BASIC FOOD CALCULATION      
   
Use this tool to estimate Basic Food benefits for CE or resource-eligible households*  
NUMBER OF AU MEMBERS ELDERLY/DISABLED MEMBER? Y/N   CATEGORICALLY ELIGIBLE?      Y/N    
       
PAY FOR HEATING OR COOLING?  Y/N  NON-HEAT ELEC.  Y/N  GAS WATER /SEWER  Y/N   WELL/SEPTIC  Y/N    TRASH   Y/N TELEPHONE   Y/N      
       
       
1. MONTHLY EARNED INCOME (NOT EXCLUDED)     5. COUNTABLE INCOME      
A. Self-employment gross income     A. Gross income     
B. Self-employment expenses -   B. Standard deduction based on AU size -  
=   C. Child support paid by AU -  
      D. Out of pocket dependent care expenses * -  
D. Earnings from wages, salary, tips, or commissions   E. Medical expenses deduction -  
E. Net self-employment +   F. Earned income deduction (20%) -  
F. Total earned income =   G. Countable income =  
             
2. MONTHLY UNEARNED INCOME (NOT EXCLUDED)     6. EXCESS SHELTER DEDUCTION      
A. Child support received by AU     A. SUA, LUA, TUA, or ZUA?              
B. PA grant (GA, RCA, TANF) +   B. Monthly rent or space rent +  
C. Penalty income (from sanctions) +   C. Monthly mortgage +  
D. Pension benefits +   D. Monthly tax and insurance outside of mortgage +  
E. Railroad retirements +   E. Repairs due to natural disaster +  
F. Social Security and SSI benefits +   F. Total shelter costs =  
G. Unemployment compensation +          
H. Other countable unearned income +   G. Total shelter costs      
I. Total unearned income =   H. ½ countable income  -  
      =  
3. GROSS INCOME            
A. Total earned income                
B. Total unearned income +              
C. Net farm loss offset (if any) -          
D. Gross income for AU =   7. NET INCOME      
      A. Countable income     
F. Gross monthly income limit for AU.     B. Shelter deduction  -  
    C. Net income for Basic Food (rounded up) =  
             
4. MEDICAL COSTS FOR ELDERLY/DISABLED     8. BASIC FOOD BENEFITS FOR MONTH      
A. One-time out-of-pocket expenses     B. Maximum allotment for AU size    
B. Ongoing monthly out-of-pocket expenses +   C. 30% of net income (rounded up) -  
C. Total estimated medical expenses =          
D. Subtract first $35 each month - 35.00          
E. Medical expense deduction =   D. Basic Food for entire month =  
           
       
* If a household is not categorically eligible or resource eligible, they are not eligible for Basic Food.