Exception to Rule
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Exception to Rule


Revised January 10, 2014



Purpose: To explain how, in certain circumstances, the department can grant exceptions to program rules.

WAC 388-440-0001Exception to rule.
WAC 388-440-0005How am I informed of the decision my request to the department for an exception to rule?

WAC 388-440-0001

WAC 388-440-0001

Effective October 1, 2013

WAC 388-440-0001 Exception to rule.

  1. The secretary of the department, or designee, authorizes department staff to request an exception to a rule in the Washington Administrative Code (WAC) for individual cases when: 

    1. The exception would not contradict a specific provision of federal law or state statute; and

    2. The client's situation differs from the majority; and

    3. It is in the interest of overall economy and the client's welfare; and

    4. It increases opportunities for the client to function effectively; or

    5. A client has an impairment or limitation that significantly interferes with the usual procedures required to determine eligibility and payment.

  2. The secretary or the secretary's designee makes the final decision on all requests for exceptions to a rule.

  3. Clients have no fair hearing rights as defined under chapter 388-02 WAC regarding exception to rule decisions by department staff.

  4. Clients who do not agree with a decision on an exception to rule may file a complaint according to chapter 388-426 WAC.

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.

WAC 388-440-0005

WAC 388-440-0005

Effective October 1, 2013

WAC 388-440-0005 How am I informed of the decision my request to the department for an exception to rule?

  1. You will receive the decision in writing within ten days when department staff: 

    1. Decides not to file the exception to rule request; or

    2. Decides to approve or deny an exception to rule request.

  2. The notice includes on how to file a complaint as specified in chapter 388-426 WAC.

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

*** As a result of implementation of the Affordable Care Act (ACA), this clarifying page may no longer be effective for medical coverage applications received on or after 10/01/2013. Please see the ACA Transition Plan for more information. Clients under 65 years of age who need to apply for medical coverage on or after 10/01/2013 should be referred to Washington Healthplanfinder. Applications for medical coverage for households where all members are 65 years of age and older should be referred to Washington Connection. ***

 

 

  • The Secretary of DSHS has delegated the authority for approval of exceptions to rule to the Economic Services Administration, Community Services Division (Administrative Policy 4.01).
  • Direct requests for exceptions to procedures or policies that are not specified in rule to a supervisor.
  • Exceptions to rule may be considered for:
    1. ABD cash.
    2. ADATSA.
    3. Child Care.
    4. WorkFirst.

NOTE:

Refer to WAC 388-501-0160 for anyone requesting an ETR for medical or dental services or related equipment to.


4.    The Secretary's coordinator for exception to rules is located in CSD Headquarters.

5.    All ETR requests must be submitted through the Barcode ETR Screen.

6.    Each CSO designates an Exception to Rule Coordinator.

7.    Requests for Exception to Rule must accurately cite the rule that is being considered for an exception. Direct questions about the correct citation to a supervisor or the Secretary's Designee in CSD headquarters.


WORKER RESPONSIBILITIES

  1. Determine on a case by case basis, using the criteria in WAC 388-440-0001, whether a request for an exception is appropriate.

  2. If the request isn't appropriate, send client ACES Online letter 0070-03 (05-177) Exception to Rule Not Requested.

  3. If the request is appropriate: 

a.    Submit the request through the ETR Screen in Barcode. The following step by step instructions for requesting an ETR are provided for DSHS staff:

ETR Process – Worker

ETR Process  – Supervisor

b. Notify the client of the decision regarding the request by sending an ACES Online letter 0070-04 (Approval) or 0070-05(Denial) or use DSHS 05-177(x).

c.Take action to authorize benefit if exception is approved.

d.Document actions on the case narrative, and retain completed ETR in the electronic case record.


ACES Information

If any exception is approved,  use the proper valid value (EP - Exception to Policy Recurring or NR - Exception to Policy Non-Recurring) on the AREQ screen to identify the payment as an exception to rule.

Document what was approved in the ETR on the REMARKS screen (F9) behind the screen that contains the information relating to the exception.

If an exception to rule is approved for Disability Lifeline time limits, you must also enter the appropriate ETR code on the WORK screen closure delay reason field:

·      RM - Receiving Medical Treatment

·      AF - Alternate Living Facility

 

Modification Date: January 10, 2014