Project Claire: case elig.html
From PikaDocs
Last modified: August 27, 2005
<!-- case_elig.html = Case Record Eligibility subtemplate -->
<!-- see corresponding code in intake_step2.html beginning at line 55 -->
<!-- FORM element closes at bottom of template -->
<form action="%%[base_url]%%/ops/update_intake.php" method="post" name="ws">
<div id="case-calculators"> <!-- wrapper for positioning all caculator elements -->
<!-- # of household members -->
<div class="household">
<span class="label">Adults</span>
<br />
<input type="text" name="adults" value="%%[adults]%%" tabindex="1" onchange="ph_change();" />
</div>
<div class="household">
<span class="label">Children</span>
<br />
<input type="text" name="children" value="%%[children]%%" tabindex="1" onchange="ph_change();" />
</div>
<div class="household">
<span class="label">Helped</span>
<br />
<input type="text" name="persons_helped" value="%%[persons_helped]%%" tabindex="1" />
</div>
<!-- wage calculator -->
<div class="wage-calculator">
<span class="label">Hourly rate x weekly hours</span>
<br />
$ <input type="text" name="dontuse1" onchange="calcWage();" tabindex="3" /> X <input type="text" name="dontuse2" onchange="calcWage();" tabindex="3" /> = $ <input type="text" name="dontuse3" tabindex="3" />
</div>
<div id="wage-button">
<input id="grid" class="initial-intake" type="image" src="images/buttons/grid.gif" onclick="sendToGrid();" alt="Send wage calculation to the income grid." title="Send wage calculation to the income grid." />
</div>
</div> <!-- "calculator" closing DIV -->
<!-- TABLE container for financial eligibility input/select elements -->
<!-- row = type of income ~ frequency ~ amount | type of asset ~ value -->
<table id="eligibility-grid">
<colgroup id="income-type">
<col span="3" />
</colgroup>
<colgroup span="2">
<col id="asset-type" span="1" />
<col span="1" />
</colgroup>
<thead>
<tr> <!-- table column headings -->
<th scope="col">Income Type</th>
<th scope="col">Frequency</th>
<th scope="col">Amount</th>
<th scope="col">Asset Type</th>
<th class="last" scope="col">Value</th>
</tr>
</thead>
<tbody> <!-- opening TBODY content -->
<tr id="first-row"> <!-- row 1 -->
<td>%%[income_type0,income_type]%%</td>
<td>%%[income_freq0,income_freq]%%</td>
<td>$ <input type="text" name="annual0" value="%%[annual0]%%" tabindex="1" /></td>
<td class="asset">%%[asset_type0,asset_type]%%</td>
<td>$ <input type="text" name="asset0" tabindex="1" onchange="asset_change();" value="%%[asset0]%%" /></td>
</tr>
<tr> <!-- row 2 -->
<td>%%[income_type1,income_type]%%</td>
<td>%%[income_freq1,income_freq]%%</td>
<td>$ <input type="text" name="annual1" value="%%[annual1]%%" tabindex="1" /></td>
<td class="asset">%%[asset_type1,asset_type]%%</td>
<td>$ <input type="text" name="asset1" tabindex="1" onchange="asset_change();" value="%%[asset1]%%" /></td>
</tr>
<tr> <!-- row 3 -->
<td>%%[income_type2,income_type]%%</td>
<td>%%[income_freq2,income_freq]%%</td>
<td>$ <input type="text" name="annual2" value="%%[annual2]%%" tabindex="1" /></td>
<td class="asset">%%[asset_type2,asset_type]%%</td>
<td>$ <input type="text" name="asset2" tabindex="1" onchange="asset_change();" value="%%[asset2]%%" /></td>
</tr>
<tr> <!-- row 4 -->
<td>%%[income_type3,income_type]%%</td>
<td>%%[income_freq3,income_freq]%%</td>
<td>$ <input type="text" name="annual3" value="%%[annual3]%%" tabindex="1" /></td>
<td class="asset">%%[asset_type3,asset_type]%%</td>
<td>$ <input type="text" name="asset3" tabindex="1" onchange="asset_change();" value="%%[asset3]%%" /></td>
</tr>
<tr> <!-- row 5 -->
<td>%%[income_type4,income_type]%%</td>
<td>%%[income_freq4,income_freq]%%</td>
<td>$ <input type="text" name="annual4" value="%%[annual4]%%" tabindex="1" /></td>
<td class="asset">%%[asset_type4,asset_type]%%</td>
<td>$ <input type="text" name="asset4" tabindex="1" onchange="asset_change();" value="%%[asset4]%%" /></td>
</tr>
<tr id="total-row"> <!-- row 6 = totals -->
<td> </td>
<td colspan="2"><b>Total:</b> $ <input type="text" name="income" tabindex="1" value="%%[income]%%" readonly="readonly" /><input type="hidden" name="income_only"/></td>
<td colspan="2"><b>Total:</b> $ <input type="text" name="assets" tabindex="1" value="%%[assets]%%" readonly="readonly" /></td>
</tr>
</tbody> <!-- closing TBODY content -->
</table> <!-- "eligibility-grid" closing TABLE -->
<!-- calculate poverty ... income justification -->
<div id="poverty-wrapper">
<div class="poverty01">
<h4>% of Poverty</h4>
<input id="calculate" class="initial-intake" type="image" src="images/buttons/calculate.gif" tabindex="1" onclick="calc_poverty();" alt="Calculate percentage of poverty" title="Calculate percentage of poverty" />
<input id="percentage" type="text" name="poverty" value="%%[poverty]%%" readonly="readonly" />
<input type="hidden" name="poverty_income_only" />
</div>
<div class="poverty02">
<h4>Income Justification</h4>
%%[just_income,just_income]%%
</div>
</div> <!-- "poverty-wrapper" closing DIV -->
<!-- pop-up help ~ income and assets -->
<div class="step2-help">
<ul>
<li><a class="context-help" href="javascript:popUp('%%[base_url]%%/helpdocs/help_financial.html')" title="Click to see definitions and applicable rules for each of these terms.">Income table</a></li>
<li><a class="context-help" href="javascript:popUp('%%[base_url]%%/helpdocs/help_financial.html')" title="Click to see definitions and applicable rules for each of these terms.">Asset rules</a></li>
<li><a class="context-help" href="javascript:popUp('%%[base_url]%%/helpdocs/help_financial.html')" title="Click to see definitions and applicable rules for each of these terms.">Over-income rules</a></li>
</ul>
</div>
<div id="status-wrapper">
<div class="status01">
<h4>Citizenship Status</h4>
%%[citizen,citizen]%%
<br />
%%[citizen_check,yes_no,checkbox]%% <span>Confirmed?</span>
</div>
<div class="status02">
<h4>Alien Status</h4>
%%[noncitizentype,noncitizentype]%%
<h4 id="document">Document Type</h4>
%%[noncitizendoc,noncitizendoc]%%
</div>
</div> <!-- "status-wrapper" closing DIV -->
<!-- pop-up help ~ citizen and aliens status -->
<div class="status-help">
<ul>
<li><a class="context-help" href="javascript:popUp('%%[base_url]%%/helpdocs/help_citizen.html')" title="Click to see definitions and applicable rules for each of these terms.">What do these terms mean?</a></li>
</ul>
</div>
<!-- notes field -->
<div class="notes">
Intake Notes:
<br />
<textarea id="intake-notes" name="intake_notes" cols="" rows="5" tabindex="1">%%[intake_notes]%%</textarea>
</div>
<input type="hidden" name="intake_id" value="%%[intake_id]%%" />
<!-- Save button -->
<input type="hidden" name="screen" value="elig"/>
<input type="hidden" name="case_id" value="%%[case_id]%%"/>
<p class="save-update">
<input id="save" class="initial-intake" type="image" src="images/buttons/save.gif" value="submit" name="update_case" tabindex="2" accesskey="s" />
</p>
</form> <!-- closing FORM -->
<!-- Scripts -->
<script type="text/javascript">
<!--
document.ws.children.focus();
//-->
</script>
<script type="text/javascript" src="%%[base_url]%%/js/case_elig.js.php"></script>
<script type="text/javascript">
<!--
// The second (non-adjusted) Income field needs to be calculated on each page view (it's not in the DB.)
income_change();
//-->
</script>
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