[Federal Register: April 12, 1999 (Volume 64, Number 69)]
[Rules and Regulations]
[Page 17919-17931]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr12ap99-27]
[[pp. 17919-17931]] Temporary Assistance for Needy Families Program (TANF)
[[
Continued from page 17918]]
[[Page 17919]]
Based on the nature or function of the contract, States must
include appropriate administrative costs associated with contracts
and subcontracts that count towards the 15% administrative cost
caps.
Line 6k. Systems. Enter in columns (A), (B), (C), and (D) the
cumulative total expenditures for systems costs related to
monitoring and tracking under the program from October 1 of the
Federal fiscal year for which the report is being submitted through
the current quarter being reported.
Note: Section 404(b)(1) of the Act limits States to which a
grant is made under section 403 to expend no more than 15% of the
grant for administrative costs. In addition, section 404(b)(2) of
the Act states that the 15% administrative cost cap shall not apply
to the use of a grant for information technology and computerization
needed for tracking or monitoring required by or under part IV-A of
the Act. The systems exclusion applies to items that might normally
be administrative costs, but are systems-related and needed for
monitoring or tracking purposes under TANF. Under our final rules
the same information technology exclusion applies to MOE
expenditures. The TANF rules at Secs. 263.2 and 263.13 provide
guidance about what is excluded under this provision.
Line 6l. Other. Enter in columns (A), (B), (C), and (D) the
cumulative total expenditures for other expenditures considered
``expenditures on non-assistance'' that were not included on Lines
6a through 6j from October 1 of the Federal fiscal year for which
the report is being submitted through the current quarter being
reported. For example, include as ``other'' costs on general family
preservation activities and parenting training. Include costs on
activities such as substance abuse treatment, domestic violence
services, and case management to the extent that such costs are not
directed at the second goal of TANF and included as work-related
costs above.
Note: In the 4th quarter annual report the State must describe
in a footnote the activities for which ``other expenditures'' under
this line item applies.
Line 7. Total Expenditures. Enter in columns (A), (B), (C), and
(D) the cumulative total expenditures (i.e., the sum of Line 5a
through Line 6l) from October 1 of the Federal fiscal year for which
the report is being submitted through the current quarter being
reported.
Line 8. Transitional Services for Employed. Enter in columns
(A), (B), (C), and (D) the cumulative total expenditures to provide
transitional services to families that cease to receive assistance
under the TANF program because of employment from October 1 of the
Federal fiscal year for which the report is being submitted through
the current quarter being reported. Expenditures reported on this
line must also be included in the expenditure categories reported on
lines 5 through 7.
Note: The expenditures reported on this line will duplicate
expenditures reported elsewhere in this report. Section 411(a)(5)
requires separate quarterly reporting of expenditures on
transitional services for families that have ceased to receive
assistance because of employment.
Line 9. Federal Unliquidated Obligations. Enter in columns (A)
and (D) the cumulative total Federal unliquidated obligations from
October 1 of the Federal fiscal year for which the report is being
submitted through the current quarter being reported. Obligations
reported on this line must meet the definition of obligations
contained in 45 CFR 92.3. For the Contingency Fund, this line should
indicate $0 for the report submitted for the fourth quarter.
Line 10. Unobligated Balance. Enter in columns (A) and (D) the
cumulative total Federal unobligated balances from October 1 of the
Federal fiscal year for which the report is being submitted through
the current quarter being reported. After the end of the Federal
fiscal year any amount reported in column (D), as an unobligated
balance, will be de-obligated by ACF.
Note: The State must report any Federal funds reserved for
``rainy day'' purposes as an unobligated balance on this line.
Unobligated balances expended in any future Federal fiscal year must
be expended only on assistance (reported on Line 5 categories of
this report) or administrative costs related to providing assistance
(reported on line 6(j)).
Line 11. State Replacement Funds. Enter in column (B) the
cumulative total State Replacement Funds expended as a result of the
imposition of a TANF penalty from October 1 of the Federal fiscal
year for which the report is being submitted through the current
quarter being reported.
Line 12. Estimate for Next Quarter Ended. Enter in column (A)
the estimate of SFAG grant award funds requested for the next
quarter ending, whose ending date was entered at the top of this
report.
Note: Section 405(c)(1) of the Act states that ACF shall
estimate the amount to be paid to each eligible State for each
quarter, such estimate is to be based on a report filed by the State
of the total sum to be expended by the State in the quarter under
the State program funded under section 403.
Appendix E--SSP MOE Data Report--Section One--Disaggregated Data
Collection for Families Receiving Assistance Under the Separate State
Program(s)
Instructions and Definitions
General Instruction: If a State claims MOE expenditures for
separate State programs (SSPs) and for persons served by those
programs, it must collect and report this information on the SSP-MOE
Data Report on SSP-MOE families receiving assistance only as
follows: (1) If the State wishes to receive a high performance
bonus, it must file the information in sections one and three of the
SSP-MOE Data Report; and (2) if the State wishes to quality for
caseload reduction credit, it must file the information in all three
sections of the SSP-MOE Data Report.
The State agency should collect and report data for each data
element. The data must be complete (unless explicitly instructed to
leave the field blank) and accurate (i.e, correct).
An ``Unknown'' code may appear only on four sets of data
elements ([#28 and #60] Date of Birth, [#29 and #61] Social Security
Number, [#37 and #67] Educational Level, and (#38 and #68]
Citizenship/Alienage). For these data elements, unknown is not an
acceptable code for individuals who are members of the eligible
family (i.e., family affiliation code ``1'').
There are six data elements for which States have the option to
report based on either the budget month or the reporting month.
These are: #14 Amount of Food Stamps Assistance; #17 Amount of Child
Support; #18 Amount of Families Cash Resources; #57 Amount of Earned
Income; and [#58 and #69] Amount of Unearned Income. Whichever
choice the State selects must be used for all families reported each
month and must be used for all months in the fiscal year.
The data elements in the SSP-MOE Data Report are similar to
those in the TANF Data Report for the TANF Program. This will give
us comparable information on the SSP programs. It will allow us, for
example, to calculate a SSP-MOE work participation rate. Because a
State's definitions and eligibility requirements for its SSPs may be
different from those in its TANF Program, the data required in its
SSP-MOE Data Report may not precisely correspond to the information
collected by the State in its SSP-MOE Data Report. We encourage
States to provide the best possible information.
1. State FIPS Code: Enter your two-digit State code from the
following listing. These codes are the standard codes used by the
National Institute of Standards and Technology.
------------------------------------------------------------------------
State Code
------------------------------------------------------------------------
Alabama......................................................... 01
Alaska.......................................................... 02
American Samoa.................................................. 60
Arizona......................................................... 04
Arkansas........................................................ 05
California...................................................... 06
Colorado........................................................ 08
Connecticut..................................................... 09
Delaware........................................................ 10
Dist. of Columbia............................................... 11
Florida......................................................... 12
Georgia......................................................... 13
Guam............................................................ 66
Hawaii.......................................................... 15
Idaho........................................................... 16
Illinois........................................................ 17
Indiana......................................................... 18
Iowa............................................................ 19
Kansas.......................................................... 20
Kentucky........................................................ 21
Louisiana....................................................... 22
Maine........................................................... 23
Maryland........................................................ 24
Massachusetts................................................... 25
Michigan........................................................ 26
Minnesota....................................................... 27
Mississippi..................................................... 28
Missouri........................................................ 29
Montana......................................................... 30
Nebraska........................................................ 31
Nevada.......................................................... 32
New Hampshire................................................... 33
New Jersey...................................................... 34
New Mexico...................................................... 35
New York........................................................ 36
North Carolina.................................................. 37
North Dakota.................................................... 38
[[Page 17920]]
Ohio............................................................ 39
Oklahoma........................................................ 40
Oregon.......................................................... 41
Pennsylvania.................................................... 42
Puerto Rico..................................................... 72
Rhode Island.................................................... 44
South Carolina.................................................. 45
South Dakota.................................................... 46
Tennessee....................................................... 47
Texas........................................................... 48
Utah............................................................ 49
Vermont......................................................... 50
Virgin Islands.................................................. 78
Virginia........................................................ 51
Washington...................................................... 53
West Virginia................................................... 54
Wisconsin....................................................... 55
Wyoming......................................................... 56
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2. County FIPS Code: Enter the three-digit code established by
the National Institute of Standards and Technology for
classification of counties and county equivalents. Codes were
devised by listing counties alphabetically and assigning
sequentially odd integers; e.g., 001, 003, 005. A complete list of
codes is available in Appendix F of the TANF Sampling and
Statistical Methods Manual.
3. Reporting Month: Enter the four-digit year and two-digit
month codes that identify the year and month for which the data are
being reported.
4. Stratum:
Guidance: All families that receive assistance under separate
State Programs (i.e, SSP-MOE families) and are selected in the
sample from the same stratum must be assigned the same stratum code.
Valid stratum codes may range from ``00'' to ``99.'' States with
stratified samples should provide the ACF Regional Office with a
listing of the numeric codes utilized to identify any
stratification. If a State opts to provide data for its entire
caseload, enter the same stratum code (any two-digit number) for
each SSP-MOE family.
Instruction: Enter the two-digit stratum code.
Family-Level Data
Definition: For reporting purposes, the SSP-MOE family means (a)
all individuals receiving assistance as part of a family under the
separate State program(s); and (b) the following additional persons
living in the household, if not included under (a) above:
(1) Parent(s) or caretaker relative(s) of any minor child
receiving assistance;
(2) Minor siblings of any child receiving assistance; and
(3) Any person whose income or resources would be counted in
determining the family's eligibility for or amount of assistance.
5. Case Number--Separate State MOE:
Guidance: If the case number is less than the allowable eleven
characters, a State may use lead zeros to fill in the number.
Instruction: Enter the number assigned by the State agency to
uniquely identify the case.
6. ZIP Code: Enter the five-digit ZIP code for the SSP-MOE
family's place of residence for the reporting month.
7. Disposition:
Guidance: A family that did not receive any assistance for the
reporting month but was listed on the monthly sample frame for the
reporting month is ``listed in error.'' States are to complete data
collection for all sampled cases that are not listed in error.
Instruction: Enter one of the following codes for each SSP-MOE
sampled case.
1=Data collection completed.
2=Not subject to data collection/listed in error.
8. Number of Family Members: Enter two digits that represent the
number of members in the family receiving assistance under the
separate State program(s). Include in the number of family members,
the noncustodial parent whom the State has opted to include as part
of the eligible family, who is receiving assistance as defined in
Sec. 260.31, or who is participating in work activities as defined
in section 407(d) of the Act.
9. Type of Family for Work Participation:
Guidance: This data element identifies whether the family would
be used in the calculations for both the overall and two-parent work
participation rates, would be used in only the overall work
participation rate, or would not be used in either work
participation rate.
A family with an adult or minor child head-of-household will be
included in the overall work participation rate unless explicitly
disregarded. See data element #41 ``Work Participation Status'' for
reasons for disregarding a family.
For the purpose of calculating the two-parent work participation
rate, the two-parent families include any family with two or more
natural or adoptive parents (of the same minor child) receiving
assistance and living in the home, unless both are minor and neither
is a head-of-household. All two-parent families are included in the
two-parent work participation rate unless the family is explicitly
disregarded. See data element #41 ``Work Participation Status'' for
reasons for disregarding a family. A two-parent family that includes
a disabled parent is not included in the two-parent work
participation rate.
A family with a minor child head-of-household should be coded as
either a single-parent family or two-parent family, whichever is
appropriate.
A noncustodial parent is defined in Sec. 260.30 as a parent who
lives in the State and does not live with his/her child(ren). The
State must report information on the noncustodial parent if the
noncustodial parent: (1) Is receiving assistance as defined in
Sec. 260.31; (2) is participating in work activities as defined in
section 407(d) of the Act; or (3) has been designated by the State
as a member of a family receiving assistance.
Instruction: Enter the one-digit code that represents the type
of family for purposes of calculating the work participation rates.
1=Family included only in overall work participation rate.
2=Two-Parent Family included in both the overall and two-parent
work participation rates.
3=Family excluded from both the overall and two-parent work
participation rates.
10. Has the Family Received Assistance Under a State (Tribal)
TANF Program Within the Past Six Months: If the SSP-MOE family has
received assistance under a State (Tribal) TANF Program within the
past six months, enter code ``1.'' Otherwise, enter ``2.''
1=Yes, family has received assistance under a State (Tribal)
TANF program within the past six months.
2=No.
11. Receives Subsidized Housing:
Guidance: Subsidized housing refers to housing for which money
was paid by the Federal, State, or local government or through a
private social service agency to the family or to the owner of the
housing to assist the family in paying rent. Two families sharing
living expenses does not constitute subsidized housing.
Instruction: Enter the one-digit code that indicates whether or
not the SSP-MOE family received subsidized housing for the reporting
month.
1=Public housing.
2=Rent subsidy.
3=No housing subsidy.
12. Receives Medical Assistance: Enter ``1'' if, for the
reporting month, any SSP-MOE family member is enrolled in Medicaid
and thus eligible to receive medical assistance under the State plan
approved under Title XIX or ``2'' if no SSP-MOE family member is
enrolled in Medicaid.
1=Yes, enrolled in Medicaid.
2=No.
13. Receives Food Stamps: Enter the one-digit code that
indicates whether or not the SSP-MOE family is receiving food stamp
assistance.
1=Yes, receives food stamp assistance.
2=No.
14. Amount of Food Stamp Assistance:
Guidance: For situations in which the food stamp household
differs from the SSP-MOE family, code this element in a manner that
most accurately reflects the resources available to the SSP-MOE
family. One acceptable method for calculating the amount of food
stamp assistance available to the SSP-MOE family is to prorate the
amount of food stamps equally between each food stamp recipient then
add together the amounts belonging to the SSP-MOE recipients.
Instruction: Enter the SSP-MOE eligible family's authorized
dollar amount of food stamp assistance for the reporting month or
for the month used to budget for the reporting month. If the SSP-MOE
family did not receive any food stamps for the reporting month,
enter ``0.''
15. Receives Subsidized Child Care:
Instruction: If the SSP-MOE family receives subsidized child
care for the reporting month, enter code ``1'' or ``2,'' whichever
is appropriate. Otherwise, enter code ``3.''
1=Yes, receives child care funded entirely or in part with
Federal funds (e.g., receives either TANF, CCDF, SSBG, or other
federally funded child care).
2=Yes, receives child care funded entirely under a State,
Tribal, and/or local program.
3=No subsidized child care received.
16. Amount of Subsidized Child Care:
Guidance: Subsidized child care means a grant by the Federal,
State or local government to or on behalf of a parent (or
[[Page 17921]]
caretaker relative) to support, in part or whole, the cost of child
care services provided by an eligible provider to an eligible child.
The grant may be paid directly to the parent (or caretaker relative)
or to a child care provider on behalf of the parent (or caretaker
relative).
Instruction: Enter the dollar amount of subsidized child care
that the SSP-MOE family has received from all sources (e.g., CCDF,
TANF, SSBG, State, local, etc.) for services in the reporting month.
If SSP-MOE family did not receive any subsidized child care for
services in the reporting month, enter ``0'' as the amount.
17. Amount of Child Support: Enter the total dollar value of
child support received on behalf of the SSP-MOE family in the
reporting month or for the month used to budget for the reporting
month. This includes current payments, arrearages, recoupment, and
pass-through amounts whether paid to the State or the family.
18. Amount of the Family's Cash Resources Enter the total dollar
amount of the SSP-MOE family's cash resources as the State defines
them for determining eligibility and/or computing benefits for the
reporting month or for the month used to budget for the reporting
month.
Amount of Assistance Received and the Number of Months That the Family
Has Received Each Type of Assistance Under the Separate State Program
Guidance: The term ``assistance'' includes cash, payments,
vouchers, and other forms of benefits designed to meet a family's
ongoing basic needs (i.e., for food, clothing, shelter, utilities,
household goods, personal care items, and general incidental
expenses). It includes such benefits even when they are provided in
the form of payments by a TANF agency, or other agency on its
behalf, to individual recipients and conditioned on their
participation in work experience, community service, or other work
activities (i.e., under the CFR Sec. 261.30).
Except where excluded as indicated in the following paragraph,
it also includes supportive services such as transportation and
child care provided to families who are not employed.
The term ``assistance'' excludes:
(1) Nonrecurrent, short-term benefits (such as payments for rent
deposits or appliance repairs) that:
(i) Are designed to deal with a specific crisis situation or
episode of need;
(ii) Are not intended to meet recurrent or ongoing needs; and
(iii) Will not extend beyond four months.
(2) Work subsidies (i.e., payments to employers or third parties
to help cover the costs of employee wages, benefits, supervision,
and training);
(3) Supportive services such as child care and transportation
provided to families who are employed;
(4) Refundable earned income tax credits;
(5) Contributions to, and distributions from, Individual
Development Accounts;
(6) Services such as counseling, case management, peer support,
child care information and referral, transitional services, job
retention, job advancement, and other employment-related services
that do not provide basic income support; and
(7) Transportation benefits provided under an Access to Jobs or
Reverse Commute project, pursuant to section 404(k) of the Act, to
an individual who is not otherwise receiving assistance.
The exclusion of nonrecurrent, short-term benefits under (1) of
this paragraph also covers supportive services for recently employed
families, for temporary periods of unemployment, in order to enable
continuity in their service arrangements.
Instruction: For each type of assistance provided under the
separate State program, enter the dollar amount of assistance that
the SSP-MOE family received or that was paid on behalf of the SSP-
MOE family for the reporting month and the number of months that the
SSP-MOE family has received assistance under the State's Separate
MOE programs. Also, for SSP-MOE Child Care, enter the number of
children covered by the child care. If, for a ``type of
assistance,'' no dollar amount of assistance was provided during the
reporting month, enter ``0'' as the amount. If, for a ``type of
assistance,'' no assistance has ever been received by the eligible
family, enter ``0'' as the number of months of assistance.
19. Cash and Cash Equivalents:
A. Amount
B. Number of Months
20. Child Care:
Guidance: Include only the child care funded directly by these
Separate State programs. Do not include child care funded under the
TANF Program or the Child Care and Development Fund.
Number of:
A. Amount
B. Children Covered
C. Number of Months
21. Transportation:
A. Amount
B. Number of Months
22. Transitional Services:
A. Amount
B. Number of Months
23. Other:
A. Amount
B. Number of Months
24. Reason for and Amount of Reduction in Assistance:
Instruction: The amount of assistance received by a SSP-MOE
family may be reduced for one or more reasons. For each reason
listed below, indicate whether the SSP-MOE family received a
reduction in assistance. Enter the total dollar value of the
reduction(s) for each group of reasons for reductions in assistance
for the reporting month. If for any reason there was no reduction in
assistance, enter ``0.''
a. Sanctions:
i. Total Dollar Amount of Reductions due to Sanctions: Enter the
total dollar value of reduction in assistance due to sanctions.
ii. Work Requirements Sanction:
1=Yes.
2=No.
iii. Family Sanction for an Adult with No High School Diploma or
Equivalent:
1=Yes.
2=No.
iv. Sanction for Teen Parent not Attending School:
1=Yes.
2=No.
v. Non-Cooperation with Child Support:
1=Yes.
2=No.
vi. Failure to Comply with an Individual Responsibility Plan:
1=Yes.
2=No.
vii. Other Sanctions:
1=Yes.
2=No.
b. Recoupment of Prior Overpayment: Enter the total dollar value
of reduction in assistance due to recoupment of a prior overpayment.
c. Other:
i. Total Dollar Amount of Reductions due to Other Reasons
(exclude the amounts for sanction and recoupment): Enter the total
dollar value of reduction in assistance due to reasons other than
sanctions and recoupment.
ii. Family Cap:
1=Yes.
2=No.
iii. Reduction Based on Family Moving into State From Another
State:
1=Yes.
2=No.
iv. Reduction Based on Length of Receipt of Assistance:
1=Yes.
2=No.
v. Other, Non-sanction:
1=Yes.
2=No.
25. Waiver Evaluation Experimental and Control Groups:
Guidance: If this data element is not applicable to your State
(Tribe), either code this element ``9'' or leave this data element
blank. In connection with waivers that are approved to allow States
to implement Welfare Reform Demonstrations, a State assigned a
portion of its cases to control groups (subject to the provisions of
the regular, statutory AFDC program as defined by prior law) and
experimental groups (subject to the provisions of the regular,
statutory AFDC program as defined by prior law as modified by
waivers). A State may choose, for the purpose of completing impact
analyses, to maintain applicable control and experimental group
treatment policies as they were implemented under their welfare
reform demonstration (including prior law policies not modified by
waivers), even if such policies are inconsistent with TANF. However,
cases not assigned to an experimental or control group but subject
to waiver policies in accordance with the terms and conditions of
the waiver approval, may not apply prior law policies inconsistent
with TANF unless such policies are specifically linked to approved
waivers. When a State continues waivers, but does not maintain
experimental and control groups for impact evaluation purposes, all
cases in the demonstration site will be treated as cases subject to
waiver policies in accordance with terms and conditions regardless
of their original assignment as control group cases (i.e., prior law
policies may only apply to the extent they are specially linked to
approved waivers and former control group cases will now be subject
to waiver policies.)
[[Page 17922]]
Instruction: Enter the one-digit code that indicates the
family's waiver evaluation case status.
1=Control group case (for impact analysis purposes).
2=Experimental group case.
3=Other cases subject to waiver policies.
9=Not applicable (no waivers apply to this case).
Person-Level Data
Person-level data has two sections: (1) The adult and minor
child head-of-household characteristic section and (2) the child
characteristics section. An adult is an individual that is not a
minor child. A minor child is an individual who (a) has not attained
18 years of age or (b) has not attained 19 years of age and is a
full-time student in a secondary school (or in the equivalent level
of vocational or technical training.)
Detailed data elements must be reported on all individuals
unless, for a specific data element, the instructions explicitly
give States an option to not report for a specific group of
individuals.
Adult and Minor Child Head-of-Household Characteristics
This section allows for coding up to six adults (or a minor
child who is either a head-of-household or married to the head-of-
household and up to five adults) in the SSP-MOE family. A minor
child who is either a head-of-household or married to the head-of-
household should be coded as an adult and will hereafter be referred
to as a ``minor child head-of-household.'' For each adult (or minor
child head-of-household) in the SSP-MOE family, complete the adult
characteristics section. As indicated below, reporting for certain
specified data elements in this section is optional for certain
individuals (whose family affiliation code is a 2, 3, or 5).
If there are more than six adults (or a minor child head-of-
household and five adults) in the SSP-MOE family, use the following
order to identify the persons to be coded: (1) The head-of-
household; (2) parents in the eligible family receiving assistance;
(3) other adults in the eligible family receiving assistance; (4)
Parents not in the eligible family receiving assistance; (5)
caretaker relatives not in the eligible family receiving assistance;
and (6) other persons, whose income or resources count in
determining eligibility for or amount of assistance of the eligible
family receiving assistance, in descending order the person with the
most income to the person with least income.
26. Family Affiliation:
Guidance: This data element is used both for (1) the adult or
minor child head-of-household section and (2) the minor child
section. The same coding schemes are used in both sections. Some of
these codes may not be applicable for adults.
Instruction: Enter the one-digit code that shows the adult's (or
minor child head-of-household's) relation to the eligible family
receiving assistance.
1=Member of the eligible family receiving assistance.
Not in eligible family receiving assistance, but in the
household:
2=Parent of minor child in the eligible family receiving
assistance.
3=Caretaker relative of minor child in the eligible family
receiving assistance.
4=Minor sibling of child in the eligible family receiving
assistance.
5=Person whose income or resources are considered in determining
eligibility for or amount of assistance for the eligible family
receiving assistance.
27. Noncustodial Parent Indicator:
Guidance: A noncustodial parent is defined in Sec. 260.30 as a
parent who lives in the State and does not live with his/her
child(ren). The State must report information on the noncustodial
parent if the noncustodial parent: (1) Is receiving assistance as
defined in Sec. 260.31; (2) is participating in work activities as
defined in section 407(d) of the Act; or (3) has been designated by
the State as a member of a family receiving assistance.
Instruction: Enter the one-digit code that indicates the adult's
(or minor child head-of-household's) noncustodial parent status.
1=Yes, a noncustodial parent.
2=No, not a noncustodial parent.
28. Date of Birth: Enter the eight-digit code for date of birth
for the adult (or minor child head-of-household) under the separate
State program in the format YYYYMMDD. If the adult's (or minor child
head-of-household's) date of birth is unknown and the family
affiliation code is not ``1,'' enter the code ``99999999''.
29. Social Security Number: Enter the nine-digit Social Security
Number for the adult (or minor child head-of-household) in the
format nnnnnnnnn. If the social security number is unknown and the
family affiliation code is not ``1,'' enter ``999999999''.
30. Race/Ethnicity:
Instruction: To allow for the multiplicity of race/ethnicity,
please enter the one-digit code for each category of race and
ethnicity of the adult (or minor child head-of-household). Reporting
of this data element is optional for individuals whose family
affiliation code is 5.
Ethnicity:
a. Hispanic or Latino:
1=Yes, Hispanic or Latino.
2=No.
Race:
b. American Indian or Alaska Native:
1=Yes, American Indian or Alaska Native.
2=No.
c. Asian:
1=Yes, Asian.
2= No.
d. Black or African American:
1=Yes, Black or African American.
2=No.
e. Native Hawaiian or Other Pacific Islander:
1=Yes, Native Hawaiian or Pacific Islander.
2=No.
f. White:
1=Yes, White.
2=No.
31. Gender: Enter the one-digit code that indicates the adult's
(or minor child head-of-household's) gender.
1=Male.
2=Female.
32. Receives Disability Benefits: The Act specifies five types
of disability benefits. For each type of disability benefits, enter
the one-digit code that indicates whether or not the adult (or minor
child head-of-household) received the benefit.
a. Receives Federal Disability Insurance Benefits Under the
Social Security OASDI Program (Title II of the Social Security Act):
1=Yes, received Federal disability insurance.
2=No.
b. Receives Benefits Based on Federal Disability Status Under
Non-Social Security Act Programs: These programs include Veteran's
disability benefits, Worker's disability compensation, and Black
Lung Disease disability benefits.
1=Yes, received benefits based on Federal disability status.
2=No.
c. Receives Aid to the Permanently and Totally Disabled Under
Title XIV-APDT of the Social Security Act:
1=Yes, received aid under Title XIV-APDT.
2=No.
d. Receives Aid to the Aged, Blind, and Disabled Under Title
XVI-AABD of the Social Security Act:
1=Yes, received aid under Title XVI-AABD.
2=No.
e. Receives Supplemental Security Income Under Title XVI-SSI of
the Social Security Act:
1=Yes, received aid under Title XVI-SSI.
2=No.
33. Marital Status: Enter the one-digit code for the adult's (or
minor child head-of-household's) marital status for the reporting
month. Reporting of this data element is optional for individuals
whose family affiliation code is 5.
1=Single, never married.
2=Married, living together.
3=Married, but separated.
4=Widowed.
5=Divorced.
34. Relationship to Head-of-Household:
Guidance: This data element is used both for (1) the adult or
minor child head-of-household section and (2) the minor child
section. The same coding schemes are used in both sections. Some of
these codes may not be applicable for adults.
Instruction: Enter the two-digit code that shows the adult's (or
minor child head-of-household's) relationship (including by
marriage) to the head of the household, as defined by the Food Stamp
Program or as determined by the State, (i.e., the relationship to
the principal person of each person living in the household.) If a
minor child head-of-household, enter code ``01.''
01=Head-of-household.
02=Spouse.
03=Parent.
04=Daughter or son (Natural or adoptive).
05=Stepdaughter or stepson.
06=Grandchild or great grandchild
07=Other related person (brother, niece, cousin).
08=Foster child.
09=Unrelated child.
10=Unrelated adult.
35. Parent With Minor Child In the Family:
Guidance: A parent with a minor child in the family may be a
natural parent, adoptive
[[Page 17923]]
parent, or step-parent of a minor child in the family. Reporting of
this data element is optional for individuals whose family
affiliation code is 3 or 5.
Instruction: Enter the one-digit code that indicates the adult's
(or minor child head-of-household's) parental status.
1=Yes, a parent with a minor child in the family and used in
two-parent participation rate.
2=Yes, a parent with a minor child in the family, but not used
in two-parent participation rate.
3=No.
36. Needs of a Pregnant Woman: Some States (Tribes) consider the
needs of a pregnant woman in determining the amount of assistance
that the SSP-MOE family receives. If the adult (or minor child head-
of-household) is pregnant and the needs associated with this
pregnancy are considered in determining the amount of assistance for
the reporting month, enter a ``1'' for this data element. Otherwise
enter a ``2'' for this data element. This data element is applicable
only for individuals whose family affiliation code is 1.
1=Yes, additional needs associated with pregnancy are considered
in determining the amount of assistance.
2=No.
37. Educational Level: Enter the two-digit code to indicate the
highest level of education attained by the adult (or minor child
head-of-household). Unknown is not an acceptable code for an
individual whose family affiliation code is ``1''. Reporting of this
data element is optional for individuals whose family affiliation
code is 5.
01-11=Grade level completed in primary/secondary school
including secondary level vocational school or adult high school.
12=High school diploma, GED, or National External Diploma
Program.
13=Awarded Associate's Degree.
14=Awarded Bachelor's Degree.
15=Awarded graduate degree (Master's or higher).
16=Other credentials (degree, certificate, diploma, etc.).
98=No formal education.
99=Unknown.
38. Citizenship/Alienage:
Instruction: Enter the one-digit code that indicates the adult's
(or minor child head-of-household's) citizenship/alienage. Unknown
is not an acceptable code for an individual whose family affiliation
code is ``1''. Reporting of this data element is optional for
individuals whose family affiliation code is 5.
1=U.S. citizen, including naturalized citizens.
2=Qualified alien.
3=Non qualified alien.
9=Unknown.
39. Cooperation with Child Support: Enter the one-digit code
that indicates whether this adult (or minor child head-of-household)
has cooperated with child support. Reporting of this data element is
optional for individuals whose family affiliation code is 5.
1=Yes, adult (or minor child head-of-household) cooperated with
child support.
2=No.
3=Not applicable.
40. Employment Status: Enter the one-digit code that indicates
the adult's (or minor child head-of-household's) employment status.
Reporting of this data element is optional for individuals whose
family affiliation code is 5.
1=Employed.
2=Unemployed, looking for work.
3=Not in labor force (i.e, unemployed, not looking for work,
includes discouraged workers)
41. Work Participation Status:
Guidance: This item could be used in calculating an SSP work
participation rate and includes information comparable to TANF. The
following two definitions are used in reporting this item and in
determining which families might be included in and excluded from
the calculations.
``Disregarded'' from the participation rate means the SSP-MOE
family is not included in the calculation of the work participation
rate.
``Exempt'' means that the individual will not be penalized for
failure to engage in work (i.e., good cause exception); however, the
SSP-MOE family is included in the calculation of the work
participation rate.
A State is not required to disregard all families that could be
disregarded. For example, a family with a single custodial parent
with child under 12 months (and the parent has not been disregarded
for 12 months) may be disregarded. However, if the single custodial
parent is meeting the work requirements, the State may want to
include the family in its work participation rate. In this
situation, the State should used work participation status code
``19'' rather than code ``01''.
Instruction: Enter the two-digit code that indicates a work
participation status for the adult or minor child head-of-household.
This data element is not applicable for individuals whose family
affiliation code is 2, 3, 4, or 5.
01=Disregarded from participation rate, single custodial parent
with child under 12 months.
02=Disregarded from participation rate because all of the
following apply: required to participate; but not participating;
sanctioned for the reporting month; but not sanctioned for more than
3 months within the preceding 12-month period.
Note: this code should be used only in a month for which the
family is disregarded from the participation rate. While one or more
adults may be sanctioned in more than 3 months within the preceding
12-month period, the family may not be disregarded from the
participation rate for more than 3 months within the preceding
12=month period.
03=Disregarded, family is part of an ongoing research evaluation
(as a member of a control group or experimental group) approved
under section 1115 of the Social Security Act.
04=Disregarded from the work participation rate based on an
inconsistency under an approved welfare reform waiver that exempts
the family from participation.
05=Disregarded from participation rate, based on participation
in a Tribal Work Program, and State has opted to exclude all Tribal
Work Program participants from its work participation rate.
06=Exempt, single custodial parent with child under age 6 and
child care available.
07=Exempt, disabled (not using an extended definition under a
State waiver).
08=Exempt, caring for a severely disabled child (not using an
extended definition under a State waiver).
09=Exempt, under a federally recognized good cause domestic
violence waiver.
10=Exempt, State waiver.
11=Exempt, other.
12=Required to participate, but not participating; sanctioned
for the reporting month and sanctioned for more than 3 months within
the preceding 12-month period.
13=Required to participate, but not participating; sanctioned
for the reporting month, but not sanctioned for more than 3 months
within the preceding 12-month period.
14=Required to participate, but not participating; and not
sanctioned for the reporting month.
15=Deemed engaged in work--single teen head-of-household or
married teen who maintains satisfactory school attendance.
16=Deemed engaged in work--single teen head-of-household or
married teen who participates in education directly related to
employment for an average of at least 20 hours per week during the
reporting month.
17=Deemed engaged in work--parent or relative (who is the only
parent or caretaker relative in the family) with child under age 6
and parent engaged in work activities for at least 20 hours per
week.
18=Required to participate and participating, but not meeting
minimum participation requirements.
19=Required to participate and meeting minimum participation
requirements.
99=Not applicable (e.g., person living in household and whose
income or resources are counted in determining eligibility for or
amount of assistance of the family receiving assistance, but not in
eligible family receiving assistance or noncustodial parent that the
State opted to exclude in determining participation rate).
Adult Work Participation Activities
Guidance: To calculate the average number of hours per week of
participation in a work activity, add the number of hours of
participation across all weeks in the month and divide by the number
of weeks in the month. Round to the nearest whole number.
Some weeks have days in more than one month. Include such a week
in the calculation for the month that contains the most days of the
week (e.g., the week of July 27--August 2, 1997 would be included in
the July calculation). Acceptable alternatives to this approach must
account for all weeks in the fiscal year. One acceptable alternative
is to include the week in the calculation for the month in which the
Friday falls (i.e., the JOBS approach). A second acceptable
alternative is to count each month as having 4.33 weeks.
During the first or last month of any spell of assistance, a
family may happen to receive assistance for only part of the month.
If a family receives assistance for only part of a
[[Page 17924]]
month, the State (Tribe) may count it as a month of participation if
an adult (or minor child head-of-household) in the family (both
adults, if they are both required to work) is engaged in work for
the minimum average number of hours for the full week(s) that the
family receives assistance in that month.
Instruction: For each work activity in which the adult (or minor
child head-of-household) participated during the reporting month,
enter the average number of hours per week of participation. For
each work activity in which the adult (or minor child head-of-
household) did not participate, enter zero as the average number of
hours per week of participation. These work activity data elements
are applicable only for individuals whose family affiliation code is
1.
42. Unsubsidized Employment.
43. Subsidized Private-Sector Employment.
44. Subsidized Public-Sector Employment
45. Work Experience
46. On-the-job Training
47. Job Search and Job Readiness Assistance:
Instruction: Do not count hours of participation in job search
and job readiness training beyond the TANF limit where allowed by
waivers in this item. Instead, count the hours of participation
beyond the TANF limit in data element #54 ``Additional Work
Activities Permitted Under Waiver Demonstration.'' Otherwise, count
the additional hours of work participation under data element #55
``Other Work Activities.''
48. Community Service Programs.
49. Vocational Educational Training:
Instruction: Do not count hours of participation in vocational
educational training beyond the TANF 12 month life-time limit where
allowed by waivers in this item. Instead, count the hours of
participation beyond the TANF limit in data element #54 ``Additional
Work Activities Permitted Under Waiver Demonstration.'' Otherwise,
count the additional hours of work participation under data element
#55 ``Other Work Activities.''
50. Job Skills Training Directly Related to Employment.
51. Education Directly Related to Employment for Individuals
with no High School Diploma or Certificate of High School
Equivalency.
52. Satisfactory School Attendance for Individuals with No High
School Diploma or Certificate of High School Equivalency.
53. Providing Child Care Services to an Individual who is
Participating in a Community Service Program.
54. Additional Work Activities Permitted Under Waiver
Demonstration:
Instruction: Some States' waivers permit participation in work
activities that are not permitted under the statute. Enter the
adult's (or minor child head-of-household's) average number of hours
per week of participation in such work activities in this data
element. For example, some State waivers permit participation in
vocational educational training and job search beyond the TANF
statutory limits. Count hours of participation in these activities
beyond the TANF limits where allowed by the State waivers in this
item. Otherwise, count the addditional hours of participation in the
activity ``Other Work Activities.''
55. Other Work Activities. This data element collects
information on work activities provided that are not permitted under
a State waiver and are beyond the requirements of the statute.
56. Required Hours of Work Under Waiver Demonstration:
Guidance: In approving waivers, ACF specified hours of
participation in several instances. One type of hour change in the
welfare reform demonstrations was the recognition, as part of a
change in work activities and/or exemptions, that the hours
individuals worked should be consistent with their abilities and in
compliance with an employability or personal responsibility plan or
other criteria in accordance to waiver terms and conditions. If the
hour requirement in this case was part of a specific work component
waiver, the State could show inconsistency and could use the waiver
hours instead of the hours in section 407.
Instruction: If applicable, enter the two-digit number that
represents the average number of hours per week of work
participation required of the individual under a work component
waiver. Otherwise, leave blank or enter ``0.'' This data element is
not applicable for individuals whose family affiliation code is 2,
3, 4, or 5.
57. Amount of Earned Income: Enter the dollar amount of the
adult's (or minor child head-of-household's) earned income for the
reporting month or for the month used to budget for the reporting
month.
58. Amount of Unearned Income: Unearned income has five
categories. For each category of unearned income, enter the dollar
amount of the adult's (or minor child head-of-household's) unearned
income.
a. Earned Income Tax Credit (EITC):
Guidance: Earned Income Tax Credit is a refundable tax credit
for families and dependent children. EITC payments are received
monthly (as advance payment through the employer), annually (as a
refund from IRS), or both.
Instruction: Enter the total dollar amount of the Earned Income
Tax Credit actually received, whether received as an advance payment
or a single payment (e.g., tax refund), by the adult (or minor child
head-of-household) during the reporting month or the month used to
budget for the reporting month. If the State counts the EITC as a
resource, report it here as unearned income in the month received
(i.e., the reporting month or budget month). If the State assumes an
advance payment is applied for and obtained, only report what is
actually received for this item.
b. Social Security: Enter the dollar amount of Social Security
benefits that the adult in the SSP-MOE family has received for the
reporting month or for the month used to budget for the reporting
month.
c. SSI: Enter the dollar amount of SSI benefits that the adult
in the SSP-MOE family has received for the reporting month or for
the month used to budget for the reporting month.
d. Worker's Compensation: Enter the dollar amount of Worker's
Compensation that the adult in the SSP-MOE family has received for
the reporting month or for the month used to budget for the
reporting month.
e. Other Unearned Income:
Guidance: Other unearned income includes RSDI benefits, Veterans
benefits, Unemployment Compensation, other government benefits,
housing subsidy, contribution/income-in-kind, deemed income, Public
Assistance or General Assistance, educational grants/scholarships/
loans, other. Do not include EITC, Social Security, SSI, Worker's
Compensation, value of food stamp assistance, the amount of the
Child Care subsidy, and the amount of Child Support.
Instruction: Enter the dollar amount of other unearned income
that the adult in the SSP-MOE family has received for the reporting
month or for the month used to budget for the reporting month.
Child Characteristics
This section allows for coding the child characteristics for up
to ten children in the SSP-MOE family. A minor child head-of-
household should be coded as an adult, not as a child. The youngest
child should be coded as the first child in the family, the second
youngest child as the second child, and so on.
If there are more than ten children in the SSP-MOE family, use
the following order to identify the persons to be coded: (1)
Children in the eligible family receiving assistance in order from
youngest to oldest; (2) minor siblings of child in the eligible
family receiving assistance from youngest to oldest; and (3) any
other children.
59. Family Affiliation:
Guidance: This data element is used both for (1) the adult or
minor child head-of-household section and (2) the minor child
section. The same coding schemes are used in both sections. Some of
these codes may not be applicable for children.
Instruction: Enter the one-digit code that shows the child's
relation to the eligible family receiving assistance.
1=Member of the eligible family receiving assistance.
Not in eligible family receiving assistance, but in the
household:
2=Parent of minor child in the eligible family receiving
assistance.
3=Caretaker relative of minor child in the eligible family
receiving assistance.
4=Minor sibling of child in the eligible family receiving
assistance.
5=Person whose income is considered in determining eligibility
for and amount of assistance for the eligible family receiving
assistance.
60. Date of Birth: Enter the eight-digit code for date of birth
for this child under the separate State programs in the format
YYYYMMDD. If the child's date of birth is unknown and the family
affiliation code is not ``1,'' enter the code ``99999999''.
61. Social Security Number: Enter the nine-digit Social Security
Number for the child in the format nnnnnnnnn. If the child's social
security number is unknown and the family affiliation code is not
``1,'' enter the 9-digit code ``999999999''. Reporting of this data
element is optional for individuals whose family affiliation code is
4.
62. Race/Ethnicity:
Instruction: To allow for the multiplicity of race/ethnicity,
please enter the one-digit code
[[Page 17925]]
for each category of race and ethnicity of the child. Reporting of
this data element is optional for individuals whose family
affiliation code is 4.
Ethnicity:
a. Hispanic or Latino:
1=Yes, Hispanic or Latino.
2=No.
Race:
b. American Indian or Alaska Native:
1=Yes, American Indian or Alaska Native.
2=No.
c. Asian:
1=Yes, Asian.
2=No.
d. Black or African American:
1=Yes, Black or African American.
2=No.
e. Native Hawaiian or Other Pacific Islander:
1=Yes, Native Hawaiian or Pacific Islander.
2=No.
f. White:
1=Yes, White.
2=No.
63. Gender: Enter the one-digit code that indicates the child's
gender.
1=Male.
2=Female.
64. Receives Disability Benefits: The Act specifies five types
of disability benefits. Two of these types of disability benefits
are applicable to children. For each type of disability benefits,
enter the one-digit code that indicates whether or not the child
received the benefit.
a. Receives Benefits Based on Federal Disability Status Under
Non-Social Security Act Programs: These programs include Veteran's
disability benefits, Worker's disability compensation, and Black
Lung Disease disability benefits.
1=Yes, received benefits based on Federal disability status.
2=No.
b. Receives Supplemental Security Income Under Title XVI-SSI of
the Social Security Act:
1=Yes, received aid under Title XVI-SSI.
2=No.
65. Relationship to Head-of-Household:
Guidance: This data element is used both for (1) the adult or
minor child head-of-household section and (2) the minor child
section. The same coding schemes are used in both sections. Some of
these codes may not be applicable for children.
Instruction: Enter the two-digit code that shows the child's
relationship (including by marriage) to the head of the household,
as defined by the Food Stamp Program or, principal person of each
person living in the household.
01=Head-of-household.
02=Spouse.
03=Parent.
04=Daughter or son (Natural or adoptive).
05=Stepdaughter or stepson.
06=Grandchild or great grandchild.
07=Other related person (brother, niece, cousin).
08=Foster child.
09=Unrelated child.
10=Unrelated adult.
66. Parent With Minor Child In the Family:
Guidance: This data element is used both for (1) the adult or
minor child head-of-household section and (2) the minor child
section. The same coding schemes are used in both sections. Code
``1'' is not applicable for children. A parent with a minor child in
the family may be a natural parent, adoptive parent, or step-parent
of a minor child in the family. Reporting of this data element is
optional for individuals whose family affiliation code is 4 or 5.
Instruction: Enter the one-digit code that indicates the child's
parental status.
1=Yes, a parent with a minor child in the family and used in
two-parent participation rate.
2=Yes, a parent with a minor child in the family, but not used
in two-parent participation rate.
3=No.
67. Educational Level: Enter the two-digit code to indicate the
highest level of education attained by the child. Unknown is not an
acceptable code for an individual whose family affiliation code is
``1''. Reporting of this data element is optional for individuals
whose family affiliation code is 4.
01-11=Grade level completed in primary/secondary school
including secondary level vocational school or adult high school.
12=High school diploma, GED, or National External Diploma
Program.
13=Awarded Associate's Degree.
14=Awarded Bachelor's Degree.
15=Awarded graduate degree (Master's or higher).
16=Other credentials (degree, certificate, diploma, etc.).
98=No formal education.
99=Unknown.
68. Citizenship/Alienage:
Instruction: Enter the one-digit code that indicates the child
citizenship/alienage. Unknown is not an acceptable code for an
individual whose family affiliation code is ``1''. Reporting of this
data element is optional for individuals whose family affiliation
code is 4.
1=U.S. citizen, including naturalized citizens.
2=Qualified alien.
3=Non qualified alien.
9=Unknown.
69. Amount of Unearned Income: Unearned income has two
categories. For each category of unearned income, enter the dollar
amount of the child's unearned income for the reporting month or for
the month used to budget for the reporting month.
a. SSI: Enter the dollar amount of SSI that the child in the
SSP-MOE family has received for the reporting month or for the month
used to budget for the reporting month.
b. Other Unearned Income: Enter the dollar amount of other
unearned income that the child in the SSP-MOE family has received
for the reporting month or for the month used to budget for the
reporting month.
Appendix F--SSP MOE Data Report--Section Two--Disaggregated Data
Collection for Families No Longer Receiving Assistance Under the
Separate State Program(s)
Instructions and Definitions
General Instruction: The State agency should collect and report
data for each data element. The data must be complete (unless
explicitly instructed to leave the field blank) and accurate (i.e,
correct).
An ``Unknown'' code may appear only on four data elements (#14
Date of Birth, #15 Social Security Number, #23 Educational Level,
and #24 Citizenship/Alienage). For these data elements, unknown is
not an acceptable code for individuals who are members of the
eligible family (i.e., family affiliation code ``1''). States are
not expected to track closed cases in order to collect information
on families for months after the family has left the rolls. Rather
it is acceptable to report based on the last month of assistance.
1. State FIPS Code: Enter your two-digit State code from the
following listing. These codes are the standard codes used by the
National Institute of Standards and Technology.
------------------------------------------------------------------------
State Code
------------------------------------------------------------------------
Alabama......................................................... 01
Alaska.......................................................... 02
American Samoa.................................................. 60
Arizona......................................................... 04
Arkansas........................................................ 05
California...................................................... 06
Colorado........................................................ 08
Connecticut..................................................... 09
Delaware........................................................ 10
Dist. of Columbia............................................... 11
Florida......................................................... 12
Georgia......................................................... 13
Guam............................................................ 66
Hawaii.......................................................... 15
Idaho........................................................... 16
Illinois........................................................ 17
Indiana......................................................... 18
Iowa............................................................ 19
Kansas.......................................................... 20
Kentucky........................................................ 21
Louisiana....................................................... 22
Maine........................................................... 23
Maryland........................................................ 24
Massachusetts................................................... 25
Michigan........................................................ 26
Minnesota....................................................... 27
Mississippi..................................................... 28
Missouri........................................................ 29
Montana......................................................... 30
Nebraska........................................................ 31
Nevada.......................................................... 32
New Hampshire................................................... 33
New Jersey...................................................... 34
New Mexico...................................................... 35
New York........................................................ 36
North Carolina.................................................. 37
North Dakota.................................................... 38
Ohio............................................................ 39
Oklahoma........................................................ 40
Oregon.......................................................... 41
Pennsylvania.................................................... 42
Puerto Rico..................................................... 72
Rhode Island.................................................... 44
South Carolina.................................................. 45
[[Page 17926]]
South Dakota.................................................... 46
Tennessee....................................................... 47
Texas........................................................... 48
Utah............................................................ 49
Vermont......................................................... 50
Virgin Islands.................................................. 78
Virginia........................................................ 51
Washington...................................................... 53
West Virginia................................................... 54
Wisconsin....................................................... 55
Wyoming......................................................... 56
------------------------------------------------------------------------
2. County FIPS Code: Enter the three-digit code established by
the National Institute of Standards and Technology for
classification of counties and county equivalents. Codes were
devised by listing counties alphabetically and assigning
sequentially odd integers; e.g., 001, 003, 005. A complete list of
codes is available in Appendix F of the TANF Sampling and
Statistical Methods Manual.
3. Reporting Month: Enter the four-digit year and two-digit
month code that identifies the year and month for which the data are
being reported.
4. Stratum:
Guidance: All families that receive assistance under separate
State Programs (i.e, SSP-MOE families) and are selected in the
sample from the same stratum must be assigned the same stratum code.
Valid stratum codes may range from ``00'' to ``99.'' States with
stratified samples should provide the ACF Regional Office with a
listing of the numeric codes utilized to identify any
stratification. If a State opts to provide data for its entire
caseload, enter the same stratum code (any two-digit number) for
each SSP-MOE family.
Instruction: Enter the two-digit stratum code.
Family-Level Data
Definition: For reporting purposes, the SSP-MOE family means (a)
all individuals receiving assistance as part of a family under the
separate State program; and (b) the following additional persons
living in the household, if not included under (a) above:
(1) Parent(s) or caretaker relative(s) of any minor child
receiving assistance;
(2) Minor siblings (including unborn children) of any child
receiving assistance; and
(3) Any person whose income or resources would be counted in
determining the family's eligibility for or amount of assistance.
5. Case Number:
Guidance: If the case number is less than the allowable eleven
characters, a State may use lead zeros to fill in the number.
Instruction: Enter the number that was assigned by the State
agency to uniquely identify the SSP-MOE family.
6. ZIP Code: Enter the five-digit ZIP code for the family's
place of residence for the reporting month.
7. Disposition: Enter one of the following codes for each SSP-
MOE family.
1=Data collection completed.
2=Not subject to data collection/listed in error.
8. Reason for Closure:
Guidance: A closed case is a family whose assistance was
terminated for the reporting month, but received assistance under
the State's MOE Program in the prior month. A temporarily suspended
case is not a closed case. If there is more than one applicable
reason for closure, determine the principal (i.e., most relevant)
reason. If two or more reasons are equally relevant, use the reason
with the lowest numeric code. For example, when an adult marries,
the income and resources of the new spouse are considered in
determining eligibility. If, at the time of the marriage, the family
becomes ineligible because of the addition of the spouse's income
and/or resources, the case closure should be coded using code ``2''.
If the family did not became ineligible based on the income and
resources at the time of the marriage, but rather due to an increase
in earnings subsequent to the marriage, then the case closure should
be coded using code ``1''.
Instruction: Enter the two-digit code that indicates the reason
for the SSP-MOE family no longer receiving assistance.
01=Employment and/or excess earnings.
02=Marriage.
03=Five-year time limit.
Sanctions:
04=Work related sanction.
05=Child support sanction.
06=Teen parent failing to meet school attendance requirement.
07=Teen parent failing to live in an adult setting.
08=Failure to meet individual responsibility plan provision or
other behavioral requirements (e.g., immunize a minor child, attend
parenting classes).
09=Failure to complete individual responsibility plan (e.g., did
not sign plan).
State Policies:
10=State time limit, if different than five-year limit.
11=Child support collected.
12=Excess unearned income (exclusive of child support
collected).
13=Excess resources.
14=Youngest child too old to qualify for assistance.
15=Minor child absent from the home for a significant time
period.
16=Failure to appear at eligibility/redetermination appointment,
submit required verification materials, and/or cooperate with
eligibility requirements.
17=Transfer to State's TANF program.
Other:
18=Family voluntarily closes the case.
99=Other.
9. Received Subsidized Housing:
Guidance: Subsidized housing refers to housing for which money
was paid by the Federal, State, or local government or through a
private social service agency to the family or to the owner of the
housing to assist the family in paying rent. Two families sharing
living expenses does not constitute subsidized housing.
Instruction: Enter the one-digit code that indicates whether or
not the SSP-MOE family received subsidized housing for the reporting
month.
1=Public housing.
2=Rent subsidy.
3=No housing subsidy.
10. Received Medical Assistance: Enter ``1'' if, for the
reporting month, any SSP-MOE family member was enrolled in Medicaid
and, thus eligible to receive medical assistance under the State
plan approved under Title XIX or ``2'' if no SSP-MOE family member
was enrolled in Medicaid.
1=Yes, enrolled in Medicaid.
2=No.
11. Received Food Stamps: Enter the one-digit code that
indicates whether or not the SSP-MOE family has received food stamp
assistance.
1=Yes, received food stamp assistance.
2=No.
12. Received Subsidized Child Care:
Instruction: If the SSP-MOE family received subsidized child
care for the reporting month (or for the last month of SSP-MOE
assistance), enter code ``1'' or ``2,'' whichever is appropriate.
Otherwise, enter code ``3.''
1=Yes, receives child care funded (entirely or in part) with
Federal funds (e.g., receives either TANF, CCDF, SSBG, or other
federally funded child care).
2=Yes, received child care funded entirely under a State,
Tribal, and/or local program (i.e., no Federal funds used).
3=No.
Person-Level Data
This section allows for coding up to sixteen persons in the SSP-
MOE family. If there are more than sixteen persons in the SSP-MOE
family, use the following order to identify the persons to be coded:
(1) The head-of-household; (2) parents in the eligible family
receiving assistance; (3) children in the eligible family receiving
assistance; (4) other adults in the eligible family receiving
assistance; (5) Parents not in the eligible family receiving
assistance; (6) caretaker relatives not in the eligible family
receiving assistance; (7) minor siblings of a child in the eligible
family; and (8) other persons, whose income or resources count in
determining eligibility for or amount of assistance of the eligible
family receiving assistance, in descending order the person with the
most income to the person with least income. As indicated below,
reporting for certain specified data elements in this section is
optional for certain individuals (whose family affiliation code is a
2, 3, 4 or 5).
13. Family Affiliation:
Instruction: Enter the one-digit code that shows the
individual's relation to the eligible family receiving assistance.
1=Member of the eligible family receiving assistance.
Not in eligible family receiving assistance, but in the
household:
2=Parent of minor child in the eligible family receiving
assistance.
3=Caretaker relative of minor child in the eligible family
receiving assistance.
4=Minor sibling of child in the eligible family receiving
assistance.
5=Person whose income or resources are considered in determining
eligibility for or amount of assistance for the eligible family
receiving assistance.
14. Date of Birth: Enter the eight-digit code for date of birth
for this individual under separate State programs in the format
[[Page 17927]]
YYYYMMDD. If the individual's date of birth is unknown and the
family affiliation code is not ``1,'' enter the code ``99999999''.
15. Social Security Number: Enter the nine-digit Social Security
Number for the individual in the format nnnnnnnnn. If the social
security number is unknown and the family affiliation code is not
``1,'' enter ``999999999''.
16. Race/Ethnicity:
Instructions: To allow for the multiplicity of race/ethnicity,
please enter the one-digit code for each category of race and
ethnicity of the SSP-MOE individual. Reporting of this data element
is optional for individuals whose family affiliation code is 4 or 5.
Ethnicity:
a. Hispanic or Latino:
1=Yes, Hispanic or Latino.
2=No.
Race:
b. American Indian or Alaska Native:
1=Yes, American Indian or Alaska Native.
2=No.
c. Asian:
1=Yes, Asian.
2=No.
d. Black or African American:
1=Yes, Black or African American.
2=No.
e. Native Hawaiian or Other Pacific Islander:
1=Yes, Native Hawaiian or Pacific Islander.
2=No.
f. White:
1=Yes, White.
2=No.
17. Gender: Enter the one-digit code that indicates the
individual's gender.
1=Male.
2=Female.
18. Received Disability Benefits: The Act specifies five types
of disability benefits. For each type of disability benefits, enter
the one-digit code that indicates whether or not the individual
received the benefit.
a. Received Federal Disability Insurance Benefits Under the
Social Security OASDI Program (Title II of the Social Security Act):
Enter the one-digit code that indicates the adult (or minor child
head-of-household) received Federal disability insurance benefits
for the reporting month (or the last month of TANF assistance). This
item is not required to be coded for a child.
1=Yes, received Federal disability insurance.
2=No.
b. Received Benefits Based on Federal Disability Status Under
Non-Social Security Act Programs: These programs include Veteran's
disability benefits, Worker's disability compensation, and Black
Lung Disease disability benefits. Enter the one-digit code that
indicates the individual received benefits based on Federal
disability status for the reporting month (or the last month of SSP-
MOE assistance). This data element should be coded for each adult
and child with family affiliation code ``1''.
1=Yes, received benefits based on Federal disability status.
2=No.
c. Received Aid to the Permanently and Totally Disabled Under
Title XIV-APDT of the Social Security Act: Enter the one-digit code
that indicates the individual received aid under a State plan
approved under Title XIV for the reporting month (or the last month
of SSP-MOE assistance). This item is not required to be coded for a
child.
1=Yes, received aid under Title XIV-APDT.
2=No.
d. Received Aid to the Aged, Blind, and Disabled Under Title
XVI-AABD of the Social Security Act: Enter the one-digit code that
indicates the individual received aid under a State plan approved
under Title XVI-AABD for the reporting month (or the last month of
SSP-MOE assistance). This item is not required to be coded for a
child.
1=Yes, received aid under Title XVI-AABD.
2=No.
e. Received Supplemental Security Income Under Title XVI-SSI of
the Social Security Act: Enter the one-digit code that indicates the
individual received aid under a State plan approved under Title XVI-
SSI for the reporting month (or the last month of SSP-MOE
assistance). This data element should be coded for each adult and
child with family affiliation code ``1''.
1=Yes, received aid under Title XVI-SSI.
2=No.
19. Marital Status: Enter the one-digit code for the marital
status of the adult (or minor child head-of-household). Leave this
field blank for other minor children. Reporting of this data element
is optional for individuals whose family affiliation code is 4 or 5.
1=Single, never married.
2=Married, living together.
3=Married, but separated.
4=Widowed.
5=Divorced.
20. Relationship to Head-of-Household:
Instruction: Enter the two-digit code that shows the
individual's relationship (including by marriage) to the head of the
household, as defined by the Food Stamp Program or, principal person
of each person living in the household. If a minor child head-of-
household, enter code ``01.''
01=Head-of-household.
02=Spouse.
03=Parent.
04=Daughter or son.
05=Stepdaughter or stepson.
06=Grandchild or great grandchild.
07=Other related person (brother, niece, cousin).
08=Foster child.
09=Unrelated child.
10=Unrelated adult.
21. Parent With Minor Child In the Family:
Guidance: A parent with a minor child in the family may be a
natural parent, adoptive parent, or step-parent of a minor child in
the family. Reporting of this data element is optional for
individuals whose family affiliation code is 3, 4, or 5.
Instruction: Enter the one-digit code that indicates the
individual's parental status.
1=Yes, a parent with a minor child in the family.
2=No.
22. Needs of a Pregnant Woman: Some States consider the needs of
a pregnant woman in determining the amount of assistance that the
SSP-MOE family receives. If the individual was pregnant and the
needs associated with this pregnancy were considered in determining
the amount of assistance for the last month of assistance, enter a
``1'' for this data element. Otherwise enter a ``2'' for this data
element. This data element is applicable only for individuals whose
family affiliation code is 1.
1=Yes, additional needs associated with pregnancy were
considered in determining the amount of assistance.
2=No.
23. Educational level: Enter the two-digit code to indicate the
educational level attained by the individual. Unknown is not an
acceptable code for an individual whose family affiliation code is
``1''. Reporting of this data element is optional for individuals
whose family affiliation code is 4 or 5.
01-11=Grade level completed in primary/secondary school
including secondary level vocational school or adult high school.
12=High school diploma, GED, or National External Diploma
Program.
13=Awarded Associate's Degree.
14=Awarded Bachelor's Degree.
15=Awarded graduate degree (Master's or higher).
16=Other credentials (degree, certificate, diploma, etc.).
98=No formal education.
99=Unknown.
24. Citizenship/Alienage:
Instruction: Enter the one-digit code that indicates the
individual's citizenship/alienage. Unknown is not an acceptable code
for an individual whose family affiliation code is ``1''. Reporting
of this data element is optional for individuals whose family
affiliation code is 4 or 5.
1=U.S. citizen, including naturalized citizens.
2=Qualified alien.
3=Non qualified alien.
9=Unknown.
25. Employment Status: Enter the one-digit code that indicates
the adult's (or minor child head-of-household's) employment status.
Leave this field blank for other minor children. Reporting of this
data element is optional for individuals whose family affiliation
code is 2, 3, 4, or 5.
1=Employed.
2=Unemployed, looking for work.
3=Not in labor force (i.e, unemployed, not looking for work,
includes discouraged workers).
26. Amount of Earned Income: Enter the amount of the adult's (or
minor child head-of-household's) earned income for the last month on
SSP-MOE assistance or for the month used to budget for the last
month on assistance. Leave these fields blank for other minor
children (i.e., children whose family affiliation code is 4).
27. Amount of Unearned Income: Enter the amount of the
individual's unearned income for the last month on SSP-MOE
assistance or for the month used to budget for the last month on
assistance. Leave these fields blank for other minor children (i.e.,
children whose family affiliation code is 4).
[[Page 17928]]
Appendix G--SSP-MOE Data Report--Section Three--Aggregated Data
Collection for Families Receiving Assistance Under the Separate State
Program(s)
Instructions and Definitions
General Instruction: The State agency must collect and report
data for each data element, unless explicitly instructed to leave
the field blank. Monthly caseload counts (e.g., number of families,
number of two-parent families, and number of closed cases) and
number of recipients must be unduplicated monthly totals. States may
use samples to estimate the monthly totals if explicitly stated in
the instruction for the data element.
1. State FIPS Code: Enter your two-digit State code.
2. Calendar Quarter: The four calendar quarters are as follows:
First quarter--January-March.
Second quarter--April-June.
Third quarter--July-September.
Fourth quarter--October-December.
Enter the four-digit year and one-digit quarter code (in the
format YYYYQ) that identifies the calendar year and quarter for
which the data are being reported (e.g., first quarter of 1997 is
entered as ``19971'').
Active Cases
For purposes of completing this report, include all eligible
families receiving assistance under the separate State programs,
i.e., SSP-MOE families. All counts of families and recipients should
be unduplicated monthly totals.
3. Total Number of SSP-MOE Families: Enter the number of
families receiving assistance under the separate State programs for
each month of the quarter. The total in this item should equal the
sum of the number of two-parent families (in item #4), the number of
one-parent families (in item #5) and the number of no-parent
families (in item #6).
A. First Month:
B. Second Month:
C. Third Month:
4. Total Number of Two-parent Families: Enter the total number
of two-parent families receiving assistance under the separate State
programs for each month of the quarter.
A. First Month:
B. Second Month:
C. Third Month:
5. Total Number of One-Parent Families: Enter the total number
of one-parent families receiving assistance under the separate State
programs for each month of the quarter.
A. First Month:
B. Second Month:
C. Third Month:
6. Total Number of No-Parent Families: Enter the total number of
no-parent families receiving assistance under the separate State
programs for each month of the quarter.
A. First Month:
B. Second Month:
C. Third Month:
7. Total Number of Recipients: Enter the total number of
recipients receiving assistance under the separate State programs
for each month of the quarter. The total in this item should equal
the sum of the number of adult recipients (in item #8) and the
number of child recipients (in item #9).
A. First Month:
B. Second Month:
C. Third Month:
8. Total Number of Adult Recipients: Enter the total number of
adult recipients receiving assistance under the separate State
programs for each month of the quarter.
A. First Month:
B. Second Month:
C. Third Month:
9. Total Number of Child Recipients: Enter the total number of
child recipients receiving assistance under the separate State
programs for each month of the quarter.
A. First Month:
B. Second Month:
C. Third Month:
10. Total Number of Non-Custodial Parents Participating in Work
Activities: Enter the total number of non-custodial parents
participating in work activities under the separate State programs
for each month of the quarter. The monthly totals for this element
may be estimated from samples.
A. First Month:
B. Second Month:
C. Third Month:
11. Total Amount of Assistance: Enter the dollar value of all
SSP-MOE assistance (cash and non-cash) provided to families under
the separate State programs for each month of the quarter. Round the
amount of assistance to the nearest dollar.
A. First Month:
B. Second Month:
C. Third Month:
Closed Cases
12. Total Number of Closed Cases: Enter the total number of
closed cases for each month of the quarter.
A. First Month:
B. Second Month:
C. Third Month:
Appendix H.--Caseload Reduction Report
[State________ Fiscal Year ________]
Part I--Implementation of All Eligibility Changes Made by the State Since FY 1995
---------------------------------------------------------------------------------------------------------------------------------------------------------
# Eligibility change Implementation date Estimated impact on caseload since change (positive or negative)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Changes Required by Federal Law
--------------------------------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------
State-Implemented Changes
--------------------------------------------------------------------------------------------------------------------------------------------------------
Changes Related to Income and Resources:
--------------------------------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------
Changes Related to Categorical or Demographic Eligibility Factors:
--------------------------------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------
Changes Related to Behavioral Requirements
--------------------------------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------
[[Page 17929]]
Changes Due to Full-Family Sanctions:
--------------------------------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------
Other Eligibility Changes:
--------------------------------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------
Estimated Total Net Impact on the Caseload of All Eligibility Changes
--------------------------------------------------------------------------------------------------------------------------------------------------------
Total Prior-Year Caseload
--------------------------------------------------------------------------------------------------------------------------------------------------------
Estimated Caseload Reduction Credit
--------------------------------------------------------------------------------------------------------------------------------------------------------
--------------------------------------------------------------------------------------------------------------------------------------------------------
Part II--Application Denials and Case Closures, by Reason
---------------------------------------------------------------------------------------------------------------------------------------------------------
Fiscal year 1995 Fiscal year ____
--------------------------------------------------------------------------------------------------------------------------------------------------------
Number Percentage Number Percentage
--------------------------------------------------------------------------------------------------------------------------------------------------------
Reason for Application Denials:
........................... ........................... ........................... ...........................
........................... ........................... ........................... ...........................
........................... ........................... ........................... ...........................
........................... ........................... ........................... ...........................
........................... ........................... ........................... ...........................
........................... ........................... ........................... ...........................
........................... ........................... ........................... ...........................
-------------------------------------------------------------------------------------------------------------------
Total Application Denials
===================================================================================================================
Reason for Case Closures:
........................... ........................... ........................... ...........................
........................... ........................... ........................... ...........................
........................... ........................... ........................... ...........................
........................... ........................... ........................... ...........................
........................... ........................... ........................... ...........................
........................... ........................... ........................... ...........................
........................... ........................... ........................... ...........................
-------------------------------------------------------------------------------------------------------------------
Total Case Closures
--------------------------------------------------------------------------------------------------------------------------------------------------------
Appendix H.--Caseload Reduction Report
State ________ Fiscal Year________
------------------------------------------------------------------------
Part III--description of the methodology used to calculate the caseload
reduction estimates (attach any supporting data to this form)
-------------------------------------------------------------------------
------------------------------------------------------------------------
Appendix H--Caseload Reduction Report
State ________ Fiscal Year ________
Part IV--Certification
I certify that we have provided the public an appropriate
opportunity to comment on the estimates and methodology used to
complete this report and considered those comments in completing it.
Further, I certify that this report incorporates all reductions in
the caseload resulting from State eligibility changes and changes in
Federal requirements since Fiscal Year 1995.
----------------------------------------------------------------------
(signature)
----------------------------------------------------------------------
(name)
----------------------------------------------------------------------
(title)
[[Page 17930]]
Instructions for Completing Form ACF-202, Caseload Reduction Report
All States wishing to receive a caseload reduction credit must
complete and submit this report on behalf of the State agency
administering the TANF program in accordance with these
instructions.
Due Date
This report must be submitted by December 31 of each year.
Submission
Submit the original to the ACF Regional Administrator. Submit a
copy to: Administration for Children and Families, Office of Family
Assistance, 5th Floor East, 370 L'Enfant Promenade, SW, Washington,
DC 20447.
General Instructions
Form ACF-202 consists of a series of tables, a narrative
description, and a certification page. If you are completing this
report electronically, you may need to add rows to some of the
tables to accommodate all the information you need to enter. If a
section of a table is not applicable, specify ``none'' or ``not
applicable,'' as appropriate in the first line.
Appendix H--Caseload Reduction Report
We have designed Form ACF-202 so that you can complete it
electronically or manually, but we do not currently have the
capacity to accept electronic submissions of the report.
Each State must submit a summary of all public comments on the
State's estimates and methodology as part of its Caseload Reduction
Report. Please be advised that there is nothing on form ACF-202 for
the State to complete for this requirement, but the instructions for
``Attachments'' direct the State to include the summary of comments.
Please remember that the caseload reduction credit is based on
changes both in the State's TANF caseload and in any separate State
program caseloads; therefore you should be sure that the figures in
this report reflect separate State program information as well as
TANF information.
If you have opted to use separate reduction credits for your
State's overall and two-parent participation rates, you must submit
separate reports for the overall and two-parent caseloads. Please
indicate at the top of each page and each attachment to which
caseload the report pertains.
<bullet> Enter the name of the State and the current fiscal year
in the space provided at the top of each page. If you are completing
the report electronically, you will only need to enter this
information once for each table and the once for the certification
page.
Instructions for Completing Part I
<bullet> Enter each eligibility change the State has made since
FY 1995 in the appropriate category (e.g., ``Changes related to
Income and Resources''), numbering each change for easy reference.
For convenience, we have separated Federal changes from State-
implemented ones and listed some common State eligibility changes;
however, you should be sure to include each change, whether Federal
or State in origin, on a separate line. If you are completing this
report electronically, you may need to add one or more rows to the
table in order to list all of your State's eligibility changes in
the various categories. If you are completing it manually, you may
need to attach additional pages instead.
Please note that you need not list any changes the State has
implemented since October 1 of the current fiscal year, since this
report applies to caseload reductions in the prior fiscal year.
You should not consider the creation of a separate State program
as an eligibility change, since separate State program caseloads
must be included in calculating the caseload reduction credit, as we
indicated above.
<bullet> For each eligibility change, enter the implementation
date and your estimate of the impact the change has had on the
caseload since its implementation. For example, if a particular
eligibility change had the effect of reducing the caseload by 5,000
cases, you should enter, ``-5,000.'' It is important that your
estimate account for the cumulative impact of each change on the
caseload since 1995, not simply the impact in the year that the
State implemented the change.
Please note that an eligibility change may have a positive or
negative effect on the caseload. If the effect was negative, include
a minus sign in front of the number. If the effect was positive,
include a plus sign in front of the number.
<bullet> Enter the total estimated impact of all the eligibility
changes you listed. In making this estimate, you should be sure that
you have not counted case impacts more than once, even if they could
be included under more than one eligibility change. Thus, the total
impact may not equal the sum of all the individual impacts because
of interaction among eligibility changes. In such cases, Part III of
the report (the methodology section) should address any
discrepancies.
<bullet> Enter the total caseload for the prior year, including
separate State program cases. You may use the combined total number
of families reported in the TANF Data Report and the SSP-MOE Data
Report (in section three of each report) for the prior year. If the
total prior-year caseload reflects adjustments you have made in
accordance with Sec. 261.40 to improve the comparability of FY 1995
and prior-year caseloads, please attach an explanation of your
adjustments.
<bullet> Enter the State's estimated caseload reduction credit.
In arriving at this number, you should subtract your estimated net
reduction in caseload due to eligibility changes from the total
caseload decline between FY 1995 and the prior year and divide the
resulting number by the total prior-year caseload. For example, if
the net result of the eligibility changes is that the State's
caseload in the prior year decreased by 2,000 from the FY 1995
level, then you should subtract 2,000 from the total caseload
decline between FY 1995 and the prior fiscal year. If there is a net
increase in caseload due to eligibility changes, you should not
subtract anything from the caseload decline between FY 1995 and the
prior year.
Instructions for Completing Part II
<bullet> Enter the prior fiscal year in the heading of the
column that follows ``Fiscal Year 1995.'' For example, if this is
the State's FY 2000 report (due by December 31, 1999), then the
column heading should read ``Fiscal Year 1999.''
<bullet> Enter each reason for application denial, the number of
denials for each such reason for the applicable fiscal year, and the
percentage that the number represents of total denials for the
fiscal year.
<bullet> Enter the total number of application denials for the
applicable fiscal year. The total percentages for each year should
equal 100.
<bullet> Enter the same information for each case closure
reason, i.e., the reason for case closures, the number of closures
for that reason, and the percentage that the number represents of
total case closures.
<bullet> Enter the total number of case closures for the
applicable fiscal year. The total percentages for each year should
equal 100.
Instructions for Completing Part III
<bullet> Describe in detail how you arrived at the estimated
impacts on the caseload of the various eligibility changes and how
you arrived at the estimated caseload reduction credit.
<bullet> If there were changes in the number or distribution of
application denials or case closures since FY 1995 that do not
appear to be consistent with the information listed in Part II of
the report, include a discussion explaining the inconsistencies.
<bullet> Attach any information that documents the State's
estimates.
Instructions for Completing Part IV
<bullet> Enter the name and title of the individual making the
certification on behalf of the State.
<bullet> Sign the certification. Although you may complete the
form electronically, you must submit this page with the original
signature to the ACF Regional Administrator and a copy to the Office
of Family Assistance, as indicated above.
Attachments
<bullet> Attach a summary of all public comments on the State's
estimates and methodology.
<bullet> Be sure that all attachments include the name of the
State and the current fiscal year and indicate that they are
attachments to Form ACF-202.
Appendix I
Annual Report on State Maintenance-of-Effort Programs: ACF-204
State ________Fiscal Year ____Date Submitted ________
Complete this form for each program for which the State claims MOE
expenditures.
1. Program Name:
[[Page 17931]]
2. Description of Major Program Activities:
3. Program Purpose(s):
4. Program Type. Program is: under the TANF program __ is a
separate State/local program __
5. Description of Work Activities (Complete only if this is a
separate State/local program):
6. Total State Expenditures for Program: ________
7. Total State MOE Expenditures: ________
8. Number of Families Served with MOE Funds: ________
This figure represents: the average monthly total ____ total for
the year ____
9. Eligibility Criteria:
10. Prior Program Authorization:
Was this program authorized and allowable under prior law?
Yes____ No ____
11. Total Program Expenditures in FY 1995. ________
This certifies that all families for which the State claims MOE
expenditures for the fiscal year meet the State's criteria for
``eligible families.''
Signature:-------------------------------------------------------------
Name:------------------------------------------------------------------
Title:-----------------------------------------------------------------
Approved OMB No. xxxx-xxxx Form ACF-204
Instruction for Completion of Form ACF-204 Annual Report on State
Maintenance-of-Effort Programs
All States must complete and submit this report in accordance
with these instructions and the requirements at 45 CFR 265.9(c) on
behalf of the State agency administering the TANF Program.
Due Dates: This form must be submitted by November 14.
States must submit this report for each fiscal year. Also, each
State must complete a form for each program for which the State has
claimed MOE expenditures for the fiscal year.
Distribution: The original copy (with original signatures)
should be submitted to: Administration for Children and Families,
Office of Family Assistance, Aerospace Building, 5th Floor, 370
L'Enfant Promenade, S.W., Washington, D.C. 20447. An additional copy
should be submitted to the ACF Regional Administrator.
General Instructions
--Round all dollar amounts to the nearest dollar. Omit cents.
--Enter State Name.
--Enter the Fiscal Year for which this report is being
submitted. Enter the date that the report is being submitted.
Line Item Instructions
Line 1. Program name. Enter the name of the program.
Line 2. Description of major activities. Describe the major
activities and major types of benefits and services provided under
the program.
Line 3. Program purpose. Provide the purpose(s) of the program
and relate this purpose to the statutory and regulatory TANF
purposes (at 45 CFR 260.20).
Line 4. Program type. Put an ``X'' on the appropriate line
(indicating whether the MOE expenditures are being made under the
TANF program or under a separate State program.
Line 5. Work program description. If the program is a separate
State program, describe the work activities (if any) provided for
eligible families and the extent to which eligible families are
subject to work requirements. If the work activities are the same as
the TANF activities, or a subset of the TANF activities, you may
include a list of the activities and a cross-reference to the
definitions provide in the annual report rather than representing
them. (It is not necessary to describe work activities provided
under TANF because that information is provided elsewhere.) Also
include information explaining whether individuals served by the
program must participate in work activities and describing the
extent to which such requirements apply (e.g., to which categories
of recipients).
Line 6. Total amount of State expenditures. Enter the total
dollar amount of State expenditures in the program during the
Federal fiscal year.
Line 7. Total State MOE expenditures. Enter the total dollar
amount of expenditures reported in item <greek-i>6 that are reported
as State MOE expenditures.
Line 8. Number of families served with MOE funds. Enter the
number of eligible families that are receiving assistance and other
forms of services and supports under the program. Also, put an ``X''
on the appropriate line to indicate whether the number being
provided is a report on the average monthly number of families being
served or on the total number served over the course of the fiscal
year.
Line 9. Eligibility criteria. Provide the eligibility criteria
for families served under this program. If the eligibility criteria
differ for different kinds of program benefits or activities,
specify the eligibility criteria for all the major benefits and
activities.
Line 10. Prior authorization. Put an ``X'' on the appropriate
line to indicate whether the program was authorized and allowable
under prior law. Programs that were previously authorized and
allowable under prior law (i.e., under an approved State IV-A plan
in effect either on Sept. 30, 1995, or August 21, 1996, at State
option) are not subject to the ``new spending'' test.
Line 11. Total program expenditures in 1995. If the program was
not previously authorized and allowable (i.e., if the answer on item
#10 is ``No''), enter the total expenditures for the program in
1995. Only qualified State expenditures above this level may count
towards the State MOE total.
Certification. The certification must be signed by an authorized
official. Under the signature line, type the title of the authorized
official, together with the agency name.
[FR Doc. 99-8000 Filed 4-9-99; 8:45 am]
BILLING CODE 4184-01-P