(1) To the extent of available funds, medical care services may be provided to:
(a) Persons eligible for the aged, blind, or disabled assistance program authorized in RCW 74.62.030 and who are not eligible for medicaid under RCW 74.09.510; and
(b) Persons eligible for essential needs and housing support under RCW 74.04.805 and who are not eligible for medicaid under RCW 74.09.510.
(2) Enrollment in medical care services may not result in expenditures that exceed the amount that has been appropriated in the operating budget. If it appears that continued enrollment will result in expenditures exceeding the appropriated level for a particular fiscal year, the department may freeze new enrollment and establish a waiting list of persons who may receive benefits only when sufficient funds are available.
(3) Determination of the amount, scope, and duration of medical care services shall be limited to coverage as defined by the authority, except that adult dental, and routine foot care shall not be included unless there is a specific appropriation for these services.
(4) The authority shall enter into performance-based contracts with one or more managed health care systems for the provision of medical care services under this section. The contract must provide for integrated delivery of medical and mental health services.
(5) The authority shall establish standards of assistance and resource and income exemptions, which may include deductibles and coinsurance provisions. In addition, the authority may include a prohibition against the voluntary assignment of property or cash for the purpose of qualifying for assistance.
(6) Eligibility for medical care services shall commence with the date of eligibility for the aged, blind, or disabled assistance program provided under RCW 74.62.030 or the date of eligibility for the essential needs and housing support program under RCW 74.04.805.
[ 2013 2nd sp.s. c 10 § 7. Prior: 2011 1st sp.s. c 36 § 6; 2011 1st sp.s. c 15 § 3; 2011 c 284 § 3; prior: 2010 1st sp.s. c 8 § 29; 2010 c 94 § 22; 1987 c 406 § 12; 1985 c 5 § 1; 1983 1st ex.s. c 43 § 2; 1982 1st ex.s. c 19 § 3; 1981 1st ex.s. c 6 § 19.]
NOTES:
Effective date—2013 2nd sp.s. c 10: See note following RCW 74.62.030.
Effective date—2011 1st sp.s. c 36 § 6: "Section 6 of this act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect July 22, 2011." [ 2011 1st sp.s. c 36 § 39.]
Findings—Intent—2011 1st sp.s. c 36: See RCW 74.62.005.
Effective date—Findings—Intent—Report—Agency transfer—References to head of health care authority—Draft legislation—2011 1st sp.s. c 15: See notes following RCW 74.09.010.
Implementation—2010 1st sp.s. c 8 §§ 1-10 and 29: See note following RCW 74.04.225.
Findings—Intent—Short title—Effective date—2010 1st sp.s. c 8: See notes following RCW 74.04.225.
Purpose—2010 c 94: See note following RCW 44.04.280.
Effective date—1983 1st ex.s. c 43: See note following RCW 74.09.700.
Effective date—1982 1st ex.s. c 19: "This act is necessary for the immediate preservation of the public peace, health, and safety, the support of the state government and its existing public institutions, and shall take effect April 1, 1982 [April 3, 1982]." [ 1982 1st ex.s. c 19 § 6.]
Effective date—Severability—1981 1st ex.s. c 6: See notes following RCW 74.04.005.
RCW 74.09.035
Medical care services—Eligibility, standards—Limits. (Effective February 1, 2022.)
(1) To the extent of available funds, medical care services may be provided to:
(a) Victims of human trafficking, as defined in RCW 74.04.005, who are not eligible for medicaid under RCW 74.09.510, section 1902(a)(10)(A)(i)(VIII) of the social security act, or apple health for kids under RCW 74.09.470, who otherwise qualify for state family assistance programs under RCW 74.04.820;
(b) Persons eligible for the aged, blind, or disabled assistance program authorized in RCW 74.62.030 and who are not eligible for medicaid under RCW 74.09.510; and
(c) Persons eligible for essential needs and housing support under RCW 74.04.805 and who are not eligible for medicaid under RCW 74.09.510.
(2) Enrollment in medical care services may not result in expenditures that exceed the amount that has been appropriated in the operating budget. If it appears that continued enrollment will result in expenditures exceeding the appropriated level for a particular fiscal year, the department may freeze new enrollment and establish a waiting list of persons who may receive benefits only when sufficient funds are available.
(3) Determination of the amount, scope, and duration of medical care services shall be limited to coverage as defined by the authority, except that adult dental, and routine foot care shall not be included unless there is a specific appropriation for these services.
(4) The authority shall enter into performance-based contracts with one or more managed health care systems for the provision of medical care services under this section. The contract must provide for integrated delivery of medical and mental health services.
(5) The authority shall establish standards of assistance and resource and income exemptions, which may include deductibles and coinsurance provisions. In addition, the authority may include a prohibition against the voluntary assignment of property or cash for the purpose of qualifying for assistance.
(6) Eligibility for medical care services shall commence with the date of eligibility for the aged, blind, or disabled assistance program provided under RCW 74.62.030 or the date of eligibility for the essential needs and housing support program under RCW 74.04.805.
(7) To the extent possible, the authority must coordinate with the department of social and health services, food assistance programs for legal immigrants, state family assistance programs, and refugee cash assistance programs.
[ 2020 c 136 § 4; 2013 2nd sp.s. c 10 § 7. Prior: 2011 1st sp.s. c 36 § 6; 2011 1st sp.s. c 15 § 3; 2011 c 284 § 3; prior: 2010 1st sp.s. c 8 § 29; 2010 c 94 § 22; 1987 c 406 § 12; 1985 c 5 § 1; 1983 1st ex.s. c 43 § 2; 1982 1st ex.s. c 19 § 3; 1981 1st ex.s. c 6 § 19.]
NOTES:
Effective date—2020 c 136: See note following RCW 74.04.005.
Effective date—2013 2nd sp.s. c 10: See note following RCW 74.62.030.
Effective date—2011 1st sp.s. c 36 § 6: "Section 6 of this act is necessary for the immediate preservation of the public peace, health, or safety, or support of the state government and its existing public institutions, and takes effect July 22, 2011." [ 2011 1st sp.s. c 36 § 39.]
Findings—Intent—2011 1st sp.s. c 36: See RCW 74.62.005.
Effective date—Findings—Intent—Report—Agency transfer—References to head of health care authority—Draft legislation—2011 1st sp.s. c 15: See notes following RCW 74.09.010.
Implementation—2010 1st sp.s. c 8 §§ 1-10 and 29: See note following RCW 74.04.225.
Findings—Intent—Short title—Effective date—2010 1st sp.s. c 8: See notes following RCW 74.04.225.
Purpose—2010 c 94: See note following RCW 44.04.280.
Effective date—1983 1st ex.s. c 43: See note following RCW 74.09.700.
Effective date—1982 1st ex.s. c 19: "This act is necessary for the immediate preservation of the public peace, health, and safety, the support of the state government and its existing public institutions, and shall take effect April 1, 1982 [April 3, 1982]." [ 1982 1st ex.s. c 19 § 6.]
Effective date—Severability—1981 1st ex.s. c 6: See notes following RCW 74.04.005.