Financial Determination - PM

Determination Information

1. In the Determination Information field, select either an existing determination record to edit, or Create New.
2. In the Determination Method field, select whether the financial determination is Brief or Full. This field will change the way calculations are done for this record. A Brief determination will only use Net Income in determining the ability to pay (unearned income is included as information only), while a Full determination will use all fields.
3. In the Determination Class field, select the determination class.
4. In the Determination Type field, select:
   • Monthly -  the ability to pay will be calculated based on all of the fields entered.
   • Full Cost - the ability to pay will be calculated the same as Monthly but the value will not be added into the Total Monthly Ability To Pay.
5. In the Determination For field, select who this determination is for.
6. In the Dependents field, enter the number of dependents.
7. In the Apply Special Exemption field, select whether or not a special exemption needs to be applied. If Yes, and it is a brief determination, the Special Exemption field from the Financial Determination Configuration form will be added to the Protected Income.

Included Assets

1. In the Included Assets field, select either an existing assets record, or Create New.
2. In the Asset Type field, select the asset type for included assets.
3. In the Financial Institution field, enter the financial institution.
4. In the Asset Value field, enter the annual value amount.
5. In the Asset Liability field, enter the annual liability amount.
6. In the Description field, enter a description for the asset record.

Excluded Assets

1. In the Excluded Assets field, select either an existing assets record, or Create New.
2. In the Asset Type field, select the asset type for excluded assets.
3. In the Description field, enter a description for the asset record.
4. In the Asset Value field, enter the annual value amount.
5. In the Asset Liability field, enter the annual liability amount.

Wages and Earned Income

1. In the Wages field, select either an existing wages record, or Create New.
2. In the Start Date and End Date fields, enter the date ranges for the wages record.
3. In the Gross Wages field, enter the amount of gross wages for the date range entered.
4. In the Description field, enter a description for the wages record.

Income

1. In the Income field, select either an existing income record, or Create New.
2. In the Income Type field, select the income type.
3. In the Income Value field, enter the monthly value amount.
4. In the Description field, enter a description for the income record.

Expenses

1. In the Expenses field, select either an existing expense record, or Create New.
2. In the Expense Type field, select the expense type.
3. In the Description field, enter a description for the expense record.
4. In the Expense Time field, select whether this expense occurs on a Monthly, Quarterly, or Annual basis.
5. In the Expense Value field, enter the value amount.

Totals

1. The Total Assets field displays the annual total of all assets from the Included Assets and Excluded Assets sections. 
   Total Assets = Total Included Asset Value + Total Excluded Asset Value
2. The Total Liabilities field displays the total amount of all financial liabilities. The amount is annual and is determined by the Included Assets, and Excluded Assets sections. Total Liabilities = Total Included Asset Liability + Total Excluded Asset Liability
3. The Net Value Of Excluded Assets field displays the annual total of all excluded assets from the Excluded Assets section. If the amount is less than zero, it will become zero.
   Net Value Of Excluded Assets = Total Excluded Asset Value - Total Excluded Asset Liability
4. The Protected Assets field displays an annual amount based on the value of Dependents and the amounts set up in the Financial Determination Configuration form.
   Note: If the value is changed from the automatic calculation, this record will be marked as overridden and will not be updated automatically if the associated configuration record is altered. The calculated value will be stored for auditing.
5. The Net Assets field displays an annual amount based on the remainder of assets left after subtracting the included, excluded, and protected assets, as well as liabilities entered.
   Net Assets = Total Assets - Total Liabilities - Net Value Of Excluded Assets - Protected Assets.
   Note: If the value is changed from the automatic calculation, this record will be marked as overridden and will not be updated automatically if the associated configuration record is altered. The calculated value will be stored for auditing.
6. The Total Income field displays the total annual amount of all income from the Income section and all wages from the Wages and Earned Income section. If the amount is less than zero, it will become zero.
   • Income=Total Income Value * 12 
   • Wages=Weekly Gross Wages * 48.
     Weekly gross wages are calculated based on the number of days entered for the gross wage.
     FICA Tax Rate is on the Financial Determination Configuration form.
   • If Determination Method is set to Full: Total Income=Income+(Wages-(Wages * FICA Tax Rate)).
   • If Determination Method is set to Brief: Total Income=Wages.
7. The Total Expenses field displays the total annual amount of all expenses from the Expense section.
   • For Expense Time Monthly, expense= Expense Value * 12.
   • For Expense Time Quarterly, expense= Expense Value * 4.
   • For Expense Time Annual, expense= Expense Value.
8. In the Apply Additional Protected Income field, select whether or not to apply additional protected income.
   Note: If there are at least two income values, and one of them is marked as SSI, this field will default to Yes.
9. The Protected Income field displays an amount based on the income from the Income, and Wages and Earned Income sections, as well as the amounts set up in the Financial Determination Configuration form.
   Note: If the value is changed from the automatic calculation, this record will be marked as overridden and will not be updated automatically if the associated configuration record is altered. The calculated value will be stored for auditing.
   • SSI=SSI Protection if there is one Income Type of SSI
     • Add=Additional Protection if Apply Additional Protected Income is Yes
     • Dep=Dependent Exemption from Financial Determination Configuration
     • Special=Special Exemption from Financial Determination Configuration if Apply Special Exemption is Yes
     • Wage=The lesser amount of either: 
       1. Monthly Total Wages
       2. 'Protected Wages'+((Monthly Total Wages - 'ProtectedWages')/2)
   • If Determination Method is set to Full: 'Protected Income'=(SSI + Add + Wage)*12.
   • If Determination Method is set to Brief: 'Protected Income'=('Dependents'*Dep)+Special.
10. The Net Income field displays an amount based on the total income and expenses entered. If the amount is less than zero, it will become zero.
    Note: If the value is changed from the automatic calculation, this record will be marked as overridden and will not be updated automatically if the associated configuration record is altered. The calculated value will be stored for auditing.
    • If Determination Method is set to Full, the Net Income is calculated by subtracting the Total Expenses and Protected Income from the Total Income.
    • If Determination Method is set to Brief, the Net Income is calculated by subtracting just the Protected Income from the Total Income.
11. The Annual Liability field is automatically populated based on the following criteria:
    Note: If this value is changed manually, the field will no longer populate automatically.
    • If the Determination Method field is set to Full, the annual liability is calculated by totaling Net Assets and Net Income.
    • If the Determination Method field is set to Brief, the annual liability is calculated using Net Income and the Brief Determination section of the Financial Determination Configuration form.
12. The Annual Ability to Pay field is automatically populated based on the following criteria:
    Note: If the value is changed from the automatic calculation, this record will be marked as overridden and will not be updated automatically if the associated configuration record is altered. The calculated value will be stored for auditing.
    • If the Determination Method field is set to Full, the annual ability to pay is calculated by subtracting Room And Board (from the Financial Determination Configuration form) from the Annual Liability.
    • If the Determination Method field is set to Brief, the annual ability to pay will be equal to the Annual Liability.
    • If the amount is less than zero, it will become zero.
13. The Lump Sum Payment Amount field displays an amount based on the calculations of net assets.
    Note: If this value is changed manually, the field will no longer populate automatically.
    • Lump Sum Payment Amount = Net Assets + Lump Sum Value Is Net Assets Plus (from the Financial Determination Configuration form).
    • If Net Assets are zero, this value will be zero.
14. The Calculated Monthly Ability To Pay field displays an amount based on the annual ability to pay and the lump sum amount. If the amount is less than zero, it will become zero.
    Calculated Monthly Ability To Pay = ((Annual Ability to Pay - Lump Sum Payment Amount)/12)
    Note: If the value is changed from the automatic calculation, this record will be marked as overridden and will not be updated automatically if the associated configuration record is altered. The calculated value will be stored for auditing.
15. In the Guarantor field, select the guarantor. This guarantor will be used in determining the spend-down amount and will be used in the 270/271 request, if processed.
16. The Spend Down Amount field displays the current spend down amount for the client and guarantor selected if a spend down amount is on record for the chosen guarantor. If no guarantor is chosen, no spend down amount will populate. The lower value between Monthly Ability To Pay and Spend Down Amount will be used as the monthly ability to pay when processing services.
    Note: If the value is changed from the automatic calculation, this record will be marked as overridden and will not be updated automatically if the associated configuration record is altered. The calculated value will be stored for auditing.
    Note: If the value is set to '0', comments will be required in the Manual Override/Internal Notes field in order to submit the form.
17. Click Process Read Time 270/271 Request to run a real time 270/271 for the client. This will update the Spend Down Amount that is stored and displayed on this form. A guarantor is required in order to process this request.
18. The Eligibility Information field displays information from the SYSTEM.eligibility_dependent_cov table when the system checks the eligibility tables for the spend-down amount.
19. The Monthly Ability To Pay field displays the value actually used by the Financial Determination record as the monthly ability to pay. This will be populated with the lesser amount of either the Spend Down Amount or the Calculated Monthly Ability To Pay.
    This will be totaled with other Monthly Ability To Pay amounts to populate the Total Monthly Ability To Pay.
20. If one of the calculations was manually overwritten, enter an explanation for this action in the Manual Override Reason / Internal Notes field.
21. In the Remarks field, enter any additional comments to go along with this financial determination.
22. Click Recalculate Ability To Pay to recalculate the ability to pay using the standard formula. Any manual overrides will be removed.
23. Click Submit.

► Dictionary Values

• Asset Type for Excluded Assets
• Determination Class
• Determination For
• Expense Type
• Income Type
• Residence Type

► SQL Tables

• SYSTEM.eligibility_dependent_cov
• SYSTEM.fin_determ
• SYSTEM.fin_determ_info
• SYSTEM.fin_determ_inc_assets
• SYSTEM.fin_determ_exc_assets
• SYSTEM.fin_determ_wages
• SYSTEM.fin_determ_income
• SYSTEM.fin_determ_expense