|
Name |
Type |
Discontinued? |
|
| 1 |
FIN_ASST_CASE_ID |
NUMERIC |
No |
|
|
|
| The unique identifier (.1 item) for the child financial assistance case record for the household member. |
|
|
| 2 |
RESIDENTIAL_ADDRESS_CITY |
VARCHAR |
No |
|
|
|
| Household member's residential city. |
|
|
| 3 |
RESIDENTIAL_ADDRESS_STATE_C_NAME |
VARCHAR |
No |
|
|
|
| The category ID for the state in the residential address for the household member. |
| May contain organization-specific values: Yes |
|
|
| 4 |
RESIDENTIAL_ADDRESS_ZIP |
VARCHAR |
No |
|
|
|
| The ZIP code of the household member's residential address. |
|
|
| 5 |
RESIDENTIAL_ADDRESS_COUNTY_C_NAME |
VARCHAR |
No |
|
|
|
| The category ID for the county in the residential address for the household member. |
| May contain organization-specific values: Yes |
|
|
| 6 |
RESIDENTIAL_ADDRESS_COUNTRY_C_NAME |
VARCHAR |
No |
|
|
|
| The category ID for the country in the residential address for the household member. |
| May contain organization-specific values: Yes |
|
|
| 7 |
RESIDENTIAL_ADDRESS_HOUSE_NUM |
VARCHAR |
No |
|
|
|
| The house number of the household member's residential address. |
|
|
| 8 |
RESIDENTIAL_ADDRESS_DISTRICT_C_NAME |
VARCHAR |
No |
|
|
|
| The category ID for the district in the residential address for the household member. |
| May contain organization-specific values: Yes |
|
|
| 9 |
MAILING_ADDRESS_CITY |
VARCHAR |
No |
|
|
|
| The city of the household member's mailing address. |
|
|
| 10 |
MAILING_ADDRESS_STATE_C_NAME |
VARCHAR |
No |
|
|
|
| The category ID for the state in the mailing address for the household member. |
| The category values for this column were already listed for column: RESIDENTIAL_ADDRESS_STATE_C_NAME |
|
|
| 11 |
MAILING_ADDRESS_ZIP |
VARCHAR |
No |
|
|
|
| The ZIP code of the household member's mailing address. |
|
|
| 12 |
MAILING_ADDRESS_COUNTY_C_NAME |
VARCHAR |
No |
|
|
|
| The category ID for the county in the mailing address for the household member. |
| The category values for this column were already listed for column: RESIDENTIAL_ADDRESS_COUNTY_C_NAME |
|
|
| 13 |
MAILING_ADDRESS_COUNTRY_C_NAME |
VARCHAR |
No |
|
|
|
| The category ID for the country in the mailing address for the household member. |
| The category values for this column were already listed for column: RESIDENTIAL_ADDRESS_COUNTRY_C_NAME |
|
|
| 14 |
MAILING_ADDRESS_HOUSE_NUM |
VARCHAR |
No |
|
|
|
| The house number of the household member's mailing address. |
|
|
| 15 |
MAILING_ADDRESS_DISTRICT_C_NAME |
VARCHAR |
No |
|
|
|
| The category ID for the district in the mailing address for the household member. |
| The category values for this column were already listed for column: RESIDENTIAL_ADDRESS_DISTRICT_C_NAME |
|
|
| 16 |
PRIMARY_PHONE_NUMBER |
VARCHAR |
No |
|
|
|
| The primary phone number of the household member. |
|
|
| 17 |
PRIMARY_EMAIL_ADDRESS |
VARCHAR |
No |
|
|
|
| The primary email address of the household member. |
|
|
| 18 |
PREFERRED_LANGUAGE_C_NAME |
VARCHAR |
No |
|
|
|
| The preferred language category ID for the household member. |
| May contain organization-specific values: Yes |
|
|
| 19 |
MARITAL_STATUS_C_NAME |
VARCHAR |
No |
|
|
|
| The marital status category ID for the household member. |
| May contain organization-specific values: Yes |
|
|
| 20 |
CITIZENSHIP_C_NAME |
VARCHAR |
No |
|
|
|
| Citizenship status category ID for the household member. |
| May contain organization-specific values: Yes |
| No Entries Defined |
|
|
| 21 |
HAS_INSURANCE_YN |
VARCHAR |
No |
|
|
|
| Household member's current health insurance status. 'Y' indicates the individual is covered by Medicare, private insurance, or other forms of insurance. 'N' indicates individual doesn't have any form of health insurance. 'NULL' indicates information hasn't been collected. |
| May contain organization-specific values: No |
| Category Entries: |
| No |
| Yes |
|
|
| 22 |
HOMELESS_STATUS_YN |
VARCHAR |
No |
|
|
|
| Indicates whether the household member is homeless. 'Y' indicates they are homeless. 'N' indicates they are not homeless. 'NULL' indicates this information has not been collected. For household members who are patients, this can be populated from the patient's stored homeless status. |
| May contain organization-specific values: No |
| Category Entries: |
| Yes |
| No |
|
|
| 23 |
WILL_LIVE_IN_CURRENT_STATE_YN |
VARCHAR |
No |
|
|
|
| Indicates whether this household member is planning on living in the state they are currently living in. 'Y' indicates they plan to continue living in the current state for the foreseeable future. 'N' indicates they plan to move to a different state. 'NULL' indicates data hasn't been collected. |
| The category values for this column were already listed for column: HAS_INSURANCE_YN |
|
|
| 24 |
REL_TO_PRIMARY_APPLICANT_C_NAME |
VARCHAR |
No |
|
|
|
| The category ID of the household member's relationship to the primary applicant. |
| May contain organization-specific values: Yes |
|
|
| 25 |
EMPLOYMENT_STATUS_C_NAME |
VARCHAR |
No |
|
|
|
| The employment status category ID for the household member. |
| May contain organization-specific values: Yes |
| Category Entries: |
| Full Time |
| Part Time |
| Not Employed |
| Self Employed |
| Retired |
| On Active Military Duty |
| Student - Full Time |
| Student - Part Time |
| Unknown |
|
|
| 26 |
EMPLOYMENT_START_DATE |
DATETIME |
No |
|
|
|
| The date when the household member started their current employment. |
|
|
| 27 |
EMPLOYER_ID |
VARCHAR |
No |
|
|
|
| Unique ID of the household member's employer or Employer name. For household members who are patients,this could be populated from patient's stored employer. The unique ID of the household member's employer if Patient Employer Free Text or Linked To EEP (I EAF 6410) item is set to 1 - Link to EEP database. This is free text if I EAF 6410 is set to 2 - Free Text. |
|
|
| 28 |
EMPLOYER_ID_EMPLOYER_NAME |
VARCHAR |
No |
|
|
|
| The name of the employer. |
|
|
| 29 |
EMPLOYER_ADDRESS_CITY |
VARCHAR |
No |
|
|
|
| The city of the household member's employer address. For household members who are patients, this can be populated from the patient's stored employer city. |
|
|
| 30 |
EMPLOYER_ADDRESS_STATE_C_NAME |
VARCHAR |
No |
|
|
|
| The category ID for the state in the employer address for the household member. |
| The category values for this column were already listed for column: RESIDENTIAL_ADDRESS_STATE_C_NAME |
|
|
| 31 |
EMPLOYER_ADDRESS_ZIP |
VARCHAR |
No |
|
|
|
| The ZIP code of the household member's employer address. |
|
|
| 32 |
EMPLOYER_ADDRESS_COUNTY_C_NAME |
VARCHAR |
No |
|
|
|
| The category ID for the county in the employer address for the household member. |
| The category values for this column were already listed for column: RESIDENTIAL_ADDRESS_COUNTY_C_NAME |
|
|
| 33 |
EMPLOYER_ADDRESS_COUNTRY_C_NAME |
VARCHAR |
No |
|
|
|
| The category ID for the country in the employer address for the household member. |
| The category values for this column were already listed for column: RESIDENTIAL_ADDRESS_COUNTRY_C_NAME |
|
|
| 34 |
EMPLOYER_ADDRESS_HOUSE_NUM |
VARCHAR |
No |
|
|
|
| The house number of the household member's employer address. |
|
|
| 35 |
EMPLOYER_ADDRESS_DISTRICT_C_NAME |
VARCHAR |
No |
|
|
|
| The category ID for the district in the employer address for the household member. |
| The category values for this column were already listed for column: RESIDENTIAL_ADDRESS_DISTRICT_C_NAME |
|
|
| 36 |
FILE_TAX_FOR_CURRENT_YEAR_YN |
VARCHAR |
No |
|
|
|
| Indicates whether this household member will be filing tax return for the current year. 'Y' indicates the household member will file taxes or is part of someone else's tax filing. 'N' indicates No. 'NULL' indicates this information isn't collected. |
| The category values for this column were already listed for column: HAS_INSURANCE_YN |
|
|
| 37 |
TAX_FILING_STATUS_C_NAME |
VARCHAR |
No |
|
|
|
| The federal tax filing status category ID for the household member. |
| May contain organization-specific values: Yes |
| Category Entries: |
| Single |
| Married Filing Jointly |
| Married Filing Separately |
| Head of Household |
| Qualifying Surviving Spouse |
|
|
| 38 |
HAS_DEPENDENT_YN |
VARCHAR |
No |
|
|
|
| Indicates whether the household member claims one or more dependents on their federal tax return. 'Y' indicates they claim dependents. 'N' indicates they don't have any dependent to claim. 'NULL' indicates this information isn't collected. |
| The category values for this column were already listed for column: HAS_INSURANCE_YN |
|
|
| 39 |
IS_DEPENDENT_YN |
VARCHAR |
No |
|
|
|
| Indicates whether the household member is claimed as a dependent on another individual’s federal tax return. 'Y' indicates they are a dependent for someone else. 'N' indicates they are not a dependent. 'NULL' indicates this information hasn't been collected. |
| The category values for this column were already listed for column: HAS_INSURANCE_YN |
|
|
| 40 |
IS_BLIND_OR_DISABLED_YN |
VARCHAR |
No |
|
|
|
| Indicates whether the household member meets the federal definition of blindness or has a qualifying disability. 'Y' indicates they meet the definition for blindness or has qualifying disability. 'N' indicates they neither meet the definition for blindness nor has a qualifying disability. 'NULL' indicates this information isn't collected. |
| The category values for this column were already listed for column: HAS_INSURANCE_YN |
|
|
| 41 |
IS_CARETAKER_YN |
VARCHAR |
No |
|
|
|
| This indicates whether the household member is the primary caretaker for a child. 'Y' indicates they are a caretaker for a child. 'N' indicates they aren't. 'NULL' indicates this information isn't collected. |
| The category values for this column were already listed for column: HAS_INSURANCE_YN |
|
|
| 42 |
IMMIGRATION_DOC_TYPE_C_NAME |
NUMERIC |
No |
|
|
|
| The immigration document type category ID for the household member. Customer-defined values represent the type of document recorded, such as a visa or permanent resident ID. |
| May contain organization-specific values: Yes |
| Category Entries: |
| Permanent Resident Card |
| Refugee Travel Document |
| Employment Authorization Document |
| Immigrant Visa |
| Arrival/Departure Record |
| Foreign Passport |
| Certificate of Eligibility for Nonimmigrant Student Status |
| Certificate of Eligibility for Exchange Visitor Status |
| Notice of Action |
| Certification from U.S Department of Health and Human Services (HHS) Office of Refugee Resettlement (ORR) |
| Document indicating withholding of removal |
| Office of Refugee Resettlement (ORR) eligibility letter |
| USCIS Acknowledment of Receipt |
| Document indicating membership in a federally recognized Indian tribe or American Indian born in Canada |
| Reentry Permit |
| Temporary Protected Status |
| USCIS Asylum Approval Letter |
| Signed Court Order |
|
|
| 43 |
IMMIGRATION_DOC_ID_NUMBER |
VARCHAR |
No |
|
|
|
| The identification number printed on the household member's immigration document, such as a visa number or permanent resident ID number. The format varies by country and document type. |
|
|
| 44 |
LIVED_IN_US_SINCE_1996_YN |
VARCHAR |
No |
|
|
|
| Indicates whether the household member has continuously lived in the United States since 1996. 'Y' indicates the member has lived in the U.S. since 1996. 'N' or NULL indicate the member has not, or this information has not been collected. |
| The category values for this column were already listed for column: HAS_INSURANCE_YN |
|
|
| 45 |
VETERAN_STATUS_C_NAME |
VARCHAR |
No |
|
|
|
| The veteran or active-duty military status category ID for the household member. |
| May contain organization-specific values: Yes |
|
|
| 46 |
STUDENT_STATUS_C_NAME |
NUMERIC |
No |
|
|
|
| The student status category ID for the household member. |
| May contain organization-specific values: Yes |
| No Entries Defined |
|
|
| 47 |
INCARCERATION_STATUS_C_NAME |
NUMERIC |
No |
|
|
|
| The incarceration status category ID for the household member. |
| May contain organization-specific values: Yes |
| Category Entries: |
| No |
| Yes - Pending Disposition of Charges |
| Yes - Convicted/Sentenced |
|
|
| 48 |
IHS_PRIMARY_TRIBE_C_NAME |
NUMERIC |
No |
|
|
|
| The primary tribe of membership category ID for the household member. Used for Indian Health Service eligibility purposes. |
| May contain organization-specific values: Yes |
| No Entries Defined |
|
|
| 49 |
RECEIVED_CARE_FROM_IHS_YN |
VARCHAR |
No |
|
|
|
| Indicates whether the household member has received care from an Indian Health Service, Tribal Health, or Urban Indian Health program, or through a referral from one of those programs. 'Y' indicates the member has received such care. 'N' or NULL indicate the member has not. |
| The category values for this column were already listed for column: HAS_INSURANCE_YN |
|
|
| 50 |
ELIGIBLE_FOR_CARE_FROM_IHS_YN |
VARCHAR |
No |
|
|
|
| Indicates whether the household member is eligible to receive care from an Indian Health Service, Tribal Health, or Urban Indian Health program, or through a referral from one of those programs. 'Y' indicates the member is eligible. 'N' or NULL indicate the member is not. |
| The category values for this column were already listed for column: HAS_INSURANCE_YN |
|
|
| 51 |
REQUESTED_COVERAGE_START_DATE |
DATETIME |
No |
|
|
|
| The date on which coverage is requested to begin for the household member. This may predate the application date, since some state Medicaid programs cover charges incurred up to three months prior to the application. |
|
|
| 52 |
TAX_FILER_NAME |
VARCHAR |
No |
|
|
|
| The name of the tax filer to whom the household member is connected for tax-filing purposes. The member's relationship to that filer is captured in REL_TO_TAX_FILER_C. Stored as free-form text because the tax filer is not necessarily on the case. |
|
|
| 53 |
REL_TO_TAX_FILER_C_NAME |
VARCHAR |
No |
|
|
|
| The category ID describing the household member's relationship to the tax filer named in TAX_FILER_NAME. Examples include son, daughter, spouse, or self when the member files their own return. |
| The category values for this column were already listed for column: REL_TO_PRIMARY_APPLICANT_C_NAME |
|
|
| 54 |
IS_PREGNANT_YN |
VARCHAR |
No |
|
|
|
| Indicates whether the household member is pregnant. 'Y' indicates the member is pregnant. 'N' or NULL indicate the member is not pregnant or this information has not been collected. |
| The category values for this column were already listed for column: HAS_INSURANCE_YN |
|
|
| 55 |
PREGNANCY_DUE_DATE |
DATETIME |
No |
|
|
|
| The expected delivery date for the household member's current pregnancy. Populated only when IS_PREGNANT_YN is 'Y'. |
|
|
| 56 |
NUMBER_OF_BABIES_EXPECTED |
INTEGER |
No |
|
|
|
| The number of babies the household member is expected to deliver in the current pregnancy. Populated only when IS_PREGNANT_YN is 'Y'. |
|
|
| 57 |
NEEDS_ADDL_CARE_HELP_YN |
VARCHAR |
No |
|
|
|
| Indicates whether the household member needs help with activities of daily living, lives in a nursing home, or stays in a medical facility. 'Y' indicates the member meets at least one of those situations. 'N' or NULL indicate the member meets none, or this information has not been collected. The three conditions are intentionally captured as one combined Y/N because the CMS Medicaid application phrases them as a single question. |
| The category values for this column were already listed for column: HAS_INSURANCE_YN |
|
|
| 58 |
MEETS_WORK_REQT_C_NAME |
NUMERIC |
No |
|
|
|
| The work-requirements compliance status category ID for the household member. |
| May contain organization-specific values: No |
| Category Entries: |
| No |
| Yes |
| Exempt |
|
|
| 59 |
WORK_REQT_EXEMPTION_C_NAME |
NUMERIC |
No |
|
|
|
| The work-requirement exemption category ID claimed by the household member. |
| May contain organization-specific values: Yes |
| Category Entries: |
| Parent/Guardian/Caretaker |
| Medically Frail - Blind or Disabled (SSI) |
| Medically Frail - Serious or Complex Medical Condition |
| Medically Frail - Disabling Mental Disorder |
| Medically Frail - Substance Use Disorder |
| Medically Frail - Physical/Intellectual/Developmental Disability |
| Currently in SUD Treatment Program |
| Incarcerated or Recently Released (within 3 months) |
| Meeting Work Requirements via TANF/SNAP |
| Former Foster Youth (under 26) |
| Disabled Veteran |
| Full-Time Student |
| Experiencing Homelessness |
| Short-Term Hardship |
|
|