Not Eligible for KTAP/MA: Complete KPC or PA-97 or enter and deny application – CLIENT’S choice.

1. Applying for or Inquiring about KTAP Is there a child* in the home for whom you are applying? • *Child for KTAP • Must be under age 18 or 18 and in high school. • There must be a child in the home to receive KTAP. Yes Enter Case Change No Do you currently receive KTAP for yourself and/or other children? Yes Are you pregnant or under age 19? No Explore Family MA Are you the parent of the child for which you are applying? Yes No No Yes Explore Adult MA Are you Aged, Blind or Disabled? Are both parents of the child in the home? Do you want benefits for yourself? KWP Case Yes Yes Yes No No No No Do you receive SSI? Not Eligible for KTAP/MA: Complete KPC or PA-97 or enter and deny application – CLIENT’S choice. Yes Payee Case

2. Applying for or Inquiring about Medicaid Is there a child* in the home for whom you are applying? • *Child for Medicaid • Must be under age 19. Yes No Explore Adult MA Are you Aged, Blind or Disabled? Do you currently receive Medicaid for yourself and/or other children? Yes Are you pregnant or under age 19? No No Yes No Yes Explore Family MA • Not Eligible for ongoing MA: Complete one of the following – client’s choice: • KPC or • PA-97 or • Enter and deny MA application Case Change – Add Member