Official Course Description: MCCCD Approval: 07/22/08
HSA110 19962-20086	LEC	2 Credit(s)	2 Period(s)
Eligibility Criteria I
An in depth exploration of the criteria needed to meet household, income and livelihood restrictions for determining eligibility for the Arizona Health Care Cost Containment System (AHCCCS). Includes calculations of expenses and deductions and their relationship to eligibility determination. Prerequisites: HSA101.

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MCCCD Official Course Competencies:
HSA110   19962-20086	Eligibility Criteria I

1.	Identify criteria required to establish households. (I)
2.	Identify exceptional households and non-household members. (I)
3.	Describe situations involving households with categorical members. (I)
4.	Identify and list examples of the different types of income. (II)
5.	Evaluate and calculate types of infrequent income and lump sum income. (II)
6.	Calculate livelihood and write livelihood casenotes. (II)
7.	Describe the process to verify medical expenses. (II)
8.	Establish 13-week periods and calculate income. (II, III)
9.	Identify allowable expenses and deductions from income. (III)
10.	Identify the categories of work related expenses. (III)
11.	Explain the process to verify, document and calculate expenses. (III)
12.	Identify and calculate allowable family expenses and deductions. (III)

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MCCCD Official Course Outline:
HSA110   19962-20086	Eligibility Criteria I

I. Households A. Ties 1. Legal 2. Lineage B. Application C. Forms Instruction D. Household Composition E. Exceptional Households 1. Absent Spouse 2. Children in Boarding School 3. Emancipated Minor 4. Disqualified Household Members 5. Household Composition F. Non-Household Members 1. Child Graduating After Turning 19 2. 19 Year Old in Home 3. Living With Relatives 4. Divorced 5. Living With Roommates G. Categorical Members 1. Social Security Income 2. Aid to Families with Dependent Children (AFDC) Cash 3. Sixth Omnibus Budget Reconciliation Act (SOBRA) H. Eligible Assistance Children (EAC) 1. Eligibility Criteria 2. Determinations II. Income/Livelihood A. Earned B. Unearned C. Disregarded D. Expenses 1. Food 2. Housing 3. Utilities 4. Transportation 5. Other Needs E. Deductions/Medical 1. Allowable 2. Verification 3. Expenses Not Allowed 4. Third Party Liability Coverage F. Periods of Time G. Guidelines H. Infrequent Income 1. One-Time 2. Semi-Annual 3. Quarterly 4. Annual 5. Lump Sum I. Verifications J. Documentation K. Calculations III. Expenses A. Work Related 1. Union Dues/Employment Agency Fees 2. Uniforms 3. Work-Related Travel Cost 4. Meals 5. Lodging 6. Licenses 7. Tools/Materials 8. Childcare/Disabled Dependent Care B. Self Employment 1. Overhead 2. Taxes and Fees 3. Wages 4. Labor 5. Maintenance/Repairs 6. Insurance 7. Inventory 8. Licenses 9. Travel and Transportation 10. Advertising 11. Depreciation C. Verification 1. Date 2. Amount 3. Type 4. Name of Payee D. Documentation 1. Case Notes 2. Statements E. Family Deductions 1. Educational 2. Disabled Dependent Care 3. Child Care 4. Spouse Maintenance 5. Alimony 6. Child Support F. Calculating Expenses and Deductions 1. 13-week Income Period 2. Livelihood

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