Part W, Healthy Texas Women (HTW)

W-100, Application Processing

Revision 19-1; Effective January 1, 2019

 

 

 

W—110 Healthy Texas Women (HTW)

Revision 17-2; Effective April 1, 2017

 

HTW provides for a continuous 12-month certification period with the following limited health care benefits:

  • Annual family planning exams
  • Family planning counseling and education
  • Treatment of certain sexually transmitted infections
  • Birth control (except emergency birth control), including methods to permanently prevent pregnancy (tubal ligations or Essure)
  • Follow-up family planning visits related to the method of birth control

Note: For individuals ages 15-17, a parent or legal guardian's signature is required.

 

W—111 Type of Assistance (TA) 41 – Health Care – HTW

Revision 19-1; Effective January 1, 2019

 

To qualify for HTW, applicants must:

  • be female, ages 15 through 44 (for applicants ages 15-17, a parent or legal guardian must apply on their behalf);
  • have countable income of less than or equal to the 200% federal poverty income limit;
  • be a U.S. citizen or legally admitted alien who meets all eligibility requirements for Medicaid;
  • be a Texas resident;
  • not be pregnant;
  • not have creditable health insurance that covers family planning services; and
  • not currently receive Medicaid, Medicare (Part A or B) or Children's Health Insurance Program benefits.

Notes:

  • A legal guardian is a person appointed by a judge to take care of a child younger than age 18.
  • Applications received for people ages 15-17 without a parent or legal guardian signature must be denied using the denial reason, “Denied 15-17 without parent or legal guardian’s signature."
  • Married minors ages 15-17 are not eligible for HTW. The HTW application must be denied using the denial reason, “Denied 15-17 married minors.”

Related Policy
General Policy, W-510

 

W—112 Application Procedures

Revision 17-2; Effective April 1, 2017

 

Applicants must complete Form H1867/H1867-S, Healthy Texas Women Application Form, or Form H1867-R/H1867-RS, Healthy Texas Women Renewal.

Note: No other application can be used to apply for HTW.

 

W—113 Requesting an Application

Revision 17-2; Effective April 1, 2017

 

Form H1867/H1867-S, Healthy Texas Women Application, may be downloaded from the HHSC Texas Works Handbook and is also available:

  • online at www.YourTexasBenefits.com;
  • online at www.healthytexaswomen.org;
  • by calling 2-1-1;
  • by calling toll-free 1-866-993-9972;
  • at the local Texas Health and Human Services Commission (HHSC) benefits office;
  • from participating family planning or participating providers; and
  • at participating Supplemental Nutritional Assistance for Women, Infants and Children (WIC) offices and community-based organizations.

On the same day the request is received, provide the applicant an application packet that includes the following:

  • Form H1867 or Form H1867-S
  • Form H0025, HHSC Application for Voter Registration
  • A postage-paid envelope addressed to:

    Texas Health and Human Services Commission
    P.O. Box 149021
    Austin, TX 78714-9021

Note: Form H0050, Parent Profile Questionnaire, is not required.

If an applicant requests help completing Form H1867/H1867-S or Form H0025, a volunteer or staff member must give help and initial the parts completed or sign Form H1867/H1867-S to show the applicant received help.

Related Policy
Registering to Vote, A-1521

 

W—120 Office Procedures

Revision 17-2; Effective April 1, 2017
 

 

W—121 Filing an Application

Revision 17-2; Effective April 1, 2017

 

Applicants submit Form H1867/H1867-S, Healthy Texas Women Application:

Texas Health and Human Services Commission
P.O. Box 149021
Austin, TX 78714-9021

  • by fax toll-free to 1-866-993-9971 (HTW designated fax line);
  • at a local HHSC benefits office; or
  • at participating family planning provider offices.

If a local HHSC benefits office receives any Form H1867/H1867-S; Form H1867-R/H1867-RS, Healthy Texas Women Application; Form H1867-R/H1867-RS, Healthy Texas Women Renewal; or Form H1831, Adjunctive Eligibility Letter, staff must date stamp and fax it to the designated fax line no later than the next business day. When an HHSC office receives Form H1867-R/H1867-RS or Form H1831, staff must date stamp and fax it to the Document Processing Center using current procedures.

Accept all submitted forms if they have the applicant's name, address and signature. HHSC does not need an original signature for faxed applications.

 

W—122 Telephonic Signatures

Revision 17-2; Effective April 1, 2017

 

The HTW program allows individuals who apply via 2-1-1 to submit applications using a telephonic signature. HHSC will send the following correspondence based on the actions taken by the individual.

Action Correspondence
Individual telephonically signs the application. Form H1031, Telephonic Signatures Cover Letter, notifies the HTW applicant or parent/legal guardian of a minor HTW applicant they submitted a telephonically signed application or renewal.
Individual declines to telephonically sign the application. Form M5021A, Signature Form, notifies the individual a signature is needed to complete the application process, and Form H1867, Healthy Texas Women Application, populated with the information provided over the phone.

 

W—123 File Date

Revision 17-2; Effective April 1, 2017

 

The file date is the day any HHSC benefits office accepts Form H1867/H1867-S, Healthy Texas Women Application; Form H1867-R/H1867-RS, Healthy Texas Women Renewal; or Form H1831, Adjunctive Eligibility Letter, containing the applicant's name, address and appropriate signature. This is day zero in the application process.

Document why a certain file date was used to determine eligibility when:

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

Note: Because family planning providers may have extended weekend hours and will fax a majority of the applications, the file date is the day it is faxed to the HTW fax line.

Related Policy
General Policy, W-910

 

W—124 Faxed Applications

Revision 17-2; Effective April 1, 2017

 

When an individual or provider states that an application was faxed to the HTW designated fax line, but it is determined that the fax was not received, verbally inform the individual or provider to fax the confirmation page and original application to determine the correct file date.

If HTW staff receives the fax confirmation page and the original application:

  • Within 30 days of the submission of the original application, the file date is the submission date as shown on the fax confirmation page. Use the date printed by the fax machine to verify the original submission date.
  • More than 30 days after the original submission date, the file date is the date the application is resubmitted.

 

W—130 Interviews

Revision 07-0; Effective July 1, 2007
 

 

W—131 General Policy

Revision 17-2; Effective April 1, 2017

 

An interview is not required when applying for or renewing an application for HTW. Schedule a telephone interview only if the individual requests an interview. Process an application or renewal by mail or telephone.

Note: Do not deny the application if the applicant misses the interview; continue determining eligibility.

W-200, Household Composition

Revision 17-2; Effective April 1, 2017

 

 

W—210 General Policy

Revision 17-2; Effective April 1, 2017

 

Household composition is self-declared. Married minors are not eligible for the Healthy Texas Women (HTW) program.

 

W—211 Budget Group

Revision 17-2; Effective April 1, 2017

 

The budget group for a minor applicant consists of the:

  • minor applicant;
  • minor's parent(s);
  • minor’s siblings; and
  • minor’s children.

The budget group for an adult applicant consists of the:

  • applicant;
  • applicant's spouse; and
  • mutual and non-mutual children under age 19 of the applicant and/or spouse.

A woman may not exclude a mandatory child from her budget group.

Do not include the following individuals in the HTW budget group:

  • individuals who do not meet age and relationship requirements;
  • Supplemental Security Income (SSI) recipients;
  • children receiving foster care or adoption assistance;
  • individuals who are incarcerated;
  • residents of state supported living centers or institutions. If the child's living arrangement is questionable, refer to A-241.3.1, Children's Living Arrangements; or
  • HTW minor's legal guardian. A legal guardian is a person who has been appointed by a judge to take care of a child younger than age 18.

 

W—212 Certified Group

Revision 17-2; Effective April 1, 2017

 

Treat women age 18 as adults. The certified group consists only of the woman (adult or minor) applying, and there can only be one certified woman on an HTW EDG. Do not certify an incarcerated woman or married minors.

 

W—220 Verification Requirements

Revision 07-0; Effective July 1, 2007

 

There are no verification requirements for household determination.

W-300, Citizenship

Revision 17-2; Effective April 1, 2017

 

 

W—310 General Policy

Revision 17-2; Effective April 1, 2017

 

The Healthy Texas Women (HTW) program follows the Medical Programs citizenship policy 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 HTW if they meet all other eligibility criteria.

W-400, Social Security Number (SSN)

Revision 13-1; Effective January 1, 2013

 

 

W—410 General Policy

Revision 13-1; Effective January 1, 2013

 

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

W-500, Age

Revision 17-2; Effective April 1, 2017

 

 

W—510 General Policy

Revision 17-2; Effective April 1, 2017

 

To receive Healthy Texas Women (HTW) benefits, an individual must be age 15 through 44. An applicant is considered age 15 the month of her 15th birthday and age 44 through the month of her 45th birthday. For individuals ages 15 through 17, a parent or legal guardian must apply on the individual's behalf.

Ten days prior to a women turning 18 years old, she will receive Form H1871, HTW Client Turning 18 Years Old, to inform her she is now responsible for managing her own HTW EDG. The form also provides information about how to report a confidential address.

Married minors are not eligible for HTW; the TF0001-W will inform the minor of other services they may be eligible to receive.

Examples:

  • A woman turns age 15 on February 9. A parent filed an HTW application January 17. The woman is ineligible to receive HTW as she is not turning age 15 in the application month. A parent or legal guardian must reapply in the month of February to meet the age requirements.
  • A woman turns age 18 on July 27. A parent filed an HTW application June 5. The woman is eligible for HTW. Ten days prior to her 18th birthday (July 17), the Form H1871 is generated to inform her once she turns 18 she is responsible for managing her own HTW EDG.
  • A woman turns age 45 on May 5. She will no longer be eligible to receive HTW benefits effective June 1.

Age is self-declared. If questionable, verify the applicant's age using the Bureau of Vital Statistics (BVS). If unable to verify using BVS, attempt to contact the applicant to clear the discrepancy. Use information provided by the applicant on a previous Eligibility Determination Group, if possible.

If an HTW application is received in a month the applicant:

  • is age 14 and the application is processed in a month she becomes age 15, deny the application because of age;
  • is age 44, and the application is processed in a month she becomes age 45, if otherwise eligible, certify for the month of application and the month of her 45th birthday; or
  • becomes age 45, and the application is processed the month after her 45th birthday, if otherwise eligible, certify for the month of application only.

Use the following denial reason:

  • English — You do not meet the age requirement for the Healthy Texas Women. To receive benefits under this program, you must be 15 through 44 years of age.
  • Spanish — Usted no llena los requisitos de edad del programa Healthy Texas Women. Para recibir beneficios bajo este programa, tiene que tener entre 15 y 44 años de edad.

Married minors ages 15 through 17 are not eligible for HTW. Advisors must use the denial reason, “Denied 15-17 married minors”. The TF0001, Notice of Case Action will include the following language:

 

English:

Notice Language –You are not able to get Healthy Texas Women services because you are an emancipated minor. You might be able to get services through other programs:

Medicaid or CHIP. Apply by: (1) going to YourTexasBenefits.com or (2) calling 2-1-1 or 1-877-541-7905 for an application (after you pick a language, press 2).

Family Planning Program services. Apply by: (1) going to HealthyTexasWomen.org or (2) calling 2-1-1 or 1-877-541-7905 (after you pick a language, press 2).

 

Spanish:

Notice Language – Usted no puede recibir servicios de Healthy Texas Women porque es una menor de edad emancipada. Es posible que usted pueda recibir servicios a través de otros programas:

Medicaid o CHIP. Para hacer la solicitud: (1) vaya a YourTexasBenefits.com o (2) llame al 2-1-1 o al 1-877-541-7905 para pedir una solicitud (después de seleccionar un idioma, oprima el 2).

Servicios del Programa de Planificación Familiar. Para hacer la solicitud: (1) vaya a HealthyTexasWomen.org o (2) llame al 2-1-1 o al 1-877-541-7905 (después de seleccionar un idioma, oprima el 2).

 

When a parent or legal guardian does not apply for a minor between the ages of 15 through 17 Advisors must use the denial reason of, “Denied 15 -17 without parent or legal guardian’s signature” The TF0001, Notice of Case Action will include the following language:

 

Notice Language–You are not able to get Healthy Texas Women services. A parent or legal guardian must apply for young women ages 15 to 17 -- that was not done in this case. You might be able to get services through other programs:

Medicaid or CHIP. Apply by: (1) going to YourTexasBenefits.com or (2) calling 2-1-1 or 1-877-541-7905 for an application (after you pick a language, press 2).

Family Planning Program services. Apply by: (1) going to HealthyTexasWomen.org or (2) calling 2-1-1 or 1-877-541-7905 (after you pick a language, press 2).

 

Spanish:

Notice Language – Usted no puede recibir servicios de Healthy Texas Women. Uno de los padres o un tutor deben llenar la solicitud para jovencitas de 15 a 17 años, lo cual no se hizo en este caso. Es posible que usted pueda recibir servicios a través de otros programas:

Medicaid o CHIP. Para hacer la solicitud: (1) vaya a YourTexasBenefits.com o (2) llame al 2-1-1 o al 1-877-541-7905 para pedir una solicitud (después de seleccionar un idioma, oprima el 2).

Servicios del Programa de Planificación Familiar. Para hacer la solicitud: (1) vaya a HealthyTexasWomen.org o (2) llame al 2-1-1 o al 1-877-541-7905 (después de seleccionar un idioma, oprima el 2).

 

W—520 Verification Requirements

Revision 07-0; Effective July 1, 2007

 

Accept self-declaration as verification of age.

 

W—530 Documentation Requirements

Revision 07-0; Effective July 1, 2007

 

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

W-600, Relationship

Revision 17-2; Effective April 1, 2017

 

 

W—610 General Policy

Revision 17-2; Effective April 1, 2017

 

To be part of the budget group, a legal parent-child relationship must exist between a child and:

  • an adoptive parent by proof of adoption; or
  • the mother by proof of having given birth to the child.

Related Policy
Budget Group, W-211

 

W—620 Verification Requirements

Revision 07-0; Effective July 1, 2007

 

Accept self-declaration as verification for establishing relationship.

 

W—630 Documentation Requirements

Revision 07-0; Effective July 1, 2007

 

Advisors must document the individual's self-declaration for establishing relationship.

W-700, Identity

Revision 13-1; Effective January 1, 2013

 

 

W—710 General Policy

Revision 13-1; Effective January 1, 2013

 

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

W-800, Residence

Revision 17-2; Effective April1, 2017

 

 

W—810 General Policy

Revision 17-2; Effective April1, 2017

 

The Healthy Texas Women (HTW) program follows Children's Medicaid policy in A-700, Residence, to determine acceptable residence eligibility.

W-900, Health Care Eligibility

Revision 19-1; Effective January 1, 2019

 

 

W—910 General Policy

Revision 17-2; Effective April 1, 2017

 

A woman is continuously eligible for 12 months beginning the first day of the month all eligibility criteria are met. There is no three months prior eligibility for the Healthy Texas Women (HTW) program.

Note: This does not include three months prior only Medicaid or Medical Assistance - Medically Needy with Spend Down programs. An applicant can apply for and receive three months prior benefits under a Medicaid program.

The medical effective date (MED) cannot precede the month of the women's 15th birthday.

This is a fee-for-service program. Fee-for-service allows access to any health care provider and self-referral to specialists. The provider submits claims directly to the claims administrator for reimbursement of covered services.

If a household failed to report required information at the time of the application that causes the woman to be ineligible for HTW, advisors must deny the case.

Eligibility Determination Groups (EDGs) with end dates do not require an action to close when the individual does not return Form H1867-R/H1867-RS, Healthy Texas Women Renewal, or Form H1831, Adjunctive Eligibility Letter. These EDGs will close the last day in the 12th month of the certification period.

Note: Women are eligible to receive HTW during their Pay for Performance forfeit month(s).

Related Policy
Pay for Performance, A-2150
Eligibility Begin Dates, W-1920

 

W—911 Current Medicaid, Medicare (Part A or B) and Children's Health Insurance Program (CHIP) Recipients

Revision 17-2; Effective April 1, 2017

 

A woman is not eligible to receive Healthy Texas Women (HTW) benefits if currently receiving Medicaid, Medicare (Part A or B) or CHIP. If an application is received for a woman who is actively receiving Medicaid, Medicare (Part A or B) or CHIP, deny the application using the following disposition denial reason:

  • English — You are ineligible to receive Healthy Texas Women services as you are currently receiving assistance under Medicare, Medicaid or CHIP.
  • Spanish — Usted no llena los requisitos para recibir los servicios del Healthy Texas Women ya que actualmente recibe ayuda de Medicare, Medicaid o CHIP.

Staff must verify via State Online Query (SOLQ) that an applicant is not currently enrolled in Medicare (Part A or B). The Texas Integrated Eligibility Redesign System (TIERS) verifies if the applicant is receiving Medicaid or CHIP benefits at application, renewal and during the HTW 12-month continuous eligibility period.

If applications are received for … and the … the advisors must … TIERS will … Note:
both HTW and Medicaid before either are processed, HTW application is certified first, continue working on the Medicaid application. If the Medicaid EDG is certified, automatically deny the HTW EDG. If the individual is eligible, the MED for the Medicaid application will follow current MED policy. If the applicant is not certified for Medicaid, she will continue to receive ongoing HTW benefits.
both HTW and Medicaid before either are processed, Medicaid application is certified first, deny the HTW application. Use the appropriate denial code and provide the individual with Form TF001W, Notice of Case Action. issue an error if the worker attempts to certify a HTW EDG and the individual is actively receiving Medicaid benefits.  

Note: This does not include three months prior only Medicaid or Medical Assistance - Medically Needy with Spend Down programs. An applicant can apply for and receive three months prior benefits under Medicaid. The three months prior check boxes will be disabled when Health Care-HTW is selected.

Related Policy
Eligibility Begin Dates, W-1920

 

W—912 Pregnant Women

Revision 17-2; Effective April 1, 2017

 

Women who are pregnant are ineligible to receive HTW benefits. If the question, "Are you pregnant?" is marked Yes on Form H1867/H1867-S, Healthy Texas Women Application; Form H1867-R/H1867-RS, Healthy Texas Women Renewal; or Form H1831, Adjunctive Eligibility Letter, deny the application/renewal using the following denial reason code and add the statement below to the comment section of Form TF001W, Notice of Case Action.

  • English — On your application, you told us you are pregnant. Women who are pregnant cannot receive Healthy Texas Women benefits. To find out if you can receive Medicaid for pregnant women, please complete, sign and return the attached application.
  • Spanish — En la solicitud, usted nos dijo que está embarazada. Las mujeres embarazadas no pueden recibir beneficios del programa Healthy Texas Women. Para saber si puede recibir Medicaid para mujeres embarazadas, por favor, llene, firme y envíe la solicitud adjunta.

Include Form H1010, Texas Works Application for Assistance — Your Texas Benefits, along with Form TF001W, Notice of Case Action, and a self-addressed stamped envelope addressed to the Document Processing Center when denying an application due to pregnancy.

If the question is not answered, pend the EDG. Allow the applicant normal processing time frames to provide an answer. Advisors must manually pend for verification. Verification is self-declared. Deny the application for failure to provide verification if the applicant/recipient does not provide verification.

Do not deny the recipient if a report of pregnancy is received during the 12-month continuous coverage period. Record the change and take action on the information at the next renewal.

Note: For HTW recipients who apply for Medicaid for Pregnant Women (TP 40), TIERS will deny the HTW EDG once the recipient is certified to receive benefits for her pregnancy.

 

W—913 Third-Party Resource (TPR)

Revision 17-2; Effective April 1, 2017

 

A woman is ineligible to receive HTW benefits if she has creditable health coverage (TPR). The applicant/recipient has creditable health coverage if her private health insurance covers family planning services.

An applicant/recipient's private health insurance is considered to cover family planning services if it provides both:

  • family planning-related physician office visits and procedures, and
  • contraceptive drugs and devices.

In making this determination, only consider whether the private health insurance provides coverage and do not give consideration to other issues such as high deductibles or dollar limits on drug coverage.

Form H1867/H1867-S, Healthy Texas Women Application, and Form H1867-R/H1867-RS, Healthy Texas Women Renewal, ask the applicant the following questions:

  1. Do you have health insurance that covers family planning services? Yes No
  2. If yes, will filing a claim on your health insurance cause physical, emotional or other harm to you from your spouse, parents or other person? Yes No
  3. If yes, you must provide an explanation below of your situation.

A HTW applicant with creditable health coverage is eligible to receive benefits only if identifying and providing information to assist in pursuing third parties is against her best interest.

Staff must pend the applicant if she does not answer questions 1 and/or 2. Allow the applicant normal processing time frames to provide an answer. Verification is self-declared by the applicant. If the applicant does not self-declare the answer to question 1 and/or 2 by the deadline, deny the application for failure to provide.

If the applicant states Yes to question 1 and question 2 but leaves question 3 blank, do not pend the applicant for an answer; continue determining eligibility.

If the applicant states Yes to question 1 and No to question 2, deny the application using the following denial reason code and add the statement below to the comment section of Form TF001W, Notice of Case Action.

  • English — On your application you told us you are covered by other health insurance. Women who are covered by other health insurance cannot receive Healthy Texas Women benefits.
  • Spanish — En la solicitud, usted nos dijo que tiene cobertura de otro seguro médico. Las mujeres con cobertura de otro seguro médico no pueden recibir beneficios del programa Healthy Texas Women.

If during the recipient's 12-month continuous coverage period she reports having creditable health insurance, record the change and take action on the TPR information at the next renewal.

 

W—914 Auto Enrollment into HTW

Revision 19-1; Effective January 1, 2019

 

Individuals receiving Medicaid for Pregnant Women (TP40) are auto-enrolled in HTW at the end of their TP40 certification (with or without a birth outcome), if the woman is not eligible for Medicaid or CHIP.

To be auto-enrolled to HTW the individual must meet the following eligibility requirements:

  • must be age 18 through 44; and
  • must not have open/active third party resources (TPR) with creditable health insurance coverage that covers family planning services.

Individuals receiving Medicaid for pregnant women who also meet auto-enrollment eligibility requirements are auto-enrolled into HTW even if they:

  • voluntarily withdraw from medical assistance, including before an eligibility determination is made; or
  • are determined to be potentially eligible for Medicaid for Parent and Caretaker Relatives (TP 08) but fail to show for the interview.

TIERS triggers Alert 824, Pregnancy Ending Test MAGI, on first day of the TP40 last benefit month to create a Task List Manager. Staff run the full modified adjusted gross income (MAGI) cascade. If the cascade results in a denial of Medicaid and CHIP because the individual:

  • does not meet eligibility requirements, then the TP40 individual is referred to the Marketplace and auto-enrolled into HTW; or
  • failed to provide the verification needed to make a Medicaid/CHIP eligibility determination, then the individual is not referred to the Marketplace but is auto-enrolled into HTW.

No additional financial or non-financial rules are applied for individuals who are auto-enrolled in HTW.

The effective date of the HTW EDG is the first day of the month following the end of the TP40 certification month.

When a woman is auto-enrolled into HTW, TIERS generates:

  • a TF001W– Notice of Case Action; and
  • Form H1872, HTW Opting Out and Reporting Confidential Address.

The Form H1872 provides the HTW individual with an opportunity to voluntarily withdrawal (opt out) and report a confidential address. The Form TF001W and H1872 is mailed to the individual's current case address, since a confidential address for the HTW individual may not be available at the time of auto-enrollment.

Related Policy
Confidentiality, W-2400

 

W—920 Verification Requirements

Revision 17-2; Effective April 1, 2017

 

Accept self-declaration of pregnancy and TPR.

 

W—930 Documentation Requirements

Revision 07-0; Effective July 1, 2007

 

For TPR, staff must document in case comments:

  • the availability of TPR for family planning services;
  • if filing a claim would cause physical, emotional or other harm to the individual; and
  • why, if provided.

W-1000, Domicile

Revision 17-2; Effective April 1, 2017

 

 

W—1010 General Policy

Revision 17-2; Effective April 1, 2017

 

Domicile verification is used to determine who is included in the budget group. A child must live in the home with a Healthy Texas Women (HTW) applicant/individual to be included in the budget group. A home is the family setting maintained or being established, as evidenced by continuation of responsibility for day-to-day care of the child by the relative with whom the child is living.

A child living in the home is not a requirement to receive HTW benefits. Domicile verification is not required when the HTW applicant has no children.

 

W—1020 Verification Requirements

Revision 07-0; Effective July 1, 2007

 

Accept self-declaration as verification of domicile.

W-1100, Deprivation

Revision 17-2; Effective April 1, 2017

 

Deprivation does not apply to Healthy Texas Women (HTW).

W-1200, Child Support

Revision 17-2; Effective April 1, 2017

 

Child and medical support requirements do not apply to Healthy Texas Women (HTW).

W-1300, Resources

Revision 17-2; Effective April 1, 2017

 

 

W—1310 General Policy

Revision 17-2; Effective April 1, 2017

 

Resources are exempt for Healthy Texas Women (HTW). However, staff must remember to verify income, such as royalties, dividends or interest generated by a resource.

W-1400, Income

Revision 19-1; Effective January 1, 2019

 

 

W—1410 General Policy

Revision 17-2; Effective April 1, 2017

 

Income is any type of payment that is of gain or benefit to a household. Income is either counted or exempted from the budgeting process. Earned income is related to employment and entitles a household to deductions not allowed for unearned income. Unearned income is income received without performing work-related activities. It includes benefits from other programs. To determine the date income can reasonably be anticipated, use factors specific to the source of income and the distance it has to travel through the mail, weekends and holidays.

Consider the income of any person who is included in the certified or budget group/Eligibility Determination Group (EDG). 

Retirement, Survivors, and Disability Insurance (RSDI); Supplemental Security Income (SSI); Veterans Affairs (VA) benefits; or other such funds legally obligated to a beneficiary are not counted if a payee who is not a member of the household:

  • receives the funds; and
  • does not make the money available to the beneficiary.

In the beneficiary’s EDG, the total amount of the legally obligated funds the payee makes available to the beneficiary in cash, by way of vendor payment or through items purchased for the beneficiary using the beneficiary's money (includes payments made by the payee to a third party on behalf of the beneficiary) is counted as unearned income. Any portion of the funds the payee keeps for the payee's own use is counted as unearned income in the payee's EDG.

The income of the following individuals must be considered:

  • any person who is included in the certified or budget group/EDG member, including disqualified members;
  • any person living in the home who is not included in the certified or budget group but who is legally responsible for a member of the certified group; and
  • an alien's sponsor.

Exception: the income of a legal guardian for an HTW minor is not considered when determining the HTW eligibility.

If a woman is determined to be eligible, the EDG should not be denied if the budget group income increases above the income limit. The budget should be adjusted to reflect the new income.

Do not set a special review if the individual indicates that a change in income from any source will occur before the next renewal.

Since the Healthy Texas Women (HTW) provides limited benefits, a woman is not required to pursue and accept all income to which she is legally entitled per A-1311, Requirement to Pursue Income.

Note: As a prudent worker judgment, staff should inform the applicant of any income for which she may be eligible to receive.

 

W—1411 Types of Income

Revision 15-4; Effective October 1, 2015
 

 

W—1411.1 Disability Benefits

Revision 15-4; Effective October 1, 2015

 

 

W—1411.1.1 Agent Orange Settlement Payments

Revision 15-4; Effective October 1, 2015

 

Agent Orange Settlement Payments disbursed by AETNA Insurance Company and paid to the following individuals are exempt:

  • veterans with disabilities exposed to Agent Orange while in Vietnam who suffer from total disabilities caused by any disease, and
  • survivors of these deceased veterans.

These veterans receive yearly payments. Survivors of these deceased veterans receive a lump-sum settlement payment.

Note: Veteran's Administration payments are counted as unearned income, including benefits paid to veterans with service-connected disabilities resulting from exposure to Agent Orange. See W-1411.4.20, Veterans Benefits.

 

W—1411.1.2 Disability Insurance Benefits

Revision 15-4; Effective October 1, 2015

 

Count as unearned income.

 

W—1411.1.3 Radiation Exposure Compensation Act Payments

Revision 15-4; Effective October 1, 2015

 

Payments from the Radiation Exposure Compensation Act (the "Act"), Public Law 101-426, are exempt.

The Act established a program to pay damages to individuals for injuries or deaths caused by exposure to radiation from nuclear testing and uranium mining. When the affected individual is deceased, the surviving spouse, children, parents, grandchildren, or grandparents receive the payments.

 

W—1411.1.4 Worker's Compensation

Revision 15-4; Effective October 1, 2015

 

The gross benefit is counted as unearned income, less amounts:

  • recouped for a prior worker's compensation overpayment, or
  • paid for attorney's fees. Note: The Texas Workers' Compensation Commission (TWCC) or a court sets the amount of the attorney's fee to be paid.

A deduction from the gross benefit for court-ordered child support payments is not allowed.

Exception: Worker's compensation benefits paid to the individual for out-of-pocket medical expenses are considered as reimbursements.

 

W—1411.2 Education and Training

Revision 15-4; Effective October 1, 2015
 

 

W—1411.2.1 Educational Assistance

Revision 15-4; Effective October 1, 2015

 

Educational assistance, including educational loans, are exempt, regardless of the source. Loans for education, including loans from relatives or other people, are considered as educational assistance only if payment is deferred.

Educational assistance is:

  • any financial aid for vocational or educational courses from:
    • an organization (such as fraternal, alumni, etc.); or
    • a government program or agency (such as the U.S. Office of Education, Department of Veterans Affairs, or Texas Department of Assistive and Rehabilitative Services).
  • provided to students who are enrolled in a:
    • program that provides for completion of a secondary high school diploma or the equivalent (such as a general equivalency diploma [GED]);
    • school for people with intellectual or physical disabilities; or
    • post-secondary institution.

Note: "Post-secondary" includes institutions of higher education and others not requiring a high school diploma (such as community colleges and vocational educational programs) authorized by the state to provide educational or training programs beyond secondary education.

The U.S. Office of Education under Title IV of the Higher Education Act administers most educational assistance programs. A few examples of the most common Title IV educational assistance grants include:

  • Pell Grants,
  • Stafford Loan Program,
  • Parent Loans for Students (PLUS Loans),
  • Supplemental Educational Opportunity Grants,
  • College Work Study, and
  • Carl D. Perkins Loans (Title IV, Part E) (formerly National Direct Student Loans).

The National Community Services Act (NCSA) program also provides educational assistance. Individuals are awarded from $1,000 to $4,000 per year of completed services to apply toward past or future educational expenses. The educational award is not counted, as it is always made payable directly to the financial institution or institution of higher learning.

The Department of Veterans Affairs administers education programs designed for veterans, reservists, members of the National Guard, and their widows and orphans. These include:

  • Montgomery GI Bill (MGIB) Active Duty Educational Assistance Program,
  • Vocational Rehabilitation,
  • Post-Vietnam Era Veterans' Educational Assistance Program (VEAP),
  • Survivor's and Dependent's Educational Assistance (DEA), and
  • MGIB - Selected Reserve Educational Assistance Program.

 

W—1411.2.2 Job Training

Revision 15-4; Effective October 1, 2015

 

 

W—1411.2.2.1 Workforce Innovation and Opportunity Act (WIOA)

Revision 15-4; Effective October 1, 2015

 

All WIOA payments are exempt.

 

W—1411.2.2.2 Other Job Training and Training Allowances

Revision 15-4; Effective October 1, 2015

 

Portions of payments earmarked as reimbursements for training-related expenses are exempt, and any excess is counted as earned income.

 

W—1411.3 Employment and Self-Employment Income

Revision 15-4; Effective October 1, 2015

 

 

W—1411.3.1 Children's Earned Income

Revision 17-2; Effective April 1, 2017

 

Exempt the earnings of a child under age 18 who is:

  • a full-time student, including a home-schooled student; or
  • a part-time student employed less than 30 hours a week.

Exempt the earnings of an 18-year-old in the budget group if the 18-year-old is:

  • a full-time student, including a home-schooled child, or a part-time student employed less than 30 hours a week; and
  • considered a child. A child is defined as a household member under 19 years of age unless the child is married or legally emancipated.

 

W—1411.3.2 Contractual Earnings

Revision 15-4; Effective October 1, 2015

 

Contractual earnings are wages and salaries only. Self-employment income, unearned income, or income received on an hourly or piecework basis are not included. The two basic types of contractual earnings are:

  • Seasonal employment — available only during certain months of the year and recurs each year. Examples: School-related employment, certain types of farm work, and summer or winter employment. Divide seasonal employment that is a household's annual means of support over 12 months. If the income supports the household for only a portion of the year and the household has income from other sources the rest of the year, average the earnings over the time they are intended to cover.
  • Contractual employment — nonseasonal employment that is contracted for a specific time and does not recur. Divide earnings over the time covered by the contract.

 

W—1411.3.2.1 Monthly Budgeting of Contractual Earnings

Revision 15-4; Effective October 1, 2015

 

Contractual earnings may be budgeted monthly by:

  • dividing the total gross amount earned under the contract by the number of months the contract covers or by 12 months, whichever is applicable; and
  • adding this amount to any other income, and then budgeting according to usual procedures. Note: These steps should not be followed if the income is not received as stipulated in the contract or if labor disputes interrupt income.

If the individual's employment situation changes and the income is not received as stipulated in the contract or if labor disputes interrupt income, advisors should:

  • recompute the income or adjust the benefits accordingly; and
  • document all the facts that caused the recomputation or adjustment.

 

W—1411.3.3 Military Pay and Allowances

Revision 15-4; Effective October 1, 2015

 

Military pay and allowances for housing, food, base pay, and flight pay is counted as earned income, less pay withheld to fund education under the GI Bill.

 

W—1411.3.3.1 Family Subsistence Supplemental Allowance (FSSA)

Revision 15-4; Effective October 1, 2015

 

FSSA is a monthly payment made to certain low-income service members and their families so they will not have to depend on the Supplemental Nutrition Assistance Program (SNAP) to meet their needs. The service members' pay statements usually include the FSSA and are counted as earned income.

 

W—1411.3.3.2 Combat (Hazardous Duty) Payments

Revision 15-4; Effective October 1, 2015

 

All of the combat payments, also known as hazardous duty payments, received by a legal parent who is a member of the U.S. military, absent solely because the individual has been deployed to a combat zone, are counted as earned income.

 

W—1411.3.4 Self-Employment

Revision 15-4; Effective October 1, 2015

 

Self-employment income is usually income from one's own business, trade, or profession rather than from an employer. However, some individuals may have an employer and receive a regular salary. If an employer does not withhold income taxes or Federal Insurance Contributions Act (FICA) taxes, even if required to do so by law, the person is considered self-employed.

Advisors must inform households in writing to keep self-employment records and receipts for verification purposes for future recertifications. Form TF0001, Notice of Case Action, contains the self-employment information.

 

W—1411.3.4.1 Types of Self-Employment Income

Revision 15-4; Effective October 1, 2015

 

Types of self-employment include:

  • odd jobs, such as mowing lawns, babysitting, and cleaning houses;
  • owning a private business, such as a beauty salon or auto mechanic shop;
  • farm income; and
  • income from property.

For details about determining the amount of self-employment income for TWHP, see the following sections:

  • A-1323.4.4, Determining the Amount of Self-Employment Income;
  • A-1323.4.5, Allowable Costs of Producing Income;
  • A-1323.4.6, Computation Methods;
  • A-1323.4.7, Determining Net Self-Employment Income;
  • A-1323.4.8, Changes in Annual or Seasonal Self-Employment Income; and
  • A-1323.4.9, Rebudgeting Income and Expenses.

 

W—1411.3.4.2 Property Income

Revision 15-4; Effective October 1, 2015

 

Income from renting, leasing, or selling property on an installment plan is self-employment income. Property includes equipment, vehicles, and real property.

Income from property is counted as:

  • earned if the:
    • person spends an average of at least 20 hours a week in management or maintenance activities; or
    • income is from noncommercial boarding situations.
  • unearned if the person spends an average of less than 20 hours a week in management or maintenance activities.

Work-related expenses are allowed for earned income. For unearned income, only the expenses associated with producing the income should be deducted.

If the individual sells property on an installment plan, the payments are counted as income. The balance of the note is exempted as an inaccessible resource.

 

W—1411.3.4.3 Noncommercial Roomer/Boarder Payments

Revision 15-4; Effective October 1, 2015

 

The noncommercial roomer/boarder policy is used if a noncertified household member makes payments to a certified member under a formal or informal landlord/tenant relationship. Payments made by boarders for room, meals, and other shelter expenses are counted. Payments made by roomers for room and other shelter expenses are counted.

See A-1323.4.5, Allowable Costs of Producing Income, to determine the countable amount of noncommercial roomer/boarder payments. If there is not a formal or informal landlord/tenant relationship, A-1326.1, Cash Gifts and Contributions, policy applies.

Roomer/boarder status should not be given to:

  • anyone whose income can be applied to the certified group; or
  • a dependent child who is an ineligible alien.

 

W—1411.3.5 Wages, Salaries, Commissions and Tips

Revision 15-4; Effective October 1, 2015

 

The actual gross amount of all wages, salaries, commissions, bonuses and tips count as earned income before deductions such as flexible fringe benefits, cafeteria plans and employee retirement contributions are withheld from the amount.

Wages held by the employer at the request of the employee or garnished wages are counted as income in the month the household would otherwise have been paid. If, however, an employer holds the employee's wages as a general practice, this money counts as income in the month it is paid.

An advance counts in the month it is received. When an advance is repaid, the payback amount is deducted from the gross pay and the remainder is budgeted as the countable gross amount.

 

W—1411.3.5.1 Federal Tax Refunds and Earned Income Tax Credits (EIC)

Revision 15-4; Effective October 1, 2015

 

Households with tax dependents and earnings below levels established by the Internal Revenue Service (IRS) are potentially eligible to receive EIC payments from the IRS.

EIC money is included in an individual's:

  • paycheck (advance EIC payments) before the individual files an income tax return, or
  • IRS refund after the individual files an annual income tax return.

Federal tax refunds and EIC payments are exempt.

 

W—1411.3.5.2 Flexible Fringe Benefits

Revision 15-4; Effective October 1, 2015

 

Fringe benefit plans allow the employee to choose from benefit components such as insurance, extra vacation time, and payments to third parties for medical bills or child care. These are also called "cafeteria plans."

Under some plans, employers may:

  • withhold wages to pay for benefits selected by the employee; or
  • offer benefit credits in addition to wages, which the employee can use to purchase benefits.

Some plans may pay the remaining unused credit as part of the employee's wages.

If the employer … the advisor must count …
withholds the employee's wages to purchase benefits, the held wages as earnings in the pay period the employee would have normally received them.
provides credit in addition to wages, as earnings only the portion that is paid directly to the employee. If the employer pays the unused credit in cash, the advisor must follow the steps below to determine the countable excess income:
  1. Determine the total amount of gross wages/salary.
  2. Add the benefit credit amount to the wages/salary from Step 1.
  3. Subtract the cost of fringe benefits up to the amount of the benefit credit from the amount in Step 2.
  4. The remaining income from Step 3 is the countable gross earned income for the EDG.

 

W—1411.3.5.3 Income from Tips

Revision 15-4; Effective October 1, 2015

 

Household members who are employed in service-related occupations (beauticians, waiters, delivery staff, etc.) are likely to earn tips in addition to wages. Tips are counted as earned income.

Tip income is added to wages before applying conversion factors.

Note: Tips are not considered as self-employment income unless related to a self-employment enterprise.

 

W—1411.3.5.4 Vacation Pay

Revision 15-4; Effective October 1, 2015  

 

If an individual receives vacation pay … the payment is considered …
during or before termination of employment, earned income.
after termination of employment in one lump sum, a liquid resource in the month received.
after termination of employment in multiple checks, unearned income.

 

W—1411.3.6 Temporary Census Income

Revision 15-4; Effective October 1, 2015  

 

Exempt wages.

 

W—1411.4 Government Payments

Revision 15-4; Effective October 1, 2015  

 

Government payments are counted unless exempted in this section or by other policy in W-1400, Income.

 

W—1411.4.1 Adoption Assistance

Revision 15-4; Effective October 1, 2015  

 

Adoption assistance payments are exempt.

 

W—1411.4.2 Crime Victim's Compensation Payments

Revision 15-4; Effective October 1, 2015  

 

Crime victim's compensation payments are provided from the funds authorized by state legislation to assist a person who:

  • was a victim of a violent crime;
  • was the spouse, parent, sibling, or adult child of a victim who died as a result of a violent crime; or
  • is the guardian of a victim of a violent crime.

The Office of the Attorney General (OAG) distributes the payments monthly or in a lump sum. These payments are exempt.

 

W—1411.4.3 Government Disaster Payments

Revision 15-4; Effective October 1, 2015

 

Federal disaster payments and comparable disaster assistance provided by states, local governments, and disaster assistance organizations are exempt if the household is subject to legal penalties when the funds are not used as intended (including temporary employment of six months or less for disaster-related work, paid under the Workforce Innovation and Opportunity Act and funded by the National Emergency Grant).

Examples:

  • Payments by the Individual and Family Grant Program or Small Business Administration to rebuild a home or replace personal possessions damaged in a disaster.
  • Payments from the Federal Emergency Management Agency (FEMA) to assist with rent.

 

W—1411.4.4 Government Housing Assistance

Revision 15-4; Effective October 1, 2015

 

The value of government housing or rental subsidies, whether cash, two-party check, in-kind, or vendor-paid, are exempt.

 

W—1411.4.5 Transitional Living Allowance

Revision 15-4; Effective October 1, 2015  

 

Transitional living allowances (TLA) are exempt. The Texas Department of Family and Protective Services (DFPS) distributes TLA to a foster child who:

  • is under age 21;
  • has completed the preparation for adult living (PAL) classes; and
  • has left foster care or is transitioning out of foster care.

Payments:

  • are received for a maximum of 12 months;
  • cannot exceed $500 a month;
  • cannot total more than $1,000; and
  • are intended for expenses other than ongoing room and board.

 

W—1411.4.6 Reserved for Fture Use

Revision 18-3; Effective July 1, 2018

 

 

 

W—1411.4.7 National and Community Services Act (NCSA)

Revision 15-4; Effective October 1, 2015  

 

The NCSA established a corporation to administer paid volunteer service programs. The corporation provides funds, training, and technical assistance to states and communities to develop and expand human, education, environmental, and public safety services.
The corporation oversees programs created under the Domestic Volunteer Service Act (DVSA) of 1973 such as:

  • Volunteers in Service to America (VISTA),
  • Retired and Senior Volunteer Program (RSVP),
  • Foster Grandparents, and
  • Senior Companion Program.

The corporation also administers programs established in 1993 that include:

  • AmeriCorps,
  • Learn and Serve, and
  • National Senior Service Corps (Senior Corps).

For programs established in 1973:

Payments, living allowances, and stipends are exempt.

For programs established in 1993:

Payments except on-the-job-training (OJT) payments are exempt. 

OJT payments for adults are counted as earned income. A child's OJT payment is exempt if the child is under:

  • age 19; and
  • under parental control of another household member.

Exception: OJT payments received by AmeriCorps volunteers are exempt.

 

W—1411.4.8 Native and Indian Claims

Revision 15-4; Effective October 1, 2015

 

Exempted payments made to Native Americans under various public laws include, but are not limited to, the following:

  • Distributions from Native Corporations made under the Alaska Native Claims Settlement Act (ANCSA) (Public Law [PL] 92-203 and Section 15 of PL 100-241).
  • Funds distributed per capita or held in trust by the Indian Claims Commission for members of Indian tribes, as follows:
    • Grand River Band of Ottawa Indians (PL 94-540);
    • Income to certain tribal members from land held in trust by the United States government (PL 94-114, Section 6);
    • Income resulting from provisions of PL 92-254; and
    • Red Lake Band of Chippewa (PL 98-123, Section 3) or Assiniboine Tribe of the Fort Belknap Indian Community, and the Assiniboine Tribe of the Fort Peck Indian Reservation (PL 98-124, Section 5).
  • Funds distributed by the Secretary of Interior to tribal members from:
    • tribal trust funds on a per capita basis (PL 98-64); or
    • judgment funds from claims against the United States and held in trust or distributed on a per capita basis (PL 93-134, as amended by 97-458).
  • Payments by the Indian Claims Commission to the:
    • Passamaquoddy Tribe, the Penobscot Nation, and the Houlton Band of Maliseet Indians or any of their members [Maine Indian Claims Settlement Act of 1980, PL 96-420, Section 9(c)].
    • Confederated Tribes and Bands of Yakima Indian Nation or the Apache Tribe of the Mescalero Reservation (PL 95-433).
    • Seneca Nation or its members (Seneca Nation Settlement Act of 1990, PL 101-503).
    • Blackfeet, Gros Ventre, and Assiniboine tribes of Montana (PL 97-408).
    • Saginaw Chippewa of Mississippi [PL 99-123, Section 6(b)(2)].
  • Payments to the Turtle Mountain Band of Chippewa, Arizona (PL 97-403).
  • Payments to heirs of deceased Indians made under the Old Age Assistance Claims Settlement Act (PL 98-500).

Exception: Money given to Native Americans from gaming revenues (such as from casino profits, race tracks, lotteries, etc.) is not exempt under these laws. Gaming revenues are counted as unearned income.

 

W—1411.4.9 Nutrition Programs

Revision 15-4; Effective October 1, 2015

 

The following amounts are exempt:

  • the value of food assistance under the Child Nutrition Act of 1966 and under the National School Lunch Act; and
  • benefits received under Title VII, Nutrition Program for the Elderly, of the Older American Act of 1965.

 

W—1411.4.10 One-Time Grandparent Payments

Revision 15-4; Effective October 1, 2015

 

One-Time Grandparent payments are exempt as income.

 

W—1411.4.11 One-Time Temporary Assistance for Needy Families (OTTANF)

Revision 15-4; Effective October 1, 2015

 

OTTANF is exempt as income.

 

W—1411.4.12 Payments to Vietnam Veterans' Children

Revision 15-4; Effective October 1, 2015

 

 

W—1411.4.12.1 Payments to Vietnam Veterans' Children Born with Spina Bifida (Public Law 104-204)

Revision 15-4; Effective October 1, 2015

 

These VA payments made to Vietnam veterans' children who are born with spina bifida are exempt.

 

W—1411.4.12.2 Payments to Children of Women Vietnam Veterans Born with Certain Birth Defects (Public Law 106-419)

Revision 15-4; Effective October 1, 2015

 

VA payments made to the children of women Vietnam veterans who are born with a birth defect are exempt.

 

W—1411.4.13 Payments to Victims of Nazi Persecution

Revision 15-4; Effective October 1, 2015

 

Payments made to individuals because of their status as victims of Nazi persecution are exempt.

 

W—1411.4.14 Payments to World War II Filipino Veterans and Spouses

Revision 15-4; Effective October 1, 2015

 

Under the American Recovery and Reinvestment Act of 2009 (Division A, Title X, Section 1002), some World War II Filipino veterans who served in the military forces of the Government of Commonwealth of the Philippines, and their spouses, are authorized to receive one-time lump-sum payments of up to $15,000.

These payments are exempt.

 

W—1411.4.15 Relocation Assistance

Revision 15-4; Effective October 1, 2015

 

The following payments are exempt if provided under:

  • Title II of the Uniform Relocation Assistance and Real Property Acquisitions Act of 1970;
  • Title I of Public Law 100-383 (these payments are made to Aleuts or individuals of Japanese ancestry [or their heirs] who were relocated during World War II); or
  • Public Law 93-531 to members of the Navajo or Hopi Tribes.

 

W—1411.4.16 Retirement, Survivors, and Disability Insurance (RSDI)

Revision 15-4; Effective October 1, 2015

 

The benefit amount, including the deduction for the Medicare premium, less any amount that is being recouped for a prior RSDI overpayment, is counted as unearned income.

Note: The Social Security Administration (SSA) may deposit RSDI benefits into a Direct Express card debit account. See www.ssa.gov/pubs/10073.html.

 

W—1411.4.17 Supplemental Security Income (SSI)

Revision 15-4; Effective October 1, 2015

 

The income of an SSI recipient is exempt.

 

W—1411.4.18 Temporary Assistance for Needy Families (TANF)

Revision 15-4; Effective October 1, 2015

 

The TANF benefit amount (after recoupment) counts as unearned income.

Retroactive or restored TANF or refugee cash assistance payments are exempt as income.

 

W—1411.4.18.1 TANF Annual School Subsidy Payment

Revision 15-4; Effective October 1, 2015

 

TANF annual school subsidy payments are exempt.

 

W—1411.4.19 Unemployment Compensation

Revision 15-4; Effective October 1, 2015

 

The gross unemployment insurance benefit (UIB), less any amount being recouped for a UIB overpayment, counts as unearned income.  

Exception: The gross amount counts if the household agreed to repay a SNAP overpayment through voluntary garnishment.

 

W—1411.4.20 Veterans Benefits

Revision 15-4; Effective October 1, 2015

 

The VA provides payments to veterans with disabilities and/or their spouses/dependents and to spouses/dependents of deceased veterans. VA benefits are not subject to federal or state income tax or child support garnishment.

Three basic VA benefit programs are described in this section:

  • Pension,
  • Disability Compensation, and
  • Dependency and Indemnity Compensation (DIC).

VA Pension

VA pension payments are made to certain veterans with disabilities based on financial needs. Low-income veterans who either have a disability or are age 65 and older may be eligible for a VA pension if they have 90 days or more of active military service with at least one day during a period of war. Payments are made to bring the veteran's total income, including other retirement or Social Security income, to a level set by Congress. Recipients must re-qualify each year to continue to receive payments. There is a similar pension benefit available for surviving spouses and dependent minor children of such deceased veterans.

VA Disability Compensation

VA disability compensation is a payment made to a veteran with a service-related disability. Eligibility is not based on financial need. The amount of the payment varies with the percentage of the veteran's disability and the number of the veteran's dependents living in or out of the home. The payment can also be made to a spouse, child or parent of a veteran because of the service-related death of the veteran.

Dependency and Indemnity Compensation

DIC is a monthly benefit paid to eligible survivors of active duty service members and survivors of those veterans whose deaths are determined by VA to be service-related. This payment is a flat monthly payment, regardless of other income. The payment is payable for the life of the spouse, provided the spouse does not remarry before age 57; however, should a remarriage end, DIC benefits can be reinstated. This payment is adjusted annually for cost-of-living increases and is non-taxable. VA adds a monthly transitional payment to the surviving spouse with minor children for the first two years of DIC entitlement or until the last child turns age 18, whichever occurs first. See http://benefits.va.gov/Compensation/current_rates_dic.asp for current payment amounts.

Veterans with certain disabilities may be eligible for additional special monthly compensation such as:

  • Aid and Attendance and Housebound payments, which are an allowance to veterans and dependents who are in need of regular aid and attendance by another person, or a veteran who is permanently housebound; and
  • reimbursement for unusual medical expenses.

The gross benefit less any amount recouped or suspended for VA overpayment is counted as unearned income, except as described below for reimbursement for medical and attendant care expenses. These special compensation payments that are intended to cover medical and attendant care expenses are exempt. These payments are exempt as reimbursement as explained in A-1332, Reimbursements.

Apportioned VA payments are a direct payment of the dependent's portion of the VA benefit to a dependent spouse or child not living with the veteran. Apportioned VA payments are unearned income to the dependent spouse or child not living with the veteran.

Other Types of Veterans Benefits

  • Military retirement payment — A payment made to an individual who retired from active duty military service after at least 20 years of service. Military retirement is not a VA program, but is paid by the Defense Finance and Accounting Service in Cleveland (DFAS-CL). The gross payment is counted as unearned income.
  • Survivor Benefit Plan (SBP) — Active duty members are automatically enrolled in this program. Surviving spouses and/or children of service members who die while on active duty may be entitled to SBP payments made by DFAS-CL. SBP payments are equal to 55 percent of what a member's retirement pay would have been had the member been retired at 100 percent disability. An SBP payment is reduced by the amount of payments provided under the VA DIC program.

At retirement, retirees may choose to purchase the SBP. In this case, the SBP pays retired military members’ eligible survivors an inflation-adjusted monthly income. Basic SBP for a spouse pays a benefit equal to 55 percent of the retired individual's pay. Eligible children may also be SBP beneficiaries while they are dependents of the retired individual, either alone or added to spouse coverage. Any VA DIC paid to a spouse is subtracted from SBP payments, although VA DIC payments to or for children do not affect SBP payments. SBP premiums are refunded to the survivor if the monthly VA DIC amount is greater than the SBP monthly annuity.

The gross amount of any SBP payment is counted as unearned income.

VA educational assistance programs — Different programs provide education assistance, including vocational rehabilitation. The policy in A-1322.1, Educational Assistance, applies.

 

W—1411.4.21 DFPS Relative Caregiver Reimbursement Program Payments

Revision 15-4; Effective October 1, 2015

 

One-time integration payments are exempt from income.

Flexible support payments are exempt from income.

 

W—1411.4.22 Healthy Marriage Development Program Payments

Revision 15-4; Effective October 1, 2015

 

A payment received for completing the Healthy Marriage Development Program is exempt. The advisor must document as required by policy in A-1380, Documentation Requirements.

 

W—1411.5 Income from Property

Revision 15-4; Effective October 1, 2015

 

 

W—1411.5.1 Dividends and Royalties

Revision 15-4; Effective October 1, 2015

 

Dividends count as unearned income. Exception: Dividends from insurance policies are exempt as income.

Royalties count as unearned income, less any amount deducted for production expenses and severance taxes.

 

W—1411.5.2 Payments for Mineral Rights

Revision 15-4; Effective October 1, 2015

 

Payments for mineral rights count as unearned income.

 

W—1411.6 Other

Revision 15-4; Effective October 1, 2015

 

 

W—1411.6.1 Cash Gifts and Contributions

Revision 18-1; Effective January 1, 2018

 

Cash gifts and contributions count as unearned income unless they:

  • are made by a private, nonprofit organization on the basis of need; and
  • total $300 or less per household in a federal fiscal quarter. The federal fiscal quarters are January to March, April to June, July to September, and October to December.

If these contributions exceed $300 in a quarter, the excess amount counts as income in the month received.

Exception: Contributions from noncertified household members are budgeted according to policy explained in W-1411.6.1.1, Contributions from Noncertified Household Members.

Related Policy
MyGoalsPayments, A-1326.1

 

W—1411.6.1.1 Contributions from Noncertified Household Members

Revision 15-4; Effective October 1, 2015  

 

If a noncertified person(s) lives in the home with a member of the budget group and shares household expenses (no landlord/tenant relationship), any payments the noncertified person makes to the unit for common household expenses (including food, shelter, utilities, and items for home maintenance) are exempt. If a noncertified household member makes additional payments for use by a certified member, it is a contribution.

If a noncertified household member makes payments to a certified member under a formal or informal landlord/tenant relationship, countable income is determined according to the roomer/boarder policy in W-1411.3.4.3, Noncommercial Roomer/Boarder Payments.

 

W—1411.6.1.2 Gifts from Tax-Exempt Organizations

Revision 15-4; Effective October 1, 2015

 

Gifts from tax-exempt organizations are exempt if the gift is for a child with a life-threatening condition and the amount of the gift is:

  • less than $2,000 annually, and
  • not converted to cash.

If the gift is converted into cash or exceeds $2,000 a year, the conversion or the excess counts as unearned income in the month of receipt and is exempt as a resource in the months that follow.

 

W—1411.6.2 Child Support

Revision 15-4; Effective October 1, 2015

 

Payments obtained on behalf of a child count as unearned income. Payments are considered as child support if:

  • a court ordered the support, or
  • the child's caretaker or the person making the payment states the purpose of the payment is to support the child.

Advisors must consider the following in determining child support:

  • Gifts or donations as contributions are not considered child support. Gifts are items or money that only benefit the child for a specific purpose, such as a birthday present. These gifts or donations include (but are not limited to) clothes, toys, or personal items, or money to purchase clothes, toys, or personal items.
  • Ongoing child support income is considered as income to the children, even if someone else living in the home receives it.
  • Child support arrears is considered as unearned income to the caretaker.

If an absent parent is making child support payments but moves back into the home of the caretaker and child, the child support is not counted. The earnings and/or other income count as a regular household member.

If a caretaker receives current child support for a nonmember (or a member who is no longer in the home) but uses the money for personal or household needs, the amount counts as unearned income. The amount actually used for or provided to the nonmember for whom it is intended to cover is not counted.

If a single payment covers two or more children (including at least one who is not an applicant/recipient) and the support order does not specify a portion for each child, the payment is prorated among all of the children. When two or more children receive child support from the same father and one child receives Supplemental Security Income, the payment is always prorated.

 

W—1411.6.2.1 Counting Child Support

Revision 15-4; Effective October 1, 2015  

 

For child support paryments issued via … funds are …
warrants, mailed from Austin, Texas, the day after the disbursement date listed on the Texas Child Support Enforcement System (TXCSES) inquiry system. When determining availability, consider the distance the payment has to travel through the mail.
direct deposit/electronic transfers, available two business days after the disbursement date listed on the TXCSES Web inquiry system.
Texas debit cards, available two business days after the disbursement date listed on the TXCSES Web inquiry system.

Full child support payments are counted, less the $75 disregard deduction.

 

W—1411.6.2.2 Lump-Sum Child Support Payments

Revision 15-4; Effective October 1, 2015  

 

Lump-sum child support payments received or anticipated to be received more often than once a year count as unearned income in the month received. Lump-sum child support payments received once a year or less frequently are not counted as income. See W-1412.1, Lump-Sum Payments.

Lump-sum payments on child support arrears are received from the following sources:

  • IRS intercept program — This occurs when the IRS intercepts the absent parent's tax refund to pay child support arrears.
  • Excess payment — When the OAG sends a second excess payment to the individual, the advisor receives Form H1719, Notice of Excess Payment, with the date and the amount. See the glossary for more information.
  • OAG adjustments — The advisor receives a PBS-OAGF1 Report, Clients Receiving a Lump Sum Adjustment from OAG-Possible Ineligibility. The Texas Health and Human Services Commission (HHSC) produces this report when the OAG makes adjustments to an EDG that result in a lump-sum amount being distributed to the individual. Adjustments may occur when federal distribution changes are implemented, court orders are modified, or EDG errors are corrected.

Lump-sum payments on current child support are received from the following sources:

  • Advance pay — Advance pay occurs when the absent parent is current on obligated amounts and voluntarily pays an amount in advance of the obligated monthly amount. Example: The absent parent is obligated to pay $200 a month and is current on that amount. The absent parent loses his job and receives a severance payment of $2,000 and decides to pay $1,000 in advance to cover child support for the next five months. The payment to the individual is not counted as income.
  • Future pay — Future pay occurs when the absent parent is current on obligated amounts and voluntarily and routinely pays an extra amount over the obligated amount. Example: The absent parent is obligated to pay $200 a month and is current on that amount. The absent parent pays $25 extra each month (or some months). The OAG releases the money as received. This payment counts as unearned income if the advisor can anticipate that it will be received more often than once a year.

 

W—1411.6.2.3 Medical Support Payments

Revision 15-4; Effective October 1, 2015  

 

When a court order is entered, it designates the amount of child support and/or medical support a parent receives on behalf of the children. Medical support is in the form of:

  • health insurance, ordered in addition to child support; or
  • a cash amount for the purpose of offsetting medical expenses.

If the individual does not receive Medicaid and is responsible for paying medical expenses, the payments are considered a reimbursement and the policy for reimbursement in W-1412.2, Reimbursements, applies.

If the individual has an open child support EDG with the OAG for children receiving Medicaid, the OAG processes medical support payments through an interface with HHSC/Third Party Recovery, and the individual does not receive a direct payment. If an individual is not referred to the OAG for services and is receiving or begins receiving cash medical support payments, the individual is required to remit the payments to the Third Party Recovery unit. Cash medical support payments that the individual receives and remits to Third Party Recovery are not counted. Any of the cash medical support payment from the absent parent that the individual continues to keep counts as income.

 

W—1411.6.3 Energy Assistance

Revision 15-4; Effective October 1, 2015  

 

Exempt energy assistance.

Exception: Count cash payments received from private nonprofit organizations as unearned income.

 

W—1411.6.4 Foster Care and Permanency Care Assistance (PCA) Payments

Revision 15-4; Effective October 1, 2015  

 

Foster care or permanency care payments are exempt.

Note: Do not include a person receiving foster care or permanency care payments in a budget or certified group.

 

W—1411.6.5 In-Kind Income

Revision 15-4; Effective October 1, 2015  

 

In-kind income is exempt.

 

W—1411.6.6 Interest

Revision 15-4; Effective October 1, 2015  

 

Interest counts as unearned income.

 

W—1411.6.7 Loans (Noneducational)

Revision 15-4; Effective October 1, 2015  

 

Financial assistance is considered a loan if:

  • there is an understanding that the individual will repay the money; and
  • the individual can reasonably explain how the loan will be repaid.

These loans are exempt from income. Contributions that are not considered loans are counted as unearned income.

 

W—1411.6.8 Pensions

Revision 15-4; Effective October 1, 2015  

 

A pension is any benefit derived from former employment (such as retirement benefits or a disability pension). A pension counts as unearned income.

 

W—1411.6.9 Trust Funds

Revision 15-4; Effective October 1, 2015  

 

Withdrawals or dividends that the household can receive from a trust fund that is exempt from resources count as unearned income.

 

W—1411.6.10 Resettlement-Reception and Placement (R&P)

Revision 15-4; Effective October 1, 2015  

 

R&P counts as income in the month received.

 

W—1411.6.11 Refugee Cash Assistance (RCA)

Revision 15-4; Effective October 1, 2015  

 

RCA counts as income in the month received.

 

W—1411.6.12 Match Grant

Revision 15-4; Effective October 1, 2015  

 

Count match grant as income in the month received.

 

W—1411.6.13 Spousal Diversion and Dependent Allowance

Revision 15-4; Effective October 1, 2015  

 

The portion of income from a spouse or parent in a nursing facility that is diverted to the family members living in the community counts as unearned income.

The spousal diversion and dependent allowance are determined by the Medicaid for the Elderly and People with Disabilities worker processing the application for nursing facility coverage. When nursing facility coverage is approved and disposed, the Texas Integrated Eligibility Redesign System (TIERS) will add this income in the community family member's approved Texas Works (TW) EDGs upon running Eligibility. Advisors do not make Data Collection entries for this income.

 

W—1411.6.14 Welfare-to-work Income

Revision 15-4; Effective October 1, 2015  

 

Welfare-to-work income is exempt.

 

W—1411.6.15 Alimony Received

Revision 15-4; Effective October 1, 2015  

 

Alimony received is counted as unearned income for the individual who received the payment.

 

W—1411.6.16 Annuity

Revision 15-4; Effective October 1, 2015  

 

An annuity is a series of payments paid under a contract and made at regular intervals over a period of more than one full year. Payments can be either fixed (under which one receives a definite amount) or variable (not fixed). An individual can buy the contract alone or with the help of an employer.

Annuity payments are counted as unearned income.

 

W—1411.6.17 Capital Gains

Revision 15-4; Effective October 1, 2015  

 

Capital gains are profit from the sale of property or of an investment when the sale price is higher than the initial purchase price (for example, profits from the sale of stocks, bonds, or from the sale of real estate).

Capital gains are exempt.

 

W—1411.6.18 Housing Allowance

Revision 15-4; Effective October 1, 2015  

 

Housing allowances are exempt.

 

W—1411.6.19 Life Estate

Revision 15-4; Effective October 1, 2015  

 

Life estate income is income an individual receives from ownership of property that an individual only possesses ownership of for the duration of one’s life (for example, rental income).

Life estate income is counted as unearned income.

 

W—1411.6.20 Jury Duty Pay

Revision 15-4; Effective October 1, 2015  

 

Jury duty pay is taxable income received from jury duty as compensation.

Jury duty pay is exempt.

 

W—1411.6.21 Court Awards

Revision 15-4; Effective October 1, 2015  

 

Court awards are taxable money that an individual receives as the result of a lawsuit (for example, compensation for lost wages or punitive damages awards).

Follow policy in W-1412.1, Lump-Sum Payments.

 

W—1411.6.22 Canceled Debt

Revision 15-4; Effective October 1, 2015  

 

Canceled debts are debts that have been canceled, forgiven, or discharged, and the canceled amount is included as countable income on federal income tax returns (for example, loan foreclosures or canceled credit card debt).

Canceled debt income is exempt.

 

W-1411.6.23  MyGoals Payments

Revision 19-1; Effective January 1, 2019

 

MyGoals payments are cash payments received by participants in the MyGoals for Employment Success demonstration project. The demonstration studies the impact of combining workforce development and financial payments on employment outcomes for recipients of the Housing and Urban Development, Section 8 Rental Assistance. Only residents within the jurisdiction of the Houston Housing Authority are selected to participate in the project. 

MyGoals payments are counted as cash contributions made by a private, nonprofit organization according to policy in A-1326.1, Cash Gifts and Contributions.

 

W—1412 Types of Payments

Revision 15-4; Effective October 1, 2015

 

 

W—1412.1 Lump-Sum Payments

Revision 15-4; Effective October 1, 2015

 

Lump sums received once a year or less are exempt, unless specifically listed as income. Note: Retroactive or restored payments are considered to be lump-sum payments and are exempt. Any portion that is ongoing income is separated from a lump-sum amount and counted as income.

Example: A person receives a lump-sum payment in the amount of $4,950 from the SSA in the month of March. Effective that same month, the person receives his first monthly RSDI payment of $950, which is included in the $4,950 lump-sum payment. Staff must budget the $950 RSDI payment beginning with the month of March as an ongoing payment and consider the $4,000 as a lump-sum payment.

A lump-sum payment counts as income in the month received if the individual gets it or expects to get it more often than once a year.

Exceptions: Contributions, gifts, and prizes count as unearned income in the month received, regardless of frequency of pay.

If a lump sum reimburses a household for burial, legal, medical bills or damaged/lost possessions, the countable amount of the lump sum is reduced by the amount earmarked for these items.

Federal tax refunds and EICs are exempt as income.

 

W—1412.2 Reimbursements

Revision 15-4; Effective October 1, 2015

 

A reimbursement (not to exceed the individual's expense) is exempt if it is provided specifically for a past or future expense:

  • that is not included in HHSC's standard of need, or
  • for medical needs that are not paid by Medicaid.

If the reimbursement exceeds the individual's expenses, any excess counts as unearned income. A reimbursement to exceed the individual's expenses is not considered unless the individual or provider indicates the amount is excessive.

Note: A reimbursement for future expenses is exempt only if the individual plans to use it as intended.

 

W—1412.3 Third-Party Beneficiary

Revision 15-4; Effective October 1, 2015

 

Money an individual receives that is intended and used for maintenance of a nonmember is exempt.

If an individual receives a single payment for more than one beneficiary, the amount actually used for the nonmember is excluded up to the nonmember's identifiable portion or prorated portion, if the portion is not identifiable.

 

W—1412.4 Vendor Payments

Revision 15-4; Effective October 1, 2015

 

Payments that a person or organization outside the household makes directly to the individual's creditor or person providing the service are exempt.

Exception: Money legally obligated to the household, but which the payer makes to a third party for a household expense is counted as income.

Example: The absent parent is court-ordered to pay $400 a month. Instead, the absent parent pays $150 cash support and also pays $300 of the custodial parent's rent directly to the landlord for a total of $450. The $150 cash and $250 of the vendor-paid rent counts as child support, since that portion is legally obligated to the individual. The $50 amount over the legally obligated child support of $400 is considered an exempt vendor payment.

 

W—1413 Income Limits

Revision 17-2; Effective April 1, 2017

 

See the income limit for HTW (TA 41) in C-131.1, Federal Poverty Income Limits (FPIL).

 

W—1414 Calculating Household Income

Revision 17-2; Effective April 1, 2017

 

Use the policy in A-1350, Calculating Household Income, for TP 40, MA – Pregnant Women.

Exceptions:

  • Reasonable compatibility does not apply to HTW.
  • Budget expenses following the TANF and SNAP policy in Section A-1358, How to Budget Expenses.

 

W—1415 Determining Countable Income in Special Household Situations

Revision 15-4; Effective October 1, 2015

 

Use the policy in A-1360, Determining Countable Income in Special Household Situations, for TP 40, MA – Pregnant Women.

 

W—1420 Adjunctive Eligibility

Revision 17-2; Effective April 1, 2017

 

Do not verify income or expenses if it is determined the applicant or recipient is adjunctively eligible. A woman is adjunctively eligible if in the application month or in the ninth month of the 12-month certification period she is included in an active:

  • SNAP EDG;
  • TANF EDG;
  • TP 08, MA - Parents and Caretaker Relatives EDG; or
  • Children's Medicaid EDG (TP 43, TP 44 and TP 48), including being an EDG name on a TP 45, MA – Newborn Children EDG.

Exception: A woman is not adjunctively eligible if the only services received in the month adjunctive eligibility is being determined are expedited SNAP benefits with postponed verification.

Adjunctive eligibility is determined at application and renewal. TIERS determines adjunctive eligibility and omits the income and expense pages if the applicant/individual is determined adjunctively eligible.

A woman can also be adjunctively eligible if it is verified that she or someone in her budget group received Women, Infants and Children (WIC) benefits in the HTW application month.

Note: At renewal, consider a woman adjunctively eligible for HTW if the household received WIC benefits in any of the last three months of the 12-month certification period.

 

W—1430 Reserved

Revision 13-1; Effective January 1, 2013

 

 

W—1431 Women, Infants and Children (WIC) Verification

Revision 17-2; Effective April 1, 2017

 

Use the following documents to verify WIC eligibility:

  • active WIC voucher;
  • verification of certification letter; or
  • active Electronic Benefit Transfer (EBT) shopping list.

WIC verification must be current. Verify that the applicant received WIC benefits in the HTW application month.

 

W—1432 Income Verification

Revision 19-1; Effective January 1, 2019

 

If the applicant or recipient is determined adjunctively eligible, do not verify income or expenses.

For proof/verification of income, accept a copy of any one or more of the following:

  • a paycheck stub issued in the last 60 days from the file date;
  • a copy of the most recent tax return;
  • the most recent Social Security statement or check;
  • the most recent child support check;
  • proof of self-employment;
  • a letter from an employer verifying current income and frequency of payment; or
  • the most recent proof of other income received.

Use the Children's Medicaid verification policy in A-1371, Verification Sources, and the additional sources listed below to verify the household income.

Additional income verification sources for HTW include:

  • C-820, Data Broker;
  • C-825.14.1, OAG Child Support Data;
  • C-832, Office of the Attorney General (OAG) Inquiry; and
  • C-833, TXCSES Web Child Support Portal Inquiry.

When two or more consecutive pay stubs are submitted and the income amounts on the stubs are not identical, the eligibility determination is based on an average of the income reflected in the multiple pay stubs. Exclude pay stubs that appear to be non-representative when averaging.

When two or more non-consecutive pay stubs are submitted, if representative, the most recent pay stub is used to determine the income. If non-representative, use the next most recent representative pay stub.

Note: When possible, use the year-to-date method to determine the amount of the missing pay stubs.

Related Policy
Adjunctive Eligibility, W—1420 

 

W—1440 Documentation Requirements

Revision 07-0; Effective July 1, 2007

 

Follow the current Medical Programs policy for documenting income in A-1380, Documentation Requirements.

W-1500, Deductions

Revision 17-2; Effective April 1, 2017

 

 

W—1510 General Policy

Revision 15-4; Effective October 1, 2015

 

Households are allowed the following deductions:

  • work-related expense deduction — up to $120;
  • dependent care;
  • payments to dependents living outside the home;
  • alimony;
  • child support payments — deduct child support payments made by a member of the budget group; and
  • $75 disregard — deduct up to $75 of child support received by members of the budget group.

 

W—1511 Rules That Apply to Deductions

Revision 17-2; Effective April 1, 2017

 

Actual amounts (amounts that have already been billed) are used for the interview month, and amounts that have not been billed may be projected.

  • The following expenses are not deducted:
    • expenses paid to another member of the same Eligibility Determination Group (EDG);
    • expenses paid by a reimbursement, an exempt vendor payment or in-kind benefit; or
    • past-due balances, late charges or finance charges.
  • The most recent month's bills are used to project expenses. Unexpected changes should be considered during the certification period.
  • Only household expenses expected during the certification period should be considered.
  • The income conversion factors are used to determine monthly expenses if expenses are billed weekly, biweekly or semi-monthly.

Deductions must not be allowed if:

  • verification of the expense is required;
  • the household fails to provide required verification; and
  • the advisor is not able to verify the expense directly using other automated systems that are acceptable verification sources and accessible to the advisor or through another method.

Note: The EDG must not be denied for failure to provide the verification.

 

W—1512 Types of Deductions

Revision 15-4; Effective October 1, 2015

 

 

W—1512.1 Earned Income Deduction

Revision 15-4; Effective October 1, 2015

 

The earned income deduction is the work-related expense.

 

W—1512.1.1 Work-Related Expense

Revision 15-4; Effective October 1, 2015

 

A work-related expense deduction of up to $120 a month (not to exceed the person's monthly earnings) is allowed from the earned income of each employed household member whose needs are included in the budget or certified group.

 

W—1512.2 Dependent Care Deduction

Revision 15-4; Effective October 1, 2015

 

The maximum dependent care deduction is up to and including:

  • $200 a month for each child under age 2;
  • $175 a month for each child age 2 or older; and
  • $175 a month for each adult with disabilities.

An earned income deduction is allowed for the actual cost of unreimbursed payments up to and including the maximum amount when the individual incurs an expense for:

  • the care of a child or adult with disabilities (even when the child or adult with disabilities is not included in the budget group); and/or
  • transportation of a child to and/or from day care or school.

The expense must be both necessary for employment and incurred by an employed person who is included in the budget group.

 

W—1512.3 Diversions, Alimony and Payments to Dependents Outside the Home

Revision 15-4; Effective October 1, 2015

 

The following deductions are allowed:

  • alimony; and
  • payments to dependents living outside the home.

 

W—1512.4 Child Support Deductions

Revision 15-4; Effective October 1, 2015

 

Child support payments made by a member of the budget group are deducted.

Exceptions:

  • Child support payments paid directly or through the Office of the Attorney General to a child living in the home are not deducted.
  • If a payment is intended for more than one child and only one child lives in the home, only the portion of the payment that is for the child that does not live in the home is deducted.

 

W—1512.4.1 Allowable Child Support Deductions

Revision 15-4; Effective October 1, 2015

 

Allowable child support payments may be in the form of:

  • cash support;
  • medical support; or
  • payments to third parties.

A levy or garnish fee charged by an employer is not deductible.

A legal obligation is not required to allow the deduction.

 

W—1512.4.2 Budgeting Child Support Deductions

Revision 15-4; Effective October 1, 2015

 

Child support collected through a tax intercept is not an allowable child support deduction.

A child support payment may be owed by one household member but be paid by another member. The child support expense for the household member paying the expense is allowed.

If the household member with the legal obligation or the household member paying the legal obligation leaves the home, the household's eligibility for the deduction must be redetermined.

 

W—1512.5 $75 Disregard Deduction

Revision 15-4; Effective October 1, 2015

 

Up to $75 of child support received by members of the budget group may be deducted.

 

W—1520 Verification Requirements

Revision 15-4; Effective October 1, 2015

 

Verify the following at application, complete review (if the deduction is new) or if the amount changes:

  • dependent care;
  • actual amount of child support and alimony paid to persons outside the home; and
  • actual amount of payment to persons outside the home whom a person can claim as tax dependents or is legally obligated to support.

Note: Do not reverify deductions at renewal unless the individual reports a change in the amount.

Use the Temporary Assistance for Needy Families (TANF) verification sources listed in A-1441, Verification Sources.

If an individual fails to provide proof/verification of deductions, do not deny the case. Disallow the deduction. If the individual subsequently provides proof/verification, use the proof/verification at the next renewal if the proof/verification is dated within 90 days of the renewal file date.

If by omitting the deduction the application is denied, and the individual subsequently provides the proof/verification by the 60th day of the file date, reopen the application using the date the proof/verification was provided as the new file date.

 

W—1530 Documentation Requirements

Revision 17-2; Effective April 1, 2017

 

Use the TANF and Supplemental Nutrition Assistance Program (SNAP) documentation policy found in A-1450, Documentation Requirements.

Note: Do not delay disposition if an applicant does not provide verification by the due date on Form H1020, Request for Information or Action, and all other pended information has been provided if the applicant is income-eligible to receive Healthy Texas Women (HTW) benefits without the deductions.

W-1600, School Attendance

Revision 17-2; Effective April 1, 2017

 

School attendance requirements are not applicable for Healthy Texas Women (HTW).

W-1700, Management

Revision 17-2; Effective April 1, 2017

 

Management requirements are not applicable for Healthy Texas Women (HTW).

W-1800, Reminders

Revision 17-2; Effective April 1, 2017

 

 

W—1810 General Policy

Revision 17-2; Effective April 1, 2017

 

Before certifying applicants and recertifying individuals, complete the following:

Note: HTW applications and renewals may have a telephonic signature when the applicant/client calls 2-1-1 and applies for or renews eligibility for HTW.

  • During processing or during an interview, note if the applicant indicates changes on Form H1867/H1867-S, H1867-R/H1867-RS, or H1831. Document the nature of the change and when the individual expects the change to occur.
  • Give the applicant Form H1019-W, HTW Report of Change. Explain that she must report address changes within 10 days after knowing about the change. Indicate the appropriate reporting requirement on page one.
  • Refer the applicant to other programs she might be eligible for such as the Supplemental Nutrition Assistance Program (SNAP); Temporary Assistance for Needy Families (TANF); Medicaid; Family Planning; Supplemental Security Income (SSI); Women, Infants and Children (WIC); and Social Security. Refer people with disabilities or age 65 and older 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) program.
  • Inform the applicant of her right to appeal any HHSC action that affects her eligibility.
  • Inform the applicant that the information she provides is subject to verification by third parties.

There is no requirement to inform individuals to report accidents.

Related Policy
Telephonic Signatures, A-122

 

W—1820 Documentation Requirements

Revision 17-2; Effective April 1, 2017

 

Document that Form H0025, HHSC Application for Voter Registration, was given to the applicant in the Agency Use Only section of Form H1867/H1867-S, Healthy Texas Women Application Form.

Related Policy
Registering to Vote, A-1521

W-1900, Case Disposition

Revision 19-1; Effective January 1, 2019

 

 

W—1910 Notice to Applicants

Revision 19-1; Effective January 1, 2019

 

Case disposition is the individual's notice of eligibility status. At the end of the interview or during the processing of Form H1867/H1867-S, Healthy Texas Women Application; Form H1867-R/H1867-RS, Healthy Texas Women Renewal; or Form H1831, Adjunctive Eligibility Letter, give the individual one or more of the following notices if the case is pended, certified, sustained or denied:

Form H1020, Request for Information or Action, which 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/case if the individual does not take action, if applicable; or

Form TF001W, Notice of Case Action, which informs the individual of the:

  • date benefits begin;
  • date of denial;
  • right to appeal; and
  • address and telephone number of free legal services available in the area.

HTW individuals who are auto-enrolled receive Form H1872, HTW Opting Out and Reporting Confidential Address, along with Form TF001W. The Form H1872 informs the individual of the:

  • options to voluntary withdrawn from HTW; and
  • process to report a confidential address.

HTW individuals turning 18 years old receive Form H1871, HTW Client Turning 18 Years Old, ten days prior to their 18th birthday, which informs the individual of:

  • the process to report a confidential address; and
  • their responsibility to manage their HTW benefits.

Note: For individuals who only speak Spanish, ensure that all comments provided are in Spanish.

 

W—1920 Eligibility Begin Dates

Revision 17-2; Effective April 1, 2017

 

The applicant is eligible the first day of the file date month or, if ineligible the month of application for certain reasons, the month following the month of application.

Women who are auto-enrolled into Healthy Texas Women (HTW) have an effective date of the first of the month following the Medicaid for Pregnant Women (TP 40) end date. Example: If the TP 40 end date is September 30, then the HTW effective date is October 1.

A woman is ineligible to receive HTW benefits if she applies the month after her 45th birthday.

Related Policy
Current Medicaid, Medicare (Part A or B) and Children's Health Insurance Program (CHIP) Recipients, W-911

 

W—1930 Length of Certification

Revision 17-2; Effective April 1, 2017

 

The Texas Integrated Eligibility Redesign System (TIERS) calculates an end date from the date the advisor certifies the application/renewal as follows:

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

Women are continuously eligible for Healthy Texas Women benefits for 12 months or through the month of the woman's 45th birthday, whichever is earlier.

Exception: A woman does not receive her 12 months of continuous eligibility if she:

  • is found eligible for Medicaid, Medicare (Part A or B) or the Children's Health Insurance Program;
  • dies;
  • voluntarily withdraws; or
  • moves out of Texas.

 

W—1940 Setting Special Reviews

Revision 07-0; Effective July 1, 2007

Do not set a special review even if a known change is to occur during the woman's 12-month continuous eligibility period. Document the known change and use the information at the next renewal. Follow current procedures and report the known change if the applicant has other active Eligibility Determination Group cases.

 

W—1950 Adverse Action

Revision 15-4; Effective October 1, 2015

Any household receiving a notice of adverse action has the right to request a fair hearing. In some situations, households may continue benefits pending an appeal. 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.

For adverse action, use current policy in A-2340, Adverse Action.

W-2000, Processing Time Frames

Revision 19-1; Effective January 1, 2019

 

 

W—2010 Applications

Revision 17-2; Effective April 1, 2017

 

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 was provided as the new file date.

Use the original Form H1867/H1867-S, Healthy Texas Women Application, or an untimely Form H1867-R/H1867-RS, Healthy Texas Women Renewal, 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.

 

W—2020 Deadlines

Revision 13-1; Effective January 1, 2013

 

Provide Form TF001W, Notice of Case Action, the same day eligibility is determined for an application but no later than 45 days from the file date.

 

W—2030 Missed Appointments

Revision 07-0; Effective July 1, 2007

 

No appointment is required to process an application or renewal unless requested by the applicant/individual. If requested, provide the applicant/individual a telephone interview. If she fails to keep the appointment, do not deny the application/renewal but continue to process.

 

W—2040 Pending Information on Applications

Revision 15-4; Effective October 1, 2015

 

Advisors must request documents that are readily available to the household to be sufficient verification. Each handbook section lists potential verification sources. C-900,Verification and Documentation, gives information on verification procedures.

In determining eligibility, advisors 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.

 

W—2050 Notice of Renewal/Expiration

Revision 17-2; Effective April 1, 2017

 

The Texas Integrated Eligibility Redesign System (TIERS) sends a renewal packet during the 10th month of the 12-month continuous eligibility period if it is determined that the recipient is not adjunctively eligible. If she is determined adjunctively eligible, TIERS sends Form H1831, Adjunctive Eligibility Letter, in lieu of the renewal application.

Staff must determine if a woman is eligible to continue to receive Healthy Texas Women (HTW) benefits using the same eligibility requirements for an application. If Form H1831 states Yes to the pregnancy question, deny the renewal using the denial reason language in W-913, Pregnant Women.

If the woman states on Form H1831 that she has creditable health insurance that covers family planning services and that filing a claim will not cause her physical, emotional or other harm, deny the renewal using the denial reason language in W-914, Third-Party Resource (TPR).

 

W—2060 Processing Renewals

Revision 07-0; Effective July 1, 2007

 

 

W—2061 How to Process a Renewal

Revision 19-1; Effective January 1, 2019

 

Renewals are processed by mail or phone. There is no interview requirement for a HTW renewal.

Verification from an associated Eligibility Determination Group (EDG) can be used if provided within 90 days of the HTW file date.

Follow the policy below when Form H1867-R/H1867-RS, Healthy Texas Women Renewal, or Form H1831, Adjunctive Eligibility Letter, is returned for a renewal:

  • If the woman previously reported a change that did not have to be acted on before the renewal, but does not send verification with Form H1867-R/H1867-RS or Form H1831, request verification via Form H1020, Request for Information or Action.
  • If she provides Form H1867-R/H1867-RS or Form H1831 indicating no change and has an associated EDG, review the associated EDG to determine if there is documentation to clear any conflicting information. If not, request new verification via Form H1020.
  • If she returns Form H1867-R/H1867-RS or Form H1831 reporting changes, provides verification, and there is no associated EDG, process the renewal using the new verification.
  • If she returns Form H1867-R/H1867-RS or Form H1831 reporting changes, provides verification, and there is an associated EDG, review the associated EDG and use the information provided for the HTW EDG as it is the most recent. The information may vary from the other EDG information since less documentation is required.
  • If the associated EDG has other information that the family did not report for the HTW EDG, that would impact HTW eligibility, contact the woman (by telephone or Form H1020 with the due date) to determine if the information in the associated EDG is correct before denying or taking adverse action on the EDG.
  • If the family reports new information that must be considered for the associated EDG such as a new job, follow current procedures to report the change on the other associated EDG.
  • If she returns Form H1867-R/H1867-RS or Form H1831, reporting changes without verification, and has an associated EDG, request new verification via Form H1020. Do not renew eligibility if the information reported on Form H1867-R/H1867-RS or Form H1831 must be verified and verification/proof is not provided. Do not allow a deduction expense if the individual does not provide verification.
  • If she returns Form H1867-R/H1867-RS or Form H1831 indicating changes, does not provide verification, and does not have an associated EDG, request information needed to determine eligibility. If she does not provide the information, do not renew eligibility.

Exception: Do not verify an income or expense change at renewal that was reported during the 12-month eligibility period if the individual is only required to provide Form H1831 at renewal since she was determined adjunctively eligible.

Process a denial action to close the EDG and record workload activity if the woman is not eligible for another 12-month continuous eligibility period.

Process the action before cutoff in the 12th month to ensure the denial code reflects the specific reason for denial.

Note: If the woman does not return the renewal form or adjunctive eligibility letter, take no action. TIERS automatically terminates the TA 41 EDG at the end of the 12-month eligibility period through a Mass Update.

When a TA 41 EDG exceptions out of the Mass Update auto-denial process and does not automatically terminate for failure to return a renewal packet, TIERS triggers Alert 876, Mass Update Exception: Run EDBC to terminate TA 41 EDG, which instructs staff to take manual action to terminate the TA 41 EDG.

 

W—2062 Summary of Due Dates for Form H1020, Request for Information or Action

Revision 07-0; Effective July 1, 2007

 

Case Action Due Date Final Due Date
Application 10 days
  • 30 days, or
  • 10th day if 10 days end after 30th day
Untimely renewal 10 days
  • 30 days, or
  • 10th day if 10 days end after 30th day
Timely renewal 10 days
  • last workday of last benefit month, or
  • 10th day if 10 days end after last benefit month
Incomplete review 10 days
  • 10 days

Note: Staff have until the 45th day of the file date to determine eligibility.

 

W—2070 Renewal Time Frames

Revision 17-2; Effective April 1, 2017

 

HHSC must receive an individual's renewal application on or before the first day of the last month of certification. Consider a renewal untimely if received after the first day of the last month of certification. Process an untimely renewal using application processing time frames.

Staff must determine renewal eligibility on a timely submitted renewal no later than the last workday of the last month of certification to be considered processed timely.

If an individual is determined adjunctively eligible, TIERS mails the individual Form H1831, Adjunctive Eligibility Letter, in the 10th month of the 12-month certification period. Form H1831 informs the individual that the certification is ending and that she is financially eligible for a new 12-month certification. The individual must also meet non-financial requirements for HTW. Form H1831 asks the individual if she is pregnant or has creditable health insurance. Staff must determine, based on the answers provided by the individual, if she is eligible to continue receiving HTW benefits.

Individuals must sign and return the form, complete the renewal process via YourTexasBenefits.com, or call 2-1-1 to complete a telephone renewal and meet all non-financial requirements in order to receive continued benefits.

HHSC must receive Form H1831 no later than the last workday of the last certification month for the individual to receive a new 12-month continuous eligibility period. If HHSC does not receive the form by the last workday of the last certification month, the individual must reapply using Form H1867/H1867-S, Healthy Texas Women Application Form.

For adjunctively eligible individuals, staff must complete renewals by the last workday of the last certification month, or within five workdays from receiving Form H1831 if received on the last workday of the last certification month.

 

W—2080 Pending Information

Revision 17-2; Effective April 1, 2017

 

If the applicant cannot furnish all required proof/verification during the interview or with the application, allow the household at least 10 days to provide it. The due date must be a workday. Determine what sources of proof/verification are readily available to the household and request those first if you expect them to be sufficient proof/verification. If the applicant has an active or inactive EDG, check to see if any proof/verification previously provided on another EDG can be used to determine eligibility for HTW.

Note: Do not use proof/verification more than 90 days old from the HTW file date.

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

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

Exception: Verification of U.S. citizenship for applicants must be from a Medicaid acceptable source.

Form H1867/H1867-S, Healthy Texas Women Application Form, and Form H1867-R/H1867-RS, Healthy Texas Women Renewal, provide the applicant/individual the opportunity to provide a different mailing address and contact telephone number due to confidentiality issues. Since HTW provides family planning services, it is imperative for advisors to respect the privacy of an applicant/individual.

W-2100, Changes

Revision 19-1; Effective January 1, 2019

 

 

W—2110 How to Report a Change

Revision 17-2; Effective April 1, 2017

 

Healthy Texas Women (HTW) individuals can report changes:

  • via YourTexasBenefits.com;
  • via Your Texas Benefits Mobile App;
  • by calling or visiting a local Texas Health and Human Services Commission (HHSC) Benefits Office;
  • in writing, by mail or fax;
  • by completing Form H1019, Report of Change, or Form H1019-W, HTW Report of Change, and mailing or faxing the form to a local HHSC Benefits Office; or
  • by calling 2-1-1.

Note: When a change is reported by calling 2-1-1, staff must verify that the person speaking has the authority to report a change.

A woman is continuously eligible for HTW for 12 months or through the month of her 45th birthday, whichever is earlier.

Report the following changes:

  • an individual's change of address;
  • death of the individual;
  • voluntary withdrawal of the individual;
  • an individual's receipt of creditable health coverage; or
  • if the individual moves out of Texas.

Process all other changes, including the report of creditable health coverage and agency-generated changes, at the next renewal.

Exception: If the applicant/individual failed to report required information at the time of the application that causes the applicant/individual to be ineligible for HTW, advisors must deny the case.

 

W—2111 Changes Received via Telephone

Revision 17-2; Effective April 1, 2017

 

When an individual reports a change by telephone that includes a HTW Eligibility Determination Group (EDG) in the case, staff must verify that the person reporting the change is the HTW applicant/recipient, or for HTW minor recipients, the parent or legal guardian, before discussing any information regarding the HTW EDG.

If the individual is the HTW applicant/recipient or parent/legal guardian, ask the individual which EDGs the change pertains to – all EDGs including HTW, all EDGs excluding HTW or only HTW, and take the appropriate action.

If the individual is not the HTW applicant/recipient or parent/legal guardian, do not discuss the HTW EDG information with this person; only discuss the information regarding the other EDGs.

If the change is a mailing address change for only the HTW EDG, enter the mailing/confidential address into the Issuance Address page for the HTW EDG. Do not enter the new mailing address in the Address page, as this will change the Case Level Address for all of the other EDGs.

 

W—2112 Changes Received via Mail

Revision 19-1; Effective January 1, 2019

 

When a person reports a change by mail and there is an HTW EDG in the case, staff must determine if the change pertains to all EDGs including HTW, all EDGs excluding HTW, or only the HTW EDG.

If the written change:

  • does not specifically state that the mailing address change is for the HTW EDG, only take action on the appropriate EDGs, excluding the HTW EDG;
  • specifically states the change is for only the HTW EDG, only make changes to the HTW EDG and no other EDGs; or
  • specifically states the change is for all EDGs including the HTW, take action on all EDGs as stated by the HTW recipient.

Note: The written report of change must specifically state the name of the person reporting the change to process an HTW change. Compare the name provided to the HTW recipient, or parent or legal guardian for HTW minors. If this person is not the HTW recipient or parent or legal guardian, do not change the mailing or confidential address for the HTW EDG.

 

W—2113 Changes Received at a Local HHSC Benefits Office

Revision 17-2; Effective April 1, 2017

 

If an individual visits a local eligibility office, staff must determine the person is the HTW applicant/recipient or parent/legal guardian of an HTW minor.

If the individual is the HTW applicant/recipient or parent/legal guardian, ask the individual which EDGs the change pertains to – all EDGs including HTW, all EDGs excluding HTW or only HTW, and take the appropriate action.

If the individual is not the HTW applicant/recipient or parent/legal guardian, do not discuss the HTW EDG information with this person; only discuss the information regarding the other EDGs.

 

W—2120 Action on Changes

Revision 15-4; Effective October 1, 2015

 

If an individual reports a change or the advisor receives an agency-generated change during the 12-month continuous eligibility period and has:

  • No associated EDG, document the change and handle at renewal, unless it is a change of address, the certified woman dies, a voluntary withdrawal, or the individual moves out of Texas.
  • An associated EDG, document the change and handle at renewal unless it is a change of address, the certified woman dies, a voluntary withdrawal, or the individual moves out of Texas. Process the change for an associated EDG using current process.
  • A change of address, mail the individual Form H0025, HHSC Application for Voter Registration, to register to vote based on the new address. If the individual contacts the local eligibility office or 2-1-1 to decline the opportunity to register to vote after receipt of Form H0025, mail Form H1350, Opportunity to Register to Vote, to the individual for a signature. File Form H1350 in the case record when the individual returns the form and retain the form for at least 22 months.

Related Policy
Registering to Vote, A-1521

 

W—2130 Determining Whether New Income Information Is a Reported Change

Revision 17-2; Effective April 1, 2017

 

When an advisor processes a HTW application/renewal during a Temporary Assistance for Needy Families (TANF)/Medicaid/Supplemental Nutrition Assistance Program (SNAP) certification period and a household member's source of income currently budgeted on another active EDG has not changed, the advisor must determine whether the member is reporting a change in income. To do this, the advisor determines if the income verification the applicant provided with the HTW application/renewal is:

  • a more recent payment than previously verified; and
  • within the range of payments previously verified that are currently used in the budget for the associated active case(s), whether the individual provides only one or more than one payment.

If a change is reported during the HTW application/renewal, the advisor processing the HTW EDG must take action on the associated TANF/Medicaid/SNAP EDG. The file date is considered the report date for purposes of determining the effective date of the change. The date the advisor works the HTW EDG and becomes aware of the change is day zero for purposes of taking action on the change for the associated EDG. The individual must provide any requested verification by the due date on Form H1020, Request for Information or Action, to be considered timely verification.

For more information, see policy in B-623.1, Determining Whether New Income Information Is a Reported Change.

W-2200, Fair Hearings

Revision 17-2; Effective April 1, 2017

 

 

W—2210 Appeals Procedures

Revision 17-2; Effective April 1, 2017

 

Healthy Texas Women (HTW) applicants/individuals receiving a notice of adverse action are not entitled to continued benefits when benefits are denied for any reason if doing so would extend the 12-month continuous eligibility period.

Refer to B-1000, Fair Hearings, for specific appeals policy and procedures.

W-2300, Automated Support

Revision 15-4; Effective October 1, 2015

 

 

W—2310 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.

W-2400, Confidentiality

Revision 19-1; Effective January 1, 2019

 

The Texas Health and Human Services Commission (HHSC) must accommodate reasonable requests to receive communications by alternative means or at alternate locations.

The individual must specify in writing the alternate mailing address or means of contact and include a statement that using the home mailing address or normal means of contact could endanger the individual. The following forms allow individuals to provide a confidential mailing address and/or telephone number:

  • Form H1867/H1867-S, Healthy Texas Women Application Form;
  • Form H1867-R/H1867-RS, Healthy Texas Women Renewal;
  • Form H1871, HTW Client Turing 18 Years Old; and
  • Form H1872, HTW Opting Out and Reporting Confidential Address.

Staff must not provide any information regarding Healthy Texas Women (HTW) to anyone other than the certified household member or the parent/legal guardian of an HTW minor.

 

W—2410 Applications

Revision 17-2; Effective April 1, 2017

 

When a woman submits an HTW application and provides a mailing/confidential address, staff must determine if the current mailing address, if any, on the Texas Integrated Eligibility Redesign System (TIERS) is the same as the mailing/confidential address on the HTW application.

If the current mailing address is:

  • Different from the address provided on the HTW application or no case information exists in TIERS, enter the mailing/confidential address provided on the HTW application in the Issuance Address page for the HTW Eligibility Determination Group (EDG).
  • The same as the address provided on the HTW application, no action is required.

If the physical address is different on the HTW application than what is verified in TIERS, report the new address using current change processes for the other EDGs.

Related Policy
How to Report a Change, W-2110
Changes, B-600

 

W—2420 Renewals

Revision 19-1; Effective January 1, 2019

 

TIERS mails out Form H1867-R/H1867-RS, Healthy Texas Women Renewal, or Form H1831, Adjunctive Eligibility Letter, in the 10th month of the 12-month certification period. TIERS uses the Form TF001W, Notice of Case Action, address hierarchy when mailing these correspondences.

When staff receive Form H1867-R, H1867-RS or Form H1831, staff must determine if the person has provided a new mailing or confidential address for the HTW EDG. Staff perform an inquiry in the Issuance Address page to determine if the mailing/confidential address has changed or was not entered.

Staff must also determine if the person has a different mailing address for the HTW renewal than the other EDGs.

If the mailing or confidential address:

  • is different from the other EDGs, then enter the mailing or confidential address into the Issuance Address page for the HTW EDG;
  • is different from the Issuance Address page, enter the new mailing or confidential address into the Issuance Address page for the HTW EDG;
  • was never provided, enter the mailing or confidential address into the Issuance Address page; and
  • is the same as the current mailing address for the other EDGs, no action is required.

If the physical address is different on the HTW renewal packet or the adjunctive eligibility letter than what is verified in TIERS, report the new address using current change processes for the other EDGs.

Related Policy
How to Report a Change, W-2110
Changes, B-600

 

W—2430 Telephone Numbers

Revision 17-2; Effective April 1, 2017

 

Staff must determine if the telephone number provided by the HTW applicant is different than what was provided for the other EDGs.

If the telephone number is different, document the following in the case comments:

Use (insert telephone number) when contacting the individual regarding HTW EDG information.

 

W—2440 Creating Separate Cases

Revision 17-2; Effective April 1, 2017

 

Follow the steps listed below to determine if a new case is needed when a woman applies for HTW. Perform an inquiry for every woman applying for HTW to determine if she is included in an existing EDG.

If the applicant … and … then …
does not have an existing HTW EDG, she or her spouse (or non-spouse with mutual children in the budget group) is the case name on an existing case, associate her HTW application with that case.
does not have an existing HTW EDG, she is included in an EDG in someone else’s case such as her mother, father, non-spouse with no mutual children, etc., create a new case for her and associate the HTW application with the new case.

Because of the confidentiality issues with HTW, staff must correctly determine and create a separate case. Failure to correctly create a separate HTW case will cause TIERS to send Form TF001W, Notice of Case Action, to an incorrect address and include the HTW information on the notice.