1. California Department of Aging Senior Community Service Employment Program 2012

2. Agenda Number in Family Acceptable Source Documentation To establish a family of one Includable Family Income Two-step process Acceptable Source Documentation Excluded Family Income Acceptable Source Documentation

3. Number in Family Data validation requirements permit three forms of documentation for family size. Official documents or business records Detailed case notes Signed attestation

4. Acceptable Source Documentation HUD form Lease Beneficiary form (to substantiate a spouse for family of two) Detailed case notes Number in Family

5. Acceptable Source Documentation (cont.) Signed attestation from third party who has knowledge of participant’s number in family TEGLs are available at this website. http://www.doleta.gov/Seniors/html_doc s/TEGL.cfm Number in Family

6. Documentation to Establish Family-of-One Is Due to Disability  Receipt of Social Security Disability Insurance (SSDI)  Other SSA records  School records Number in Family

7. Documentation to Establish Family-of-One Is Due to Disability  Sheltered workshop certification  Social Service records or referral  Certification from medical professional or medical records Number in Family

8. Eligibility Sample Worksheets Income Eligibility Worksheet Eligibility 1.pdf and Eligibility 2.pdfEligibility 1.pdf Eligibility 2.pdf

9. Total Includable Family Income Determination of income is a two-step process. *Ensure that total includable family income was correctly calculated. *Ensure that family income is less than or equal to 125% of the federal poverty line for the appropriate family size.

10. Documentation:  Official documents and business records establish includable income  Attestation established that no other includable income exists. Note: The TEGL requires that the record of documents must be jointly signed by the participant and the grantee interviewer. Total Includable Family Income

11. Acceptable Source Documentation Case note must:  Confirm zero income and/or that no other family income exists  Explain how participant supported themselves Total Includable Family Income

12. Signed attestations can be used only for claims of zero income.  A participant or third party attestation must include how participant supported self.  The participant’s self-attestation must also document that no other includable family income exists. Total Includable Family Income

13. Government records or other official documents:  Pay stubs  Social Security Award letters  Earning statements from employers  Pension Statements  Bank statements showing interest

14. EarningsBenefits received under Title II of the SSA (75% is includable.) Survivor benefitsPension or retirement income Interest incomeDividends Rents, royalties, and estates and trusts Educational assistance AlimonyFinancial assistance from outside the household Other income Total Includable Family Income

15. Total Excluded Family Income Social Security Disability Insurance Unemployment Compensation 25% of Social Security Veterans payment Supplemental Security Income Public Assistance

16. Income from other employment and training programs Disability Benefits Child support Workers Compensation Capitol Gains Withdrawals of bank deposits Total Excluded Family Income

17. Gifts Lump-sum inheritances, insurance payments, gambling and lottery earnings Total Excluded Family Income

18. CONTACT YOUR ANALYST FOR MORE INFORMATION. PEGGY STADLER pstadler@aging.ca.gov pstadler@aging.ca.gov PHIL CARR pcarr@aging.ca.gov pcarr@aging.ca.gov

19. THANK YOU!