Page 48

Title 5: Centrally Administered Programs Page 41 Iowa Department of Human Services Employees’ Manual Chapter E: Healthy and Well Kids in Iowa (hawk-i) Income Revised August 20, 2010 Verification of Income

3. A hawk-i application is received July 13 from Mr. E. All questions are answered and Mr. E sends the following pay stubs with the application. Pay date 7-09 7-02 6-25 6-18 Gross Pay $765.00 $100.00 $765.00 $765.00 Mr. E explains on the application that the reduced pay for the July 2 pay stub was due to a temporary plant closing, and that the plant is not expected to close again so his income is expected to continue at its normal rate. Since it seems clear from the pay stubs submitted that Mr. E’s “normal rate” is $765.00 per week, no further pay stubs are needed. The counselor documents in the case file the reason non-consecutive pay stubs were used. 4. Mr. and Mrs. F apply for hawk-i for their children. Mrs. F has regular earned income and Mr. F receives UIB. When annualizing family income, only the remaining balance of UIB will be counted. Complete and Incomplete Income Verification Review pay stubs pin combination with the application and the family’s circumstances to determine whether they provide sufficient verification. Pay stubs submitted that do not cover the 30-day period before the date of application and pay stubs that cover less than a 30-day period should not automatically be classified as incomplete. Also, pay stubs submitted that cover the 30-day period should not automatically be considered as complete verification.

1. A hawk-i application is received January 23 from Mr. and Mrs. F. All questions are answered. Mr. F is unemployed and Mrs. F sends the following weekly pay stubs from her job with the application. Pay date 01-07 12-31 Gross Pay $810.00 $943.00 Even though Mrs. F did not send all of her pay stubs from the 30-day period before the application date, annualized gross income can be determined from the year-to-date amount showing on the December 31 pay stub.