Ineligibility Notice (Output)

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The Ineligibility Notice (Output) is generated for the participant when they are determined ineligible to receive WIC benefits. The document is generated in response to the following user actions: When the Create Ineligibility Notice check box is checked and OK is clicked on the Mark Applicant as Ineligible screen, or when the OK button is clicked on the Generate Ineligibility Notices screen.

Data Elements

This section describes the data elements that print on the system output. Because of space constraints, the layout may be slightly different and/or all characters may not print within the space allotted.

Client Name

This value is the full name of the client.

Origin of Data Element

The value is taken from the Last-Name, First-Name, and Middle-Initial columns of the MEMBER table of the client.

Format

The value prints in {first name} {middle initial}. {last name} format.

Client Mailing Address

This value is the mailing address of the household of the client.

Origin of Data Element

The value is taken from the Mail-Address of the HOUSEHOLD table of the client.

Format

The value prints as its literal value.

Client Mailing City

This value is the mailing city of the household of the client.

Origin of Data Element

The value is taken from the Mail-City of the HOUSEHOLD table of the client.

Format

The value prints as its literal value.

Client Mailing State

This value is the mailing state of the household of the client.

Origin of Data Element

The value is taken from the Mail-State column of the HOUSEHOLD table of the client.

Format

The value prints as its literal value.

Client Mailing ZIP Code

This value is the mailing ZIP code of the household of the client.

Origin of Data Element

The value is taken from the Mail-ZIP column of the HOUSEHOLD table of the client.

Format

The value prints in #####-#### format.

Client Telephone Number

This value is the telephone number of the client.

Origin of Data Element

The value is taken from the Telephone-1 column of the HOUSEHOLD table for the household of the household member scheduled for the appointment.

Format

The value prints in ###-###-#### format.

Client State WIC ID

This value is the State WIC ID of the client.

Origin of Data Element

The value is taken from the State-WIC-Identifier column of the MEMBER table of the client.

Format

The value prints as its literal value.

Gender

This value is the gender of the client.

Origin of Data Element

The value is taken from the Gender column of the MEMBER table.

Format

The value prints as its literal value.

Race

This value is the race/ethnicity of the client.

Origin of Data Element

The value is taken from the Race-Ethnicity column of the MEMBER table.

Format

The value prints as its literal value.

Income

This value is the income for the household of the client.

Origin of Data Element

The value is taken from the Amount column of the INCOMEITEM table. The value will display in either weekly, monthly, or yearly amounts depending on the setting of the State business rule, INCOMEVIEWFREQ.

Format

The value prints in $###,####.### format.

Family Size

This value is the number of members in the household of the client.

Origin of Data Element

The value is the HouseholdSize column of the HOUSEHOLD table of the client.

Format

The value prints in ## format.

Income Proof

This value is the proof of income presented by the client during certification.

Origin of Data Element

The value is taken from the ProofOfIncome column of the first INCOMEITEM table for the income contact.

Format

The value prints as its literal value.

Client First Name

This value is the first name of the client.

Origin of Data Element

The value is taken from the First-Name column of the MEMBER table of the client.

Format

The value prints as its literal value.

Ineligibility Reason(s)

This value is the ineligibility reason indicating why the client is no longer eligible for WIC benefits.

Origin of Data Element

The value is populated from the appropriate values in the Reference Dictionary table. It will be the associated description for the CertIneligibilityReason column of the CERTCONTACT table.

Format

The value prints as its literal value.

Fair Hearing Officer Name

This value is the name of the fair hearing officer for the agency.

Origin of Data Element

The value is taken from the Fair-Hearing-Officer-Name column of the AGENCY table.

Format

The value prints as its literal value.

Agency Name

This value is the name of the agency.

Origin of Data Element

The value is taken from the look up database.

Format

The value prints as its literal value.

Agency Address

This value is the address of the agency.

Origin of Data Element

The value is taken from the look up database.

Format

The value prints as its literal value.

Agency City

This value is the city of the agency.

Origin of Data Element

The value is taken from the look up database.

Format

The value prints as its literal value.

Agency State

This value is the state of the agency.

Origin of Data Element

The value for your state will be hard coded into the document.

Format

The value prints as the literal value of your state.

Agency ZIP Code

This value is the ZIP code of the agency.

Origin of Data Element

The value is taken from the look up database.

Format

The value prints in #####-#### format.

Fair Hearing Officer Telephone Number

This value is the telephone number of the agency.

Origin of Data Element

The value is taken from the Fair-Hearing-Officer-Telephone column of the AGENCY table.

Format

The value prints as its literal value.

Filter Criteria

Participant Marked as Ineligible

The system generates the notice on demand when the participant is marked as ineligible when completing the Certification Guided Script.

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