| 100 |
Income Maintenance Prorate - Used only for exceptions to central prorating with TA 11, TA 12, TA 13, and TA 41. |
| 101 FOOD |
Food |
| 102 CLOTH |
Clothing |
| 103 HHSE |
Household Supplies |
| 104 PE |
Personal Essentials |
| 105 REST |
Restaurant Allowance (For a partial restaurant allowance, use code 101 FOOD for meals at home and code 105 REST for meals in a restaurant.) |
| 106 BOARD |
Board - Use whether in boarding house or with private family. (Use also when client in shelter care home requires none of the personal service, i.e., receiving lodging and meals only.) |
| 107 RENT |
Rent (Also use for client's paying rooming only, whether in a hotel, rooming house, or with a private family.) |
| 108 PROP |
Property Payments (This includes property taxes and insurance.) |
| 109 ESA |
Excess Shelter Allowance |
| 117 PERS |
Personal Allowance
In the PERSONS column enter one of the following codes to show what items are to be included in the client's personal allowance. This code along with the number of persons eating together (Item 23) and the degree of activity (Item 68) allows the
system to determine the correct amount for food, clothing, household supplies, and personal essentials.
NOTE: When the number of FS eligible unit members in Item 23 is less than the actual number of persons eating together, the Personal Allowance cannot be centrally determined. Enter code 16 in the
PERSONS column of code 117. Then enter the individual personal allowance amounts in codes 101, 102, 103, and 104.
When the amount allowed for an item is not the same as the amount shown in the allowance chart, exclude it when coding this item.
CODES (entered in the PERSONS column of code 117):
01 Food, clothing, household supplies, personal essentials
- 02 Clothing, personal essentials
- 03 Clothing, household supplies, personal essentials
- 04 Household supplies, personal essentials
- 05 Personal essentials
- 06 Food, household supplies, personal essentials
- 07 Food, clothing, personal essentials
- 08 Food, clothing, household supplies
- 09 Food, personal essentials
- 10 Food, household supplies
- 11 Food, clothing
- 12 Household supplies
- 13 Clothing
- 14 Food
- 15 Clothing, household supplies
- 16 None
Boarder(s) Living With the Client
A boarder who lives with the client is included in the number eating together. Since the number of persons eating together includes the boarder, this affects the client's personal allowance. Omit
clothing and personal essentials when coding these cases and enter the clothing and personal essentials allowances in codes 102 and 104.
Long Term Care
Enter code 16 when the person is in an LTC facility. (Entry of code 12, 13, 14, or 15 in Item 20 authorizes the $30 personal allowance.) |
| 130 |
Reimbursement of Protective Payee Account (One-month Only) |
| 131 CH |
Coal for Heating (Standard allowance centrally used) |
| 133 MGH |
Metered Gas for Heating (Standard allowance centrally used) |
| 135 BHG |
Bottled Gas for Heating (Standard allowance centrally used) |
| 137 FOH |
Fuel Oil for Heating (Standard allowance centrally used) |
| 139 CF |
Cooking Fuel - Any Kind (Standard allowance centrally used) |
| 140 ELT |
Electricity (Standard allowance centrally used) |
| 142 SAS |
Special Allowance for Sewer |
| 143 WATER |
Water (including sewer tax) (Standard allowance centrally used) |
| 144 GARB |
Garbage Disposal or Trash Removal |
| 150 |
Appeal Decision, Income Maintenance Payment (One-month Only) |
| 155 |
Administrative Expense, Child Care to Attend an Appeal Hearing (One-month Only) |
| 227 LAUND |
Laundry |
| 228 PHONE |
Telephone |
| 232 SHO |
Shopping Service |
| 233 REC |
Reading or Guide Service for Recreation
AABD(B) (Category 02) Only |
| 234 |
Repair of Braille Writers, Typewriters, Radios (One-month Only)
AABD(B) (Category 02) Only |
| 235 ANML |
Service Animal Allowance |
| 237 B TC |
Additional Allowance for Attendance at Blind Training Center
AABD(B) (Category 02) Only |
| 238 SC EX |
Transportation, Lunches, Special Fees, for Children in Regular Attendance in High School, College, or Unpaid Vocational Training |
| 239 O CL |
Outsized Clothing |
| 251 CNSL |
Nursing Care or Personal Care in a Home NOT Subject to Licensing
 (Enter amount in excess of $999.99 in Item 80 Code 256.)
|
| 252 SCSH |
Sheltered Care/Sheltered Home
(Enter amount in excess of $999.00 in Item 80 Code 256.) |
| 253 SCIS |
Sheltered Care/Intermediate/Skilled
(Enter amount in excess of $999.00 in Item 80 Code 256.) |
| 255 |
Correction of an Underpayment (One-month Only) |
| 256 SCBIG |
Sheltered/Nursing/Personal Care Rate in Excess of $999.99. |
| 276 RCH |
Relative Providing Care in Home - Valid for cases approved prior to 07/01/83. Use only with TA 40, TA 45, or TA 62. |
| 325 INEXM |
Income Exemption |
| 326 G ADJ |
Grant Adjustment - Adjustment due to SSI cost of living increase |
| 329 RFGEE |
Refugee/asylee who lost SSI due to expiration of 7-year limit. |
| 364 TD U |
Ulcer Diet
(Includes other chronic conditions requiring a bland low-residue diet) |
| 365 TD D1 |
Diabetic Diet - Adults, Less Than 1700 Calories |
| 366 TD D2 |
Diabetic Diet - Adults, 1700 Calories or More |
| 367 TD D3 |
Diabetic Diet - All Children |
| 368 TD H1 |
High Protein/High Calorie/High Vitamin Diet - 13 years of age and over |
| 369 TD H2 |
High Protein/High Calorie/High Vitamin Diet - 6 through 12 years of age |
| 370 TD H3 |
High Protein/High Calorie/High Vitamin Diet - 3 through 5 years of age |
| 467 DINC |
Diverted Income -
Enter the code and amount of the client's income that is diverted to the needs of a person(s) for whom the client is responsible. This amount cannot exceed the total amount of budgeted income (excluding SSI) shown in Item
90. |
