Part F, Former Foster Care in Higher Education (FFCHE)

F-100, Application Processing

Revision 19-4; Effective October 1, 2019

 

 

F—110 Application Procedures

Revision 15-4; Effective October 1, 2015

 

Section 17, Senate Bill 10, passed by the 80th Texas Legislature, Regular Session, 2007, requires the Texas Health and Human Services Commission (HHSC) to provide Medicaid coverage to certain former foster care youth attending school.

HHSC uses state funds to pay for the Former Foster Care in Higher Education (FFCHE) program. Since this program is funded entirely by the state, it is not considered Medicaid and is identified as a Health Care Benefits program instead of Medicaid or medical assistance.

Effective January 1, 2014, new individuals will not be certified for FFCHE. Individuals receiving FFCHE as of December 2013 and eligible for Former Foster Care Children (FFCC) transitioned to FFCC January 1, 2014. Applications and redeterminations for FFCHE disposed on or after January 1, 2014, will be reviewed for FFCC eligibility. Those individuals not eligible for FFCC will continue to receive FFCHE until they age out of the program or are no longer eligible, whichever comes first.

Exception: HHSC received federal approval to provide health care coverage for individuals living in Texas who aged out of foster care under an Interstate Compact on the Placement of Children (ICPC) agreement. These individuals may be eligible for FFCHE or Medicaid for Transitioning Foster Care Youth (MTFCY), explained in Part M, Medicaid for Transitioning Foster Care Youth (MTFCY).

 

F—111 Type of Assistance (TA) 77 – Health Care – FFCHE

Revision 19-4; Effective October 1, 2019

 

To be eligible for FFCHE benefits, a person must:

  • have had an ICPC agreement*;
  • currently reside in Texas;
  • be ages 21 up to 23;
  • have been in any state's conservatorship on their 18th birthday;
  • be enrolled in an institution of higher education located in Texas;
  • not have adequate health coverage as defined by HHSC; and
  • meet all other medical programs eligibility criteria such as citizenship or alien eligibility.

*Staff must contact the Texas Department of Family and Protective Services (DFPS) to determine whether the person had an ICPC agreement. DFPS has three business days to respond.

Specialized staff process all FFCHE case actions.

 

F—112 Application Processing

Revision 15-4; Effective October 1, 2015

 

Individuals who have had an ICPC agreement may apply by completing Form H1868, Application for Health Care Benefits. The Spanish version of the FFCHE application is Form H1868-S. Staff must determine whether the applicant is in need of the English or Spanish version when a request for an application is received.

Note: Advisors must also accept any of the applications explained in A-113, Application Requests and Submissions. CBS advisors must request any additional information needed to make an eligibility determination.

 

F—113 Requesting an Application

Revision 15-4; Effective October 1, 2015

 

Individuals who have had an ICPC agreement may request an FFCHE application by calling 2-1-1.

Note: If an individual requests an application at a local eligibility determination office, the advisor must refer the applicant to CBS and provide appropriate contact information.

On the same day the request is received, the advisor provides the applicant an application packet that includes:

  • Form H1868, Application for Health Care Benefits;
  • Form H1870, School Enrollment Verification Form;
  • Form H0025, HHSC Application for Voter Registration; and
  • a business reply envelope addressed to the HHSC Document Processing Center (DPC).

CBS advisors will send individuals who have had an ICPC agreement and are enrolled in MTFCY the following forms two months prior to aging out of MTFCY:

  • Forms H1868/H1868-S, Application for Health Care Benefits;
  • Forms H1870/H1870-S, School Enrollment Verification Form; and
  • a business reply envelope.

CBS advisors must document in TIERS Case Comments, "Special Review completed; Forms H1868 and H1870 mailed to client."

If an applicant requests help completing an application, a volunteer or staff member must provide assistance. Anyone assisting the applicant in completing a paper application must initial the part completed, or sign the form indicating assistance was provided.

Related Policy
Registering to Vote, A-1521

 

F—114 Authorized Representatives (AR)

Revision 15-4; Effective October 1, 2015

 

An individual may designate an individual or organization as an AR, following the policy explained in A-170, Authorized Representatives (AR).

 

F—120 Office Procedures

Revision 10-2; Effective April 1, 2010

 

 

 

F—121 Filing an Application

Revision 15-4; Effective October 1, 2015

 

Individuals who have had an ICPC agreement may submit Form H1868/H1868-S:

  • by mail to the HHSC DPC at:

    HHSC
    P.O. Box 149024
    Austin, TX 78714-9024

or

  • by toll-free fax to 1-877-447-2839.

Note: Applicants cannot submit Form H1868/H1868-S via telephone or online through YourTexasBenefits.com.

If a local eligibility determination office receives an application, staff must date stamp and fax the application to the DPC non-expedited fax line (1-877-447-2839) no later than the next business day.

Note: Advisors follow policy found in A-121, Receipt of Application, regarding what constitutes a valid application and what to do when the agency receives an incomplete application.

 

F—122 File Date

Revision 15-4; Effective October 1, 2015

 

The file date is the day any local eligibility determination office, call center vendor, or other HHSC-contracted entity accepts an application containing the applicant's name, address and an appropriate signature. The file date is considered day zero in the application process.

Advisors must document why a certain file date was used to determine eligibility when:

  • the file date used differs from the received date on the application, or
  • the application has two received dates (stamp dates).

Note: For applications received outside of normal business hours, the file date is the next business day.

 

F—130 Interviews

Revision 10-2; Effective April 1, 2010

 

 

 

 

F—131 General Policy

Revision 15-4; Effective October 1, 2015

 

An interview is not required when applying for or renewing an application for the FFCHE program. Advisors must schedule a phone interview only if the individual requests an interview. The State Portal Scheduler does not support scheduling an interview for the FFCHE program. Any requests for an interview must be scheduled manually.

Note: An application must not be denied if the applicant misses the interview, and the advisor should continue to determine eligibility.

F-200, Household Composition

Revision 15-4; Effective October 1, 2015

 

 

F—210 General Policy

Revision 15-4; Effective October 1, 2015

 

The Modified Adjusted Gross Income (MAGI) household composition and certified Eligibility Determination Group (EDG) for Former Foster Care in Higher Education (FFCHE) consists of the applicant only. The applicant is the only certified member on the FFCHE EDG.

Example: An individual, age 22, is married and lives with her husband and their child. The individual applies for and is eligible for the FFCHE program. The MAGI household composition and certified EDG consists of only the individual. Her husband and child are not included.

 

F—220 Verification Requirements

Revision 15-4; Effective October 1, 2015

 

There are no verification requirements for household composition. Accept the individual’s statement as verification.

F-300, Citizenship

Revision 15-4; Effective October 1, 2015

 

 

F—310 General Policy

Revision 15-4; Effective October 1, 2015

 

The Former Foster Care in Higher Education (FFCHE) program follows the Medical Programs policy for citizenship and alien status eligibility in A-300, Citizenship.

Exception: Applicants do not receive the period of reasonable opportunity explained in A-351.1, Reasonable Opportunity.

Applicants who are U.S. citizens and certain legally admitted alien residents are eligible for FFCHE if they meet all other eligibility criteria.

Reminder: The State Online Query (SOLQ) and the Wire Third-Party Query (WTPY) inquiry systems cannot be used to verify citizenship for this program. See F-2140, Pending Information on Applications.

F-400, Social Security Number (SSN)

Revision 10-2; Effective April 1, 2010

 

 

F—410 General Policy

Revision 10-2; Effective April 1, 2010

 

Applicants must provide an SSN or apply for one through the Social Security Administration before certification. Use policy in A-411, Determining Advisor Action at Application, listed under the All Programs heading when an applicant does not have an SSN.

F-500, Age

Revision 15-4; Effective October 1, 2015

 

 

F—510 General Policy

Revision 15-4; Effective October 1, 2015

 

Applicants are eligible to receive Former Foster Care in Higher Education (FFCHE) program benefits beginning the month after their 21st birthday through the end of the month of their 23rd birthday. Applicants who wish to have coverage during the month of their 21st birthday must apply for benefits under an appropriate Medicaid program.

Note: These individuals may be eligible for Medicaid for Transitioning Foster Care Youth (MTFCY) during the month of their 21st birthday. See Part M, Medicaid for Transitioning Foster Care Youth (MTFCY).

 

F—520 Verification Requirements

Revision 10-2; Effective April 1, 2010

 

Accept self-declaration as verification of age.

 

F—530 Documentation Requirements

Revision 10-2; Effective April 1, 2010

 

Document the individual's self-declaration establishing the age.

F-600, Relationship

Revision 15-4; Effective October 1, 2015

 

 

Relationship requirements do not apply to the Former Foster Care in Higher Education (FFCHE) program.

F-700, Identity

Revision 10-2; Effective April 1, 2010

 

 

F—710 General Policy

Revision 10-2; Effective April 1, 2010

 

To establish identity, follow the Medical Programs policy in A-600, Identity.

F-800, Residence

Revision 15-4; Effective October 1, 2015

 

 

F—810 General Policy

Revision 15-4; Effective October 1, 2015

 

To determine residence eligibility, follow TP 33, TP 34, TP 35, TP 43, TP 44, TP 45 and TP 48 policy in A-700, Residence.

F-900, Adequate Health Coverage (Third-Party Resource)

Revision 17-2; Effective April 1, 2017

 

 

F—910 General Policy

Revision 17-2; Effective April 1, 2017

 

An applicant/recipient is not eligible to receive Former Foster Care in Higher Education (FFCHE) benefits if the individual currently has adequate health coverage. Adequate health coverage is also known as a third-party resource (TPR). Adequate health coverage is defined as receiving coverage under:

  • group health insurance;
  • health insurance coverage;
  • Medicare (Part A or Part B);
  • Medicaid (with the exception of the Healthy Texas Women, Medicaid with Spend Down, and Community Attendant);
  • armed forces insurance; or
  • a state health risk pool.

Deny an application for an individual who has adequate health coverage.

Do not consider a plan with a limited scope of coverage such as dental, vision, long-term care, etc., or for only a specific illness/disease, such as drug/substance abuse, as adequate health coverage.

Consider an applicant/recipient as having adequate health coverage even if it has limits on benefits or high deductibles.

If staff receive a task with information that the individual has TPR and the “NHIC” box is greyed out, advisors deny rather than pend the EDG. This information has already been verified by the Office of Inspector General – Third Party Liability area. 

When an FFCHE applicant is denied due to adequate health care coverage, Form TF0001, Notice of Case Action, will read:

“We found that you already have private health insurance. To learn more about the insurance you already get, call toll-free 1-800-846-7307 (after you pick a language, press 2).”

In some instances, the parents of FFCHE recipients have TPR coverage for them without the individual knowing. If the individual states they are not aware of the TPR, staff should advise them to call the claims administrator’s Third Party Liability Customer Service Line at 1-800-846-7307 and select option 2. This will allow the individual to obtain information regarding their TPR.

If the TPR information in the Texas Integrated Eligibility Redesign System (TIERS) has been verified by the claims administrator but needs to be updated, staff should fax the completed Form H1039, Medical Insurance Input, to the claims administrator at 512-514-4215.

 

F—920 Verification Requirements

Revision 10-2; Effective April 1, 2010

 

Accept self-declaration of adequate health coverage.

Exception: If an applicant is denied due to receiving adequate health coverage and the applicant calls to notify HHSC that the medical insurance is not adequate health coverage, staff would need to verify if the coverage is considered adequate health coverage.

 

F—930 Documentation Requirements

Revision 10-2; Effective April 1, 2010

 

Staff must document in case comments the existence of adequate health coverage.

F-1000, Eligibility Begin Dates

Revision 15-4; Effective October 1, 2015

 

 

F—1010 General Policy

Revision 15-4; Effective October 1, 2015

 

The applicant is eligible for 12 months beginning the first day of the application month if all eligibility criteria are met. The applicants are eligible to receive benefits beginning the month after their 21st birthday through the end of the month of their 23rd birthday.

The medical effective date cannot precede the:

  • effective date of the program (October 1, 2009), or
  • the month after the individual's 21st birthday.

If an applicant applies in the month of the applicant’s 21st birthday, the individual cannot be eligible for the Former Foster Care in Higher Education (FFCHE) program until the following month.

Applicants who wish to have coverage during the month of their 21st birthday must apply for benefits under an appropriate Medicaid program.

Note: These individuals may be eligible for Medicaid for Transitioning Foster Care Youth (MTFCY) during the month of their 21st birthday. See Part M, Medicaid for Transitioning Foster Care Youth (MTFCY).

Examples:

  • An individual turns age 21 on May 5. She filed an FFCHE application on May 1. The individual is ineligible to receive FFCHE during May, the month of application, since she turns 21 during May. Her eligibility begin date will be June 1. If the applicant wishes to receive benefits for the application month, she must file an application for an appropriate Medicaid program.
  • The individual turns age 23 on May 5. She is no longer eligible to receive FFCHE benefits effective June 1.

Three months prior coverage is not available in the FFCHE program. An applicant may apply for three months prior coverage under a Medicaid program and receive assistance if eligible.

In the event an FFCHE recipient becomes pregnant and does not apply for or is not eligible for Medicaid, the newborn is not eligible for TP 45 – Medicaid for Newborn Children. If the mother wants coverage for the baby, she must apply for Medicaid; if eligible, the child will be certified for TP 43 – Medical Assistance for Children Under Age 1.

 

F—1011 Types of Coverage

Revision 15-4; Effective October 1, 2015

 

FFCHE recipients will have two types of coverage. The type of coverage determines how recipients access their health care services.

Fee-for-Service – Initial coverage for FFCHE recipients. Although FFCHE individuals are not Medicaid recipients, they will have access to any Medicaid provider and will be allowed to self-refer to specialists. The provider submits claims directly to the claims administrator for reimbursement of the FFCHE-covered services (the coverage mirrors services available to Medicaid recipients). The Texas Health and Human Services Commission (HHSC) will use state funds to pay these claims.

Managed Care – A service delivery program that provides medical care in a managed care setting. The state pays a monthly premium to the health maintenance organization (HMO) for each recipient enrolled in the plan. The plan processes all provider claims.

Enrollment into managed care is mandatory for FFCHE recipients; however, when a recipient is determined eligible for the FFCHE program, fee-for-service coverage is provided until the recipient is enrolled into managed care. Managed care coverage is determined using prospective enrollment following current cutoff rules. Managed care health benefits are provided through the STAR Program.

Example: An application is received on January 1 and processed on January 25 (after cutoff); the managed care effective date is March 1. The initial months (January and February) will be covered as fee-for-service.

F-1100, Domicile

Revision 10-2; Effective April 1, 2010

 

 

Domicile requirements do not apply to the Former Foster Care in Higher Education program.

F-1200, Deprivation

Revision 10-2; Effective April 1, 2010

 

 

Deprivation requirements do not apply to the Former Foster Care in Higher Education program.

F-1300, Child Support

Revision 10-2; Effective April 1, 2010

 

 

Child and medical support requirements do not apply to the Former Foster Care in Higher Education program.

F-1400, Resources

Revision 15-4; Effective October 1, 2015

 

 

Resources are not considered in determining eligibility for Former Foster Care in Higher Education (FFCHE).

 

F-1500, Income

Revision 15-4; Effective October 1, 2015

 

 

Income is not considered as a factor in determining eligibility for Former Foster Care in Higher Education (FFCHE).

F-1600, Deductions

Revision 15-4; Effective October 1, 2015

 

 

Since there is no income test, deductions are not considered as a factor in determining eligibility for Former Foster Care in Higher Education (FFCHE).

F-1700, School Enrollment

Revision 15-4; Effective October 1, 2015

 

 

F—1710 General Policy

Revision 15-4; Effective October 1, 2015

An applicant or recipient must be enrolled in an institution of higher education located in Texas to receive Former Foster Care in Higher Education (FFCHE) health care benefits. The applicant/recipient may be attending school half-time or full-time. There is no requirement regarding the number of hours the student must be taking. The following are considered institutions of higher education:

  • college (public or private),
  • community college,
  • junior college,
  • technical institute, and
  • university.

Note: Trade schools such as beauty schools or mechanic schools do not meet the definition of an institution of higher education.

 

F—1720 Verification Requirements

Revision 15-4; Effective October 1, 2015

School enrollment must be verified at application and renewal. The following are valid sources of verification for school enrollment:

  • financial aid statement;
  • enrollment certification;
  • official fee receipt; and
  • Form H1870, School Enrollment Verification Form.

Note: Online courses are only acceptable if the university/college has a branch located in Texas.

 

F—1730 Documentation Requirements

Revision 10-2; Effective April 1, 2010

Document the type of institution the applicant/recipient is attending and the source of school enrollment verification.

F-1800, Management

Revision 15-4; Effective October 1, 2015

 

 

Management requirements are not applicable for the Former Foster Care in Higher Education (FFCHE) program.

F-1900, Reminders

Revision 15-4; Effective October 1, 2015

 

 

F—1910 General Policy

Revision 15-4; Effective October 1, 2015

 

Before certifying applicants and recertifying recipients, complete the following:

  • Ensure the applicant completes each question and signs and dates the application.
  • Give the applicant Form H1019-F, Reporting Changes to Your Case. Explain that changes must be reported within 10 days after knowing about the change. Indicate the appropriate reporting requirement on Page 1.
  • Refer the applicant to other programs for which the individual might be eligible such as the Supplemental Nutrition Assistance Program (SNAP); Temporary Assistance for Needy Families (TANF); Medicaid; Supplemental Security Income (SSI); or Retirement, Survivors and Disability Insurance (RSDI). Refer individuals with a disability who are ineligible for Medical Programs for families and children to the Texas Health and Human Services Commission (HHSC) Medicaid for the Elderly and People with Disabilities (MEPD) programs.
  • Inform applicants of the right to request a review of their case for any HHSC action that affects their eligibility.
  • Inform the applicant that the information provided is subject to verification by third parties.

There is no requirement to inform individuals to report accidents.

 

F—1920 Documentation Requirements

Revision 15-4; Effective October 1, 2015

 

Document that Form H0025, HHSC Application for Voter Registration, was given to the applicant, authorized representative or representative payee in the Agency Use Only section of the application.

Related Policy
Registering to Vote, A-1521

F-2000, Case Disposition

Revision 15-4; Effective October 1, 2015

 

 

F—2010 Notice to Applicants

Revision 15-4; Effective October 1, 2015

 

When processing an application, redetermination or change, advisors are required to inform the individual if their request is pended, certified, sustained, or denied. Eligibility Determination Group (EDG) disposition is the end result of processing the request for assistance and will generate Form TF0001, Notice of Case Action. However, if the EDG cannot be disposed because it is pending for additional information/verification, the advisor must provide the individual with Form H1020, Request for Information or Action.

 

Form H1020, Request for Information or Action

Form H1020 informs the individual of the:

  • reason the case is pending;
  • action the individual or advisor must take;
  • date by which the individual or advisor must take action; and
  • date the advisor must deny the application or case if the individual does not take action, if applicable.

Note: For Spanish-speaking only individuals, ensure that all comments provided are in Spanish.

 

Form TF0001F, Notice of Case Action

TF0001F informs the individual:

  • the date benefits begin; or
  • the date of denial; and
  • about his/her right to request a review of the case action.

Note: For Spanish-speaking only individuals, ensure that all comments provided are in Spanish.

 

F—2020 Length of Certification

Revision 15-4; Effective October 1, 2015

 

The Texas Integrated Eligibility Redesign System (TIERS) calculates the eligibility end date from the date the advisor disposes the EDG as follows:

  • Applications – initial certification month plus 11 months.
  • Renewals – 12 months from the last certification month.

Individuals are eligible for Former Foster Care in Higher Education (FFCHE) health care benefits for 12 months or through the month of their 23rd birthday, whichever is earlier.

Exception: A individual is not eligible to receive 12 months of coverage if the individual:

  • reaches age 23,
  • dies,
  • voluntarily withdraws,
  • moves out-of-state,
  • reports receipt of adequate health coverage, or
  • is not attending an institution of higher education.

 

F—2030 Setting Special Reviews

Revision 15-4; Effective October 1, 2015

 

Use Medical Programs policy in A-2330, Setting Special Reviews, to set special reviews.

 

F—2040 Adverse Action

Revision 15-4; Effective October 1, 2015

 

After certification, give households advance notice of adverse actions to deny benefits except for reasons listed in A-2344.1, Form TF0001 Required (Adequate Notice), and A-2344.2, No Form TF0001 Required.

Former FFCHE recipients receiving a notice of adverse action do not have the right to request a fair hearing. FFCHE recipients can request a review of their case action. See F-2300, Request for Review.

F-2100, Processing Time Frames

Revision 15-4; Effective October 1, 2015

 

 

F—2110 Applications

Revision 15-4; Effective October 1, 2015

 

Advisors must make an eligibility determination by the 45th day from the file date.

Reopen an application denied for failing to furnish information/verification if the missing information is provided by the 60th day from the file date. Use the date the missing information/verification was provided as the new file date.

Use the original application or renewal form until it is 60 days old. If the information on the form has changed or is more than 45 days old, the individual and advisor must update the form.

 

F—2120 Deadlines

Revision 10-2; Effective April 1, 2010

 

Provide Form TF0001-F, Notice of Case Action, the same day eligibility is determined for an application but no later than 45 days from the file date.

 

F—2130 Missed Interviews

Revision 10-2; Effective April 1, 2010

 

No interview is required to process an application or renewal unless requested by the applicant or recipient. If requested, provide the individual with a telephone interview. If the individual fails to keep the interview, do not deny the application or renewal but continue to process the request for assistance.

 

F—2140 Pending Information on Applications

Revision 10-2; Effective April 1, 2010

 

Advisors must request documents that are readily available to the household and consider it sufficient verification. Use the verification sources listed in the various eligibility elements of Part A, Determining Eligibility, as potential and acceptable sources of verification. C-900, Verification and Documentation, gives information on verification procedures.

In determining eligibility, staff must consider any information the individual reports between the application date and the decision date. Include any information the individual reports during the application decision process.

 

F—2150 Notice of Renewal/Expiration

Revision 15-4; Effective October 1, 2015

 

The Texas Integrated Eligibility Redesign System (TIERS) sends a renewal packet containing Form H1869, Renewal for Health Care Services; Form H1870, School Enrollment Verification Form; and a business reply envelope in the 11th month of the 12-month certification period.

 

F—2160 Processing Renewals

Revision 10-2; Effective April 1, 2010

 

 

F—2161 How to Process a Renewal

Revision 15-4; Effective October 1, 2015

 

Former Foster Care in Higher Education (FFCHE) recipients receive a passive renewal. Individuals are only required to return a renewal packet if information they provided during the application process has changed. If the individual does not return a renewal packet by the first calendar day of the last month of the certification period, TIERS automatically re-certifies the FFCHE Eligibility Determination Group (EDG) for another 12-month period, or through the month of the individual’s 23rd birthday, whichever is earlier. This will not require the Centralized Benefit Services (CBS) advisor to run eligibility or dispose the case.

Exception: School enrollment must be verified at application or renewal for FFCHE. If an FFCHE individual does not return the renewal packet, TIERS will process the passive renewal and will pend the EDG for school enrollment verification. If verification is not provided, the advisor will be required to run eligibility and dispose the case to sustain or deny benefits.

There is no interview requirement for an FFCHE renewal. The file date is the day any local Texas Health and Human Services Commission (HHSC) eligibility determination office receives the FFCHE application.

Verification from an associated EDG can be used if provided within 90 days of the FFCHE file date.

Follow the policy below when Form H1869/Form H1869-S, Renewal for Health Care Benefits, is returned for a renewal.

If the individual provides Form H1869/Form H1869-S indicating no change and has an associated EDG, review the associated EDG to determine if there is any conflicting data and if there is any documentation to clear the conflicting information. If not, request new verification via Form H1020, Request for Information or Action.

If the individual returns Form H1869/Form H1869-S reporting changes, provides verification and there are no associated EDGs, process the renewal using the new verification.

If the individual returns Form H1869/Form H1869-S reporting changes, provides verification and there are associated EDGs, review the associated EDGs and use the most recent information provided.

If the associated EDGs have other information the family did not report for the FFCHE EDG that would impact FFCHE eligibility, contact the individual (by telephone or Form H1020 with due date) to determine if the information in the associated EDGs is correct before denying or taking adverse action on the EDG.

If the individual returns Form H1869/Form H1869-S reporting changes without verification and has associated EDGs, request new verification via Form H1020.

If the individual returns Form H1869/Form H1869-S indicating changes, does not provide verification and does not have associated EDGs, request information needed to determine eligibility. If the individual does not provide the information, do not renew eligibility.

 

F—2170 Renewal Time Frames

Revision 10-2; Effective April 1, 2010

 

If the individual returns a renewal packet, advisors must make an eligibility determination by the 30th day from the file date.

Note: A renewal application is considered a renewal if it is received by the last day of the 12-month certification period.

Reopen a renewal application denied for failing to furnish information or verification if the missing information/verification is provided by the 60th day from the file date. Use the date the missing information/verification was provided as the new file date.

Use the original Form H1869/Form H1869-S, Renewal for Health Care Benefits, until it is 60 days old. If the information on Form H1869/Form H1869-S has changed or is more than 45 days old, the individual and advisor must update the form.

Reminder: Consider a renewal application received after the last day of the 12-month certification period as an application using application processing time frames.

 

F—2180 Pending Information

Revision 15-4; Effective October 1, 2015

 

Allow the household at least 10 days to provide missing information/verification. The due date must be a workday. Advisors must request documents that are readily available to the household if the documents are anticipated to be sufficient verification. If the applicant has any active or inactive EDGs, check to see if any verification previously provided for another EDG can be used to determine eligibility for FFCHE.

Use verifications accepted for Temporary Assistance for Needy Families (TANF), Medical Programs or the Supplemental Nutrition Assistance Program (SNAP).

For example, if you accept wage verification for a SNAP case, that same verification is acceptable for TANF, Medical Programs or FFCHE.

Exception: Verification of U.S. citizenship for applicants must be from a Medicaid-acceptable source. Staff cannot access the State Online Query/Wire Third-Party Query (SOLQ/WTPY) inquiry to verify citizenship or Retirement, Survivors and Disability Insurance (RSDI) for FFCHE processing. Advisors must request other types of verification, such as copies of birth certificates for citizenship and award letters for RSDI benefits.

Note: Do not use verification that is over 90 days old from the FFCHE file date.

 

F—2181 Summary of Due Dates for Form H1020, Request for Information or Action

Revision 15-4; Effective October 1, 2015

 

Case Action Due Date Final Due Date
Application 10 days
  • 30th day, or
  • 10th day if the household's Form H1020 due date extends beyond the 30th day
Renewal 10 days 30th day, or by the 10th day if the household's Form H1020 due date extends beyond the last day of the last benefit month
Incomplete review 10 days 10th day

 

Note: Staff have until the 45th day from the file date to determine eligibility for applications.

F-2200, Changes

Revision 15-4; Effective October 1, 2015

 

 

F—2210 How to Report a Change

Revision 15-4; Effective October 1, 2015

 

Centralized Benefit Services (CBS) staff process all changes for Former Foster Care in Higher Education (FFCHE) recipients. FFCHE recipients can report changes:

  • online through YourTexasBenefits.com;
  • by visiting a local eligibility determination office (which will forward the change to CBS);
  • by calling 2-1-1; or
  • in writing, by mail or fax, or by completing Form H1019-F, Reporting Changes to Your Case. The individual may mail or fax the change to:
    • Document Processing Center:
      HHSC
      P.O. Box 149024
      Austin, TX 78714-9024
      Toll-free fax: 1-877-447-2839
    • A local eligibility determination office (which must send the change to CBS).

Note: When an FFCHE recipient reports a change by telephone, staff must verify that the person speaking is the individual or the authorized representative.

An FFCHE recipient must report the following changes:

  • Address changes
  • Receipt of health insurance
  • Pregnancy
  • If the individual moves out of state
  • School enrollment status – no longer attending school

Exception: Individuals receiving FFCHE as of December 2013 and not eligible for Former Foster Care Children (FFCC) must also report income changes.

 

F—2220 Action on Changes

Revision 10-2; Effective April 1, 2010

 

Follow policy listed in B-600, Changes, for Medical Programs to determine how to process changes for FFCHE recipients.

F-2300, Request for Review

Revision 18-1; Effective January 1, 2018

 

 

F—2310 Request for Review Procedures

Revision 18-1; Effective January 1, 2018

 

Former Foster Care in Higher Education (FFCHE) recipients receiving notice of adverse action are not entitled to continued benefits when the Texas Health and Human Services Commission (HHSC) denies benefits for any reason if granting continued benefits would extend the 12-month eligibility period or extend the benefits past the person’s 23rd birthday.

FFCHE recipients do not have the right to request a fair hearing. FFCHE recipients can request a review of the case action. A request for review is any expression of dissatisfaction with an adverse action. Advisors must tell FFCHE recipients that they must submit requests for review in writing.

FFCHE recipients have 30 business days from the date of the notification letter to submit a request for review concerning the decision that resulted in an adverse action. They must submit the request for review in writing to:

  • Health and Human Services Commission
    Attention: Complaint Department
    P. O. Box 149027
    Austin, TX 78714-9027; or
  • by toll-free fax to 877-542-5951.

Upon receipt of the request for review, HHSC (Centralized Benefit Services staff) reviews the adverse action and responds in writing within 10 business days from the date of receipt of the request. The response letter (Form TF0001F, Notice of Case Action) has information about the agency’s answer to the request for review. HHSC staff document the final decision in the Texas Integrated Eligibility Redesign System (TIERS) Case Comments.

When HHSC receives a request for review after 30 business days or finds the request for review is not for an adverse action, HHSC denies the request and generates Form TF0001F, which informs the household of the denial reason.

F-2400, Automated Support

Revision 15-4; Effective October 1, 2015

 

 

F—2410 Data Broker

Revision 15-4; Effective October 1, 2015

 

Advisors must follow the policy explained in C-817, Electronic Data Sources (ELDS), and C-820, Data Broker.