Appendix A: BUDGET GROUP EXAMPLES

List of Household Composition Examples

1. TANF Child Living with Single Parent (Deprivation – Absence)

2. TANF Child Living with Two Parents (Deprivation – Incapacity)

3. TANF Child Living with Two Parents (Deprivation - Under-Employed)

A) Example 1

B) Example 2

4. Non-Parental Specified Relative with TANF Parent in the Household (see CAH 110.41)

5. Exceptions to Living with Specified Relative (see CAH 127.6)

6. Pregnant Woman (see CAH 110.211)

A) Unmarried Pregnant Woman Over the Age of 18

B) Married Pregnant Woman

C) Unmarried Pregnant Minor Parent

7. TANF Minor Parent (see CAH 110.6)

A) Minor Parent also a TANF Child

B) Minor Parent NOT a TANF Child

C) Minor Parent Exempt from Requirements to live in an Adult Supervised Household

D) Minor Parent Living with Legal Guardian (Non-Relative)

8. TANF Eligibility Based on Paternity (see CAH 131.222)

A) Paternity Established

B) Paternity NOT Established

9. Step-Parent in TANF Group (see CAH 110.41)

A) Step-Parent Not Specified Relative

B) Step-Parent as Specified Relative

10. Half Sibling in TANF Budget Group

A) Half Sibling Deprived

B) Half Sibling Not Deprived

11. Multiple TANF Budget Groups in a Common Residence

A) Example 1

B) Example 2

12. SSI Budget Groups

A) Single Parent SSI Adult

B) Two Parent with One SSI Adult

C) SSI Child – Adult Only TANF

D) Two Parent TANF with SSI Children

13. Refugee

A) Same Entry Dates

B) Different Entry Dates

Accurate data entry on the relationship screen is the key to receiving the correct eligibility results; if you are not receiving the correct eligibility results, review data entry on the relationship screen.

*The relationship codes used in the examples reflect the relationship to the Head of Household*

1. TANF Child Living with Single Parent (Deprivation - Absence)

The Household consists of Ms. Kathy Bates applying for TANF for herself and her daughter, Princess, age 11. Princess’s father is absent.

Head of Household: Ms. Kathy Bates

• Princess – Kathy’s 11 year old daughter – D

Budget Group Results:

2. TANF Child Living with Two Parents (Deprivation – Incapacity)

The household consists of Mrs. Mary Poppins applying for TANF for herself, Jake, her husband, and Peter their 11 year old son.  Jake has a temporary medical incapacity.

Head of Household: Mrs. Mary Poppins

• Jake – (incapacitated) Mary’s husband – H

• Peter– Mary and Jakes 11 year old son – S

Budget Group Results:

3. TANF Child Living with Two Parents (Deprivation - Under-Employed)

A) Mrs. Molly Spock is applying for TANF for herself and Janet, her 7 year old daughter. Molly is married to Fred Spock and they have one common child, 4 year old Timmy. Molly and Fred are both unemployed. Fred receives Unemployment Compensation benefits.

Head of Household: Ms. Molly Spock

• Fred Spock – Molly’s husband – H

o Janet Spock– Molly’s and Fred’s 7 year old daughter – D

o Timmy Spock – Molly and Fred’s 4 year old son - S

Budget Group Results:

B) Mr. Samuel Addams applies for TANF for himself, Samantha his 25 year old girlfriend and Ned and Ted, their 5 year old twins.

Head of Household: Samuel Addams

• Samantha Frank – Samuel’s Girlfriend – NR

o Ned – Samuel and Samantha’s 5 year old son - S

o Ted – Samuel and Samantha’s 5 year old son - S

Budget Group Results:

4. Non-Parental Specified Relative with TANF Parent in the Household

*A specified relative who is not the parent of the TANF child when the parent lives in the household but does not meet specified relative requirements*

Ms. Penny Dennis is receiving TANF benefits for herself and 2 of her children, Tommy, age 13 and Rick, age 7. Rita, the 24 year daughter of Ms. Penny Dennis moves in and brings her 7 month old daughter Maya.  The court has awarded custody of Maya to Ms. Penny Dennis (grandmother) because of Rita’s drug addiction.  Ms. Penny Dennis applies for TANF for Maya. Rita is the biological parent of Maya and is required to be included in the budget group. Rita cannot be the designated specified relative because she does not have care and control of Maya.  Ms. Penny Dennis will be the specified relative and payment name for 2 budget groups.

Head of Household: Ms. Penny Dennis

• Rita – Penny’s 24 year old daughter - D

o Maya – Penny’s 7 month old granddaughter - GD

• Tommy – Penny’s 13 year old son - S

• Rick – Penny’s 7 year old son – S

Budget Group Results:

5. Exceptions to Living with Specified Relative (also see, CAH 127.6)

Ms. Ruiz and her child, Tomas, age 5. Ms. Ruiz is involved in an automobile accident and will be hospitalized for at least three months. A neighbor who is not related to the Tomas agrees to care for him until the mother is discharged from the hospital.

The mother’s temporary emergency has been verified and her care and control of Tomas has not legally ended but the neighbor has assumed care and control, TANF payments are authorized in the name of the caretaker/neighbor.

Head of Household: Ms. Debbie Down (Neighbor)

• Tomas – TANF Child (temporarily residing with neighbor, due to an emergency situation) - NR

Note: To receive the correct eligibility results, Debbie must be listed as “Other” on the relationship screen.

Budget Group Results:

6. Pregnant Woman

A) Unmarried Pregnant Woman OVER the Age of 18

Miss Suzie Gray, an unmarried pregnant woman, applies for assistance because she is unable to continue working full-time due to her pregnancy. Miss Suzie Gray verifies her baby is due in 2 1/2 months, and the fetus, if born, would qualify as a TANF dependent child. Miss Suzie Gray intends to raise the child. The CAO authorizes Miss Suzie Gray for TANF. Income from part-time employment is adjusted against the FSA for one, as the fetus is not included in the FSA.

Head of Household: Suzie Gray

• Number of unborn = 1

NOTE: If the alleged father/boyfriend is in the household, he would be ineligible for TANF benefits until the TANF child is born and paternity has been established and proven to be the TANF child’s father.

Budget Group Results:

(Adult only – No TANF Child Case)

B) MARRIED Pregnant Woman

Mrs. Marcy Strayer a legally married pregnant woman is applying for TANF. Mrs. Marcy Strayer resides with her husband Philip Strayer.

NOTE: Because the two are married by law it is presumed that the husband is the father of the unborn child. See Chapter 131.22

Head of Household: Mrs. Marcy Strayer

• Phillip – Marcy’s Husband - H

Budget Group Results:

NOTE: If Philip has income/resources, they will be deemed because he is an LRR to his spouse. See CAH 155.1

C) Unmarried Pregnant Minor Parent

When the pregnant woman is a minor residing in the home of a parent, legal guardian, or other adult relative or in an adult-supervised supportive living arrangement (because she does not meet any of the exemptions listed in Section 110.6) the minor parent may not be designated as a specified relative nor payment name for herself. The adult with whom the minor parent is living must complete the application and could be the payment name. If the adult is a specified relative for the minor parent, that person does not have to be included in the budget group.

NOTE:  Income from the minor parent's parent is deemed to the budget group. See Chapter 155.

The household applying for TANF consists of Karen Phor, her husband, Ben Phor and their pregnant minor daughter Dottie, age 16.

Head of Household: Mrs. Karen Phor

• Ben Phor – Karen’s husband – H

• Dottie – Karen’s 16 year old daughter – D

Budget Group Results:

7. TANF Minor Parent

A)  Minor Parent also a TANF Child

If the minor parent qualifies as a TANF child and his or her parents and siblings are applying for or receiving cash benefits, the minor parent must be included in his or her parent’s budget group and cannot be the specified relative for his or her own child. The minor parent’s child is also included as a TANF child.

Ms. Leslie Moppit and her son Anthony, age 14 and daughter April, age 17 are applying for TANF benefits. April is a minor parent and her son, Tyler, age 2, resides in the household. Ms. Leslie Moppit has to apply for the household.

Head of Household: Leslie Moppit

• April – Leslie’s 17 year old daughter - D

o Tyler – April’s 2 year old son - GS

• Anthony – Leslie’s 14 year old son – S

Budget Group Results:

B) Minor Parent NOT a TANF Child

Carmen Phor is applying on behalf of her minor parent granddaughter, Dottie, age 16 and Dottie’s 1 month old son. Dottie’s grandfather, Ben also resides in the household

Head of Household: Mrs. Carmen Phor

• Ben – Carmen’s Husband – H

• Dottie – Carmen’s 16 year old – GD

o Dan – Dottie’s 1 month old son – GGS

Budget Group Results:

C) Minor Parent Exempt from Requirements to live in an Adult Supervised Household

Miss Teri Cameron, an emancipated minor parent is applying for her 3 month old son Logan.

Head of Household: Teri Cameron – age 17

• Logan – Teri’s 3 month old son – S

Budget Group Results:

D) Minor Parent Living with Legal Guardian (Non-Relative)

Ms. Pat Blair is a non-relative person applying on behalf of Penny Hearst, age 16 and Penny’s 1 month old son, Lester. Pat Blair is the legal guardian and has care and control of Penny and Lester.

Head of Household: Pat Blair – Legal Guardian

• Penny Hearst – 16 year old – OR

• Lester Hearst – Penny’s 1 month old son – NR

NOTE: To receive the correct eligibility results, Pat must be listed as “Other” on the relationship screen.

Budget Group Results:

8. TANF Eligibility Based on Paternity

A) Paternity Established

Common residence consists of Ms. Kimberly Stanton, her daughter Rose, age 5, Ms. Stanton’s boyfriend Robert Evers and his son Roger Evers, age 12 and their one year old common son Steve Stanton-Evers, age 3 months old.

Head of Household: Kimberly Stanton

• Rose – Kimberly’s 5 year old daughter - D

• Robert – Kimberly’s Boyfriend - NR

• Roger – Roberts 12 year old son - NR

• Steve – Kimberly’s and Roberts 3 month old son – S

Budget Group Results:

B) Paternity NOT Established

Ms. Kimberly Stanton is applying for her daughter, Rose, age 5 because of deprivation due to absence of a parent, Ms. Stanton is included as a parent in the budget group. Ms. Stanton is also applying for her 3 month old son, Steve. Steve’s alleged father resides in the household but paternity has not been established. Steve qualifies as a TANF child because of the absence of a parent, paternity not established. Steve is a half-brother to Rose.

Ms. Kimberly Stanton’s boyfriend, Robert, and Robert’s son, Roger, age 12 also reside in the household and if he were applying for TANF, Robert and Roger would be in a separate TANF budget group. His 12 year old son, Roger, qualifies as a dependent child because of absence of a parent. Until paternity was established, Roger would not be considered a half sibling to Steve.

Head of Household: Kimberly Stanton

• Rose – Kimberly’s 5 year old daughter - D

• Robert – Kimberly’s Boyfriend - NR

• Roger – Roberts 12 year old son - NR

• Steve – Kimberly’s and Roberts 3 month old son - S

Budget Group Results:

9. Step-Parent in TANF Budget Group

A) Step-Parent Requesting

Mrs. Sharon Brown is applying for her household which consists of daughter, Theresa, age 16, her son Terry, age 10 and her husband Dwayne Homar. Dwayne is the step-father of Theresa and Terry.

Head of Household: Sharon Brown

• Terry Brown – Sharon’s 10 year old son - S

• Theresa Brown – Sharon’s 16 year old daughter – D

• Dwayne Homar – Sharon’s Husband - H

Budget Group Results:

B) Step-Parent NOT Requesting

Head of Household: Sharon Brown

• Terry Brown – Sharon’s 10 year old son - S

• Theresa Brown – Sharon’s 16 year old daughter – D

• Dwayne Homar – Sharon’s Husband – H

Budget Group Results:

10. Half Sibling in TANF Budget Group

The household consists of Ms. Barbara Young, her daughter Sophie, age 10, her boyfriend Tom Brooks and Tom and Barbara’s common son, Sean, age 5. Paternity has been established that Tom is Sean’s Father. Tom is incapacitated.

Head of Household: Ms. Barbara Young

• Tom Brooks – Barbara’s Boyfriend - NR

• Sophie Young – Barbara’s 14 year old Daughter - D

• Sean Young-Brooks – Barbara and Tom’s 5 year old Son - S

Budget Group Results:

11. Multiple TANF Budget Groups

A) The household consists of Ms. Jackie Smith, her daughter, Mary, age 16, Mary’s son, Bob, age 1. The household also consists of Ms. Jackie Smith’s three sons, John, age 12, Jim, age 14 and adult son Bert, age 22 and Bert’s two children, Sam and Susan, both age 4. Although Mary is a parent, she is a minor parent who qualifies as a TANF child and is required to be in her sibling’s budget group. Mary’s child, Bob, is also included as a TANF child.

However, Ms. Jackie Smith’s adult son, Bert, will be in a separate budget group. Bert does not qualify as a TANF dependent child because of his age and he is therefore not required to be in his siblings' budget group. Bert qualifies as the specified relative for his children and is a mandatory member in the budget group with his dependent children.

Everyone in this household is applying for cash benefits. Budget groups are established.

NOTE:  Each TANF budget group will receive a full monthly assistance payment based on the FSA for the number of persons in each budget group.

Head of Household: Ms. Jackie Smith

• Bert Smith – Jackie’s 22 year old son - S

o Sam – Bert’s 4 year old son – GS

o Susan – Bert’s 4 year old daughter – GD

• Mary Smith – Jackie’s 16 year old – D

o Bob Smith – Mary’s 1 year old son - GS

• Jim Smith – Jackie’s 14 year old son – S

• John Smith – Jackie’s 12 year old son - S

Budget Group Results:

B) Mrs. Kelly Scott is applying for her three daughters, Karen, age 16, Rita, age 13 and Kaye, age 11. She is also applying for three additional family members, her niece Sherri Scott, age 15 (whose parents are also deceased), her two grandchildren, Lane, age 10, whose parents are deceased and Karen’s daughter, Lorene, age 1.

Head of Household: Mrs. Kelly Scott

• Karen Scott – 16 year old daughter - D

o Lorene – Karen’s 1 year old daughter - GD

• Rita Scott – Kelly’s 13 year old daughter – D

• Kaye Scott – Kelly’s 11 year old daughter – D

• Lane Scott – Kelly’s 10 year old grandson – GS

• Shari Scott – Kelly’s 15 year old niece - NC

Budget Group Results:

NOTE: Kelly Scott will be the payment name for ALL three budget groups.

12. TANF and SSI Budget Groups

A) Single Parent SSI Adult

The household consists of Ms. Pat Smart who is an SSI Recipient and she is applying for TANF for her two children, her son, Sam, age 7 and daughter, Samantha, age 5. There will be two budgets groups.

Head of Household: Ms. Pat Smart

• Sam Smart – Pat’s 7 year old son – S

• Samantha Smart – Pat’s 5 year old daughter – D

Budget Group Results:

(Child Only TANF Case)

B) Two Parent TANF with One SSI Adult

The household applying for TANF consists of Mr. Jim Sark who is an SSI recipient, his wife, Jamie and their daughter, April, age 12.

Head of Household: Mr. Jim Sark

• Jamie Sark – Jim’s wife - W

• April Sark – Jim and Jamie’s 12 year old daughter – D

Budget Group Results:

C) SSI Child – Adult Only TANF

The household applying for TANF consists of Ms. Amber Franky and her daughter, Annie, age 6. Anne is an SSI recipient.

Head of Household: Ms. Amber Franky

• Annie Franky (SSI Recipient)  – Amber’s 6 year old daughter – D

Budget Group Results:

D) Two Parent TANF with SSI Children

The household applying for TANF consists of Mr. Burt Earnest, his wife, Bee and their two daughter’s Darlene and Cassidy, both age 8. Darlene and Cassidy are both SSI recipients.

Head of Household: Mr. Burt Earnest

• Bee Earnest – Burt’s Wife - W

• Butch Earnest – Burt and Bee’s 10 year old son - S

• Darlene Earnest (SSI Recipient) - Burt and Bee’s 8 year old daughter - D

• Cassidy Earnest (SSI Recipient)  - Burt and Bee’s 8 year old daughter - D

Budget Group Results:

13. Refugee – (Time Limited Program – 9 months from Date of Entry)

A)  Same Date of Entry

Mr. Kim Chen and his wife Mrs. Jia Chen reside in a single family home. Mr. and Mrs. Chen qualify under the Refugee Resettlement Program (RRP) as a refugee. For purposes of identifying the higher rate of Federal reimbursement for cash assistance provided to refugees, The Budget group would be coded by the appropriate refugee program status code (D 02). They will two separate budget groups.

Head of Household: Mr. Kim Chen

• Jia Chen – Kim’s Wife - W

Budget Group Results:

NOTE:  Beginning with the ninth month, determination for continued eligibility using standard Cash/MA regulations will be required.

B) Different Date of Entry

Mr. Min Kim and wife Sing Kim reside in a single family home. Mr. and Mrs. Kim qualifies under the Refugee Resettlement Program (RRP) as a refugee. For purposes of identifying the higher rate of Federal reimbursement for cash assistance provided to refugees, The budget would be coded by the appropriate refugee program status code (D 02). In this situation, there will be 2 separate  time limited budget groups that will receive the full FSA.

Date of Entry: Mr. Kim (January) – Mrs. Kim (February)

Head of Household: Mr. Min Kim

• Sing Kim – Min’s Wife - W

Budget Group Results:

Reissued February 4, 2015, replacing August 7, 2014