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{"sheet":"Budget","index":0,"n_rows":41,"n_cols":12,"rows_kept":41,"cut":false,"hidden":false,"merged":[[37,3,37,5],[38,3,38,5],[29,0,29,1],[30,0,30,1],[31,0,31,1],[6,0,6,1],[8,0,8,1],[9,0,9,1],[11,0,11,1],[12,0,12,1],[13,0,13,1],[14,0,14,1],[15,0,15,1],[17,0,17,1],[18,0,18,1],[20,0,20,1],[21,0,21,1],[22,0,22,1],[23,0,23,1],[24,0,24,1],[28,0,28,1],[10,0,10,1],[63,9,63,10],[45,9,45,10],[46,9,46,10],[47,9,47,10],[42,9,42,10],[43,9,43,10],[44,9,44,10],[41,9,41,10],[62,3,62,4],[63,3,63,4],[43,3,43,4],[42,3,42,4],[41,3,41,4],[48,9,48,10],[64,9,64,10],[49,9,49,10],[51,9,51,10],[52,9,52,10],[53,9,53,10],[55,9,55,10],[57,9,57,10],[62,9,62,10],[50,9,50,10],[64,3,64,4],[57,3,57,4],[55,3,55,4],[47,3,47,4],[44,3,44,4],[46,3,46,4],[45,3,45,4],[50,3,50,4],[53,3,53,4],[51,3,51,4],[49,3,49,4],[52,3,52,4],[48,3,48,4]]}
[]
["Adult Public Assistance (APA) Eligibility & Benefit Level Worksheet"]
[]
["Case Name: ",null,null,"Benefit Issued",null,"Benefit Entitled to",null,null,"A1E","Individual, Living Independently",null,"Input value"]
["Case Number:",null,"Year",2016,"Year",2016,null,null,"B1E","Individual, In Another's Household",null,"Formula (no input)"]
[null,null,"Mo/Year",null,"Mo/Year",null,null,null,"H1E","Individual, In Assisted Living Home",null,"Link to tables (no input)"]
["Household Type/Living Arrangement ",null,null,"A1E",null,"A1E",null,null,"A2S","Couple, One Eligible, Living Independently"]
[null,null,null,{"$f":"IF(D7=\"A2S\",\"Use Deemed Worksheet\",IF(D7=\"B2S\",\"Use Deemed Worksheet\",IF(D7=\"H2S\",\"Use Deemed Worksheet\",\"\")))","v":""},null,{"$f":"IF(F7=\"A2S\",\"Use Deemed Worksheet\",IF(F7=\"B2S\",\"Use Deemed Worksheet\",IF(F7=\"H2S\",\"Use Deemed Worksheet\",\"\")))","v":""},null,null,"B2S","Couple, One Eligible, In Another's Household"]
["Countable Gross Earned Income",null,null,0,null,null,null,null,"H2S","Couple, One Eligible, In Assisted Living Home"]
["Spouse/Sponsor Countable Earned Income",null,null,0,null,null,null,null,"A2C","Couple, Both Eligible, Living Independently"]
["Adjusted Gross Earned Income",null,null,0,null,null,null,null,"B2C","Couple, Both Eligible, In Another's Household"]
["Total Countable Earned Income",null,null,{"$f":"IF(D11>0,D11,SUM(D9:D10))","v":0},null,{"$f":"IF(F11>0,F11,SUM(F9:F10))","v":0},null,null,"H2C","Couple, Both Eligible, In Assisted Living Home"]
["Other Allowable Deductions:",null,null,null,null,null,null,null,"NHP","Nursing Home, Personal Needs Standard"]
["$65 Deduction",null,null,{"$f":"IF(Deemed!$D$27=\"yes\",0,IF(D12>0,65,0))","v":0},null,{"$f":"IF(Deemed!$D$27=\"yes\",0,IF(F12>0,65,0))","v":0},null,null,"NH3","Nursing Home, Special Income LTC 300% Standard"]
["1/2 work incentive deduction",null,null,{"$f":"IF(Deemed!$D$27=\"yes\",0,SUM((D12-D13)-D14)/2)","v":0},null,{"$f":"IF(Deemed!$D$27=\"yes\",0,SUM((F12-F13)-F14)/2)","v":0},null,null,"Ineligible"]
["Work expense for blind & self support"]
[null,"Total Allowable Deductions",null,{"$f":"IF(Deemed!$D$27=\"yes\",0,SUM(D13:D16))","v":0},null,{"$f":"IF(Deemed!$D$27=\"yes\",0,SUM(F13:F16))","v":0}]
["Net Earned Income",null,null,{"$f":"SUM(D12-D17)","v":0},null,{"$f":"SUM(F12-F17)","v":0}]
["Net Earned Income",null,null,{"$f":"ROUND(D18,0)","v":0},null,{"$f":"ROUND(F18,0)","v":0}]
[]
["Countable Gross Unearned Income"]
["Spouse/Sponsor Countable Unearned Income"]
["Adjusted Gross Unearned Income"]
["Total Countable Unearned Income",null,null,{"$f":"IF(D23>0,D23,SUM(D21:D22))","v":0},null,{"$f":"IF(F23>0,F23,SUM(F21:F22))","v":0}]
["$20 Disregard"]
[null,"Net Unearned Income",null,{"$f":"IF(Deemed!$D$27=\"yes\",D24,SUM(D24-D25))","v":0},null,{"$f":"IF(Deemed!$D$27=\"yes\",F24,SUM(F24-F25))","v":0}]
[null,"Net Unearned Income",null,{"$f":"ROUND(D26,0)","v":0},null,{"$f":"ROUND(F26,0)","v":0}]
[]
["Total Countable Earned/Unearned Income",null,null,{"$f":"SUM(D27+D18)","v":0},null,{"$f":"SUM(F27+F18)","v":0}]
["Total Countable Earned/Unearned Income",null,null,{"$f":"ROUND(D29,0)","v":0},null,{"$f":"ROUND(F29,0)","v":0}]
["APA Need Standard",null,null,{"$f":"VLOOKUP(D7,Standards!$D$22:$N$32,HLOOKUP(Budget!D5,Standards!$E$20:$N$21,2,FALSE),FALSE)","v":1362},null,{"$f":"VLOOKUP(Budget!F7,Standards!$D$22:$N$32,HLOOKUP(Budget!F5,Standards!$E$20:$N$21,2,FALSE),FALSE)","v":1362}]
["APA Maximum Payment Standard",null,null,{"$f":"VLOOKUP(D7,Standards!$D$38:$N$47,HLOOKUP(Budget!D5,Standards!$E$36:$N$37,2,FALSE),FALSE)","v":1095},null,{"$f":"VLOOKUP(F7,Standards!$D$38:$N$47,HLOOKUP(Budget!F5,Standards!$E$36:$N$37,2,FALSE),FALSE)","v":1095}]
[null,"Payment",null,{"$f":"IF(B4=\"\",\"\",IF(D7=\"Ineligible\",0,IF(D29>D31,0,IF(AND(D30<D31,(D32-D30<0)),1,SUM(D32-D30)))))","v":""},null,{"$f":"IF(B4=\"\",\"\",IF(F7=\"Ineligible\",0,IF(F29>F31,0,IF(AND(F30<F31,(F32-F30<0)),1,SUM(F32-F30)))))","v":""}]
[]
[null,"Day application was received"]
[null,"Number of days in the month"]
[null,"Prorated Payment amount",null,{"$f":"IF(B4=\"\",\"\",IF(D35>0,(((D36+1)-D35)/D36)*D33,\"\"))","v":""},null,{"$f":"IF(B4=\"\",\"\",IF(F35>0,(((F36+1)-F35)/F36)*F33,\"\"))","v":""}]
[null,"Overpayment/Underpayment",null,{"$f":"IF(B4=\"\",\"\",IF(D33-F33=0,\"\",IF(D33<F33,\"Underpayment\",\"Overpayment\")))","v":""}]
[null,"Final Payment Needed",null,{"$f":"IF(B4=\"\",\"\",IF(D35>1,D37-F37,D33-F33))","v":""}]
[]
[null,null,"Important:  Case Name must be completed."]

{"sheet":"Deemed","index":1,"n_rows":53,"n_cols":9,"rows_kept":53,"cut":false,"hidden":false,"merged":[[0,1,0,6],[7,1,7,3],[32,1,32,4],[11,5,11,6],[10,5,10,6],[17,5,17,6],[25,4,25,5],[26,4,26,5],[31,1,31,3],[32,5,32,6],[22,1,22,2],[13,5,13,6],[14,5,14,6],[15,5,15,6],[16,5,16,6],[18,1,18,6],[28,1,28,5],[4,1,4,3],[5,1,5,3],[6,1,6,3],[8,1,8,3],[17,1,17,4],[15,1,15,2],[16,1,16,2],[26,1,26,2],[27,1,27,2],[27,4,27,5],[12,5,12,6],[19,1,19,3],[22,4,22,5],[23,4,23,5],[24,4,24,5],[2,1,2,3],[3,1,3,3],[11,1,11,2],[14,1,14,2],[25,1,25,2],[20,1,20,3],[12,1,12,2],[13,1,13,2],[23,1,23,2],[21,1,21,2],[24,1,24,2],[46,5,46,6],[37,1,37,4],[34,5,34,6],[35,5,35,6],[36,5,36,6],[38,2,38,3],[37,5,37,6],[51,4,51,8],[49,5,49,6],[40,5,40,6],[33,1,33,4],[34,2,34,4],[35,2,35,4],[36,2,36,4],[38,4,38,6],[33,5,33,6],[49,1,49,3],[44,1,44,3],[45,1,45,3],[51,1,51,3],[39,5,39,6],[44,5,44,6],[45,5,45,6],[47,1,47,3],[50,1,50,3],[50,4,50,5],[29,1,29,5],[43,5,43,6],[43,1,43,3],[42,1,42,3],[41,5,41,6],[41,1,41,3],[39,1,39,3],[48,1,48,3],[40,1,40,3],[42,5,42,8],[48,5,48,8],[47,5,47,6],[46,1,46,3]]}
[]
["Year","SSI Case???","No"]
[{"$f":"Budget!D5","v":2016},"Earned Income, List source",null,null,"SP Ineligible",null,null,null,"Information (no Input)"]
[null,null,null,null,null,null,null,null,"Input Information"]
[null,null,null,null,null,null,null,null,"Formula (No Input)"]
[null,null,null,null,null,null,"***Change all \"yes\" to \"no\""]
[]
[]
[null,"Gross Earned Income of Ineligible Spouse",null,null,{"$f":"SUM(E4:E8)","v":0}]
[null,null,null,{"$f":"IF(E12>0,\"SSI Income - Not Eligible\",\"\")","v":""},""]
[null,"Unearned Income, list source",null,"Need Based?",null,"Countable"]
[null,"Supplemental Social Security Income - SSI",null,"No",null,{"$f":"IF(D12=\"yes\",0,E12)","v":0}]
[null,"VA Pension(needs based)",null,"No",null,{"$f":"IF(D13=\"yes\",0,E13)","v":0}]
[null,null,null,null,null,0]
[null,null,null,null,null,0]
[null,null,null,null,null,0]
[null,null,null,null,null,0]
[null,"Gross Countable Unearned Income of Ineligible Spouse",null,null,null,{"$f":"SUM(F12:F17)","v":0}]
[]
[null,"Are there Children in the Home ?",null,null,"No"]
[null,"Amount of Deduction>>>",null,null,{"$f":"HLOOKUP(Budget!$D$5,Standards!$E$3:$N$15,5,FALSE)-HLOOKUP(Budget!$D$5,Standards!$E$3:$N$9,3,FALSE)","v":367}]
[null,"Child's Name & Source",null,"In?","CH Income","",""]
[null,null,null,"No",null,null,{"$f":"IF(D23=\"yes\",IF(E23>$E$21,0,$E$21-E23),\"\")","v":""}]
[null,null,null,"No",null,null,{"$f":"IF(D24=\"yes\",IF(E24>$E$21,0,$E$21-E24),\"\")","v":""}]
[null,null,null,"No",null,null,{"$f":"IF(D25=\"yes\",IF(E25>$E$21,0,$E$21-E25),\"\")","v":""}]
[null,null,null,"No",null,null,""]
[null,"Sponsor",null,"No","No Allocations",null,{"$f":"IF(D27=\"yes\",HLOOKUP($A$3,Standards!$E$3:$N$5,3,FALSE),\"\")","v":""}]
[null,"Sponsor's Spouse",null,"No","No Allocations",null,{"$f":"IF(D28=\"yes\",E21,\"\")","v":""}]
[null,"If more than 4 Children enter additional adjustments here: "]
[null,"Total Children's Deduction:",null,null,null,null,{"$f":"ROUND(G31,0)","v":0}]
[null,null,null,null,null,null,{"$f":"SUM(G23:G29)","v":0}]
[null,"Are there Court Ordered Support Payments ?"]
[null,"Child Support?"]
[null,"Spousal Support?"]
[null,null,"Other (list)"]
[null,null,"Other (list)"]
[null,null,"Other (list)"]
[null,"Total Support Payments",null,null,null,{"$f":"SUM(F33:F37)","v":0}]
[]
[null,"Total Gross Unearned Income:",null,null,{"$f":"F18","v":0},{"$f":"IF(E41+E42>E40,\"Excess Deduction\",\"\")","v":""}]
[null,"Total Sponsor's & Child's Adjustment:",null,null,{"$f":"IF(G30=\"\",0,G30)","v":0}]
[null,"Total Support Payments:",null,null,{"$f":"IF(F38=\"0\",0,F38)","v":0},{"$f":"IF(E41+E42<E40,0,(E41+E42)-E40)","v":0}]
[null,"Net Countable Unearned Income:",null,null,{"$f":"IF(SUM(E41+E42>E40),0,E40-(E41+E42))","v":0},{"$f":"IF(E52=\"yes\",\"Transfer this to Spouse/Sponsor Countable Unearned Income on Budget\",\"\")","v":""}]
[null,"Total Countable Earned Income:",null,null,{"$f":"E9","v":0}]
[null,"Less Excess Adjustment:",null,null,{"$f":"F42","v":0}]
[null,"If $20 not on PI's add it here with $65"]
[null,"Add all other exclusions & allocations and enter here"]
[null,"1/2 of remaining",null,null,{"$f":"(E44-E45-E46-E47)/2","v":0}]
[null,"Net Countable Earned Income:",null,null,{"$f":"IF(E45>E44,0,E44-E45)","v":0},{"$f":"IF(E52=\"yes\",\"Transfer this to Spouse/Sponsor Countable Earned income on Budget\",\"\")","v":""}]
[null,"Amount used to determine if SSI counts?",null,null,{"$f":"SUM(E43+(E44-E45-E46-E47-E48))","v":0}]
[null,"Difference Between SSI Couple & Single",null,null,{"$f":"E21","v":367}]
[null,"Is Net income countable?",null,null,{"$f":"IF(C2=\"no\",\"Enter Net Countable Unearned and Net Countable Earned amounts in budget\",IF(AND(Deemed!$E$40=0,Deemed!$E$44=0),\"\",IF(Deemed!$E$50<=Deemed!$E$51,\"YES\",\"NO\")))","v":"Enter Net Countable Unearned and Net Countable Earned amounts in budget"}]
[null,null,null,null,{"$f":"IF(AND(E52=\"no\",C2=\"yes\"),\"Use SSI Couple Standard for countable income\",\"\")","v":""}]

{"sheet":"Standards","index":2,"n_rows":49,"n_cols":17,"rows_kept":49,"cut":false,"hidden":false,"merged":[]}
[]
[null,null,null,"Table 1","SSI Pymt Standards"]
[null,null,null,null,2013,2014,2015,2016,2017,2018,2019,2020,2021,2022,null,"A1E","Individual, Living Independently"]
[null,null,"SSI HH","Column",2,3,4,5,6,7,8,9,10,11,null,"B1E","Individual, In Another's Household"]
[null,null,"A1E","A1E",710,721,733,733,735,750,771,783,null,null,null,"H1E","Individual, In Assisted Living Home"]
[null,null,"B1E","B1E",473.34,480.67,488.67,488.67,490,500,514,522,null,null,null,"A2S","Couple, One Eligible, Living Independently"]
[null,null,"A2C","A2C",1066,1082,1100,1100,1103,1125,1157,1175,null,null,null,"B2S","Couple, One Eligible, In Another's Household"]
[null,null,"B2C","B2C",710,721,733,733,735,750,771,783,null,null,null,"H2S","Couple, One Eligible, In Assisted Living Home"]
[null,null,"D","NHP",30,30,30,30,30,30,30,30,null,null,null,"A2C","Couple, Both Eligible, Living Independently"]
[null,null,null,"H1E",710,721,733,733,735,750,771,783,null,null,null,"B2C","Couple, Both Eligible, In Another's Household"]
[null,null,"w/o inc.","A2S",1066,1082,1100,1100,1103,1125,1157,1175,null,null,null,"H2C","Couple, Both Eligible, In Assisted Living Home"]
[null,null,"w/o inc.","B2S",710,721,733,733,735,750,771,783,null,null,null,"NHP","Nursing Home, Personal Needs Standard"]
[null,null,"w/o inc.","H2S",1066,1082,1100,1100,1103,1125,1157,1175,null,null,null,"NH3","Nursing Home, Special Income LTC 300% Standard"]
[null,null,"w/ inc","H2C",1066,1082,1100,1100,1103,1125,1157,1175]
[null,null,"D","NH3","-","-","-","-","-","-","-","-","-","-"]
[null,null,null,null,{"$f":"SUM(E5:E15)","v":7607.34},{"$f":"SUM(F5:F15)","v":7722.67},7850.67,7850.67,7872,8030,8256,8384,0,0]
[]
[]
[null,null,null,"Table 2","APA Need Standards"]
[null,null,null,null,2013,2014,2015,2016,2017,2018,2019,2020,2021,2022]
[null,null,null,"Column",2,3,4,5,6,7,8,9,10,11]
[null,null,null,"A1E",1319,1339,1362,1362,1366,1393,1432,1145]
[null,null,null,"B1E",1090,1106,1125,1125,1128,1151,1183,890]
[null,null,null,"H1E",1319,1339,1362,1362,1366,1393,1432,883]
[null,null,null,"A2S",1584,1608,1635,1635,1640,1673,1720,1304]
[null,null,null,"B2S",1251,1270,1292,1292,1296,1322,1359,986]
[null,null,null,"H2S",1584,1608,1635,1635,1640,1673,1720,883]
[null,null,null,"A2C",1954,1983,2017,2017,2023,2063,2121,1703]
[null,null,null,"B2C",1626,1650,1678,1678,1683,1717,1765,1326]
[null,null,null,"H2C",1954,1983,2017,2017,2023,2063,2121,1375]
[null,null,null,"NHP",200,200,200,200,200,200,200,200]
[null,null,null,"NH3",2130,2163,2199,2199,2205,2250,2313,2349]
[null,null,null,null,{"$f":"SUM(E22:E32)","v":16011},{"$f":"SUM(F22:F32)","v":16249},16522,16522,16570,16898,17366,13044,0,0]
[]
[null,null,null,"Table 3","APA Max Pymt Standards"]
[null,null,null,null,2013,2014,2015,2016,2017,2018,2019,2020,2021,2022]
[null,null,null,"Column",2,3,4,5,6,7,8,9,10,11]
[null,null,null,"A1E",1072,1083,1095,1095,1097,1112,1133,1145]
[null,null,null,"B1E",841,849,857,857,858,868,882,890]
[null,null,null,"H1E",810,821,833,833,835,850,871,883]
[null,null,null,"A2S",1231,1242,1254,1254,1256,1271,1292,1304]
[null,null,null,"B2S",937,945,953,953,954,964,978,986]
[null,null,null,"H2S",810,821,833,833,835,850,871,883]
[null,null,null,"A2C",1594,1610,1628,1628,1631,1653,1685,1703]
[null,null,null,"B2C",1253,1264,1276,1276,1278,1293,1314,1326]
[null,null,null,"H2C",1266,1282,1298,1298,1303,1325,1357,1375]
[null,null,null,"NHP",200,200,200,200,200,200,200,200]
[null,null,null,"NH3","-","-","-","-","-","-","-","-","-","-"]
[null,null,null,null,{"$f":"SUM(E38:E47)","v":10014},{"$f":"SUM(F38:F47)","v":10117},10227,10227,10247,10386,10583,10695,0,0]

{"sheet":"Sheet3","index":3,"n_rows":0,"n_cols":0,"rows_kept":0,"cut":false,"hidden":false,"merged":[]}