TSOA income and resources

Revised date
Purpose statement

This section explains the income and resource rules and standards that apply to the Tailored Supports for Older Adults (TSOA) program.

WAC 182-513-1635 Tailored Supports for Older Adults (TSOA) - Income Eligibility

WAC 182-513-1635 Tailored Supports for Older Adults (TSOA) — Income Eligibility.

Effective October 6, 2023

  1. To determine income eligibility for the tailored supports for older adults (TSOA) program, the medicaid agency or the agency's designee uses the following rules depending on whether the person is single or married.
  2. If the TSOA applicant is single:
    1. Determine available income under WAC 182-513-1325;
    2. Exclude income under WAC 182-513-1340; and
    3. Compare remaining gross nonexcluded income to 400 percent of the federal benefit rate (FBR) for the supplemental security income (SSI) cash grant program. To be eligible, a person's gross income must be equal to or less than 400 percent of the FBR.
  3. If the TSOA applicant is married:
    1. Determine available income under WAC 182-513-1330 with the exception of subsection (5) of that section;
    2. Exclude income under WAC 182-513-1340;
    3. Compare the applicant's remaining gross nonexcluded income to 400 percent of the FBR. To be eligible, a person's gross income must be equal to or less than 400 percent of the FBR.
  4. The FBR changes annually on January 1st.
  5. The current TSOA income standard is found on the Washington apple health income and resource standards chart, institutional standards section; see www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/program-standard-income-and-resources.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

Note:

  • Community income rule does not apply to TSOA.
  • TSOA is a gross income test, so standard SSI-related deductions, such as the $20 disregard, work-related expenses, and the earned income deduction, are not deducted.

WAC 182-513-1640 Tailored Supports for Older Adults (TSOA) - Resource Eligibility

WAC 182-513-1640 Tailored supports for older adults (TSOA) — Resource eligibility.

Effective October 9, 2023

  1. The resource standard for a single applicant for tailored supports for older adults (TSOA) is six times the Washington state average monthly private nursing facility rate, as determined by the department of social and health services under chapter 74.46 RCW.
  2. The resource standard for a married couple is six times the Washington state average monthly private nursing facility rate, as determined by the department of social and health services under chapter 74.46 RCW, for the TSOA applicant plus the state spousal resource standard for the spousal impoverishment protections community (SIPC) spouse. The state spousal resource standard may change annually on July 1st.
  3. The medicaid agency or the agency's designee uses rules in WAC 182-513-1350 (1), (3) and (4) to determine general eligibility relating to resources, availability of resources, and which resources count.
  4. The TSOA recipient has one year from the date of initial eligibility of TSOA to transfer resources in excess of the TSOA standard to the SIPC spouse.
  5. The resource standard for TSOA changes annually on January 1st based on the current average private nursing facility rate, as determined by the department of social and health services under chapter 74.46 RCW.
  6. The current TSOA standards and the current average private nursing facility rate are found on the Washington apple health income and resource standards chart, institutional standards section; see www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/program-standard-income-and-resources.

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

Clarifying Information

Note:   Excess home equity, transfer penalties, annuities LTC provision don’t apply. We do count the Community Spouse pension as a resource for TSOA just like COPES. TSOA and MAC are not considered ‘paid care’ for the purposes of transferring the home in 182-513-1363.

The $53,100 does not increase – it’s a set amount.

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