WAC 182-513-1225 Medicaid Personal Care (MPC)

WAC 182-513-1225 Medicaid Personal Care (MPC)

Effective February 25, 2023

1. Medicaid personal care (MPC) is a state-plan benefit available to a client who is determined:
   1. Functionally eligible for MPC services under WAC 388-106-0200 through 388-106-0235; and
   2. Financially eligible for a noninstitutional categorically needy (CN) or alternative benefits plan (ABP) Washington apple health (medicaid) program.
2. MPC services may be provided to a client residing at home, in a department-contracted adult family home (AFH), or in a licensed assisted living facility that is contracted with the department to provide adult residential care services.
3. A client who resides in an alternate living facility (ALF) listed in subsection (2) of this section:
   1. Keeps a personal needs allowance (PNA) under WAC 182-513-1105; and
   2. Pays room and board up to the room and board standard under WAC 182-513-1105, unless CN eligibility is determined using rules under WAC 182-513-1205.
4. A client who receives MPC services under the health care for workers with disabilities (HWD) program under chapter 182-511 WAC must pay the HWD premium in addition to room and board under WAC 182-513-1105, if residing in an ALF.
5. A client may have to pay third-party resources as defined under WAC 182-513-1100 in addition to room and board.
6. Current PNA and room and board standards are found at www.hca.wa.gov/free-or-low-cost-health-care/i-help-others-apply-and-access-apple-health/program-standard-income-and-resources.