Using CIS – Chapter 11 |
Scratchpad |

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1:CAMACA MEDICAL ASSISTANCE CALCULATION __/__/____ __:__:__:
2: App Operator: _________ [Page __ of __ __ _]:
3:Co Record Cat Day Mo Yr R/O Pers Preg? Age65? QMB? Disabled? HH <21?:
4:__ _______ ___ __ __/____ _ __ _ _ _ _ _ :
5: :
6: #Ch <1: __ #Ch 1> <6: __ #Ch >6: __ MNO? _ MO 1 _ 2 _ 3 _ 4 _ 5 _ 6 _ :
7: :
8: Recip # _________ Deemed? _ Deemed Elg St: __ NA Deps: __ Support: ____.__:
9: :
10: Earned: ____.__ Incent: TANF? _ GA? _ SSI? _ [AFDC? _] :
11: W/P Ded: TANF: ___.__ GA: ___.__ SSI: ___.__ :
12: Incap/Dep Care: # >2: __ ____.__ # <2: __ ____.__ F/P Time? _ :
13: :
14: Unearned: ____.__ Unearned Ded: ___.__ Support: ____.__ Ver: _ :
15: :
16: PD MA Exps: _____.__ UNPD Non-MA Exps: _____.__ UNPD MA Exps: _____.__ :
17: :
18: Net Inc $ ____.__ {Net Inc $ ____.__} {Net Inc $ ____.__}:
19: Cat Limit $ ____.__ {Cat Limit $ ____.__} {Cat Limit $ ____.__}:
20: Net - $10 $ ____.__ :
21: Needed MA Exp $ ____.__ :
22: Patient Pay $ ____.__ :
23: XMIT: _ :
24: :
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Use to calculate eligibility for retroactive and ongoing medical assistance including spend-down and patient-pay liability amounts. The information entered and the system calculated results are not saved for future access. | ||
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Includes the data elements necessary to capture earned, unearned, support, and deemed income. The profit or gross amount of self-employment and room and board earned income must be determined before entering data. All types of deemed income, except deeming to a SSI-related category, can be calculated. | ||
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Cannot be used to calculate lump sum income. | ||
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In most instances, all of the household’s income can be entered on one screen. Access a second, third, etc., CAMACA when: 1) entering earned income information for one person and the budget contains another individual with earned income, 2) entering income information that is deemed and another individual in the budget also has income. Use Function key F6 to request an additional CAMACA screen. | ||
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When deeming income from a household member, all the income on the page will be used for the deeming process. Do not include another household member’s income on the screen create another screen using the F6 key. | ||
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When computing MNO, additional CAMACA screens will be generated until 6 months of income have been collected for each household member that has a CAMACA screen. The system will protect the month field which have entries after transmitting from the income screen. | ||
A Note: |
Each individual with income may have a maximum of six income screens. |
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After the calculation is complete, a message will display from the TMSP table indicating eligible or ineligible. If ineligible, a reason for ineligibility will display from the TMSP table. If more than one message needs to be displayed, the system will list the message numbers. Use function key F7 to view the messages. | ||
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The following function keys can be used on CAMACA: F3 - Message Help; F5 - Break Conversation; F6 - Request an additional CAMACA screen for the same calculation; F7- MA Scratchpad Results Messages (TMSP); F8 - Cancel Transaction; and F10 - Sign off. Exit the screen with F5, F8, or F10. | ||
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Income results will display on the last income page. | ||
Screen Name |
Full Name |
Mandatory (Y/N) |
Description | ||
Co |
County |
Y |
Enter county code. | ||
Record |
Record |
Y |
Enter the client’s record number. | ||
Cat |
Category |
Y |
Enter the category for the appropriate eligibility determination. This field will help in determining the gross and net income tests. This field will be used in conjunction with Pers, Deemed, Preg, QMB, Disabled, HH<21, Ch, and MNO. | ||
App Day/ |
Application Date, |
N |
This field applies only when the client files an application. Enter the day of the month in which retroactive or ongoing eligibility begins. For recipients, leave it blank. | ||
Mo/Yr |
Month, and Year |
Y |
Enter the first month of eligibility and the year. | ||
R/O |
Retrospective or Ongoing |
Y |
This will tell the system whether it is retroactive on ongoing coverage. Place an “R” for retroactive and an “O” for ongoing. | ||
Pers |
Number of Applicants and Recipients |
Y |
Enter the number of persons included in the applicant or recipient group; in addition, include anyone else who could be advantageous to the household. | ||
Preg? |
Pregnant |
N |
Place a “Y” in the field if calculating Healthy Beginnings (PS) for a pregnant women. | ||
Age 65? |
Age 65 or Older |
N |
Place a “Y” in the filed if calculating Healthy Horizons (PS, PG, TA (SLMB), NMP (PA), OR MNO (TA)) for a person age 65 or older. | ||
QMB? |
Qualified for Medicare Benefits |
N |
Place a “Y” in the field if the person is a Medicare recipient. | ||
Disabled? |
Disabled |
N |
Place a “Y” in this field if the category refers to a disabled category. If the client receives Medicare and has a disability, place a “Y” in both fields. | ||
HH<21? |
Household Contains a Person Under Age 21 |
Y |
When the household has a member under age 21, place a “Y” in this field. If ALL household members are 21 or older, place an “N” in this field. An “N” entry will queue the resource computation screen. | ||
#Ch <1 |
Number of Children less than 1 |
N |
For Healthy Beginnings calculations, enter the number of household children under age one. | ||
#Ch 1> <6 |
Number of Children Between 1 and 6 years |
N |
For Healthy Beginnings calculations, enter the number of household children between age one and six. | ||
#Ch >6 |
Number of Children over Age 6 |
N |
For Healthy Beginnings calculations, enter the number of household children over age six. | ||
MNO/MO 1_ 2_ 3_ 4_ 5_ 6_ |
N |
Place a “Y” in this field if determining MNO. Only a “Y” in this field will allow an entry in the month fields, MO 1_ 2_ 3_ 4_ 5_ 6_. Complete the income fields on CAMACA and place an “X” in the applicable month(s). Additional CAMACA screens will generate until the collection of six months of income. | |||
Recip # |
Recipient Number |
Y |
Data enter the recipient ID number for the person whose income is on the screen. If more than one person has earned income, use two screens listing each person’s recipient number on their respective screens. | ||
Deemed? |
Deemed |
N |
Place a “Y” if there is deeming of income to the applicant/recipient group. Enter this person’s earned and unearned income in the appropriate fields. This person can receive work, personal, and basic living needs deductions. | ||
Deemed Elg St |
Deemed Eligibility Status |
N |
Enter the eligibility status of the non-eligible person. | ||
NA Deps |
Non-applicant Dependents |
N |
Enter the number of dependents in the household who are not receiving benefits. | ||
Support |
Deemed Support Amount |
N |
Enter the amount of support paid by this non-eligible person to members outside the household. | ||
Earned |
Earned Income Amount |
N |
Enter the monthly gross earned income amount or the monthly net profit from self-employment. | ||
Incentive: TANF GA SSI |
Work Incentive: TANF, GA, SSI |
N |
If the applicant is eligible for an earned income incentive, place a “Y” under the appropriate type of incentive. TANF refers to TANF related categories. GA refers to GA related categories. SSI refers to SSI related categories. For MNO categories, the applicant/recipient group must be eligible for and needs the incentive to qualify for benefits. | ||
W/P Ded: TANF, GA, SSI |
Work/Personal Deductions: TANF, GA, SSI |
N |
Enter the amount of the work and personal deductions for each employed client. Reminder: TD parents are considered TANF related. There is a minimum of $90 for TANF related MNO. For GA related NMP there is a maximum of $25. | ||
AFDC? |
AFDC |
Y |
This field is presented when there is a fail condition for Healthy Beginnings or TANF related NMP when using the TANF incentive. The system only allows entry when the category symbol is a PC, PU, PS, or PD and the TANF incentive is a “Y”. A “Y” or an “N” entry is required in this field to proceed with the calculation. A “Y” entry queues the CAMACU screen. An “N” entry will give the income results and cannot be changed to a “Y”. If an “N” entry is made in error, and the income results are displayed, F8 and reenter the information. | ||
Incap/Dep Care: # <2 |
Number of Dependent children under age 2 |
N |
Enter the number of children under two and the actual cost of the dependent care in the Incap/Dep Care #<2 field. | ||
Incap/ Dep Care: # >2 |
Number of Incapacitated Adults or Dependent Children over Age 2 |
N |
Enter the number of children age two or older and or the number of incapacitated persons and the actual cost of the care in the Incap/Dep Care #>2 field. $175 for children age 2 and up or an incapacitated person for full-time employment 2. The GA related NMP category of PD only receives the maximum allowance of $25 for work/personal expenses including dependent care. | ||
Incap/Dep Care: F/P Time? |
Full-time or Part-time Employment |
N |
For incapacitated care or dependent care expenses, enter either “F” for full time or “P” for part time employment. | ||
Unearned |
Unearned Income Amount |
N |
Enter the monthly gross amount of unearned income. | ||
Unearned Ded |
Unearned Income Deduction Amount |
N |
Enter the amount of allowable deductions. | ||
Support |
Support Amount |
N |
Enter the actual monthly amount of voluntary or court ordered support. | ||
Ver |
Verification |
Y |
Use this field to record how the income and resource data was verified. Access the TVER table for a list of codes. | ||
PD MA Exps |
Paid medical expense amount |
N |
Enter the amount of medical expenses paid by the client. This field will be used in the calculation of the spend-down and patient-pay amounts, if necessary. | ||
UNPD Non-MA Exps |
Unpaid non-covered medical expense amount |
N |
Enter the amount of unpaid medical expenses that will not be covered by Medicaid, remains a legal obligation of the client, will not be covered by a third party, and was not previously used as an MA expense. This field will be used in the calculation of spend-down and patient-pay amounts, if necessary. | ||
UNPD MA Exps |
Unpaid medical expense amount |
N |
Enter the amount of unpaid MA expenses that the client is applying for medical assistance coverage. This field is used in the calculation of the patient-pay liability amount, if necessary. | ||
Screen Name |
Full Name |
Description |
Net Inc |
Net Income Amount |
This is calculated by the system. For the Healthy Beginnings program, the system will only display results in the first column if there is an entry in either the Preg and or Ch<1 field. The system will only display an entry in the second field if there is an entry in the Ch 1> <6 field. The third field will display the results when there is an entry in the Ch >6 field. Results for the Healthy Horizons SLMB program will show in the first field. The QI-1 results will show in the second field. The third field will display the QI-2 results. |
Cat Limit |
Category Income Limit |
The system will enter the appropriate limit from the system reference tables. For the Healthy Beginnings program, the system will display the 185% limit in the first field when there is an entry in Preg and or Ch <1 field. The second field will display the 133% limit when there is an entry in the Ch 1> <6 field. The system will display the 100% limit in the third field when there is an entry in the Ch >6 field. Limits for the Healthy Horizons SLMB program will show in the first field. The QI-1 limits will show in the second field. The third field will show the QI-2 limits. |
Net - $10 |
Net Income After Subtracting $10 |
This field gives the net income after subtracting the $10. This is part of the NMP spend-down process. |
Needed MA Exp |
Amount of Medical Expenses Needed To Qualify |
This is a system calculation. This will give the spend-down amount if the client is over income for the category. |
Patient Pay |
Patient-Pay Liability Amount |
The system will calculate the patient-pay liability for MNO categories with unpaid medical expenses. |
CAMACA requires county number, record number, category, MO, YR, number of persons, HH<21, recipient number, and verification code entries.
Type over or blank out existing information to correct entries.
Do not exit CAMACA if entry of information for a different budget, record number, or month is needed. When the result of the original entry is displayed, change the appropriate information, and transmit to display the new results.
A Exception: |
For MNO calculations, once the MO field has a “Y” entry the field is protected and cannot be changed. If a mistake is made in an MO field, F8, then start over. |
If there is no income for the initial month for Special Programs, NMP, or any month during an MNO computation either leave the fields blank or enter a zero in the income fields. Reminder: For MNO, check the appropriate month(s) with zero income.
Manually compute net profit for self-employment and roomers/boarders. Enter this figure as the gross income for the household in the appropriate field.
If the household qualifies for an incentive, place a “Y” in the appropriate field.
A Note: |
MNO applicants/recipients receive the incentive if eligible for and need it to qualify for benefits. |
If eligible for work and personal deductions, enter the eligible amount in the appropriate field.
If deeming income from an LRR, place a “Y” in the Deemed field and list the eligibility status code. Data enter the number of dependents the LRR has which are not applying for medical assistance. Data enter the amount of support payments the LRR makes to his dependents that do not reside with him/her and which he/she does or could claim on his Federal Tax return. Enter the LRR’s earned, unearned, and support income in the appropriate fields. Enter the W/P deductions in the appropriate field for which he/she qualifies.
Enter the amount of medical expenses paid in the month of application and or retroactive period in the PD MA Exp field. Enter the amount of unpaid medical expenses that will not be covered by Medicaid in the UNPD Non-MA Exp field. Enter the amount of unpaid medical expenses in the UNPD MA Exp field that are being reviewed for Medicaid coverage.
If the household income exceeds the net limit, the system will determine if the household qualifies for spend-down or spend-down with patient-pay. The CAT field must be a category that allows spend-down or spend-down with a patient-pay liability.
Complete CAMACA for the first individual with income. After entering all data for the first individual hit function key F6. A second CAMACA is presented for entry of an additional individual’s income. If a third CAMACA is needed to gather data on another individual’s income, hit F6 after entering data on page 2. Transmit after the last person’s income is collected. Results are displayed on the last income page.
When F6 is used the following fields are refreshed and protected: Co, Record, Cat, App Day, Mo/Yr, R/O, Pers, Preg, Age65, QMB, Disabled, HH<21, and all Ch fields.
To change entries on a prior page, return to the prior page by entering that number in the paging field. Type in any new data. Any changes to Co, Record, Cat, App Day, Mo/Yr, R/O, Pers, Age65, QMB, Disabled, HH<21, and all Ch fields must be done on the first page. This will change the information on all subsequent screens.
When changes are done on page 1, the system forces transmission through all pages to recalculate the income with the new data. Results are displayed based on your new entries.
If an additional screen was not requested prior to transmitting, do not panic. A warning message will be displayed before the income calculation. At this point you can F6 or change any additional information before the final results are computed.
When a PC, PU, or PS (healthy Beginnings) fails the income computation when given the TANF work incentive, CAMACA will display an AFDC field. If the household is eligible for a pre-TANF determination of medical assistance, place a “Y” in this field. CAMACU will queue to allow the pre-TANF computation. If the household is not eligible for the pre-TANF calculation, place an “N” in this field. CAMACU will not be accessible with an “N” entry.
When the HH<21 field is an “N”, CAMARE will queue for completion. There are edits in place to prevent access to the CAMARE screen for TANF-related categories.

Revised: September 15, 2000