MEH 5.1.6 Participation Status Codes

5.1.6 Participation Status Codes

The following are the abbreviations which you will see in CARES Client Assistance for Re-employment & Economic Support that explain each person’s status in the case. These describe who is in or out of the FTG, and how that person’s income Income is anything you receive in cash or in kind that you can use to meet your needs for food, clothing, and shelter. and assets are counted

AA ALLOCATED ADULT - An adult who is ineligible for AFDC-MA AFDC-MA is the category of Medicaid that is based on rules for the Aid to Families with Dependant Children Program (AFDC) that were in effect on July 16, 1996. but someone in the MA group is legally responsible for this adult. S/he is not in the FTG. S/he receives income from a spouse in the MA group.

AC ALLOCATED CHILD - A child who is ineligible for AFDC-MA, but someone in the MA group is legally responsible for this child. S/he is not in the FTG. S/he receives income from a parent in the MA group.

AD ALIEN SPONSOR DEEMER - A person who supports an alien’s entry into the U.S. S/he is not in the AFDC-MA group or FTG. Add his/her income to the MA group after deductions. The AD only applies to AFDC-MA.

CA COUNTED ADULT - An adult who is ineligible for MA but legally responsible for someone in the MA group. S/he is part of the FTG. Count his/her income and assets.

CC COUNTED CHILD - A child who is ineligible for MA but legally responsible for someone in the MA group. S/he is part of the FTG. Count his/her income and assets.

CD COMMUNITY DEPENDENT - In spousal impoverishment cases only, this is the tax dependent living with community spouse. Income is subtracted from the institutionalized spouse in post-eligibility to calculate the family member income allowance. The dependent is not in the FTG, and do not count his/her income and assets.

CS COMMUNITY SPOUSE - In spousal impoverishment cases only, this is the spouse of an institutionalized person living in the community. Count his/her assets for the initial spousal impoverishment determinations only, never thereafter. The institutionalized spouse can allocate income in post-eligibility treatment of income. The CS is not in the FTG.

EA ELIGIBLE ADULT An adult who is non-financially eligible and part of the MA group. S/he is in the FTG. Count his/her income and assets.

EC ELIGIBLE CHILD A child who is non-financially eligible and part of the MA group. S/he is in the FTG. Count his/her income and assets.

FL FISCAL ALLOCATOR Person who has legal responsibility to someone in the FFU. This person’s income and assets are allocated by the number of people for whom s/he is legally responsible and themself. This only relates to FFU.

FM FISCAL MEMBER - Person ( not the FFU target ) for whom a fiscal allocator is legally responsible. S/he receives income and assets from the fiscal allocator when determining FFU. This only relates to FFU.

PD PARENT DEEMER - Person is ineligible for a reason other than non-cooperation with TPL, CS, SSN, or MSL. S/he is not in the FTG, but count his/her income after subtracting an amount for their needs. Count his/her assets. Applies to AFDC-MA only.

SD SANCTIONED DEEMER - Legally responsible for an MA group member. This person is ineligible because of non-cooperation with TPL, CS, SSN or MSL. S/he is not in FTG or MA group. Count his/her income, allowing deductions except the earned income one, and assets. This only applies to AFDC-MA.

SI INCOME SPOUSE - The spouse of the Medicaid Purchase Plan (MAPP The Medicaid Purchase Plan (MAPP) offers people with disabilities who are working or interested in working the opportunity to obtain health care coverage through the Wisconsin Medicaid Program.) applicant is always considered the “income spouse” (as long as they live together). In a household in which both spouses are applying for MAPP, the husband will be considered the wife’s income spouse and the wife will be considered the husband’s income spouse.

TC TEST CHILD - Test children only apply to BC and MAPP. For BC, the test child is ineligible for BC solely because of insurance access or coverage, or because s/he’s on another type of MA.

For MAPP, the test child is any natural or adoptive child of the MAPP client. S/he is part of the FTG. For both BC and MAPP, do not count the test child(ren)’s income and assets.

TD STEPPARENT DEEMER - A TD is an ineligible stepparent who is married to a MA group member. Count his/her income, minus income set aside to meet the needs of the spouse and children. Do not count his/her assets or include him/her in the FTG. Applies to AFDC-MA only.

XA EXCLUDED ADULT - An adult who is not requesting MA/BC and is not legally responsible for an eligible group member. S/he is not part of the FTG. Do not count his/her income or assets.

XC EXCLUDED CHILD - A child who is not requesting MA/BC and is not legally responsible for an eligible group member. S/he is not part of the FTG. Do not count his/her income or assets.

5.1.6.1 Table Definitions

CARES Part Status Code = The participation status code that CARES uses to determine how the individual relates to the Medicaid Group, Fiscal Test Group or Family Fiscal Unit.

Term = The words that are used to describe this Medicaid filing unit concept.

Definition = A description of what types of individuals and under what circumstances this term is applied to an individual.

AFDC-Medicaid Only = Describes whether this filing unit term only applies to the AFDC-Medicaid group.

FFU Only = Describes whether this filing unit term only applies to the Family Fiscal Unit policies and processes.

MA Group = Describes whether this type of filing unit participation status is included in the Medicaid group.

FTG = Describes whether this type of filing unit participation status is included in the Medicaid Fiscal Test Group and thus increase the group size.

Count their income – Giver = Describes whether an individual with this filing unit participation status provides money to individuals whose income is counted in the determination of eligibility.

Count their income – Receiver = Describes whether an individual with this filing unit participation status is provided money by individuals outside of the group in the determination of eligibility.

Count Their Assets = Describes how the assets of an individual with this filing unit participation status are treated.

CARES Part Stat Code	Term	Definition	AFDC-MA Only	FFU Only	MA group	FTG	Count Their Income		Count Their Assets
							Giver	Receiver
AA	Allocated Adult	Someone, ineligible for AFDC-Medicaid, for whom a person in the AFDC-Medicaid group is legally responsible	Yes	NA	No	No	-	Receiving income from a spouse in the AFDC-Medicaid Group	No
AC	Allocated Child	A child (not deprived) ineligible for AFDC-Medicaid whose parent is in the AFDC-Medicaid group is legally responsible.	Yes	NA	No	No	-	Receiving income from a parent in the AFDC-Medicaid Group	No
AD	Alien Sponsor Deemer	An individual agreeing to support an alien who has entered the USA	Yes	NA	No	No	Count their income after deductions	-	Count their assets (minus set aside
CA	Counted Adult	An adult ineligible for Medicaid who is legally responsible for someone in the Medicaid group.	No	NA	No	Yes	Count their income	-	Count their assets
CC	Counted Child	A child ineligible for Medicaid who is legally responsible for someone in the Medicaid group.	No	NA	No	Yes	Count their income	-	Count their assets
CD	Community Dependent	Spousal Impoverishment Only A tax dependent living with the community spouse	No	NA	No	No	-	Subtract income in the inst’lized spouse’s post-eligibility treatment of income equal to the calculated Family Member Income Allowance	No
S	Community Spouse	Community Spouse	No		No	No	-	Subtract income in the inst’lized spouse’s post-eligibility treatment of income equal to the amount actually made available to the community spouse as the Community Spouse Income Allocation	Count the spouse’s assets only in the initial determination of the institutionalized spouse’s Medicaid eligibility
EA	Eligible Adult	An adult who is non-financially eligible for Medicaid.	No		Yes	Yes	Count their income	Count their income	Count their assets
EC	Eligible Child	A child who is non-financially eligible for Medicaid.	No		Yes	Yes	Count their income	Count their income	Count their assets
FL	Fiscal Allocator	A person who is legally responsible for the individual in the FFU AG.	No	YES – included in group size	No	NA	Count their income for the person for whom they are legally responsible after dividing their total income by the number of persons in the household for whom they are legally responsible		Count their assets for the person for whom they are legally responsible after dividing their assets by the number of persons in the household for whom they are legally responsible plus themselves
FM	Fiscal Member	A person, not the FFU target, for whom a fiscal allocator is legally responsible.	No	Yes- included in group size	No	NA		Receives income from LRR after division of income by number of individuals for whom the fiscal allocator is legally responsible plus the LRR.	Receives assets from LRR after division of assets by number of individuals for whom the fiscal allocator is legally responsible plus the LRR.
PD	Parent Deemer	This person is ineligible for a reason other than non-cooperation with child support, TPL, MSL or SSN requirements and is legally responsible for someone in the group.	Yes	NA	No	No	Count their income after subtracting an amount for their needs.		Count their assets
SD	Sanctioned Deemers	This person is ineligible because of non-cooperation with child support, TPL, MSL or SSN requirements and is legally responsible for someone in the group.	Yes	NA	No	No	Count their income allowing all deductions except the earned income deduction.		Count their assets
SI	Income Spouse	MAPP Only The spouse of the applicant in a MAPP case (as long as they live together).	NA	NA	No	Yes	Yes	Yes	No
TC	Test Child	BadgerCare and MAPP Only For BC, a child who is ineligible solely because of health insurance coverage or access, or is on another type of MA. For MAPP, any natural or adoptive child of the MAPP client. Include in the group size.	No	NA	No	Yes	No	No	No
TD	Stepparent Deemer	An ineligible stepparent with a spouse in the AFDC-Medicaid group.	Yes	NA	No	No	Count income minus income set aside to meet the needs of the spouse and his/her children.		No
XA	Excluded Adult	An adult who is either not requesting MA/BC or is non-financially ineligible and not a LRR for a MA Group member.	No	NA	No	No	No	No	No
XC	Excluded Child	A child who is either not requesting MA/BC or is non-financially ineligible and not a LRR for a MA Group member.	No	NA	No	No	No	No	No

* Listed below are explanations of what the “Giver” and “Receiver” mean under the “Count Their Income” heading:

Giver – When the individual being described is not in the MA group.
Receiver – When the individual being described is in the MA group.

This page last updated in Release Number : 02-03

Release Date : 07/01/02

Effective Date : 07/01/02