ALIEN INFORMATION - A |
Item Number |
Revised
Date |
PROGRAM SECTION |
File
Format |
A-1 | 01-05 | Immigrant Status/Program Qualification Chart | DOC | | PDF |
A-2 | 05-03 | Guidance on Noncitizen Verification (Food Stamp Program) | DOC |
| PDF |
A-3 | 1998 | Samples of INS Documents | |
| PDF |
A-4 | 01-01 | User Instructions - SSA 40 Qualifying Quarters of Coverage | DOC | | PDF |
A-5 | 06-98 | Consent for Release of Information (SSA-3288) | | | PDF |
A-6 | 06-98 | Request to Resolve Questionable Quarters of Coverage (SSA-512) | | | PDF |
A-7 | 06-98 | Request for Quarters of Coverage History Based on Relationship (SSA-513) | | | |
A-8 | 05-98 | Guidance on 40 Qualifying Quarters | | | PDF |
A-9 | 05-03 | Guidance on the Five Year Residency Requirement - Food Stamp Program | DOC |
| PDF |
A-10 | 05-02 | Systematic Alien Verification for Entitlements (SAVE) Handbook | | |
PDF |
A-11 | | INS Class of Admission Codes | | | PDF |
A-12 | 07-08 | Citizenship and Identify Verification For Medical Assistance and General Assistance |
DOC |
| PDF |
| |
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APPEALS/CLAIMS/DISQUALIFICATIONS/LEGAL - B |
Item Number |
Revised
Date |
PROGRAM SECTION |
File
Format |
B-1 | 10-99 | Food Stamp Disqualification Consent Agreement | DOC | | PDF |
B-2 | 10-99 | GA Disqualification Consent Agreement | DOC | | PDF |
B-3 | 10-99 | TAF Disqualification Consent Agreement | DOC | | PDF |
B-4 | 05-01 | Motion to Dismiss | DOC | | PDF |
B-5 | 05-03 | Appeal Summary | DOC | | PDF |
B-6 | 05-07 | Request for Trust/Annuity Clearance
| DOC | | PDF |
| |
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| | | | | |
| |
Item Number |
Revised
Date |
PROGRAM SECTION |
File
Format |
C-1 | | Information for Parents/Providers: | | | PDF |
C-2 | 01-02 | Introduction: Quality Standards for Family Child Care Settings | | | |
C-3 | 05-03 | Choosing Child Care | DOC | | |
C-4 |
07-07 |
CC R&R Service Delivery Areas |
|
|
|
C-5 |
05-05 |
Hiring Someone To Work In Your
Home HTML |
|
|
PDF |
C-6 |
01-02 |
Five Steps to Choosing Quality
Child Care |
|
|
|
C-7 |
10-04 |
Guidelines
for Clarifying Child Care Licensure Requirements in Public School Programs |
DOC |
|
|
C-8 |
06-04 |
Core
Competencies for Early Child Care and Education Professionals |
|
|
|
C-9 |
01-07 |
In-Home
Child Care Handbook (ES-1654) |
DOC |
|
|
C-9S |
01-07 |
In-Home Child Care Handbook (ES-1654) (Spanish) |
DOC |
|
PDF |
C-9A |
05-05 |
|
DOC |
|
|
C-10 |
10-07 |
Child Care Provider Handbook (ES-1655) |
DOC |
|
|
C-10S |
01-07 |
Child Care Provider Handbook
(ES-1655) (Spanish) |
|
|
|
C-11 |
01-07 |
The Parent - Provider Partnership Handbook
(ES-1656) |
DOC |
|
|
C-11S |
01-07 |
The Parent - Provider Partnership Handbook
(ES-1656) (Spanish) |
|
|
|
C-12 |
01-07 |
Regulated Provider Enrollment (ES-1650) |
DOC |
|
|
C-12A |
01-06 |
Obsolete |
|
|
|
C-12S |
01-07 |
Regulated Provider Enrollment (ES-1650) (Spanish) |
DOC |
|
|
C-13 |
01-07 |
Unregulated Provider Enrollment (ES-1651) |
DOC |
|
|
C-13A |
01-06 |
Obsolete |
|
|
|
C-13S |
01-07 |
Unregulated Provider Enrollment (ES-1651) (Spanish) |
DOC |
|
|
C-14 |
01-07 |
In-Home Child Care Request (ES-1652) |
DOC |
|
|
C-14A |
01-06 |
Obsolete |
|
|
|
C-14S |
01-07 |
In-Home Child Care Request (ES-1652) (Spanish) |
DOC |
|
|
C-15 |
01-07 |
Out of Home Relative Provider Enrollment
(ES-1653) |
DOC |
|
|
C-15A |
01-06 |
Obsolete |
|
|
|
C-15S |
|
Out of Home Relative Provider Enrollment
(ES-1653) (Spanish) |
|
|
|
C-16 |
01-07 |
KsCares
Provider Data Entry Instructions |
DOC |
|
PDF |
C-17 |
07-02 |
Request For Taxpayer Identification
Number and Certification (W-9) |
|
|
|
C-18 |
07-08 |
Maximum
Hourly Child Care Provider Rate Schedule |
DOC |
|
PDF |
C-19 |
07-02 |
Policy Statement on Discipline |
DOC |
|
|
C-19S |
07-02 |
Policy Statement on Discipline (Spanish) |
|
|
|
C-20 |
10-03 |
Turn
Around Communication |
DOC |
|
PDF |
C-21 |
10-05 |
Child
Care Plan Hour Worksheet
|
|
|
PDF |
C-22 |
|
"KsCares Procedure: Child Care EBT Payments for RS Clients"
|
|
|
PDF |
C-23 |
10-05 |
EBT Child Care - Information
for Parents (ES-1658) |
|
|
PDF |
C-24 |
01-06 |
Provider Tip Sheet: What to Do if
You Cannot Get a Traditional Bank Account |
|
|
PDF |
C-25 |
10-07 |
Child Care Checklist |
DOC |
|
PDF |
| |
| |
Item Number |
Revised
Date |
PROGRAM SECTION |
File
Format |
D-1 | 10-05 | CACFP Sponsors of Child Care Homes | DOC | | |
D-2 | 01-04 | Refugees and Migration Resettlement Affiliate Directory | DOC | | PDF |
| | See Web
Links for other Directories | | | |
| |
|
|
|
|
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| | | | | |
| |
Item
Number |
Revised
Date |
PROGRAM SECTION |
File
Format |
E-1 | 01-07 | Obsolete | | | |
E-2 | 05-01 | Income and Support Plan | DOC | | |
E-3 | 05-01 | Income and Support Plan II | DOC | | |
E-4 | 10-04 | TAF 60 Month Limit Questions | DOC | | |
E-5 | 05-03 | OARS Domestic Violence/Sexual Assault Screening Questions for TAF Applicants | DOC | | PDF |
E-6 | 10-06
| Self-Assessment Form | DOC | | PDF |
E-6S |
|
Self-Assessment Form (Spanish) |
DOC |
|
PDF |
E-7 | 01-07 | Case Management Summary Form | DOC | | PDF |
E-8 | 05-03 | Self-Sufficiency Agreement Format | DOC | | PDF |
E-9 | 05-03 | Work Experience Procedure/Best Practice | DOC | | PDF |
E-10 | 10-07 | Comparison of TAF and FS E&T Employment Services | DOC | | PDF |
E-11 | 10-07 | Education/Training Assistance Desk Aid | DOC | | PDF |
E-12 | 05-04 | EES Screening Tool for Referral to Rehabilitation Services | DOC | | PDF |
E-13 | 05-04 | Client Community Service Report | DOC | | PDF |
E-14 |
|
Work Program Assessment Protocol
|
DOC |
|
PDF |
E-15 |
|
|
DOC |
|
PDF |
E-15S |
|
Work Readiness Screening (Spanish)
|
DOC |
|
PDF |
E-16 |
10-06 |
You Need To Know...
About the Successful Families Program
|
DOC |
|
PDF |
E-17 |
02-07 |
Community Service Procedure/Best Practice |
DOC |
|
PDF |
E-18 |
12-07 |
Orientation to the World of Work |
DOC |
|
PDF |
E-19 |
12-07 |
Work Site Supervisor's Handbook |
DOC |
|
PDF |
| |
|
|
|
|
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| |
Item Number |
Revised
Date |
PROGRAM SECTION |
File
Format |
F-1 |
05-08 |
Monthly Family Income and Family Share Deduction Schedule for Child Care Services |
DOC |
|
|
F-1S |
05-05
|
Family Income and Share Schedule for Child Care Services (Spanish) |
|
|
|
F-2 |
10-07 |
Food Stamp Program Standards |
DOC |
|
|
F-3 |
|
Food Stamp Program Benefit Tables |
|
|
|
F-4 | 10-01
10-99 | TABLE I - TAF/GA NonShared Living HTML | DOC | | |
F-5 | 10-99 | TABLE II - TAF Shared Living | HTML | | |
F-6 | 10-99 | TABLE III - GA NonShared Living | HTML | | |
F-7 | 10-99 | GA Pro Rata Tables | HTML | | |
F-8 | 05-08 | Medicaid and HealthWave Standards | DOC | | |
F-9 | 01-92 | Cash Program Standards | | | PDF |
| 01-91 | | | | PDF |
| 01-90 | | | | PDF |
F-10 | 02-87 | GA Pro Rata Basic and Shelter Allowance | | | PDF |
F-11 | 10-07 | 130% Income Reporting Chart for Simplified Reporters | DOC | | PDF |
F-12 |
05-08 |
Grandparents as Caregivers Income Levels |
DOC |
|
PDF |
| |
|
| | |
| |
Item
Number |
Revised
Date |
PROGRAM SECTION |
File
Format |
M-1 | 10-99 | Statement of Intent to Return Home | | | |
M-2 | 10-99 | Notice of Intent to Transfer Resources | | | PDF |
M-3 | 10-99 | Notice of Intent to Allocate Income | | | PDF |
M-4 | 10-99 | Spousal Impoverishment Allowances Memorandum | | | PDF |
M-5 | 10-99 | Medicaid Transfer of Property Decision | | | PDF |
| | | | | |
| |
Item Number |
Revised
Date |
PROGRAM SECTION |
File
Format |
P-1 | 10-07 | Medically Necessary Items Which are Allowable Deductions for Food Stamps or Can be Applied Toward a Spenddown | DOC | | |
P-2 | 10-05 | Statement
of Medically Necessity | DOC | | |
P-3 | 10-99 | Protective Payment Agreement | | | |
P-4 | 07-99 | Kelley Blue Book User Instructions | | | |
P-5 | 01-03 | Statement of Common-Law Marriage | DOC | | |
P-6 | 01-05 | Landlord Letter | DOC | | |
P-7 | 10-07 | Declaration of Identity - Child
| DOC | | PDF |
P-8 |
07-06 |
Declaration of Citizenship |
DOC |
|
|
P-9 |
10-07 |
Declaration of Identity - Disabled Adult |
DOC |
|
|
P-10 |
10-07 |
Medical Transfer Checklist |
DOC |
|
PDF |
P-11 |
07-08 |
Authorization for Release of PHI |
DOC |
|
PDF |
| |
Item
Number |
Revised
Date |
PROGRAM SECTION |
File
Format |
R-1 | 07-06 | Medical Subrogation Referral - Adoption | DOC | | PDF |
R-2 | 07-06 | Medical Subrogation Referral - Injury | DOC | | PDF |
R-3 | 10-99 | Referral for Technology - Assisted Children Assessment | | | PDF |
R-4 | 05-04 | EES/RS Coordination Procedure/Best Practice | DOC | | PDF |
R-5 | 05-04 | EES/RS Monthly Communication Report: | DOC | | PDF |
| | | | | |
SOCIAL SECURITY INFORMATION - S |
Item
Number |
Revised
Date |
PROGRAM SECTION |
File
Format |
S-1 | 11-92 | Referral for Social Security Number Application | | | PDF |
S-2 | 10-99 | SSA Disability List (For Determining Disability for Food Stamps) | | | PDF |
| | | | | |
| |
Item Number |
Revised
Date |
PROGRAM SECTION |
File
Format |
T-1 | 10-06 | Components to Meet Work Requirements/ Participation | DOC | | |
T-2 | 10-04 | County Group Assignments Chart | DOC | | PDF |
| | 05-07 | Life Estate Valuation Tables | DOC | | PDF |
T-4 | 05-07 | Life Expectancy Tables | | | PDF |
T-5 | ` | RESERVED | | | |
T-6 | 10-99 | Relationship Chart (For TAF Only) | | | PDF |
T-7 | 10-07 | IR Set-Up Schedule | DOC | | PDF |
T-8 |
10-05 | Reporting
Notices Chart | DOC | | PDF |
T-9 |
10-05 |
Reporting
Requirements Notice Matrix |
DOC |
|
PDF |
T-10 |
05-08 |
Food
Stamp Shelter Changes Chart |
DOC |
|
PDF |
T-11 |
|
|
DOC |
|
PDF |
| |
|
|
|
|
|
|
|
|
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|
|
EBT - V |
Item Number |
Revised
Date |
PROGRAM SECTION |
File
Format |
V-1 | 01-08 | Electronic Benefit Transfer System Guide |
DOC | | |
V-2 | 05-05 | EBT Brochure - Cash/FS (English) | | | |
V-3 |
05-05 |
EBT Brochure - Cash/FS (Spanish) |
|
|
|
V-4 |
05-05 |
EBT Brochure - Child Care (English) |
|
|
|
V-5 |
05-05 |
EBT Brochure - Child Care (Spanish) |
|
|
|
| | | | | |
| |
| |
Item
Number |
Revised
Date |
PROGRAM SECTION |
File
Format |
X-1 | 05-05 | Abbreviations & Acronyms
Used by KS Dept. of SRS See Web
Links | | | |
X-2 | 07-01 | An Expanded Definition of "Eligible Foods" | | | |
X-3 | 05-07 | Appointment of Authorized Agent |
DOC | | PDF |
X-4 | 08-96 | Authorization to Furnish Information and Release From Liability (Funeral Assistance Program) | | | |
X-5 | 10-05 | Back of Notices of Action | DOC | | |
X-6 | 01-07 | Definitions of Common Terms | DOC | | |
X-7 | 01-02 | Safeguarding Federal Tax Information | | | |
X-8 | 01-07 | ICT CHECKLIST | DOC | | |
X-9 | 10-99 | Concerns About A Case Received in Transfer from XX County | | | |
X-10 |
01-06 |
SRS Institutions: Procedures
For Placement of Confirmed Perpetrator Names on Adult Protective Services
(APS) Registry |
DOC |
|
PDF |
X-11 |
01-08 |
APS Fax Transmittal |
DOC |
|
|
| |
|
|
|
|
|
WORKSHEETS - W |
Item
Number |
Revised
Date |
PROGRAM SECTION |
File
Format |
W-1 | 10-99 | Costs of Goods Sold (Attachment) | | | |
W-2 | 10-99 | Daily Business Log Sheet | DOC | | |
W-3 | 11-97 | Determining Medical For a Person Being Added to TAF | | | |
W-4 | 07-07 | Financial Eligibility Determination Worksheet for Nursing Facility Cases | DOC | | |
W-5 | 07-07 | Funeral Assistance Worksheet | | | |
W-6 | 05-00 | MA-CM Electronic Worksheet | XLS | | |
W-6A | 05-00 | Electronic Worksheet Instructions | DOC | | PDF |
W-7 | 02-94 | Self-Employment Worksheet | | | |
W-8 | 01-01 | SSI Eligibility Determination Worksheet (Electronic) | DOC | | |
W-9 | 07-08 | Transfer of Property Worksheet | DOC | | |
W-10 |
05-08 |
Annuity Evaluation Worksheet |
DOC |
|
|
W-11 |
03-08 |
TAF Change Form |
XLS |
|
PDF |
W-11a |
03-08 |
TAF Change Form Instructions |
DOC |
|
PDF |