family Planning services.
2. All men and women are to be provided information about available services, where to access services or a referral to the social service case worker upon request to discuss the benefits of Family Planning Services.
3. All TANF clients must receive a minimum set of information about Family Planning services as listed at https://www.dshs.wa.gov/esa/chapter-1-engaging-parents-workfirst/13-front-screening-and-referrals

Worker Responsibilities 

What Happens After the Client is Referred to a Social Worker to discuss Family Planning?

1. Inform all referred men and women of available benefits and services under the Family Planning program.
2. Inform them they have family planning resources available under Washington Apple Health coverage.
3. Ensure that Family Planning information, pamphlets, brochures, and local provider lists are provided to the individual.
4. Refer the individuals to the WithinReach website for information on birth control and family planning services.

Best Practices 

1. Conduct an assessment of the client’s needs and barriers to self-sufficiency with regard to family planning. Arrange for other services as needed (such as shelter, clothing, food, mental health, etc.).
2. Collaborate with local Family Planning agencies to provide educational sessions on Family Planning Program services.
3. Engage in outreach activities in the community to reach eligible or potentially eligible clients and provide program awareness.
4. Establish relationships with other community agencies to create effective cross agency referrals to Family Planning services. Some examples include Division of Children and Family Services, Chemical Dependency Treatment Centers, Schools, Colleges, and Job Training Programs.
5. Conduct client follow-up to discuss:
   1. If the client is using method of choice, and
   2. How family planning methods are working.

The social service case worker and case manager need to complete documentation of referrals, actions, and results in eJAS.

Revised January 3, 2012

Purpose:

To provide information and guidelines to social service case workers regarding victims of Family Violence.

1. Family Violence crosses all socio-economic boundaries. DSHS adopted the Family Violence Option to PROWRA in 1996 and is, therefore, required to screen and identify all TANF clients for Family Violence. (See WAC 388-61-001.) However any client who utilizes any service provided by the Community Services Office may be affected by Family Violence.
2. The case worker may find out about a client who is dealing with Family Violence in several different ways including:
   • A referral from the WorkFirst Case Manager, or
   • Self-disclosure by the client while being assessed for other issues.

GUIDELINES

1. The case worker must interview and assess for safety and other needs.
2. The case worker must determine if the client:
   1. Needs immediate help to ensure safety for themselves or their children;
   2. Has been mentally, physically or emotionally hurt;
   3. Needs assistance with shelter / housing;
   4. Has a current protection order or wishes to obtain one. If the client wishes to pursue a protection order, offer a referral to a family violence advocate for help in considering all risk factors involved;
   5. Has a safety plan;
   6. Is a battered immigrant (see EA-Z Manual - Citizenship and Alien Status - B. - Eligibility Restrictions for TANF), determine if client needs assistance with obtaining employment authorization; or
   7. Needs help to establish good cause for not cooperating with the Division of Child Support. See Good Cause.
3. The case worker must refer the client for appropriate services such as shelter, legal, health, transportation, etc., taking into account linguistic and cultural needs in making referrals.

Best Practices

Victims of Family Violence may be reluctant or unwilling to talk to you about what is going on. Some common situations and possible actions may include:

There are on-site domestic violence advocates stationed in several CSOs. If your office has an advocate on site, coordinate services with them. If you don’t have an advocate, establish working relationships with your local community resources. See the Department’s website for Domestic Violence and Victim Services Programs for ways to create a process to coordinate with your local resources.

WFHB Chapter 6.5 - Family Violence

EA-Z Manual - Confidentiality B. - Address Confidentiality Program.

Purpose:

This category describes the First Steps Program which is designed to promote healthy birth outcomes, increase access to early prenatal care, and reduce infant morbidity and mortality.

Guidelines

The 1989 Maternity Care Access Act, implemented as First Steps, seeks to reduce poor birth outcomes, maternal and infant illness and death as well as increase access to maternity and infant care for low-income families. The First Steps program is administered by the Health Care Authority (HCA).

Medical Services

• Prenatal care

• Delivery

• Post pregnancy follow-up, including family planning

• Dental Care

• One year of family planning services post pregnancy

• One year of full medical for newborns

Enhanced Services

• Maternity Support Services (MSS)

• Infant Case Management (ICM)

• Childbirth Education (CBE)

Expedited Alcohol and Drug Assessment and Treatment Services

• Alcohol and drug assessment

• Alcohol and drug treatment

Other Services

• Expedited eligibility determination

• Outreach

• Transportation

• Interpreter services

Worker Responsibilities

Provide all pregnant women with information regarding the services available through the First Steps program.

If a woman reports she is pregnant and is not active on Washington Apple Health (WAH) Medicaid, refer them to www.wahealthplanfinder.org to apply for pregnancy medical.  

If a woman already has health insurance and reports she is pregnant, let her know she can access First Steps by contacting the Within Reach Family Hotline at 1-800-322-2588 or by contacting a Local First Steps provider. Additional information regarding the First Steps program can be found at https://www.hca.wa.gov/free-or-low-cost-health-care/i-need-medical-dental-or-vision-care/first-steps-maternity-and-infant-care.

INCAPACITY REQUIREMENTS FOR REFERRAL TO THE HOUSING AND ESSENTIAL NEEDS (HEN) PROGRAM

WAC 388-447-0001 What are the incapacity requirements for referral to the housing and essential needs (HEN) program?

 Worker Responsibilities

1. Determine eligibility for ABD cash assistance and HEN Referral by applying the Concurrent Disability/Incapacity Determination process.
2. Approve incapacity if the individual is ineligible for ABD and meets the non-Progressive Evaluation Process (PEP) criteria outlined in WAC 388-447-0001 (6) (b) through (i).
3. If the individual is ineligible for ABD and does not meet the non-PEP criteria outline above, determine incapacity by applying the eight step HEN Referral PEP outlined in WAC 388-447-0030 through 388-447-0100.
4. If the individual meets any of the incapacity requirements outlined in WAC 388-447-0001 (6) (a) through (i), approve HEN Referral for 12 months.

Purpose:

How to provide individuals contacting the department for services with information and referrals to community resources.

Guidelines

1. Information and Referral (I & R) is a service available to all persons who request it from the department regardless of how they make such a request.

2. Resources available to assist the client will vary depending on whether the client is currently receiving services from DSHS.

3. Any staff person can refer the client to a Social Worker for I & R assistance if the staff person cannot directly assist the client by providing either the requested information or referral.

4. Staff should make referrals in an efficient manner that connects the person directly with the resource and eliminates any unnecessary steps or time.

Worker Responsibilities

1. Discuss the person’s needs with them.
2. Determine if there are resources within the department or community to meet the client’s needs and make an appropriate referral.
3. If the person appears to be able to make their own appointment with the resource, give them the information they need to do so. If it appears the person needs help to connect with the resource, provide them with appropriate assistance.
4. Document the information that you gave to the person (if appropriate) or referrals that were made on the person’s behalf. Make the documentation in the system associated with the program from which the person is receiving services. For example:

Purpose: 

Provide information for the identification of learning disabilities and deficits and use of the Washington State Learning Needs Screening tool.

Definitions

1. Learning disability:

   1. Is a neurological condition that impedes the individual's ability to store and/or process information.

   2. Can affect the individual's social skills and ability to read, write, speak, and compute math. Individuals with learning disabilities are generally (but not necessarily) of above average intelligence.

   3. Always creates a disparity between the individual's measured IQ and performance IQ. For example, the individual may have a measured IQ of 125 but as a result of dyslexia, has reading skills that are below average.

2. Learning deficits and learning needs:

Individuals lacking educational opportunities or who have had other issues that have interfered with learning are often mislabeled as having learning disabilities because the effects on the individual's performance may be similar. However, an individual who has very little education or has never learned to read has a learning deficit, not a learning disability.

3. Acquired impairments:

Acquired impairments, resulting from head injury trauma or other types of injury may also affect the individual's ability to process information. As a result, an acquired impairment may be mislabeled as a learning disability. For example, following a motorcycle accident that resulted in a head injury, the person has poor memory. The poor memory is a result of the accident (an acquired impairment) not a learning disability in and of itself.

Distinguishing Characteristics

• People can overcome a learning deficit through remediation, such as additional schooling.

• Learning disabilities are not reversible and are a life-long issue but individuals with learning disabilities may develop accommodation skills and strategies that aid in lessening the effects of the learning disability.

• A true learning disability rarely prevents an individual from becoming employed or self-sufficient.

• Specific strategies or accommodations may be needed in order for the individual to be successfully employed. For example;

  • A strategy may involve encouraging the individual to choose a career that takes advantage of the individual's strengths and minimizes the areas of difficulty.

  • An accommodation might involve having the individual's work hours listed in a column rather than in a matrix or using a small tape recorder instead of making a "To-Do" list.

Guidelines 

1. The Learning Needs Screening Tool does not distinguish learning disabilities from learning deficits.

2. A high score obtained on this instrument is only an indicator of the possible existence of learning deficits and disabilities. For example, the client may obtain a high score as a result of having either poor reading skills due to a lack of education, or dyslexia.

3. Determination of a true learning disability is accomplished only through the administration of intelligence tests and other psychological measurements.

4. It is usually much more effective to determine what the client needs in order to succeed rather than focusing on the disability or deficit. For example, if it is known that the client has poor reading skills, the client may need to choose a career that does not require extensive reading or obtain additional schooling to improve his/her reading skills.

Worker Responsibilities

1. Screen clients for learning deficits and disabilities using either the e-JAS or hard copy of the Washington State Learning Needs Screening Tool (DSHS 15-250(x). 

2. If learning needs or deficits are suspected then consider referring the client to local resources such as the Learning Disabilities Association of Washington or your local community college.

3. Document action and outcomes as appropriate in e-JAS and in the client's Service Plan or IRP.

   1. WF Handbook  - Learning Disabilities 6.6

   2. Learning Needs Screening Tool

Purpose: 

A budget proviso was included in the 2006 Supplemental budget that allows the Department of Social and Health Services (DSHS), Economic Services Administration to refer children and families receiving Washington Apple Health to the Early Childhood Intervention Prevention Services (ECLIPSE) (formerly Medicaid Treatment Child Care (MTCC)) program beginning July 1, 2006. The program is administered by the Department of Children, Youth and Families.

Guidelines

Early Childhood Intervention Prevention Services (ECLIPSE) (formerly MTCC) is an early intervention/prevention program authorized by the Department of Children, Youth and Families (DCYF).  ECLIPSE serves children ages zero to five years old who are at risk of child abuse and neglect and may be experiencing behavioral health issues due to exposure to toxic stress. ECLIPSE services include medically necessary; age appropriate, psychosocial services for young children who are exposed to substantial environmental, familial, and biological risk factors that can impact their social development, behavior, and overall mental health.

ECLIPSE services are provided in two community-based programs in Washington through a contract with DCYF, Childhaven in King County and Catholic Charities Serving Central Washington in Yakima County.

ECLIPSE services include behavioral screening, clinical assessment, treatment planning, monthly home visits, and center-based infant, toddler, and preschool individual treatment and socialization opportunities.

The day program is offered Monday through Friday and operates year round. Individual treatment and socialization is offered in an age appropriate early learning environment that promotes self–help skills, pro-social skills, models self-regulation techniques, and practices and reinforces positive peer to peer and child to adult caregiver interactions.

Economic Services Administration, Child Welfare (DCYF), and Public Health Nurses can make referrals to ECLIPSE for identified children that are at risk of abuse or neglect.

Eligibility

Any identified child on Washington Apple Health at risk of abuse or neglect can be referred to ECLIPSE.

The following characteristics may be used to identify families that are at risk of abuse or neglect. One or more of these characteristics in and of themselves do not constitute abuse and/or neglect, although the more factors that are apparent strengthen the potential that the family may be at risk.

• Perceived and/or actual sources of financial and emotional support (socially and financially isolated), especially with any or all of the following:
  • Age of children (0-5)
  • Several children close in age
  • Young parent(s): teens and early twenties (and therefore, young children)
• Mental health/Substance abuse
  • Drug or alcohol abuse by the parent(s) and not in treatment
  • Mental illness diagnosed and not controlled
  • Depression
• Domestic violence with violent partner still in family
• Chronically Impoverished (i.e. consistently during one or more years)
• Severe emotional problems of a child or a mentally ill child
• Poor education and work experience
• History of abuse/neglect for the child
• Parental history of abuse/neglect as a child

Worker Responsibility

The Community Services Office (CSO) Social Worker must:

• Identify and assess families that are at risk of abuse or neglect.\
• Work with the ECLIPSE provider to determine if a referral is appropriate and space is available.
• If appropriate, complete the Referral/Authorization Form 13-001 and send to dcyf.esaeclipsereferrals@dcyf.wa.gov.  The referral  will be reviewed and sent to the DCYF ECLIPSE Administrator for authorization.
• Act as the case manager while the child remains in the program.
• Document in eJAS and update IRP as appropriate when the parent is involved in program activities.
• If available, attend the ECLIPSE Provider Multi-Disciplinary case staffing(s) for referred families.

 DCYF must:

• Process the referral/authorization.
• Forward the completed authorization form to the ECLIPSE provider.
• Review the Statement of Medical Necessity to determine medical necessity.
  • If the Statement of Medical Necessity is denied the social worker or biological parent can Request for Review.
• Authorize payment for services not to go over 6 months if Statement of Medical Necessity approved.
• Track referrals and authorizations.

 ECLIPSE provider must:

• Conduct a comprehensive assessment and diagnosis, and complete Statement of Medical Necessity form within 30 calendar days from the first day in which the child attends the program.
• Send completed Statement of Medical Necessity forms to DCYF.
• Complete the ITP within 50 calendar days of the first day the child attends the facility. 
• Review and update the treatment plan at intervals no greater than every 6 months.
• Send quarterly  progress reports if requested by referent.

Revised on: July 1, 2020

Clarifying Information

Reimbursements described in this section are solely to pay the fees necessary to obtain objective medical evidence of an impairment that limits work activity. We do not pay for medical evidence to evaluate medical conditions that are not claimed or unlikely to impair work functions.

If a person meets all of the non-disability/incapacity eligibility requirements listed in WAC 388-400-0060 or WAC 388-400-0070, we reimburse for the costs of obtaining the objective evidence necessary to determine disability/incapacity based on our published fee schedules.

1. Clients must be determined financially eligible before we authorize an evaluation or payment.
2. We request medical records if available before authorizing new evaluations or services.
3. Payments do not apply to services authorized by the Division of Disability Determination Services (DDDS) or medical examinations or reports required by court order or treatment placement.
4. Payments for medical evidence related to TANF cases are authorized in eJAS as Support Services (WorkFirst Handbook 2.2).
5. See WorkFirst Handbook 3.6.1 for information regarding reimbursement for medical evidence associated with TANF/SFA ineligible parent time limit extensions.

What is "Current" Medical Evidence?

1. Initial decision: Current medical evidence for an initial decision must be based on an examination or findings from within 90 days of the date of application. Only request new medical evidence when available evidence is either older than 90 days or insufficient to determine disability.
   
   1. Document your reason for obtaining new medical evidence.
   2. For the purposes of establishing a diagnosis, medical evidence older than 90 days from the date of application is acceptable when it is:
      • A report within the past 5 years that includes a diagnosis of a medically determinable impairment based on an examination by an “acceptable medical source,” defined in WAC 388-449-0010 and WAC 388-447-0005;
      • Intelligence testing scores from a Wechsler Adult Intelligence Scale (WAIS - III or IV editions) administered after age 18; or
      • A diagnostic imaging report such as an X-ray or MRI when referenced in an examination performed within 90 days of application.
2. Review decision: Current medical evidence for a review decision must be based on an examination or findings from within the past 45 days for the ABD Program or 90 days for the HEN Referral Program.
   
   1. If the client has seen a medical provider within the past 45 days, request a report from records rather than authorizing a new evaluation whenever possible.
   2. If existing available medical records are not sufficient to determine disability, clearly document the reason for obtaining any new testing or evaluations at review.

Medical Evaluations and Testing

1. General physical evaluation: A general physical evaluation should contain all of the following information:
   
   1. The chief complaint and symptoms reported by the client;
   2. Medical history including onset date and treatment history;
   3. Physical examination findings including but not limited to: vital signs, observations, a description of any abnormal findings, and range of motion (when appropriate);
   4. Results of diagnostic testing and imaging (e.g. labs, X-rays, pulmonary function tests, etc.);
   5. A diagnosis and International Classification of Diseases (ICD) code for any impairment that affects work activity and is supported by objective findings;
   6. A description of how the medical condition impacts the client's overall ability to perform basic work-related activities;
   7. A description of any non-exertional limitations which may include workplace restrictions;
   8. A prognosis including an estimate of how long the functional impairment will persist at the current level of severity;
   9. Current or past drug or alcohol use;
   10. An opinion whether current impairments which limit work activity are primarily the result of alcohol or drug use within the past 60 days;
   11. Recommendations for additional testing or consultation;
   12. Treatment recommendations;
   13. The name, title and signature of the person performing the evaluation;
   14. The date of service; and
   15. Copies of all available chart notes, hospital discharge summaries, diagnostic reports, and other medical records from the past six months.
2. Comprehensive physical evaluation (e.g. orthopedic, neurological): A comprehensive physical evaluation contains all of the information listed under the general physical evaluation section above, in addition to:
   
   1. Progression of symptoms such as motor loss, sensory loss, or mental restrictions;
   2. Description of any restrictions on personal care or daily activities caused by the condition; and
   3. Copies of clinic records.
3. Psychological and psychiatric evaluation:
   
   1. A Psychological evaluation is a diagnostic interview, including an MSE (mental status exam) and an assessment of daily living skills conducted by an “acceptable medical source” defined in WAC 388-449-0010.
   2. A Psychiatric evaluation is a diagnostic interview, including an MSE (mental status exam) and an assessment of daily living skills conducted by a licensed psychiatrist (MD, DO).
   3. Both evaluation types result in a written report that must include:
      1. The chief complaint or the impairment/symptoms claimed by the client;
      2. Psychosocial history including onset date and treatment history;
      3. Educational and work history;
      4. Any past or present drug or alcohol use, including treatment history;
      5. A description of the client's activities of daily living;
      6. A list of all mental health symptoms that impact the client's ability to work, including a description of the severity and frequency of those symptoms;
      7. A diagnosis; from the current Diagnostic and Statistical Manual of Mental Disorders (DSM), or lack thereof, of any impairment that impacts work activity and is supported by objective findings;
      8. A description of how the medical condition impacts the client's overall ability to perform basic work-related activities;
      9. An opinion whether any current limitations on work activity are primarily the result of a substance use disorder;
      10. A prognosis including an estimate of how long any functional impairment will persist at the current level of severity;
      11. An opinion of the client's capacity to manage funds;
      12. Treatment recommendations;
      13. The name, title, and signature of the person performing the evaluation; and
      14. The date of service.
4. Psychological diagnostic testing is only reimbursed when necessary to establish a diagnosis or the severity of a mental health impairment. Psychological diagnostic testing is limited to the following:
   
   1. Evaluation of personality disorders:
      1. MMPI-II: Minnesota Multiphasic Personality Inventory
      2. PAI-II: Personality Assessment Inventory
   2. Evaluation of depression:
      1. BDI-II: Beck Depression Inventory
      2. HAM-D: Hamilton Rating Scale for Depression
   3. Evaluation of anxiety:
      1. BAI: Beck Anxiety Inventory
      2. HAM-A: Hamilton Rating Scale for Anxiety
   4. Evaluation of a potential cognitive disorder:
      1. WAIS-III or WAIS IV: Wechsler Adult Intelligence Scale
      2. WMS-III: Wechsler Memory Scale
      3. TONI-4: Test of Nonverbal Intelligence, Fourth Edition
      4. Trails: Trail Making Test Parts A and B
   5. Evaluation of potential memory malingering:
      1. REY 15-Item Memory Test
      2. TOMM: Test of Memory Malingering
   6. Evaluation of potential psychiatric illness malingering
      1. M-FAST: Miller Forensic Assessment of Symptoms Test
      2. SIRS: Structured Interview of Reported Symptoms

Sub-test scores, statistical scores, and a narrative summary of all tests must be included. Please see Mental Incapacity Evaluation Services: Fee Schedule, for limitations on testing reimbursements and additional details.

Psychological Evaluations from Providers who are not an ABD “Acceptable Medical Source”

1. Psychological evaluations or reports from the following sources may only be used for purposes of determining incapacity for the HEN Referral program per WAC 388-447-0005:
   1. Clinical social worker;
   2. Mental health professional (MHP); or
   3. Physician treating the individual for a mental impairment
2. No reimbursement, other than copy fees, shall be authorized for psychological evaluations or reports authored by the sources listed above.

ProviderOne and the Social Service Payment System (SSPS)

1. Providers and Medical Record Companies must be enrolled with ProviderOne to claim and receive payment for incapacity evaluation services and medical records. 
2. Only use SSPS to reimburse for Medical Records (billed with a date of service prior to July 1, 2020) and SSI Medical Evidence Transportation costs. Refer to SSPS Manual Appendix H for details regarding available Service Codes and how to use them.
3. Pay either the provider's usual and customary fee or the maximum payment, whichever is less. Refer to the Medical Evidence Fee Schedules section for maximum payment amounts.

ABD/HEN Referral Payment Review Request

The Payment Review Request (PRR) tool in ICMS can be used to identify and report psychological and physical functional evaluations that lack elements required by ABD/HEN Referral program rules, and are in need of further review. Please visit the ABD/HEN Referral Payment Review Request section of the CSD Procedure Handbook for additional information.  

Purpose: 

Provide a basic overview of services available to assist clients in accessing mental health services.

Clarifying Information

The following resources are available to assist  adults, youth and families with children in accessing mental health services. Depending on the situation access to mental health treatment and services may require facilitating the referral  through the person’s primary care provider, Regional Support Network (RSN) or local mental health provider. It is highly recommended that each office know and collaborate with  all local mental health providers and RSN.

If it appears the individual is in crisis due to a mental illness referral should be immediately made to the RSN for emergency crisis intervention services. A Designated Mental Health Professional (DMHP) will determine if an involuntary mental health evaluation and treatment is warranted. Crisis services are available to any person regardless of income or citizenship status. If the crisis requires the involvement of law enforcement ask the 911 operator to involve Crisis Intervention Team [CIT] officers if they are available in your community. They are trained to de-escalate violent situations in which a mental illness may be a contributing factor.

Regional Support Network (RSN) Mental Health Prepaid Health Plans

RSNs, through licensed mental health agencies, provide medically necessary services to clients eligible for the Title XIX Medicaid program as well as some other persons with a diagnosed mental illness An in-person appointment with the mental health provider will be necessary to make that determination. Services include emergency crisis intervention, case management, counseling and psychotherapy, and psychiatric treatment, including medication management. A directory of RSNs and licensed community mental health agencies is available at the link listed below.

Medicaid Healthy Options Program

Title XIX Medicaid clients who are enrolled in Healthy Options are eligible for limited mental health services through the Healthy Options health plans. The benefits include psychiatric and psychological testing, evaluation and treatment and unlimited medication management when provided in conjunction with mental health treatment covered by the Contractor. Mental health benefits offered through the Healthy Options plans are limited to those Title XIX who do not meet the RSN’s Access to Care Standards.  Detailed information is provided at the Healthy Options website listed below.

Primary Care Provider (Family Physician)

Clients with depression or anxiety disorders may be served by accessing the person’s Primary Care Provider to assist in determining if the mental disorder is treatable by medication or other services covered by health insurance or medical coupons. The primary care provider’s medical assessment may also be helpful in documenting the need for treatment when referring the client to a psychiatrist or other mental health services provider.

WorkFirst/ TANF

TANF/WorkFirst clients may be screened using the Depression and Anxiety Disorder screens in the e-JAS Mental Health Category in the Social Services Assessment. If, as a result of the e-JAS Depression and Anxiety Disorder screenings, it appears the client needs further evaluation, refer the client to his or her primary care provider or local mental health service provider.

RESOURCES

Washington Apple Health 

http://www.samhsa.gov (Substance Abuse and Mental Health Services Administration)

Search IESA Clarification Database (internal use only)

SSI facilitation of a non-U.S. citizen and naturalization referral. 

Worker Responsibilities 

Search IESA Clarification Database

1. Because the rules under which non-United States (non-U.S.) citizens are eligible for Social Security benefits are very complex, refer all persons, including ABD cash and TANF recipients, who are non-U.S. citizens and appear to meet SSA disability or aged criteria directly to the local Social Security Administration (SSA) office before providing SSI facilitation services.
   
   NOTE: Open the SSI Facilitation screen in ICMS for ABD cash recipients
2. When SSA accepts an application from the ABD recipient:
   1. Verify with the local SSA office that an SSI application was filed.
   2. Request ABD certification
   3. Verify that a valid DSHS 18-235, Interim Assistance Reimbursement Authorization (IARA) has been filed with SSA.  If not, take the necessary steps to provide an IARA to SSA.
   4. Document and update the SSI Facilitation screens in ICMS.
   5. Provide Equal Access and SSI Facilitation services to assist the recipient throughout the application process.
3. When SSA rejects an SSI application because of citizenship status, of a person defined as qualified alien per WAC 388-424-0001), and the person has lived in the United States for at least four years:
   1. Schedule a face-to-face interview whenever possible. Explain the advantages of becoming a U.S. citizen such as: citizenship gives them the right to apply for federal benefits, vote and makes traveling abroad easier.
      
      NOTE: Never tell the person that they must become a U.S. Citizen.
   2. Suggest that the person contacts agencies in their local area that can help them become US citizen. You may give them a NATURALIZATION REFERRAL LIST which provides a list of agencies that have historically provided naturalization services.
   3.  If the person needs help contacting the naturalization agency:
      1. Call one of the local naturalization agencies to make an appointment for the person. 
      2. Help the person make transportation arrangements, such as contacting a friend or relative of the person.
      3. Give the person the NATURALIZATION REFERRAL LIST.
   4. Enter “SSI/SSA denied-Non Citizen (SN)” as the closing reason code on the SSI Facilitation screen in ICMS. Enter the date that you made the naturalization referral in the date field. 
   5. When a person who is a non-U.S. citizen reports SSI approval, explain that unless they naturalize they will only receive SSI for seven years from the date they entered the U.S:
      1. As a refugee, asylee, Cuban/Haitian entrant, Amerasian, victim of trafficking, Special Immigrant from Iraq or Afghanistan, or
      2. They have had deportation or removal withheld.
   6. Review the benefits of citizenship and the list of naturalization services providers.

Revised on: April 19, 2021

WAC 388-449-0001 What are the disability requirements for the Aged, Blind, or Disabled (ABD) program?

Clarifying Information

1. The Disability Specialist reviews available records and approves ABD when the client meets any non-SEP criteria outlined in WAC 388-449-0001. Non-SEP approval criteria include when the client:
   1. Has an existing ABD approval that hasn’t ended and can be reopened;
   2. Is determined blind or disabled by the Social Security Administration (SSA);
   3. Is determined disabled by the Division of Disability Determination Services (DDDS) for Non-Grant Medical Assistance with current date of eligibility or reexamination waived;
   4. Has had their Supplemental Security Income (SSI) payment stopped because they are not a citizen;
   5. Is eligible for long-term care services from the Aging and Long-Term Support Administration (ALTSA) for a medical condition that is expected to last twelve months or more or result in death; or
   6. Is functionally eligible for services from the Developmental Disabilities Administration (DDA).

Related Procedures (Staff Only)

• ABD Referrals 

Revised July 25, 2012

The following is a list of naturalization services agencies. See the Naturalization chapter for the referral information.

All agencies are authorized to provide immigration services and can help connect you to someone who speaks your language.

Naturalization Services Referral List  

Asian Counseling & Referral Service
3639 Martin Luther King 
Way South
Seattle, WA 98144
(206) 695-7600
Hmong, Mien, Chinese, Vietnamese, Laotian

Catholic Community Services of King County
4250 Mead Street
Seattle, WA 98118
(206) 725-2090
Russian, Ukrainian, Somali, Arabic, Kurdish

Center for Multi Cultural Health
105 14th Ave #2C
Seattle, WA 98122
(206)461-6910
Russian, Ukrainian, Khmer, Amharic, Tigrinya

Chinese Information Service Center
611 S. Lane St.
Seattle, WA 98104
(206) 624-5633
Cantonese, Mandarin, Vietnamese

Filipino Community of Seattle*
5740 ML King Jr. Way S
Seattle, WA 98118
(206) 722-9372
Filipino dialects

Lutheran Community 
Services NW
115 NE 100th St., Suite200
Seattle, WA 98125
(206) 694-5742
French, Arabic

Korean Women’s Assn.
123 East 96th Street
Tacoma, WA 98445
(253) 535-4202
Korean, Ukrainian, Russian Vietnamese, Cambodian

Multi Cultural Self Sufficiency Movement
11016 Bridgeport Way SW
Tacoma, WA 98499
(253) 584-5615
Korean, Russian, Ukrainian, Romanian, Moldavian,Spanish

Tacoma Community House
1314 South L St.
Tacoma, WA 98415
(253) 383-3951
Russian, Ukrainian, Vietnamese, Spanish, Cambodian, Lao

East African Community Development Council
7101 Martin Luther King
Way South, Suite 203
Seattle, WA 98146
(206) 7355-6343
Somali, Oromo, Amharic, Tigrinya 
Ready by Five
414 North Third Street
Yakima, WA 98901
(509) 454-2493
Portuguese, Spanish, Russian

Khmer Community of Seattle-King County
10025 16th Ave SW
Seattle, WA 98146
(206) 762-3922
Bosnian, Khmer, Vietnamese, Somali, Amharic, Tigrinya

International Rescue
Committee
100 S. King St. ,Suite 570
Seattle, WA 98104
(206) 623-2105
Spanish, German, French

International Rescue
Committee
16256 Military Road S. #206
SeaTac, WA 98188
(206) 623-2105
Bosnian, Somali, Arabic, Vietnamese, Amharic, Russian, Tigrinya, Nepali, Burmese, Chin

Jewish Family Services
1601 16th Avenue 
Seattle, WA 98122
(425) 643-2221
Russian, Farsi,

Neighborhood House
905 Spruce St., Suite 200
Seattle, WA 98104
(206) 461-8430
Vietnamese, Other

NW Immigrant Rights Project
615 2nd Ave. Suite 400
Seattle, WA 98104
(206) 957-8604
Any Language

NW Immigrant Rights Project
121 Sunnyside Ave.
PO Box 270
Granger, WA 98932
(509) 854-2100
Spanish

Refugee & Immigrant 
Services NW
2000 Tower Street
Everett, WA 98201-1352
(425) 388-9307
Russian, Ukrainian

East African Community Services
7054 32nd Ave. South,
Suite 207
Seattle, WA 98118
(206) 721-1119
Somali, Eritrean, Oromo, Tigrinya, Iraqi, Sudanese

Lao Community  Services
7101 Martin Luther King
Way South, Suite 214
Seattle. WA 98118
(206)  501-4115
Laotian

Refugee Federation Service Center Coalition 
7101 Martin Luther King
Way South, Suite 214
Seattle. WA 98118
(206) 725-9181
Russian, Ukrainian, Somali
Cambodian, Vietnamese, Bhutanese, Burmese

Eritrean Community of Seattle and Vicinity
2404 East Spruce
Seattle, WA 98122
Tigrinya, Amharic

Korean Women’s  Assn.
5305 East 18th St., Ste 117
Vancouver, WA 98661
(360) 906-0577
Russian, Ukrainian

Refugee Women’s Alliance
4008 M.L.King Way S.
Seattle, WA 98108
(206) 721-0243
Somali, Vietnamese, Amharic,

Sea Mar Community Health Centers
8915 14th Ave S
Seattle, WA 98108
(206) 764-4700
Spanish

St. James ESL Program
804 9th Avenue
Seattle, WA 98104
(206) 382-4511
Russian, Vietnamese

Ukrainian Community Center of Washington
221 Hardie Avenue NW
Renton, WA 98057
(425) 430-8229
Ukrainian, Russian, Polish

Literacy Source
720 N. 35th, Suite 103
Seattle, WA 98103
(206) 782-2050
Spanish, Hindi, Tamil, Malayalam, French, German

World Relief-Kent
841 N. Central Ave. N.
SuiteC-106
Kent, WA 98032
(253) 277-1121
Ukrainian, Russian, Belarusian, Moldavian, Polish

World Relief
(Spokane)
1522 N. Washington, 
Suite 204
Spokane, WA 99201
(509) 484-9829 
Russian, Swahili, Arabic, Spanish, French,  Karen, Burmese, Nepali, Hindi, Kirundi/Kinyarwanda

Multi Cultural Self Sufficiency Movement
30819 14th Ave. S. #F
Federal Way, WA 9800
(253) 945-6010
Korean, Russian, Ukrainian, Romanian, Moldavian,Spanish

Lutheran Community 
Services NW
3600 Main St. Suite 200
Vancouver, WA 98663
(360) 694-5624
Russian, Ukrainian, Bosnian, Spanish, Burmese

World Relief
(TriCities)
2600 N. Columbia Center
Blvd., Suite 206
Richland, WA  99352
(509) 734-5477
Arabic, Burmese, Russian, Serbo-Croation, Somali, Spanish, Ukrainian

Somali Community Services Coalition
15027 Military Road South
Suite 4 and 5
Seattle, WA 98188
(206) 431-7967
Somali
Korean Women’s Assn.
4629 168th St. SW #G
Lynnwood, WA 98037
(425) 742-3696
Korean, Russian, Ukrainian

Purpose: 

To provide social service specialists with guidelines and the process for using information we have, when the provider has been in our system through ABD cash or the HEN Referral program and they are applying to be paid through the Working Connection Childcare.

WAC 170-290-0135- In-home/relative providers 

Clarifying Information -WAC 170-290-0135

When a person is receiving ABD cash or HEN Referral services and medical, social or criminal information is available, use the following process to determine if that information indicates the person is unable to meet the needs of caring for a child/children and therefore not suitable to receive WCCC payment as an in-home/relative provider.

See WAC 170-290-0135 and WAC 170-290-0140 (4).

Worker Responsibilities - WAC 170-290-0135

1. Review the “letter of recommendation” from 3rd party who knows the provider.  This letter must be included in the WCCC referral.
2. Review medical, social or criminal evidence in the person’s case record including incapacity evaluations, supporting evidence from assessments, and Social Security disability status.
3. Review the person’s statement about their ability to perform the care functions and meet the responsibilities listed in WAC 170-290-0135.
4. If the medical evidence conflicts with the statement from either the third party or the person, we deny the payment for childcare.
5. Notify WCCC worker of the decision to deny.
6. Document your findings in eJAS or ICMS notes.

WAC 388-473-0010 What are ongoing additional requirements and how do I qualify?

WAC 388-473-0040 Assistance for service animals as an ongoing additional requirement.

• Clarifying Information 

WAC 388-473-0070 Transportation as an ongoing additional requirement. 

WAC 388-473-0080 Medically related items or services as an ongoing additional requirement. 

WAC 388-478-0050 Payment standards for ongoing additional requirements.

WAC 388-478-0050 Payment standards for ongoing additional requirements.

See Ongoing Additional Requirements in the Eligibility A-Z Manual for more information about role of the Financial Worker in setting up OAR benefits for the customer.

Eligibility Determination 

1. A customer may request Ongoing Additional Requirements from either financial eligibility staff or Social Service Specialist. If the request is made to financial eligibility staff, they will direct customers to a Social Service Specialist.

2. The Social Service Specialist verifies the need and determines eligibility for OAR benefits through an assessment. The assessment may include an interview, collateral contacts, or verification from a provider. If verification is needed to make an OAR decision, refer to the CSD Procedure Handbook for next steps. The Social Service Specialist determines if the need is one-time or reoccurring. Some benefits are only a one-time payment. Other benefits can occur monthly and are reviewed at regular intervals (see Review Periods in WAC 388-473-0010). An example of a one-time benefit is an individual who needs assistance obtaining a bus pass at a reduced rate. Once the bus pass is obtained, they are able to pay the reduced rate ongoing and would not need continued OAR for transportation.

3. We do not approve Ongoing Additional Requirement benefits if:

      a. The assistance they are requesting is available to them through another program (TANF, RCA, HEN, etc.); agency (ALTSA, DDA, etc.); provider; Medicaid; or community partners.

      b. The person lives in an institution, licensed Adult Family Home (AFH), Assisted Living Facility (ALF), or Enhanced Services Facility (ESF); or

      c. The assistance unit is a child-only case.

4. We approve OAR when we have all information and verification needed to make a decision.

 5. For HCS cases, the HCS social worker or Area Agency on Aging (AAA) case manager makes the determination of the need of OAR and notifies the financial worker of the decision using the DSHS 14-443 Financial Social Service Communication form. (This form is located in the Barcode ECR under the forms tab.)

Verification

All initial requests begin with an assessment by the Social Service Specialist. Certain benefit types have conditions for approval and verification or documentation that is needed before a decision regarding OAR can be made. Refer to chart below. For medically related benefits, see section below under Worker Responsibilities-WAC 388-473-0080.

Review Periods

1. Review eligibility cycles for Ongoing Additional Requirements using the chart found in WAC 388-473-0010.

      a. However, if the Social Service Specialist determines that the person does not need the OAR service for the entire review period, it can be approved with a shorter review period.

        b. Reviews can be done early “any time need or circumstances are expected to change” per WAC 388-473-0010.

Clarifying Information - WAC 388-473-0040

What is a service animal?

The ADA (Americans with Disabilities Act) defines a service animal as any guide dog, signal dog, or miniature horse trained to provide assistance to an individual with a disability. If they meet this definition, animals are considered service animals under the ADA, regardless of whether they have been licensed or certified by a state or local government. Any reference below to service animal follows this definition.

Service animals perform some of the functions and tasks that individuals with a disability cannot perform for themselves.  Guide dogs are one type of service animal, used by some individuals who are blind. This is the type of service animal with which most people are familiar, but there are service animals that assist persons with other kinds of disabilities in their day-to-day activities.

Some examples include:

• A person with hearing impairment being alerted to sounds.
• A person with mobility impairment being assisted with balance, pulling their wheelchair, or carrying and picking up things.
• A person with depression having a dog that is trained to perform a task to remind them to take their medication.
• A person with PTSD having a dog that is trained to lick their hand to alert them to an oncoming panic attack.
• A person who has epilepsy having a dog that is trained to detect the onset of a seizure and then help the person remain safe during the seizure.

A service animal is not a pet or an emotional support animal, per ADA guidelines.

Worker Responsibilities - WAC 388-473-0040 [Assistance for Service Animals]

1.   Use the following criteria to determine if the person's OAR request for a service animal qualifies for benefits. The dog or miniature horse:

       a. Must help the person with a sensory, mental, or physical disability.

       b. The training does not need to be formal, but the dog or miniature horse should be trained to help the person with tasks related to the disability (do not ask for proof of training).

Worker Responsibilities-WAC 388-473-0070 [Transportation]

Examples of questions to ask that may be helpful in making a determination:

• What is your primary need related to transportation assistance (i.e. what is the purpose of the transportation)?
• How will receiving transportation assistance help you continue to function and live independently?
• What has changed with your situation or what challenges are you facing that led you to seek help with transportation?
• Do you live in an area that offers reduced or free transportation passes?
• Have you requested other transportation services available (as appropriate)?
  
  • Support Services – TANF, RCA
  • Housing and Essential Needs (HEN)
  • Reduced or free bus passes
  • Medicaid Transportation services

Worker Responsibilities-WAC 388-473-0080 [Medically Related Items]

We issue benefits for medically related items or services when a person did not qualify for the service or item from any state, federal, or private insurance coverage or they have been unable to obtain a replacement through state, federal, or private insurance. Definition of and verification needed for medically related items and services are listed below:

Clarifying Information - WAC 388-478-0050

1. Services with an annual limit are limited to one payment every 12 months.

2. The following services are issued at a set standard amount as described in WAC even if the need is less: restaurant meals, laundry, service animal food, telephone, transportation, veterinary cost for service animal. For other services, determine amount based on need  not exceeding maximum standard amount.

3. The standards and limits outlined in the WAC are per person, not per household

4. A household could have more than one person who is eligible for the same OAR benefit.

5. OAR amounts for a service animal are limited per person and not per animal.

LINKS

• Service Animals | ADA.gov
• International Association of Assistance Dog Partners (IAADP) article The World of Assistance Dogs.

Revised on: June 11, 2020

WAC 388-400-0055 – Who is eligible for the pregnant women assistance (PWA) program?

Clarifying Information

1. WorkFirst Social Services Specialists provide case management and support to PWA recipients.
2. Once an individual is determined eligible for PWA, their referral to the Housing and Essential Needs (HEN) program remains valid for 24 consecutive months. The individual is not required to meet any eligibility criteria outlined in WAC 388-400-0055 to maintain their referral to HEN.

Purpose:

This category provides rules, policy and information to determine a pregnant and/or parenting minor's eligibility for TANF or SFA cash assistance and WorkFirst Support Services based upon the required Teen Living Assessment and school requirements.

WAC 388-486-0005 - Unmarried pregnant or parenting minors - Required living arrangement

WAC 388-486-0010 - Unmarried pregnant or parenting minors - Required school attendance

Purpose

Program Standards are consistent with Policy and WAC rules already in place. They are driven by State, Federal and acceptable Standard Practices. They are key points that make the outcome of a program successful.

To read what the Program Standards are for any of the services provided by social service case workers, click on a program category below.

Revised July 17, 2017

Guidelines

CSD Social Services Staff only assigns a Protective payee to a cash assistance client when the client:

1. Has a history of mismanagement of funds. See WAC 388-460-0035 When is a protective payee assigned for mismanagement of funds? and Payees on Benefit Issuances - Protective Payees (EA-Z manual). 
2. Is an unmarried pregnant or parenting minor receiving benefits for themselves and/or their child.  See WAC 388-460-0040 When is a protective payee assigned to TANF/SFA pregnant or parenting minors? and Payees on Benefit Issuances - Protective Payees (EA-Z manual).

Clarifying Information:

1. Social Services Staff must follow the process for assigning a protective payee to individuals if there is evidence of the following:

   1. Repeated failure to meet obligations for rent, food and other essentials on behalf of themselves or a child in their care;
   2. Repeated requests for additional help because of an eviction or shut-off notice;
   3. A child is not being properly cared for;
   4. Mismanagement of funds due to misuse of alcohol or drugs;
   5. Use of EBT cash benefits at prohibited locations as determined by the Office of Fraud and Accountability two or more times.

2. Social Services Staff will assign a protective payee only when other approaches to correct or address mismanagement of funds have been unsuccessful.

   1. EXCEPTION: When Social Services Staff receive notice from the Office of Fraud and Accountability (OFA) that a client has used their EBT cash benefits at prohibited locations two or more times, a protective payee must be assigned.

3. Social Services Staff will not establish a protective payee when the cause of unpaid obligations is simply insufficient funds or a temporary lack of funds due to an emergency.

4. Social Services Staff must assign a protective payee for minor parent cases unless the client:
   
   1. Is emancipated;
   2. Is married;
   3. Has turned eighteen years old

Purpose:

This category contains rules and procedures for the Refugee Assistance Program and contains the following sections and

WAC 388-466-0005- Immigration status requirement for refugee assistance

WAC 388-466-0140 - Income and resources for refugee assistance eligibility

WAC 388-466-0120 - Refugee cash assistance

WAC 182-507-0130 - Refugee medical assistance (RMA)

WAC 182-507-0135 - Refugee medical assistance (RMA)

WAC 388-466-0150 - Refugee employment and training services 

Revised March 21, 2023

Clarifying Information

Supplemental Security  Income (SSI)

1. SSI is administered by the Social Security Administration (SSA).
2. SSI (Title 16) is a Federal assistance program that provides cash and medical benefits to people who:
   1. Do not have qualifying work quarters for Social Security Disability Insurance (SSDI, Title 2),
   2. Meet the same disability criteria as SSDI, and
   3. Meet financial resource and income limits set by SSA.
3. When SSI is approved, and a valid authorization 18-235 is established, SSA reimburses the state for assistance provided to ABD cash recipients while the SSI application is pending (interim assistance).

Social Security Disability Insurance (SSDI)

1. SSA determines SSDI eligibility for every person who applies for SSI.
2. A concurrent claim means that a person has applied for both SSI and SSDI.
3. To be eligible for SSDI, a person must have worked and contributed to Social Security for a required number of work quarters.
4. States do not receive interim assistance reimbursement for SSDI payments.

 Benefits of Receiving SSI

1. ABD cash or TANF recipients who are approved for SSI typically receive:
   
   1. Increased income,
   2. Access to vocational retraining programs and supported work programs, and
   3. Long term eligibility for cash and medical assistance.
2. DSHS benefits through recovery of interim assistance and reduced caseloads.
3. Households receiving TANF receive higher income because SSI payments are not counted as income to the rest of the household.

Presumptive Disability

SSA may find that persons who meet certain severe disability criteria are presumptively disabled.  The list of allegations that meet Social Security Administration (SSA) presumptive disability criteria are maintained on the SSA website.

Worker Responsibilities

When a client appears to meet SSA presumptive disability criteria:

1. Refer the client directly to SSA and instruct them to claim financial hardship.
2. When SSA decides the person has a presumptive disability, they authorize SSI benefits for up to six months while the Division of Disability Determination Services (DDDS) reviews the disability.
3. Presumptive payments may end if DDDS is unable to make a determination within the review period, but DDDS will continue to process the case until a final determination is made.
4. It is critical that the person's payment status is tracked and cash assistance not provided while a person is receiving presumptive disability payments.  SSA provides these payments as emergency assistance (which is why the person must claim financial hardship to get them), which excludes them from reimbursement as interim assistance.
5. Notify financial services to terminate an ABD cash recipient’s benefits when the person begins receiving presumptive SSI benefits.

Compassionate Allowances

SSA has an obligation to provide benefits quickly to applicants whose medical conditions are so serious that they clearly meet disability standards.  Compassionate Allowances allow SSA to target the most obviously disabled individuals for allowances based on minimal objective medical evidence that can be obtained quickly.

The List of Compassionate Allowances Conditions can be found on the SSA website.  Be sure to check the list regularly for new conditions.

Worker Responsibilities

When a person appears to meet SSA Compassionate Allowances criteria:

1. Refer the client directly to SSA for a Compassionate Allowances determination.
2. Notify financial services to terminate an ABD cash recipient's benefits when the person begins receiving SSI benefits.

Disability Listings

SSA refers to their disability criteria as the “Listings” and publishes them in Disability Evaluation Under Social Security. SSA considers a person disabled when the medical disorder meets or equals the listed disability criteria.

Disability Decision

The Division of Disability Determination Services (DDDS):

1. Decides if a person applying for SSI, SSDI, or Non-Grant Medical Assistance (NGMA) meets disability criteria;
2. Uses a sequential evaluation  similar to the ABD cash process  to determine the effect of the physical and/or mental impairment and the combined effect of multiple impairments; and
3. Considers the effect of the following on the person’s ability to work:
   
   1. Current and past work activity.
   2. Severity of impairment.
   3. Residual functional capacity.
   4. Age.
   5. Education.

Worker Responsibilities

1. Assist ALL ABD, RCA, or TANF recipients who appear to be eligible for SSI. Assistance includes:
   
   1.  Assessing client needs and appropriateness for SSI facilitation.
   2.  Helping complete SSA application forms.
   3.  Tracking SSA applications.
   4.  Coordinating services.
2. Provide facilitation services to All:
   
   1. ABD cash recipients who meet SSI citizenship/immigration requirements.
   2. RCA cash recipients who appear to meet SSI disability criteria.
   3. TANF recipients who appear to meet SSI disability criteria.
   NOTE:  Refer all non-citizen ABD recipients directly to SSA to determine whether they meet SSI citizenship/immigration requirements.  When SSA verifies the non-citizen is eligible to apply for SSI, provide SSI facilitation.
   NOTE:  Clients who are age 65 or older, terminally ill (TERI cases), Compassionate Allowances, and those that meet presumptive listing criteria should be immediately referred to SSA.  Do not submit an SSI application. SSA must process these claims directly.
3. Develop professional working relationships with:
   
   1. Social Security District Office (SSADO).
   2. Division of Disability Determination Services (DDDS).
   3. Home and Community Services (HCS).
4. Provide Equal Access (EA) assessment, planning, and services as appropriate.
5. Adhere to the following timeframes and procedures:
   
   1. Assist the person with filing the initial SSI application within 60 calendar days of an ABD cash approval and within 90 days of the date a person receiving TANF is referred for facilitation services.
   2. Meet filing deadlines for reconsideration requests and hearings.
   3. Verify that a current DSHS 18-235, Interim Assistance Reimbursement Authorization (IARA), is on file with Social Security Administration (SSA) within 10 working days after approval for ABD cash, or 30 days after the date the form is signed by the person (whichever date comes first).

Social Security Links:

Social Security Listings

Evidentiary Requirements

Social Security Administration

SSDI

Social Security Employment Programs

Search IESA Clarification Database

Revised April 26, 2023

Purpose

This section contains information regarding actions that are necessary when a Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) determination is made by the Social Security Administration (SSA).

WAC 388-449-0150 - When does my eligibility for the Aged, Blind, or Disabled (ABD) cash benefits end?

SSI/SSDI Approvals

1. When disability is approved at the Initial or Reconsideration level, the Division of Disability Determination Services (DDDS) notifies the Social Security Administration District Office (SSADO).
   1. The Office of Quality Review (OQR) reviews a percentage of DDDS approvals and denials for quality assurance and has the authority to overturn DDDS decisions.
   2. Approvals by an Administrative Law Judge (ALJ) at the Hearing level or the Appeals Council Review are binding and are not reviewed by the OQR.
2. The SSADO conducts a financial eligibility review before final approval of SSI benefits.
   1. The financial eligibility review usually involves a mandatory interview with the client.
   2. SSI Facilitators may need to assist with the SSA financial eligibility review process.
   3. The client cannot enter SSI/SSDI pay status until the financial eligibility review is completed.
   4. Terminate ABD assistance if the client fails to complete the mandatory SSA financial eligibility review.
   5. SSA sends the client written notice regarding SSI/SSDI once the financial eligibility review is completed.

Review of ABD Assistance Following SSI/SSDI Denial

WAC 388-449-0150 - When does my eligibility for the Aged, Blind, or Disabled (ABD) cash benefits end?

1. Eligibility for ABD assistance ends when:
   
   1. SSA makes an unfavorable disability determination at the Initial, Reconsideration, or Hearing level and the client fails to file a timely appeal; or
   2. A final unfavorable disability determination is made at the Appeals Council Review or by the ALJ after remand by the Appeals Council.
2. Eligibility for ABD assistance may also end following an SSI/SSDI denial when:
   
   1. The client no longer meets ABD income and resource requirements; or
   2. The client no longer meets ABD disability criteria.
3. When SSA denies an application at the Initial, Reconsideration, or Hearing level, the SSI Facilitator reviews the SSA determination and performs a brief review of all available medical evidence to identify if the client's conditions have improved or deteriorated
   
   1. If the client no longer appears to meet ABD disability criteria, the SSI Facilitator notifies the Disability Specialist that an early Disability Review may be needed. The Disability Specialist reviews the medical evidence in detail, and if warranted, requests current medical evidence and initiates an early ABD Disability Review.
   2. If the client appears likely to meet ABD disability criteria, the SSI Facilitator determines an early ABD Disability Review is not necessary and continues with the SSI Facilitation process.
4. If SSA denied the application due to income or resources, the SSI Facilitator notifies financial regarding the denial. Financial reviews the case to determine if the client continues to meet ABD income and resource requirements.

Clarifying Information

If a client is denied SSI due to failure to apply for early retirement benefits, ABD eligibility should continue. Retirement does not meet the definition of federal aid assistance. We determine the client has good cause because pursuing early retirement would result in a significant penalty in their retirement benefit amount.

Termination of ABD Assistance Following SSI/SSDI Denial

1. Terminate ABD assistance when a client no longer meets program eligibility criteria per WAC 388-400-0060 and WAC 388-449-0001.
2. Authorize the HEN Referral program only if the ABD termination is based on an SSA disability denial at the Initial, Reconsideration, Hearing, or Appeals Council Review level and the client meets incapacity criteria defined in WAC 388-447-0001.
3. Do not authorize the HEN Referral program if the ABD termination is based on an SSA denial for failing to follow through with an SSI program rule or application requirement (e.g. failing to provide information requested by SSA, failing to attend a required SSA interview, or failing to attend a Consultative Examination (CE) appointment).

Appealing SSI/SSDI Denials

1. ABD recipients must appeal SSI/SSDI denials through the Appeals Council Review stage as a condition of eligibility for ABD assistance.
   
   1. All appeal requests (e.g. Reconsideration, Hearing, and Appeals Council Review) must be filed within 60 calendar days of the SSA denial unless there is good cause for the missed deadline. Only SSA can determine whether there is good cause for a missed appeal deadline.
2. An ABD recipient cannot choose to withdraw an active appeal without losing ABD assistance, including instances when withdrawal is recommended by their legal representative.

Filing a Request for Reconsideration

Reconsideration is the first level of appeal when an SSI/SSDI application is denied.

1. Always request Reconsideration when an ABD recipient’s SSI/SSDI application is denied, including instances when an early ABD Disability Review is initiated.
2. A Request for Reconsideration must be filed within 60 calendar days of the SSI/SSDI initial application denial and include:
   
   1. A completed iAppeal (SSA-561 and SSA-3441);
   2. A signed and dated SSA-827 and SSA-3288;
   3. Any new medical evidence in the Electronic Case Record (list the CSO as a medical source in the iAppeal); and
   4. A new SSA-3373 Function Report and Personal Observation statement when warranted.

Legal Representation

1. Explain the potential benefits of obtaining legal representation.
2. A person has the right to select an attorney, friend, or other individual to represent them. They also have the right to decline assistance and represent themselves at a SSI Hearing or Appeals Council Review.
3. When a client chooses to have a legal representative:
   
   1. Do not recommend a specific attorney;
   2. Inform the client that legal representatives may also charge for expenses incurred while representing the client; and
   3. Provide the client with a DSHS 09-972 SSI Legal Representation form.

Filing a Hearing Request

The Hearing is the second level of appeal when an SSI/SSDI application is denied.

1. If the client obtains legal representation, the attorney will file the Hearing request.
2. When a client is without legal representation, or the client is in danger of missing the appeal deadline, the SSI Facilitator assists the client with filing the Hearing request.
3. A Hearing request must be filed within 60 calendar days of the SSI/SSDI Reconsideration denial and include:
   
   1. A completed iAppeal (HA-501 and SSA-3341);
   2. A signed and dated SSA-827; and
   3. Any new medical evidence (copied from the ECR).

Filing a Request for Appeals Council Review

1. If the client has a legal representative, the representative may file the request for an Appeals Council Review.
2. If the client does not have a legal representative or the legal representative chooses not to request an Appeals Council Review, and the client continues to appear to meet ABD disability criteria, the SSI Facilitator will assist the client with filing the written Appeals Council Review request.
3. The Appeals Council Review request must be filed within 60 calendar days of the SSI/SSDI Hearing denial and include:
   
   1. A completed iAppeal (HA-520-U5);
   2. A signed and dated SSA-827; and
   3. Any new medical evidence (copied from the ECR).

Related Procedures (Staff Only):

ABD Early Disability Review at SSI Denial

Revised on June 16, 2023

WAC 388-449-0200 - Am I eligible for cash assistance for Aged, Blind, or Disabled (ABD) while waiting for Supplemental Security Income (SSI)?

WAC 388-449-0210 - What is interim assistance and how do I assign it to the department?

Clarifying Information

1. Persons receiving ABD cash are required to sign a DSHS 18-235, SSI Interim Assistance Reimbursement Authorization (IARA) agreeing to pay interim assistance.
2. The State of Washington and the Social Security Administration (SSA) have a written agreement that the IARA is also a notice of intent to file an SSI application.
3. The IARA signed date is the protective filing date when:
   
   1. The IARA is filed with the SSA District Office within 30 days of the client's signature date on the IARA.
   2. An SSI application is filed with SSA within 60 calendar days of the client's signature date on the IARA.
4. Once the IARA is filed with SSA, the IARA is effective for interim assistance repayment for as long as the SSI application is active.

NOTE:

1. When the IARA is received in the mail by HIU:
   
   1. The HIU staff will sign the IARA and fax to the appropriate SSA office with an SSA cover letter.
   2. The IARA received date will automatically fill in ICMS SSI Tracking Screen with the date the HIU prints the IARA SSA cover letter.
   3. The HIU staff will image the IARA and assign it to the SSIF of record.
   4. Unsigned or unusable IARAs will be imaged with a cover letter indicating the IARA was not sent to SSA and a new IARA will need to be obtained.

Related Procedures (Staff Only) 

• SSI Initial Application Print and Mail Procedure
• Submitting an SSA iClaim/i3368
• Interim Assistance Reimbursement Authorization (IARA) DSHS 18-235
• SSI Facilitation-Application | DSHS (wa.gov)
• SSI Facilitation - SSA Determinations and Appeals | DSHS (wa.gov)

Clarifying Information

Clients who are age 65 or older, terminally ill (TERI cases), compassionate allowances, and those that meet presumptive listing criteria should be immediately referred to SSA. Do not submit an SSI application. SSA must process these claims directly.

Social Security Disability Insurance (SSDI)

1. SSA determines SSDI eligibility for every person who applies for SSI.
2. A concurrent claim means that a person has applied for both SSI and SSDI.
3. To be eligible for SSDI, a person must have worked and contributed to Social Security for a required number of work quarters.
4. States do not receive interim assistance reimbursement for SSDI payments.

 Benefits of Receiving SSI

1. ABD cash or TANF recipients who are approved for SSI typically receive:
   1. Increased income,
   2. Access to vocational retraining programs and supported work programs, and
   3. Long term eligibility for cash and medical assistance.
2. DSHS benefits through recovery of interim assistance and reduced caseloads.
3. Households receiving TANF receive higher income because SSI payments are not counted as income to the rest of the household.

Presumptive Disability

SSA may find that persons who meet certain severe disability criteria are presumptively disabled.  The list of allegations that meet Social Security Administration (SSA) presumptive disability criteria are maintained on the SSA website.

Worker Responsibilities

When a client appears to meet SSA presumptive disability criteria:

1. Refer the client directly to SSA and instruct them to claim financial hardship.
2. When SSA decides the person has a presumptive disability, they authorize SSI benefits for up to six months while the Division of Disability Determination Services (DDDS) reviews the disability.
3. Presumptive payments may end if DDDS is unable to make a determination within the review period, but DDDS will continue to process the case until a final determination is made.
4. It is critical that the person's payment status is tracked and cash assistance not provided while a person is receiving presumptive disability payments. SSA provides these payments as emergency assistance (which is why the person must claim financial hardship to get them), which excludes them from reimbursement as interim assistance.
5. Notify financial services to terminate an ABD cash recipient’s benefits when the person begins receiving presumptive SSI benefits.

Compassionate Allowances

SSA has an obligation to provide benefits quickly to applicants whose medical conditions are so serious that they clearly meet disability standards.  Compassionate Allowances allow SSA to target the most obviously disabled individuals for allowances based on minimal objective medical evidence that can be obtained quickly.

The List of Compassionate Allowances Conditions can be found on the SSA website.  Be sure to check the list regularly for new conditions.

Worker Responsibilities

When a person appears to meet SSA Compassionate Allowances criteria:

1. Refer the client directly to SSA for a Compassionate Allowances determination.
2. Notify financial services to terminate an ABD cash recipient's benefits when the person begins receiving SSI benefits.

Disability Listings

SSA refers to their disability criteria as the “Listings” and publishes them in Disability Evaluation Under Social Security. SSA considers a person disabled when the medical disorder meets or equals the listed disability criteria.

Disability Decision

The Division of Disability Determination Services (DDDS):

1. Decides if a person applying for SSI, SSDI, or Non-Grant Medical Assistance (NGMA) meets disability criteria;
2. Uses a sequential evaluation similar to the ABD cash process to determine the effect of the physical and/or mental impairment and the combined effect of multiple impairments; and
3. Considers the effect of the following on the person’s ability to work:
   1. Current and past work activity.
   2. Severity of impairment.
   3. Residual functional capacity.
   4. Age.
   5. Education.

Worker Responsibilities

1. Assist ALL ABD or TANF recipients who appear to be eligible for SSI.

   Assistance includes:

   1. Assessing client needs and appropriateness for SSI facilitation.
   2. Helping complete SSA application forms.
   3. Tracking SSA applications.
   4. Coordinating services.
2. Provide facilitation services to All:
   1. ABD cash recipients who meet SSI citizenship/immigration requirements.
   2. TANF recipients who appear to meet SSI disability criteria
   NOTE: Refer all non-citizen ABD recipients directly to SSA to determine whether they meet SSI citizenship/immigration requirements. When SSA verifies the non-citizen is eligible to apply for SSI, provide SSI facilitation.
   NOTE: Clients who are age 65 or older, terminally ill (TERI cases), Compassionate Allowances, and those that meet presumptive listing criteria should be immediately referred to SSA. Do not submit an SSI application. SSA must process these claims directly.
3. Develop professional working relationships with:
   1. Social Security District Office (SSADO).
   2. Division of Disability Determination Services (DDDS).
   3. Home and Community Services (HCS).
4. Provide Equal Access (EA) assessment, planning, and services as appropriate.
5. Adhere to the following timeframes and procedures:
   1. Assist the person with filing the initial SSI application within 60 calendar days of an ABD cash approval and within 90 days of the date a person receiving TANF is referred for facilitation services.
   2. Meet filing deadlines for reconsideration requests and hearings.
   3. Verify that a current DSHS 18-235, Interim Assistance Reimbursement Authorization (IARA), is on file with Social Security Administration (SSA) within 10 working days after approval for ABD cash, or 30 days after the date the form is signed by the person (whichever date comes first).

Social Security Links:

• Social Security Listings
• Evidentiary Requirements
• Social Security Administration
• SSDI
• Social Security Employment Programs

Purpose:

This section contains information about: ABD cash eligibility for clients receiving Home and Community Services (HCS) services. SSI Facilitation services for clients receiving HCS services. Coordination between HCS and the CSO.

Worker Responsibilities

Facilitation Services for Clients Receiving HCS Services

1. When HCS refers an ABD cash client to CSD for facilitation services, SSI Facilitators must provide facilitation services, with the exception of HCS Region 2 which has SSI facilitators.
2. The referral packet from HCS to CSD should contain:
   1. Copy of the completed HCS CARE Assessment.
   2. Available medical and work history information.
   3. A signed SSA-827, Authorization for Source to Release Information to the Social Security Administration for each identified source of medical evidence and two extras.
   4. A signed DSHS 14-012, Authorization to Release Information.
   5. Copy of any medical documentation.
   6. Information about any need for retroactive Medicaid coverage.
3. On receipt of a complete packet from HCS, CSD  begins SSI facilitation.

Coordination between HCS and the CSO

HCS and CSD staff work closely together to coordinate the exchange of the following information:

1. Change of address.
2. SDX or BENDEX update.
3. ACES alerts.
4. SSI/SSDI approval or denial.
5. Change in eligibility.
6. New medical information.
7. Copy of any new CARE assessment.
8. Change in client advocate information.
9. Updated personal observations.

CSD Regional Contacts

 HCS and DDA Regional and Statewide Contacts

Purpose: 

This section is under revision and will include detailed information on how to read and use SDX information and alerts.

Worker Responsibilities

Tracking the SSI Application

Notify clients that they must inform the department when they receive any information from SSA or DDS.

1. Monitor and track all pending SSI applications to ensure timely filing of reconsideration requests and appeals.
2. Use tracking systems to monitor client participation in the application process.

ICMS

Use ICMS to track and record the progress of SSI applications.  The DDDS interface is updated weekly.  SSI facilitation activity reports available in ICMS are:

• SSI Activity Report.
• SSI Data Roster including the name and phone number of the DDS adjudicator.
• DDS status report.
• SSI Overdue Activity reports.

State Data Exchange (SDX)

The SDX is an exchange of information about a person’s SSI status that is updated weekly.

SDX information is available through ICMS or ACES.  To access SDX data in ACES, see SDX in the ACES User Manual.

State Online Query (SOLQ)

The SOLQ contains real time SSA information. Access the SOLQ through ACES.

See SOLQ in the ACES User Manual for instructions for using SOLQ.

Other Sources

• Social Security Administration District Office (SSADO).
• Client advocate.
• Client contact person.
• Protective payee.
• Mental health counselor.
• Social service agencies working with the client.

Revised August 31st, 2016

• Social Security Administration
• SSI
• SSDI
• Hearings and Appeals
• Ticket to Work
• Work Incentives

Revised on March 9, 2020

Purpose

This section includes a list of common forms you may use or encounter in SSI Facilitation.

Links

• Electronic DSHS Forms
• Social Security Administration Forms

Revised on: May 11, 2021

WAC 388-449-0200 - Am I eligible for cash assistance for Aged, Blind, or Disabled (ABD) while waiting for Supplemental Security Income (SSI)?

Clarifying Information

1. For Interim Assistance Reimbursement (IAR) policy information, see SSA Interim Assistance Reimbursement Authorization.
2. ABD recipients who are not U.S. citizens must cooperate with the SSI/SSDI application process until it is established by SSA that they don’t meet the requirements for either program.
3. If ABD is closed for not participating in the SSI application process, we consider ABD eligibility once the client takes necessary steps (within their power) to participate.
4. SSI Facilitators assist with the SSI application process. See the CSD Procedures Handbook: SSI Facilitation- Good Cause Process.
5. ABD recipients must participate in medical treatment for their disabling condition(s) unless they have good cause not to do so. Good cause reasons include the following:
   
   1. The treatment provider has identified a risk that the treatment may cause further limitations or loss of function, and the client is not willing to take the risk.
   2. Treatment is not available without an out of pocket cost to the client,
   3. The client’s fear of the treatment may interfere with the treatment or reduce its benefits.
   4. The client practices an organized religion that prohibits the treatment.
   5. The client has been diagnosed with a terminal illness and does not wish to accept treatment.
   6. The client’s disability is permanent and there is no available treatment to improve the condition.
6. Disability Specialists verify medical treatment participation for ABD recipients every six months and provide ongoing support to the client to help them participate as needed. See CSD Procedures Handbook: ABD Medical Treatment for Disabling Conditions.

Related Procedures (Staff Only)

• SSI Facilitation- Good Cause Process
• ABD Medical Treatment for Disabling Conditions

Revised on: May 2, 2022

See the CSO locator for CSO contact information.