Information Collected for Determining IV-E FCM Eligibility

The tables accessed from the links below summarize where Ohio SACWIS obtains information reflected on the eligibility determination screens. The system draws some of the information from other areas in Ohio SACWIS, while you complete other information in the Financial screens. For instructions on determining a child's eligibility for IV-E FCM, see Determine eligibility for IV-E FCM.

Field	Obtained From	Field	Obtained From
Determination type	User selected	Effective Date	Legal Status - Court
Eligibility Month	User selected	Termination Date	User entered

Field	Obtained From	Field	Obtained From
Person ID	System-assigned	SSN	Person profile – Basic tab
Name	Person profile – Basic tab	Title IV-E #	Add'l Tab
Gender	Person profile – Basic tab	Birth City, State, Country	Person profile – Basic tab

Field	Obtained From	Field	Obtained From
Requirement 1: U.S. Citizen	User selected	Requirement 2: Agency Legal Custody	Legal status – Court
Requirement 2: Effective Date	Agency legal status – Court	Requirement 2: Termination Date	Agency legal status – Court
Requirement 3: Best Interest Statement	Ruling record – Court	Ruling Date	Ruling record – Court
Requirement 4: Reasonable Efforts Statement	Ruling record – Court	Requirement 4: Ruling Date	Ruling record – Court
Requirement 5: Eligibility Month	Eligibility Details Screen	Requirement 5: DOB	Person profile – Basic tab
Requirement 5: Child’s Age in Eligibility Month	System calculated from DOB	Requirement 6: Was the child removed from a specified relative	User selected
Requirement 6: Name of Relative	Person search	Requirement 6: Relationship	User selected
Requirement 6: Did the child live with a specified relative	User selected	Requirement 6: How Verified	User selected

Field	Obtained From	Field	Obtained From
Deprivation Type	User selected	Which Parent	User selected
How Verified	User selected	Father: 2 year earnings	User selected
Mother: 2 year earnings	User selected	PWE	User selected
PWE employed less than 100 hours	User selected	PWE’s work is intermittent	User selected

Field	Obtained From	Field	Obtained From
SFU member names with calculations	Sum of Employment/ Income Record	Stepparent Budget	Stepparent Budget Worksheet
Minor Parent	Worksheet	Intentional Program	Worksheet
Total SFU Members	Calculated from the SFU member list	Total Countable Income	Income/Resource Summary Worksheet

Field	Obtained From	Field	Obtained From
Need Standard based on SFU	Total countable income from the SFU – Employment/Income record	Does the child meet the 185% need standard	Total countable income from the SFU – System Calculated from Need Standard table

Field	Obtained From	Field	Obtained From
Name	Person profile – Basic tab	DOB	Person profile – Basic tab
Age	System calculated	Relationship to child	Relationship Grid on the case profile
Receives SSI/FCM/AA	Employment/Income record	Worksheets Completed	Budget Worksheets

Field	Obtained From	Field	Obtained From
Name	Person profile – Basic tab	Relationship to child	Relationship Grid on the case profile
Address	Address on the person profile	Income Verified	Income/Resource Summary
Resource Verified	Income/Resource Summary

Field	Obtained From	Field	Obtained From
Placement Provider	Placement record	Provider Type	Provider record
Placement Begin Date	Placement record	Placement End Date	Provider record
License Date	Provider’s certification record	Licensed/Certified Placement	Provider’s certification record
The child was placed in a reimbursable setting	Provider’s certification record	Reason for Non-Reimbursability	Placement and certification records

Field	Obtained From	Field	Obtained From
Program Eligible Date	Initial eligibility record	Effective Date	Initial eligibility record
The child’s countable income	Child’s Needs Worksheet – Income & Resources