PM 18-05-05

TANF

  1. Determine eligibility for extended medical (see WAG 18-05-04).
  2. If not eligible for extended medical, SWAP the case.
  3. revised textIf income is less than the All Kids/FamilyCare Assist Standard, update Items 30, 80 and 90.
  4. revised textFor children (persons under age 19), if income exceeds the All Kids Assist Standard:
    1. If the LMDD is within 12 months, enter a code in Item 78 so that the child receives All Kids Assist for the remainder of the 12 month period. Do not update Item 30.
    2. If the LMDD is not within 12 months, review eligibility for All Kids Share, Premium or Rebate. If income is more than 300% of the FPL, put child in spenddown status (enter code 390 in Item 80).
    3. If the child does not qualify for Rebate and income is equal to or less than 150% of the FPL, put the child in an All Kids Share case.
    4. If the child does not qualify for Rebate and income is greater than 150% but equal to or less than 300% of the FPL, put the child in an All Kids Premium case.
  5. new textFor adults (persons age 19 and over), if income exceeds the FamilyCare Assist Standard:
    1. Review eligibility for FamilyCare Share, Premium or Rebate. If the person does not qualify for FamilyCare Rebate and income is over 185% of FPL, put them in spenddown status (enter code 390 in Item 80).
    2. If income is equal to or less than 200% of the FPL, review eligibility for FamilyCare Rebate.
    3. If the person does not qualify for Rebate and income is equal to or less than 150% of the FPL, put them in a FamilyCare Share case.
    4. If the person does not qualify for Rebate and income is equal to or less than 185% of the FPL, put them in a FamilyCare Premium case.

Family Assist

  1. Determine eligibility for extended medical (see WAG 18-05-04).
  2. If not eligible for extended medical, change Item 25 to a dash (-).
  3. revised textIf income is less than the All Kids/FamilyCare Assist Standard, update Items 30, 80, and 90.
  4. revised textFor children (persons under age 19), if income exceeds the All Kids Assist Standard 
    1. If the LMDD is within 12 months, enter a code in Item 78 so that the child receives All Kids Assist for the remainder of the 12 month period. Do not update Item 30.
    2. If the LMDD is not within 12 months, review eligibility for All Kids Share, Premium or Rebate. If income is more than 300% of the FPL, put them in spenddown status* (enter code 390 in Item 80).
    3. If the child does not qualify for Rebate and income is equal to or less than 150% of the FPL, put the child in an All Kids Share case.
    4. If the child does not qualify for Rebate and income is greater than 150% but equal to or less than 300% of the FPL, put the child in an All Kids Premium case.
  5. new textFor adults (persons age 19 and over), if income exceeds the FamilyCare Assist Standard:
    1. Review eligibility for FamilyCare Share, Premium or Rebate. If the person does not qualify for FamilyCare Rebate and income is over 185% of FPL, put them in spenddown status* (enter code 390 in Item 80).
    2. If income is equal to or less than 200% of the FPL, review eligibility for FamilyCare Rebate.
    3. If the person does not qualify for Rebate and income is equal to or less than 150% of the FPL, put them in a FamilyCare Share case.
    4. If the person does not qualify for Rebate and income is equal to or less than 185% of the FPL, put them in a FamilyCare Premium case.

FamilyCare/All Kids Assist

  1. revised textFor children (persons under age 19):
    1. If the LMDD is within 12 months, enter a code in Item 78 so that the child receives All Kids Assist for the remainder of the 12 month period. Do not update Item 30.
    2. If the LMDD is not within 12 months review eligibility for All Kids Share, Premium or Rebate. If income is more than 300% of the FPL, put them in spenddown status* (enter code 390 in Item 80).
    3. If the child does not qualify for Rebate and income is equal to or less than 150% of the FPL, put the child in an All Kids Share case.
    4. If the child does not qualify for Rebate and income is greater than 150% but equal to or less than 300% of the FPL, put the child in an All Kids Premium case.
  2. new textFor adults (persons age 19 and over):
    1. Review eligibility for FamilyCare Share, Premium or Rebate. If the person does not qualify for FamilyCare Rebate and income is over 185% of FPL, put them in spenddown status* (enter code 390 in Item 80).
    2. If income is equal to or less than 200% of the FPL, review eligibility for FamilyCare Rebate.
    3. If the person does not qualify for Rebate and income is equal to or less than 150% of the FPL, put them in a FamilyCare Share case.
    4. If the person does not qualify for Rebate and income is equal to or less than 185% of the FPL, put them in a FamilyCare Premium case.

new text*Note: An Assist case managed by the All Kids Unit is canceled when determined to be financially ineligible. 

revised textExample 1: Ms. A receives All Kids/FamilyCare Assist with her 2 children. Countable monthly income is $1,800. Their LMDD is 03/2011.

On 06/07/11, Ms. A reports that she has a new job and countable income is now $2,900, which is above the All Kids/FamilyCare Assist Standard for 3. Since the LMDD is within 11 months, do not make any changes to the children's Item 78 codes. Immediately change the countable income amount in Item 80 code 158 to $2,900 and update Item 90. Since $2,900 is also above the FamilyCare Premium standard, enter Item 80 code 390 with the monthly spenddown amount for Ms. A. Do not update Item 30.

Review the children's eligibility when their REDE is due in 03/12.

revised textExample 2: Mr. B and his child receives All Kids/FamilyCare Assist. Countable income is $1,200. Their LMDD is 06/2010.

On 07/07/11, Mr. B reports that he has a new job and countable income is now $2,500, which is above the Assist standard for 2. Since the income is above the FamilyCare Premium standard for 2, change the amounts in Item 80 code 158 and Item 90, and enter Item 80 code 390 with the monthly spenddown amount for Mr. B. Since the LMDD is not within 12 months, delete the child from the case and set up an All Kids Premium Level 2 case. Update Item 30 after the child has been deleted from the case.