Family Healthcare (FAMIS) Manual

0910.030.00 BUDGETING FOR INCOME ELIGIBILITY (TMA)

IM-#48 March 27, 2003 On the second and third quarterly reports, caretakers report income and child care expenses for the second and third quarters of Transitional Medical Assistance eligibility. Accept the caretaker s statement of income and child care expense. Use the quarterly report to:

  1. determine average monthly earnings and average monthly child care expense,
  2. deduct the child care expense from earnings, and
  3. compare the remainder to 185% of the poverty level for the family size.

The assistance group for this budget includes all Transitional Medical Assistance eligible individuals, and any parent or dependent child in the household who is not an original assistance group member. If an individual moves into or out of a Transitional Medical Assistance household during the report quarter, include members in the assistance group based on the situation at the end of the quarter.

In determining if the assistance group meets the 185% test, consider the needs and gross EARNED income of every assistance group member. Consider earned income in the same manner as for MAF. In addition, deem the EARNED income of a stepparent or parent of a minor parent in the same manner as for MAF.

Allow as a deduction, unreimbursed childcare expenses paid for children. If the family receives Block Grant Childcare, allow any sliding fee or co-payment amounts.  If the remaining earned income (after the childcare expense deduction) is equal to or less than 185% of the poverty level, the family remains eligible for Transitional Medical Assistance.

If the remainder is greater than 185% of the poverty level, explore the children’s eligibility under other MC+ programs.  The quarterly report form gives the family the opportunity to report if anyone is pregnant, blind or disabled so an IM-80 (PRE) is not required.  Complete a pre-closing review based on the information available.  An Adverse Action Notice (IM-80) is required when a family member is not eligible elsewhere.  Discontinue eligibility under TMA at the end of the seventh or tenth month, whichever is applicable if there is no request for appeal.  If the family requests an appeal, allow the TMA to continue pending the outcome of the appeal.