(1) The department is responsible for determining eligibility for referral for essential needs and housing support under RCW
43.185C.220. Persons eligible for a referral are persons who:
(a) Have been determined to be eligible for the aged, blind, or disabled assistance program under RCW
74.62.030 or the pregnant women assistance program under RCW
74.62.030, or are incapacitated from gainful employment by reason of bodily or mental infirmity that will likely continue for a minimum of 90 days. The standard for incapacity in this subsection, as evidenced by the 90-day duration standard, is not intended to be as stringent as federal supplemental security income disability standards;
(b) Are citizens or aliens lawfully admitted for permanent residence or otherwise residing in the United States under color of law, or are victims of human trafficking as defined in RCW
74.04.005;
(c)(i) Have furnished the department with their social security number. If the social security number cannot be furnished because it has not been issued or is not known, an application for a number must be made prior to authorization of benefits, and the social security number must be provided to the department upon receipt;
(ii) This requirement does not apply to victims of human trafficking as defined in RCW
74.04.005 if they have not been issued a social security number;
(d)(i) Have countable income as described in RCW
74.04.005 that meets the standard established by the department, which shall not exceed 100 percent of the federal poverty level; or
(ii) Have income that meets the standard established by the department, who are eligible for the pregnant women assistance program;
(e) Do not have countable resources in excess of those described in RCW
74.04.005; and
(f) Are not eligible for federal aid assistance, other than basic food benefits transferred electronically and medical assistance.
(2) Recipients of pregnant women assistance program benefits who meet other eligibility requirements in this section are eligible for referral for essential needs and housing support services, within funds appropriated for the department of commerce, for 24 consecutive months from the date the department determines pregnant women assistance program eligibility.
(3) The following persons are not eligible for a referral for essential needs and housing support:
(a) Persons who refuse or fail to cooperate in obtaining federal aid assistance, without good cause;
(b) Persons who refuse or fail without good cause to participate in substance use treatment if an assessment by a certified substance use disorder professional indicates a need for such treatment. Good cause must be found to exist when a person's physical or mental condition, as determined by the department, prevents the person from participating in substance use treatment, when needed outpatient treatment is not available to the person in the county of their residence, when needed inpatient treatment is not available in a location that is reasonably accessible for the person, or when the person is a parent or other relative personally providing care for a minor child or an incapacitated individual living in the same home as the person, and child care or day care would be necessary for the person to participate in substance use disorder treatment, and such care is not available; and
(c) Persons who are fleeing to avoid prosecution of, or to avoid custody or confinement for conviction of, a felony, or an attempt to commit a felony, under the laws of the state of Washington or the place from which the person flees; or who are violating a condition of probation, community supervision, or parole imposed under federal or state law for a felony or gross misdemeanor conviction.
(4) For purposes of determining whether a person is incapacitated from gainful employment under subsection (1) of this section:
(a) The department shall adopt by rule medical criteria for incapacity determinations to ensure that eligibility decisions are consistent with statutory requirements and are based on clear, objective medical information; and
(b) The process implementing the medical criteria must involve consideration of opinions of the treating or consulting physicians or health care professionals regarding incapacity, and any eligibility decision which rejects uncontroverted medical opinion must set forth clear and convincing reasons for doing so.
(5) For purposes of reviewing a person's continuing eligibility and in order to remain eligible for the program, persons who have been found to have an incapacity from gainful employment must demonstrate that there has been no material improvement in their medical or mental health condition. The department may discontinue benefits when there was specific error in the prior determination that found the person eligible by reason of incapacitation.
(6) The department must review the cases of all persons who have received benefits under the essential needs and housing support program for twelve consecutive months, and at least annually after the first review, to determine whether they are eligible for the aged, blind, or disabled assistance program.
(7) The department shall share client data for individuals eligible for essential needs and housing support with the department of commerce and designated essential needs and housing support entities as required under RCW
43.185C.230.
