The following codes provide specific information about the case or customer, or are used for program monitoring.
Unless stated in the specific code box, the code applies to both Cash and Medical.
Disability/Blind/SSA Appeal Reexamine Due Date.
Enter month and year of review date in PERSONS.
Cohen vs. Miller Compensation Payments.
Payment made for late disposition of a Medical Only case.
(AABD(D) Medical Only)
Breast & Cervical Cancer Treatment.
Used only with Item 25 code 9 to identify a case being managed by the HFS Breast and Cervical Cancer Eligibility Unit.
Race and Ethnic
Under Amount enter any of the following alpha characters up to 5 allowing for those who report multiple races:
N - American Indian/Alaskan Native
A - Asian
B - Black or African American
P - Native Hawaiian or Other Pacific Islander
W - White
D = Did not answer/unknown
Enter one of the following ethnicity codes in Supplied By:
Y - Hispanic or Latino
N - Not Hispanic or Latino
D - Did not answer/Unknown
A person may report their race choice but not their ethnicity; therefore, ETH may be a D if a race is chosen and Race may be a D with a Y or N in ETH.
Date of Entry in the U.S.
Enter for a Cash or Medical case which includes a refugee, asylee, Cuban-Haitian entrant, Amerasian, trafficking victim, Iraqi Special Immigrant or Afghan Special Immigrant. Enter the earliest date for anyone on the case.
Under PERSONS, enter the date (MM/YY) the person first came to the U.S. For a Cuban or Haitian, enter the earliest date they were granted parole or otherwise issued INS documentation. For an asylee, enter the date asylum was granted. For a trafficking victim, enter the earliest date they were identified by ORR. For an Iraqi or Afghan Special Immigrant enter either the date they entered the U.S. in Special Immigrant status, or the date they were approved for Special Immigrant status while in the U.S.
Example: If the refugee entered the United States in July 2008, enter 07/08 under PERSONS.
Requires the letter A or Y in the first position of the basic number in Item 1.
(AABD(B) & AABD(D) Only)
Home & Community-Based Care for Medically Fragile and Technology Dependent Children
Entered to identify a child approved for a Home & Community-based Care waiver. Month and year waiver was approved is entered under PERSONS.
(Family Health Plans/AABD Medical)
Date of Cash Request
Enter with TA 31/TAR A7 to register a request for a SWAP from Medical to Cash.
Under AMOUNT, enter the 6-digit date the SWAP request was made.
For Sheltered Care cases to be approved prior to the 30th day, enter a Y under SUPPLIED BY.
Date of Denial
Enter when a request for a SWAP to Cash is denied.
Enter in AMOUNT the 6-digit date the SWAP request was denied. Enter in PERSONS the 2-digit denial TAR.
Process the SWAP denial using TA 31/TAR A8.
In-Home Support and Residential Waivers for Children with Developmental Disabilities/Medically Fragile Technology Dependent Children
Centrally entered to identify a child approved for a Home and Community-Based Services Waiver.
RIN = Recipient number of child receiving waiver services
PERS = Mo/Yr waiver approved
TCOST = Type of waiver
01 - Medically Fragile Technology Dependent (MFTD/HCBC) Waiver
02 - In-Support and Residential Waivers for Children with Developmental Disabilities
SBY = Parental income
1 - Child does not live with parent(s)
2 - Child is eligible considering parental income
3 - Child is only eligible waiving parental income
4 - Parent(s) refuse to provide income information
Health Insurance Premium Payment
Centrally entered when a person is enrolled in HIPP.
Amount of grant to be issued because of appeal filed.
(AABD Medical Only)
Qualified Severely Impaired Individual
Centrally entered to identify a person in Section 1619 status.
Enter when it is reported or discovered that a customer's earnings have stopped. Under PERSONS, enter the 4-digit month/year that the customer received the last paycheck.
For example, customer calls stating she was laid off on 01/28/99. She will receive her last paycheck on 02/02/99. Under CODE, enter 651 EE and under PERSONS, enter 02/99.
The purpose of this code is to prevent unnecessary PAL C and N code referrals.
656 EZ RD
REDE Method for Cases in 6-Month EZ REDE Status
Centrally entered and only applies to cases with SNAP. SUP. BY code: F means next REDE is face-to-face; M means next REDE is mail-in.
REDE Method for cases in 12-Month Mid-Point Reporting. SUP. BY code: I means next point of contact is an interim Mid-Point Report form.
Code 656 is centrally retained for 3 months after SNAP is stopped due to the expiration of the approval period. The first month of ineligibility (4-digit MO/YR) is entered under PERSONS.
Centrally entered when an address change is made using TA 31/TAR 42. One of the following codes appears in SUP. BY to identify who processed the change:
Under the PERSONS column, the centrally entered date that is the 14th day after the entry date of TA 31/TAR 42.
Office of Choice
Entered on all regular roll approvals and whenever a customer requests their case be transferred to an office that does not usually serve the area where they reside. Enter Item 80 code 668 OOC with the 4 digit month/year of the application date or the date they requested the transfer in the Persons column and the 3 digit office number of the Office of Choice in the Total Cost column.
Note: Once Item 668 OOC is entered, it cannot be deleted but may be updated when the customer requests their case be transferred to another office that does not usually serve the area where they reside.
Illinois Department of Human ServicesJB Pritzker, Governor · Grace B. Hou, Secretary
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