Part C, Appendix

C-100, Income Limits and Proration Charts

Revision 19-4; Effective October 1, 2019

 

 

C—110 TANF

Revision 11-4; Effective October 1, 2011

 

 

C—111 Income Limits

Revision 19-4; Effective October 1, 2019

 

TANF

Temporary Assistance for Needy Families (TANF) Budgetary Allowances (Oct. 1, 2019)
  Non-Caretaker Cases Caretaker Cases
Without Second
Parent
Caretaker Cases With
Second Parent
Family Size Bud Needs (100%) Rec Needs (25%) Max Grant Bud Needs (100%) Rec Needs (25%) Max Grant Bud Needs (100%) Rec Needs (25%) Max Grant
1 $256 $64 $104 $313 $78* $126 --- --- ---
2 $369 $92 $149 $650 $163 $262 $498 $125** $200
3 $518 $130 $209 $751 $188 $303 $824 $206 $332
4 $617 $154 $249 $903 $226 $364 $925 $231 $372
5 $793 $198 $320 $1003 $251 $404 $1073 $268 $432
6 $856 $214 $345 $1153 $288 $464 $1176 $294 $473
7 $1068 $267 $430 $1252 $313 $504 $1319 $330 $531
8 $1173 $293 $473 $1425 $356 $574 $1422 $356 $572
9 $1346 $337 $542 $1528 $382 $615 $1595 $399 $642
10 $1450 $363 $584 $1701 $425 $685 $1698 $425 $683
11 $1623 $406 $654 $1804 $451 $726 $1871 $468 $753
12 $1726 $432 $695 $1977 $494 $796 $1975 $494 $795
13 $1899 $475 $765 $2080 $520 $837 $2147 $537 $864
14 $2003 $501 $807 $2253 $563 $907 $2251 $563 $906
15 $2174 $544 $875 $2356 $589 $949 $2423 $606 $975
Per each additional member $173 $43 $70 $173 $43 $70 $173 $43 $70

* Caretaker of child receiving Supplemental Security Income (SSI)
** Caretaker and second parent of child receiving SSI
"Bud Needs" is budgetary needs.
"Rec Needs" is recognizable needs.

 

C—112 How to Prorate TANF Grants

Revision 15-4; Effective October 1, 2015

 

TANF

After eligibility is determined, the TANF grant amount is prorated for the first month of eligibility using the following steps:

  1. Calculate the certified group's recommended grant amount for the month based on the household size and net income. (See Step 5, line 3, page 3 of Form H1101, TANF Worksheet, or Step 5, line 3, page 2 of Form H1102, TANF Worksheet for Special Reviews and Denials.)
  2. Determine the earlier of the certification date or the 30th day after the file date. Using the chart in C-112.1, Proration Multiplier Chart, determine the appropriate proration multiplier.
  3. Multiply the recommended grant amount from Step 1 by the multiplier from Step 2.
  4. Round the amount from Step 3 down to the next dollar. If the resulting prorated grant is less than $10, the household is not eligible for a grant in the first month. The grant effective date is the first day of the following month.

Note: One-Time TANF (OTTANF) or One-Time Grandparent payments are not prorated.

 

C—112.1 Proration Multiplier Chart

Revision 01-7; Effective October 1, 2001

 

TANF

Date Financial Eligibility
Begins
Proration Multiplier
1 1
2 .97
3 .93
4 .90
5 .87
6 .83
7 .80
8 .77
9 .73
10 .70
11 .67
12 .63
13 .60
14 .57
15 .53
16 .50
17 .47
18 .43
19 .40
20 .37
21 .33
22 .30
23 .27
24 .23
25 .20
26 .17
27 .13
28 .10
29 .07
30/31 .03

 

C—120 Supplemental Nutrition Assistance Program (SNAP)

Revision 08-1; Effective January 1, 2008


   

C—121 Maximum Income Limits

Revision 19-4; Effective October 1, 2019

 

SNAP

 

SNAP Maximum Income Limits Effective Oct. 1, 2019
Household Size Gross (130%) Net (100%) 165%*
1 $1,354 $1,041 $1,718
2 $1,832 $1,410 $2,326
3 $2,311 $1,778 $2,933
4 $2,790 $2,146 $3,541
5 $3,269 $2,515 $4,149
6 $3,748 $2,883 $4,757
7 $4,227 $3,251 $5,364
8 $4,705 $3,620 $5,972
9 $5,184 $3,989 $6,580
10 $5,663 $4,358 $7,188
Each additional person $479 $369 $608

 

* The figures in the 165 percent column determine if a person who is elderly or with a disability living with others may claim separate household status even if they purchase or prepare food with the others. The figures in this column are also the income limits for categorically eligible households.

 

C—121.1 Deduction Amounts

Revision 19-4; Effective October 1, 2019

 

SNAP

  • Standard
If the eligible household size is ... then the standard deduction is ...
Three or less $167
Four $178
Five $209
Six or more $240

 

  • Standard medical expense — $137 (minus $35)
  • Actual medical expense (minus $35)
  • Homeless shelter standard — $152.06
  • Maximum excess shelter — $569
  • Standard utility allowance — $355
  • Basic utility allowance — $324
  • Telephone standard — $38

Note: A disqualified member in the household size is not used when applying the standard deduction.

Related Policy
Deductions, A-1400

 

C—122 How to Determine Monthly SNAP Allotments

Revision 19-4; Effective October 1, 2019

 

SNAP

To determine the monthly allotment for a household, advisors use the chart in C-1431, Whole Monthly Allotments by Household Size. The monthly allotment for a household with more than 10 people is determined by first determining the maximum:

  • monthly allotment by adding $146 for each additional person to the maximum SNAP allotment for a household of 10 people ($1,456);
  • gross income by adding $479 for each additional person to the maximum gross income for a household of 10 people ($5,663); and
  • net income by adding $369 for each additional person to the maximum net income for a household of 10 ($4,358).

The monthly allotment is determined by:

  • multiplying the household's net monthly income by .30;
  • rounding the cents to the next higher whole dollar amount; and
  • subtracting the rounded sum from the maximum monthly allotment for the household size.

Example: A 12-person household with a net monthly income of $964 has a monthly allotment of $1,458 ($964 × .30 = $289.20 or $290; $1,456 + $146 + $146 = $1,748; $1,748 - $290 = $1,458).

Note: The shaded portions on the table in C-1431 indicate allotments available only to categorically eligible households.

Related Policy
How to Prorate Benefits, C-123
Whole Monthly Allotments by Household Size, C-1431
Prorated SNAP Allotments by Application Date, C-1432

 

C—123 How to Prorate Benefits

Revision 19-4; Effective October 1, 2019

 

SNAP

A prorated allotment for the month of application is determined by using the chart in C-1432, Prorated SNAP Allotments by Application Date, or by:

  • subtracting the date of the application from 31;
  • multiplying the sum by the amount of the whole monthly allotment; and
  • dividing that amount by 30. If the date of the application is the 30th or 31st, the whole allotment is divided by 30. All cents are disregarded.

Example: A household with a whole monthly allotment of $395 applies on June 17. The household's prorated allotment for June is $184. (31 - 17 = 14; $395 × 14 = $5,530; $5,530 ÷ 30 = $184.33 or $184)

Note: Some categorically eligible households can receive ongoing monthly allotments of less than $10. Do not issue allotments prorated to less than $10. A one- or two-person household that qualified for a minimum monthly allotment of $16 can receive a prorated allotment of less than $16 but not a prorated allotment of less than $10.

Benefits are not prorated if the household includes a member who meets both of the following criteria:

  • is a seasonal or migrant farm worker (in or out of the workstream); and
  • was certified for SNAP in Texas or another state the month before the household applied.

Related Policy
Whole Monthly Allotments by Household Size, C-1431

 

C—130 Medical Programs

Revision 12-1; Effective January 1, 2012  

 

 

 

C—131 Income Limits

Revision 13-3; Effective July 1, 2013  

 

 

 

C—131.1 Federal Poverty Income Limits (FPIL)

Revision 19-3; Effective July 1, 2019

 

TP 33, TP 34, TP 35, TP 36, TP 43, TP 44, TP 48, TP 40, TP 42, TA 74, TA 75 and TA 76

Family Size 133% FPIL
(3-1-19)
TP 44, 34, TA 76
144% FPIL
(3-1-19)
TP 48, 33, TA 75
198% FPIL
(3-1-19)
TP 40, 42, 43, 36, 35, TA 74
1 $1,385 $1,499 $2,061
2 $1,875 $2,030 $2,791
3 $2,365 $2,560 $3,520
4 $2,854 $3,090 $4,249
5 $3,344 $3,621 $4,979
6 $3,834 $4,151 $5,708
7 $4,324 $4,682 $6,437
8 $4,814 $5,212 $7,166
9 $5,304 $5,742 $7,896
10 $5,794 $6,273 $8,625
11 $6,284 $6,803 $9,354
12 $6,774 $7,334 $10,084
13 $7,263 $7,864 $10,813
14 $7,753 $8,394 $11,542
15 $8,243 $8,925 $12,272
For each additional member $490 $531 $730

 

Note: See C-1114, Guidelines for Providing Retroactive Coverage for Children and Medical Programs, for the income limits.

 

TP 02, TA 84 (CHIP), TA 85 (CHIP-P), TA 77 and TP 70

Family Size 200% FPIL
(3-1-19)
TA 41
201% FPIL
(3-1-19)
TA 84
202% FPIL
(3-1-19)
TA 85
400% FPIL
(3-1-19)
TA 77
413% FPIL
(3-1-19)
TP 70
1 $2,082 $2,093 $2,103 $4,164 $4,299
2 $2,819 $2,833 $2,847 $5,637 $5,820
3 $3,555 $3,573 $3,591 $7,110 $7,342
4 $4,292 $4,314 $4,335 $8,584 $8,863
5 $5,029 $5,054 $5,079 $10,057 $10,384
6 $5,765 $5,794 $5,823 $11,530 $11,905
7 $6,502 $6,535 $6,567 $13,004 $13,426
8 $7,239 $7,275 $7,311 $14,477 $14,948
9 $7,975 $8,015 $8,055 $15,950 $16,469
10 $8,712 $8,756 $8,799 $17,424 $17,990
11 $9,449 $9,496 $9,543 $18,897 $19,511
12 $10,185 $10,236 $10,287 $20,370 $21,033
13 $10,992 $10,977 $11,031 $21,844 $22,554
14 $11,659 $11,717 $11,775 $23,317 $24,075
15 $12,395 $12,457 $12,519 $24,790 $25,596
For each additional member $737 $741 $745 $1,474 $1,522

 

Related Policy
Limits, A-1220
Certified Group, A-242
General Policy, M-210
General Policy, F-210
 

 

C—131.2 Medically Needy and Parents and Caretaker Relatives Medicaid

Revision 15-4; Effective October 1, 2015

 

TA 31, TP 08, TP 32, TP 56 and TA 86

- - TP 08, TA 31 and TA 86
Family Size TP 32 and TP 56 One Parent Two Parents
1 $104 $103 N/A
2 $216 $196 $161
3 $275 $230 $251
4 $308 $277 $285
5 $357 $310 $332
6 $392 $356 $367
7 $440 $389 $412
8 $475 $441 $447
9 $532 $476 $500
10 $567 $527 $535
11 $624 $562 $587
12 $659 $613 $622
13 $716 $648 $675
14 $751 $700 $710
15 $808 $734 $762
Per each additional member $57 $52 $52

 

C—131.3 Transitional Medicaid

Revision 19-2; Effective April 1, 2019

 

TP 07

Family Size 185% FPIL
(3-1-19)
TP 07
1 $1,926
2 $2,607
3 $3,289
4 $3,970
5 $4,652
6 $5,333
7 $6,015
8 $6,696
9 $7,377
10 $8,059
11 $8,740
12 $9,422
13 $10,103
14 $10,784
15 $11,466
Per each additional person $682

 

 

C—131.4 Standard MAGI Income Disregard

Revision 19-2; Effective April 1, 2019

 

Five Percentage Points of FPIL

Family Size 2019 Monthly
Disregard Amount

1

$52.05

2

$70.50

3

$88.90

4

$107.30

5

$125.75

6

$144.15

7

$162.55

8

$181.00

9

$199.40

10

$217.80

11

$236.25

12

$254.65

13

$273.05

14

$291.50

15

$309.90

Per each additional person

$18.45

 

 

C—131.5 IRS Monthly Income Thresholds

Revision 19-2; Effective April 1, 2019

 

Each year, the Internal Revenue Service (IRS) establishes income thresholds for earned and unearned income. Individuals whose income (earned, unearned, or a combination) exceeds the federal income tax filing threshold are “expected” by the IRS to file a federal income tax return under federal law. The IRS monthly income thresholds are used to determine if a person’s income must be counted when calculating Modified Adjusted Gross Income (MAGI) financial eligibility, as explained in A-1341, Income Limits and Eligibility Tests, for Medical Programs, Step 3.

Determining whether a person is expected to be required to file a federal income tax return is determined by comparing the specified income types to the IRS thresholds in the following table.

Type of
Income
2019
Threshold
Apply Threshold Value in Form H1042,
Modified Adjusted Gross Income (MAGI)
Worksheet: Medicaid and CHIP
Unearned Income $87.50
  • Pages 5-7, Step 3, Line 7
  • Pages 5-7, Step 3, Line 9
Earned Income $1,000.00
  • Pages 5-7, Step 3, Line 8

C-200, Opening, Denial, and Reinvestigation Codes (Retired as of July 1, 2013)

Revision 12-1; Effective January 1, 2012

 

 

C—210 TANF Codes

Revision 08-1; Effective January 1, 2008

 

 

C—211 Opening Codes

Revision 02-3; Effective April 1, 2002

 

TANF

Select a code for the occurrence during the six months prior to certification that is the primary reason the household needs Temporary Assistance for Needy Families (TANF). Use these codes only in Item 132 on Form H1000-A, Notice of Application.

024 Period of Lump Sum Ineligibility Shortened
Use this code to open a case previously denied because of a lump sum if the household becomes eligible because its period of ineligibility is shortened.

Earnings Lost or Reduced in the Last Six Months Because ...

025 Father Incapacitated
Earnings of the father in the home have terminated or decreased because of his illness, injury, or impairment. The onset of the disability may have occurred prior to the last six months. The disabled father must be in the home unless he is receiving medical treatment out of the home.
026 Mother Incapacitated
Earnings of the mother in the home have terminated or decreased because of her illness, injury, or impairment.
027 Other Caretaker Incapacitated
Earnings of the children's caretaker in the home, other than the father or mother, have terminated or decreased because of the caretaker's illness, injury, or impairment. Use this code if the caretaker had been supporting the children before the loss of or decrease in earnings.
028 Father Laid Off
Earnings of the children's father in the home have terminated or decreased because he has been laid off or discharged from his job or discontinued his self-employment.
029 Mother Laid Off
Earnings of the children's mother in the home have terminated or decreased because she has been laid off or discharged from her job, or discontinued her self-employment.
030 Other Caretaker Laid Off
Earnings of the children'scaretaker in the home, other than the children's mother or father, have terminated or decreased because the caretaker has been laid off or discharged from a job, or discontinued self-employment. Use only if the caretaker had been supporting the children before the loss or decrease in earnings.

Support from the Caretaker Lost or Reduced in the Last Six Months Because the Caretaker ...

031 Died
Use to indicate death of the caretaker who supported the children during the six months prior to death.
032 Left Home
Use if the caretaker supported the children during the six months prior to leaving and has not provided sufficient support since leaving.
033 Was Incarcerated
Use if the caretaker supported the children during the six months prior to incarceration.

Support from Person in the Home Other Than Father, Mother, or Other Caretaker Was Lost or Reduced in the Last Six Months Because the Person ...

034 Died
Use to indicate death of the person who supported the children during the six months prior to death.
035 Left
Use if the person supported the children during the six months prior to leaving and has not provided sufficient support since leaving.
036 Is Incapacitated
Use if the person is unable to continue supporting the children because of the person's disability.
037 Is Laid Off
Use if the person is unable to continue supporting the children because of a change in employment status.

Support from Person Outside the Home Lost or Reduced in the Last Six Months Because ...

039 Absent Father Discontinued or Reduced the Children's Support Payments
Use if the children's father has been absent for the past six months; if father left home in the past six months, use code 032.
040 Another Person Discontinued or Reduced the Children's Support Payments
Use if someone outside the home other than the children'sfather stopped or reduced the children's support payments.

Other Income Lost or Reduced in the Last Six Months Because ...

041 TANF Father, Mother, or Other TANF Caretaker Lost or had a Reduction in Income Not Listed in Codes 025-040
Examples of income include RSDI; allowance, pension, or other payment connected with military service; unemployment benefits; workers' compensation; and rental income. Do not include the loss of any income based on need.

Depletion of the Family's Assets in the Last Six Months Because of ...

042 Medical Care Cost
Medical care cost includes all items for medical or remedial care, including care in nursing facilities.
043 Other Living Costs
These costs do not include medical care costs.
044 Other Material Change
Examples of circumstances include loss of investments through business failure or loss of home or other buildings by fire. Do not use if the assets produced income that provided full or partial support. Use code 041, loss of or reduction in other income.
Use if the household was previously certified under the real property exemption based on good faith effort to sell, and the family sold the property or it is no longer accessible.

No Change in Income or Resources During the Last Six Months. The Only Change in the Last Six Months Is ...

046 Increased Need or Other Budget Items
A change in household composition or living arrangements resulted in increased needs for the TANF family.
047 No Proration of Benefits
TP 01, use this code when certifying
  • a stepchild and his parent after they have been removed from a TANF incapacity or a TANF-SP TP 61 case that is transferring to MAO, TP 07, 37, or Medical Programs for Families and Children. See B-483 for more information.
  • an other-related child after he has been removed from an existing TANF/TANF-SP case. See B-482, Separating Household Members, for more information.

    SAVERR enters asix-month periodic review in Item 141.

    Use to administratively reopen a TP 01 or 61 case after denying a TP 01 or 61 case on hold in order to prevent the automated systems from counting a month(s) toward a individual's time limit.

When used,

  • TANF grants will not be prorated, and
  • SAVERR will enter a six-month periodic review in Item 141.

No Change in Income or Resources During the Last Six Months. The Only Change in the Last Six Months Is ...

049 The Applicant Met the Eligibility Requirement for Residence
050 The Applicant Met the Eligibility Requirement for Citizenship
052 The Applicant Met Another Technical Eligibility Requirement
053 The Applicant Applied for Assistance
056 A Change That Cannot Be Related to Codes 045-053
Example is the departure of an unemployed caretaker who has not provided support.

Administrative Opening Codes

054 Post (Child Support) or Transitional Medicaid Reinstatement
Use to reinstate a denied
  • TP 20 household that returns to live in Texas, or
  • TP 07 or TP 37 household that meets the requirements in A-800, Medicaid Eligibility.
055 Denied in Error
Use to reopen a case or application that was denied by mistake.
057 Medicaid Administrative Opening Code
Use to open a
  • TP 07, 20, 29, or 37 case
  • Medical Programs for Families and Children case

When the TP 01 or TP 61 case on hold was denied, instead of transferred, in order to prevent the automated systems from counting a month(s) toward anindividual's time limit.
"Person(s) meet Medicaid eligibility requirements."
"Persona(s) llena los requisitos de elegibilidad de Medicaid."
For TPs 07, 29, and 37, also include the following message:
"While receiving transitional Medicaid, you must report to HHSC within 10 days after you move and after anyone moves in or out of your household."
"Mientras reciba Medicaid de transición, tiene que avisar a la HHSC dentro de los 10 días de su cambio de case o del cambio del número de personas de su casa."

 

C—212 Denial Codes

Revision 12-1; Effective January 1, 2012

 

TANF

Reasons for denying cases and applications are classified into three groups:

  1. ineligibility because of death of a member;
  2. need; and
  3. miscellaneous reasons.

Select the code reflecting the primary reason for denial. If a reason related to need and another reason occur at the same time, use the need code. Enter in Item 132 of Form H1000-A, Notice of Application, and Form H1000-B, Record of Case Action.

Death (058-059)

058 Death of Caretaker
No Notice.
059 Death of Child – A-500, Age/Relationship
"You no longer have children in your home who are eligible for assistance."
"Ya no hay niños en su casa que califican para asistencia."

Need (060-075)

060 Earnings of Father, Legal or Stepfather — A-1323.5, Wages, Salaries, Commission and Tips
Use for applications and ongoing cases that are not eligible for post-medical coverage.
"Earnings of father meet needs that can be recognized by this agency."
"El padre gana suficiente para cubrir las necesidades reconocidas por esta agencia."
061 Earnings of Mother, Legal or Stepmother — A-1323.5, Wages, Salaries, Commission and Tips
Use for applications and ongoing cases that are not eligible for post-medical coverage.
"Earnings of mother meet needs that can be recognized by this agency."
"La madre gana suficiente para cubrir las necesidades reconocidas por esta agencia."
062 Earnings of TANF Child – A-1323.1, Children's Earned Income
Use for applications and ongoing cases that are not eligible for post-medical coverage.
"Earnings of child meet needs that can be recognized by this agency."
"Su hijo/hija gana suficiente para cubrir las necesidades reconocidas por esta agencia."
063 Earnings of Non-Parent Caretaker — A-1323.5, Wages, Salaries, Commission and Tips
Use for applications and ongoing cases that are not eligible for post-medical coverage.
"Earnings of other person in your home meet needs that can be recognized by this agency."
"Una persona que vive en su casa gana suficiente para cubrir las necesidades reconocidas por esta agencia."
064 Support from Absent Father — A-1326.1, Cash Gifts and Contributions; A-1326.2, Child Support; A-1334, Vendor Payments (See chart in C-241, TANF and Medical Programs Chart, for appropriate reference codes.)
"Income from children's father who is outside the home meets needs that can be recognized by this agency."
"El padre que no vive en la misma casa manda suficiente dinero para cubrir las necesidades reconocidas por esta agencia."
065 Pursuit of Texas Works Activities — A-1527, The Texas Works Message
"You have chosen to pursue employment opportunities and/or save your time-limited benefits for another time."
"Usted decidió buscar empleo y/o usar sus beneficios de tiempo limitado en ortra occasión."
066 Support from Other Person Outside the Home, Including Mother — A-1326.2, Child Support; A-1334, Vendor Payments (See chart in C-241, TANF and Medical Programs Chart, for appropriate reference codes.)
"Income available to you from a person outside the home meets needs that can be recognized by this agency."
"El dinero que recibe de un pariente fuera de su casa es suficiente para cubrir las necesidades reconocidas por esta agencia."
067 RSDI — A-1324.15, Retirement, Survivors, and Disability Insurance(RSDI)
"Income available to you from social security benefit meets needs that can be recognized by this agency."
"El cheque que usted recibe ahora, o va a recibir, del seguro social es suficiente para cubrir las necesidades reconocidas por esta agencia."
068 Other Federal Benefits — A-1324.19, Veterans Benefits
"Income available to you from federal benefit or pension meets needs that can be recognized by this agency." "El dinero que usted recibe ahora de beneficios o pensiones federales es suficiente para cubrir las necesidades reconocidas por esta agencia."
069 State and Local Benefits — A-1326.9, Pensions; A-1324.18, Unemployment Compensation; A-1321.4, Workers Compensation(See chart in C-241 for appropriate reference codes.)
Includes workers' compensation, unemployment compensation, state and local government retirement benefits. "Income available to you from state or local benefit or pension meets needs that can be recognized by this agency."
"El dinero que usted recibe de beneficios o pensiones de gobierno local o del estado es suficiente para cubrir las necesidades reconocidas por esta agencia."
070 Non-Governmental Benefits — A-1326.9, Pensions
"Income available to you from pension or benefit meets needs that can be recognized by this agency."
"El dinero que recibe usted de pensiones or beneficios es suficiente para cubrir las necesidades reconocidas por esta agencia."
071 Income Not Codes 060 — 070 — A-13XX (See chart in C-241, TANF and Medical Programs Chart, for appropriate reference codes.) A-800, Medicaid Eligibility, for TP 07/37
"Income available to you meets needs that can be recognized by this agency."
"El dinero que gana o recibe usted es suficiente para cubrir las necesidades reconocidas por esta agencia."
072 Resources — A-12XX (See chart in C-241, TANF and Medical Programs Chart, for appropriate reference codes.)
"Resources available to you from other property meets needs that can be recognized by this agency."
"Los recursos que tiene usted en propiedades or dinero son suficientes para cubrir las necesidades reconocidas por esta agencia."
074 Fewer Members in Certified Group — A-1341, Income Limits and Eligibility Tests
"No unmet need for the current family size."
"Ahora que usted tiene menos familia, sus entradas son suficientes para cubrir las necesidades reconocidas por esta agencia."
075 Conflicting Information on Management — A-1700,Management
"Information on management indicates additional income."
"Según la información que tenemos acerca de su situación económica, parece ser que usted no reportó toda su entrada."
076 Refusal to Furnish Information — B-100, Processes and Processing Time Frames
Use only if a Form H1010-B, Application for Assistance -Part B: Information We Need Know, is on file. Use code 091 for failure to return Form H1010-B.
"You did not wish to furnish enough information for this agency to establish eligibility for assistance."
"Usted no quiso darnos suficiente información para poder establecer su calificación para asistencia."
077 Refusal to Follow Agreed Plan — A-1311, Requirement to Pursue Income
Use to deny ongoing cases when an individual fails to pursue potential sources of income or resources that would be made available through the individual's efforts. "You did not wish to follow agreed plan so that eligibility for assistance could be continued."
"Usted ya no califica para asistencia porque no quiso utilizar, según el plan que hablamos, otros posibles recursos."
078 Earnings/Child Support Payments Terminate — A-800, Medicaid Eligibility
Use to deny Medicaid coverage before the end of the four- or twelve-month period for
  • TP 07 or TP 37 transitional Medicaid when the caretaker relative has no earnings for one month on the 7th or 10th month Medicaid Report, or
  • TP 20 Medicaid when child support payments terminate.
"Your Medicaid coverage following denial of your grant has ended as agreed."
"Como fue acordado al terminar su concesión, su calificación para los beneficios de Medicaid termina ahora."
083 Federal Time Limits — A-1900, Federal Time Limits (FTLs)
Use to deny an application or ongoing case because a household member has received 60 months of TANF assistance. "Your household is ineligible for TANF due to federal time limits, because the following person has received 60 months of TANF cash assistance. Your family may still be eligible for Medicaid. Contact your local office for information."
"Debido alos límites de tiempo federal su unidad familiar no tiene derecho a TANF porque la siguiente persona ha recibido asistencia económica de TANF 60 meses. Es posible que sue familia todavía tenga derecho a Medicaid. Comuníquese con la oficina local para recibir información."
086 Child Admitted to Institution, Including Foster Care —A-900,Domicile
"Your child has been admitted to an institution." "Su niñoha sido admitido a un hospital u otra institución."
087 No Eligible Child – A-900, Domicile, or A-800, Medicaid Eligibility, for TP 07/37
Use to deny applications or ongoing cases because the child does not meet relationship requirements or is no longer in the home. "You no longer have children in your home who are eligible for assistance."
"Usted ya no tiene niños en su casa que califican para asistencia."
088 Residence Requirement Not Met — A-700, Residence
Use for applications and for ongoing cases when the household moves out of state. "Residence requirements are not met."
"Sus niños no califican para asistencia porque no cumplen con el requisito de residencia en el estado."
089 Citizenship or Acceptable Alien Status — A-300, Citizenship
"Your children do not meet acceptable alien status or citizen requirements for assistance."
"Sus niños no son elegibles para asistencia porque no cumplen con el requisito de ciudadanía ni de inmigrante elegible."
090 Prior Eligibility — A-800, Medicaid Eligibility; A-1900, Federal Time Limits (FTLs); A-2400, One Time Payments
  • Use to authorize Medicaid or TANF warrants for
    • denied households eligible for restored benefits.
    • deceased individuals.
    • individuals eligible for three months prior Medicaid only.
    • applicants eligible for Medicaid for the application month but ineligible for TANF or Medicaid for the month following the application month.
    • applicants eligible for TANF and Medicaid for the current month but ineligible for future months.
    "Assistance was granted during a prior period, but you are not eligible now for medical or financial assistance."
    "Usted calificó anteriormente para asistencia pero ahora ya no califica para asistencia económica ni para beneficios médicos."
  • Use to open and close TP 37 between cutoff in the 11th and 12th months.
    "Your original period of transitional Medicaid has been reinstated."
    "Su cobertura bajo Medicaid de transición ha sido aprobada de nuevo para el periodo originalmente especificado."
  • Use to authorize OTTANF benefits. "Your family will receive $1,000 for mm/dd/yy. Your family will be ineligible to apply for TANF, TANF-SP, or OTTANF until mm/dd/yy."
091 Failure to Furnish Information — B-100, Processes and Processing Time Frames
Use this code if the applicant/individual fails to return the application form. "You failed to complete and return the necessary eligibility form."
"Usted no ha entregado la forma completa que necesitamos para determinar su elegibilidad para asistencia."
092 Other Eligibility Requirements — A-132, Eligibility Factors
Use to deny applications and ongoing cases for reasons other than need but not covered by codes 076-091. It cannot be entered by advisors to deny medical assistance only cases. "You do not meet eligibility requirements for assistance."
"Usted no califica para asistencia."
Note: SAVERR enters this code at the end of the Medicaid period for TP 07, TP 20 and TP 37.
"Your Medicaid coverage has ended."
"Su cobertura de Medicaid ha terminado."
093 Adult Earnings (Refugee Only) — R-700, Age/Relationship
Use to deny RCA applications and ongoing cases that are not eligible for post medical coverage. Use only if the case is an adult case with no children.
"You will not be eligible for Medicaid after mm/dd/yy."
"La elegibilidad para Medicaid termina el mm/dd/yy."
094 Appointment Not Kept, Application/Review — B-100, Processes and Processing Time Frames
"You failed to keep your appointment."
"Usted no vino a la cita que le dimos."
095 Unable to Locate — A-700, Residence
"You cannot be located."
"No podemos localizar al solicitante."
096 Refugee Exceeds Eight-Month Limit — R-100, RCA/RMA
Use to deny an RCA application or ongoing case because the household members entered the U.S. more than eight months ago.
"You will not be eligible for TANF after mm/dd/yy."
"La elegibilidad para Medicaid termina el mm/dd/yy."
097 Filed In Error — No Notice
Use to deny a Notice of Application (NOA) that was created erroneously.
098 Voluntary Withdrawal — A-100, Application Processing
Use only if an applicant requests that the application be withdrawn, or a current recipient requests that HHSC discontinue the case and the advisor cannot determine the reason. Otherwise use the applicable code.
"You have advised us that you no longer want to apply for TANF."
"Usted nos avisó que ya no desea solicitar TANF."
"You have advised us that you no longer want to receive TANF."
"Usted nos avisó que ya no desea recibir TANF."
099 Other Miscellaneous — A-1000, Deprivation
  • Use to deny TP 01 coverage for members who must be added to a TANF-SP case.
    "Your needs are now included in the TANF-SP case."
    "Ahora el caso de TANF-SP cubre sus necesidades."
  • Use to deny a case for other miscellaneous reasons.
    "You do not presently meet eligibility requirements."
    Usted presentemente no califica para asistencia."
134 Refusal to Assign Child Support Rights — A-1100, Child Support
Use to deny an application or ongoing case because the caretaker's needs are removed for refusal to make assignment and income meets the needs of the remaining members.
"You did not wish to assign support rights to the state."
"No quiso usted conceder al estado el derecho de cobrar sostenimiento."
135 Provide AP's Info or Location — A-1100, Child Support
Use to deny an application or an ongoing case because the caretaker's needs are removed for refusal to provide information on the absent parent or cooperate in locating the absent parent, and income meets the needs of the remaining members.
"You did not supply information on the absent parent or assist support officer in locating the absent parent."
"Usted no dio información sobre el padre o la madre ausente, o no ayudó al funcionario de manutención de niños a localizar a dicha persona."
136 Provide Verification of Citizenship — A-350, Verification Requirements
Use to deny an application or ongoing case because all members in the certified group failed to provide verification of citizenship.
"You did not provide proof of U.S. Citizenship."
"Usted no presentó prueba de ciudadanía estadounidense."
137 Refusal to Help to Establish Paternity — A-1100, Child Support
Use to deny acase because the caretaker's needs are removed for refusal to cooperate in establishing paternity and income meets needs of remaining members.
"You chose not to help in establishing paternity."
"No quiso usted ayudar a establecer la paternidad."
180 Increased Earnings from Employment Services — A-1323.5, Wages, Salaries, Commission and Tips
Use to deny cases not eligible for post medical coverage if the denial results from employment or increased earnings within six months after participation in employment services. Also use to deny RCA cases because of failure to comply with employment/training requirements.
"You are now ineligible due to increased earnings after employment services."
"Usted no califica porque su salario aumentó después de su en el programa de servicios de empleo."
181 Refusal to Comply With Employment Services, Caretaker —A-1800, Employment Services
Use to deny a case because the caretaker'sneeds are removed for failure to comply and income meets needs of remaining members.
"You are now ineligible due to caretaker's refusal to register for employment services."
"Usted no califica porque no quiso inscribirse en el programa de servicios de empleo."
196 Failed to Sign the Responsibility Agreement — A-2100, Personal Responsibility Agreement
"Failure to sign the Responsibility Agreement."
"Usted no firmó el Acuerdo de Responsabilidad Personal."
200 Time Limit or Hardship Ends/Household Member Disqualified – A-2500, State Time Limits
"You are ineligible for TANF because _____________'s needs were removed following time limit policies."
"Usted no será elegible para TANF porque _____________ dejó de ser elegible según las normas de los límites de tiempo."
201 OT Ineligibility Period – A-2400, One Time Payments
"You are currently not eligible to receive TANF, OTTANF, or TANF-SP because you have received OTTANF during the past 12 months."
"En este momento usted no es elegible para recibir TANF, OTTANF, ni TANF-SP porque usted ya recibió OTTANF que cubre los últimos 12 meses."
217 Income Over 185% FPIL or No Earnings During the Fourth Month Transitional Reporting Period
"Your transitional Medicaid will be shortened to six months because you had no income or your gross earnings meet the needs that can be recognized by this agency."
"Su Medicaid de transición se recortará a seis meses porque usted no tuvo ingresos o su salario bruto es suficiente para cubrir las necesidades que este departamento puede reconocer."
230 Transitional Medicaid Expired at the End of the 12th Month — Computer Sent

 

C—213 Reinvestigation Codes

Revision 02-8; Effective October 1, 2002

 

TANF

Select the code that best represents the reason for the case action. Enter it in Item 132, Form H1000-B, Record of Case Action, if taking action to raise, lower, sustain, or transfer a case to another type program.

Reasons for Raised Grants

101 "Your available income or resources are less."
"Usted tiene ahora menos ingresos o recursos."
102 "Needs this agency can include in your check are more."
"Ahora usted tiene más necesidades que esta agencia puede cubrir con su cheque."
103 "Your income and needs have changed."
"Sus ingresos y sus necesidades cambiaron."

Reasons for Lowered Grants

104 "Your available income or resources have increased."
"Usted tiene ahora másingresos o recursos."
105 "Needs this agency can include in your check are less."
"Ahora usted tiene menos necesidades que esta agencia puede cubrir con su cheque."
106 "Your income and needs have changed."
"Sus ingresos y sus necesidades cambiaron."

Reasons for Sustained Grants and Medical Assistance

107 "Needs included in your check remain the same."
"Las necesidades cubiertas por su cheque no han cambiado."
108 "Changes in income and needs do not affect check."
"Los cambios en sus ingresos y en sus necesidades no afectan su cheque."
109 "You are receiving the maximum assistance check."
"Usted recibe la máxima cantidad de assistencia que se da."
110 "You remain eligible for medical coverage."
"Usted sigue siendo elegible para beneficios médicos."

Reasons for Change in Assistance Status

111 Use when transferring from TP 01 or 61 to any income assistance medical program.
"You are now eligible for medical coverage only."
"Usted es elegible ahora sólo para beneficios médicos."
Use when transferring from TP 01 or 61 to TP 40 to provide continuous coverage for a pregnant woman.
"The pregnant woman on your TANF case is eligible for continuous medical coverage."
"La mujer de su caso de TANF que está embarazada es elegible para cobertura médica continua."
112 Use when transferring from any income assistance medical program to TP 01 or 61.
"You are eligible for financial and medical assistance."
"Usted es elegible para beneficios médicos y asistencia financiera."

Reasons for Lowered Grants Because of Employment Services Program (ESP) Participation

115 "Earnings after ESP training have increased."
"Las entradas aumentaron después de su entrenamiento para empleo."
116 "Adult's needs removed due to refusal to participate in employment services."
"Las necesidades del adulto que se negó a participar en los servicios de empleo no pueden ser consideradas."

Transfers To and From Income Assistance Grant Programs

118 "Your family is now eligible for TANF-SP benefits only."
"Ahora su familia es elegible solamente para beneficios de TANF-SP."
119 "Your family is now eligible for regular TANF benefits only."
"Ahora su familia es elegible solamente para beneficios regulares de TANF."

Payee Change

120 Use when changing the payee from one designated relative to another relative when there is no break in assistance to the TANF children included in the case.
"You will now receive the assistance payment."
"Ahora va a recibir el cheque de asistencia a nombre de usted."

Transfers To and From Medical Programs for Families and Children

121 Use when transferring from any medical assistance program to another medical assistance program. This includes TP 07, 20, 29, 37, 40, 42, 43, 44, 45, 47, 48, and 55.
"You have been transferred to another type of medical assistance."
"Le cambiaron de una categoria del programa médico aotra."
Use when transferring from any medical assistance program to TP 40 to allow continuous coverage for a pregnant woman. This includes TPs 07, 29, 37, 47 or an active TP 55 to TP 40.
"The pregnant woman on your Medicaid case is eligible for continuous medical coverage."
"La mujer de su caso de Medicaid que está embarazada es elegible para cobertura médica continua."

Reasons for Change in Transitional Medicaid Assistance Status

123 Use for TP 07 and TP 37 when
  • shortening transitional Medicaid to end after six months, or
  • restoring transitional Medicaid back to the original 12 months.
"Your transitional Medicaid has changed because of the fourth-month Medicaid report."
"Sus beneficios de transición de Medicaid han cambiado debido a su reporte para Medicaid del cuarto mes."

Reasons for Sustaining or Raising Benefits Because of Child Support

125 Removal of child's needs due to child support from absent parent, and income changes do not affect check.
Use when removing a child's needs from the budget because of child support but other household income changes result in no grant change.
126 Sustained benefits.
"Child support activities do not affect your TANF or Medicaid benefits."
"Las actividades relacionadas con sostenimiento para niños no afectan sus beneficios de TANF ni de Medicaid."
127 Child's needs removed due to child support and your income has changed.
Use when
  • removing the needs of a child receiving child support from an absent parent, but
  • raising the grant because other income has decreased.
128 Raised grant.
"Your needs have increased and child support no longer exceeds the grant."
"Sus necesidades han aumentado y el pago de sostenimiento para niños que recibe ya no sobrepasa la cantidad de la concesión."

Reasons for Lowering Benefits Because of Child Support

129 Child's needs removed due to child support received from absent parent.
Use when lowering a grant because the needs of a child who is receiving child support from an absent parent are removed from the budget.
130 "You did not wish to assign support rights to the state."
"No quiso usted conceder al estado el derecho de cobrar sostenimiento."
131 "You did not wish to supply information on absent parent."
"No quiso usted dar informes acerca del padre/de la madre ausente."
132 "You chose not to cooperate with the child support officer."
"No quiso usted colaborar con el encargado de los cobros de sostenimiento para niños."
133 "You chose not to assist in establishing paternity."
"No quiso usted ayudar aaclarar la paternidad."
139 "Your grant has been reduced because a household member became eligible for SSI or SSA disability."

Reason/Message for Lowered Grant Because of Time Limits

138 Time Limit or Hardship Ends/Household Member Disqualified
"Your grant was lowered because __________'s needs were removed following time-limit policies."
"Se redujo su pago mensual porque _________ dejó de ser elegible según las normas de los límites de tiempo."

Reason/Message for Raised Grant Because of Time Limits

150 Time Limit or Hardship Ends/Household Member Disqualified
"Your grant was raised. However, _________'s needs were removed following time-limit policies."
"Se sebió su pago mensual. Sin embargo, __________ dejó de ser elegible según las normas de los límites de tiempo."

Reason/Message for Sustained Grant and Medical Assistance Because of Time Limits

160 Time Limit or Hardship Ends/Household Member Disqualified
Use when sustaining TP 01 or 61.
"Your grant remains the same. However, ____________'s needs were removed following time-limit policies."
"Su pago mensual seguirá igual. Sin embargo, __________ dejó de ser elegible según las normas de los límites de tiempo."

Reason/Message for Change in Assistance Status Because of Time Limits

170 Time Limit or Hardship Ends/Household Member Disqualified
Use when transferring from TP 01 or 61 to any income assistance medical program.
"You are eligible for medical assistance only. You are ineligible for a TANF grant because__________'s needs were removed following time-limit policies."
"Usted es elegible para recibir solamente ayuda médica. Dejó de ser elegible para pagos mensuales de TANF porque ____________ dejó de ser elegible según las normas de los límites de tiempo."
When transferring to TP 29, also include the following message:
"While receiving transitional Medicaid, you must report to HHSC within 10 days after you move and after anyone moves in or out of your household."
"Mientras reciba Medicaid de transición, tiene que avisar a HHSC dentro de los 10 días de su cambio de casa o del cambio del número de personas de su casa."

 

C—220 Supplemental Nutrition Assistance Program (SNAP) Codes

Revision 09-3; Effective July 1, 2009

 

 

C—221 Denial Codes

Revision 12-1; Effective January 1, 2012

 

SNAP

601 Excess Income, see C-242 for appropriate reference codes
"The amount of money you get each month is over the allowed amount."
"La cantidad de dinero que recibe cada mes sobrepasa la cantidad límite."
602 Excess Resources, see C-242 for appropriate reference codes
"The value of the things you own (resources) goes over the allowed amount."
"El valor de las cosas de las que es dueño (recursos) sobrepasan la cantidad límite."
603 Transferred Resources — A-1212
"You knowingly transferred resources to qualify for SNAP food benefits."
"Transfirio sus recursos con la intención de recibir beneficios de comida del Programa SNAP."
604 Death
No notice will be sent.
605 Program Violation
No notice will be sent.
606 Ineligible Students — A-200
"All members of your household are ineligible students."
"Todos los miembros de su casa son estudiantes inelegibles."
607 Refusal to Cooperate — C-920
"You refused to cooperate."
"Usted se negó a cooperar."
608 Voluntary Withdrawal — A-100
"You have advised us that you no longer wish to receive SNAP food benefits."
"Nos dijo que ya no quiere recibir beneficios de comida del Programa SNAP."
609 Failure to Provide Information — B-100 and C-900
"You did not provide enough information for this office to determine eligibility for SNAP food benefits."
"No nos dio información suficiente para determinar si puede recibir beneficios de comida del Programa SNAP."
610 Work Registration — A-1800
See Form H1017, Notice of Benefit Denial or Reduction, instructions for specific individual messages.
611 Voluntary Quit — A-1800
"The household's primary wage earner voluntarily left his most recent job without good cause."
"La persona que mantenia la casa dejó su empleo voluntariamente sin tener una razón aceptable."
612 Unable to Locate — A-700
"You cannot be located at the address you gave us."
"En la dirección que usted nos dió, no se le puede localizar."
613 Moved from State —
No notice will be sent.
614 Other, enter the appropriate reference
Indicate the specific reason.
615 Missed Appointment — B-100
"You failed to keep your appointment after submitting an application for SNAP food benefits."
"No se presento´ a la cita que le demos despues de presentar la solicitud de beneficios de comida del Programa SNAP."
616 No Citizens or Eligible Aliens — A-300
"No member of the household is a U.S. citizen or an alien eligible for SNAP food benefits."
"Ninguno de los miembros de su familia es ciudadano de los Estados Unidos o, elegible para recibir beneficios de comida del Programa SNAP."
617 Application Filed in Error — No Notice
Use to deny a Notice of Application (NOA) that was created erroneously.
621 Work Registrant Earnings — A-1323.5
"The amount of money you got from jobs (wages) goes over the allowed amount."
"La cantidad de dinero que recibio de trabajos (salario) sobrepasa el limite establecido."
622 Postponed Verification Not Provided – Expedited – A-145
"Your benefits were denied because you failed to provide the proof we requested when you were certified for expedited (emergency) services."
"Esta negación de beneficios se debe a que usted nunca entregó las pruebas que se le pidieron cuando le declararon elegible para los beneficios de emergencia."
625 State Office Use Only (SAVERR default code – open/close)
No notice.
626 State Office Use Only (CCDMI/permanent move)
No notice.
627 18-50 Denial — A-1900
"You have been disqualified for failing to meet the requirement for working 20 hours per week. To avoid the denial of benefits, you must begin working an average of 20 hours per week."
"Usted ha sido descalificado por no satisfacer el requisito de trabajar 20 horas por semana. Para evitar la negación de beneficios, usted tiene que comenzar a trabajar un promedio de 20 horas por semana."
630 State Office Use Only (Certification period expired)
No notice.

 

C—230 Medical Programs Codes

Revision 02-6; Effective July 1, 2002

 

 

C—231 Opening Codes

Revision 02-6; Effective July 1, 2002

 

Medical Programs

048 TP 40
Use when providing continuous coverage for pregnant woman on TP 40 using Form H1000-A.
"The pregnant woman in your household is eligible for continuous medical coverage."
"La mujer de su caso de Medicaid que está embarazada es elegible par cobertura médica continua."


TP 43, TP 44, TP 47 and TP 48
Use when providing continuous coverage for a child on TP 43, 44, 47, or 48.
"The following people in your household are eligible for continuous medical coverage."
"Las siguientes personas de su casa son elegibles para cobertura medica continua."
052 TPs 40, 43, 44, 45, 48, and 55 without spenddown
"Meets eligibility requirements."
"Llena los requisitos de elegibilidad."
055 TPs 40, 43, 44, 45, 48, and 55 without spenddown
Use to reopen a case or application that was denied by mistake.
"Denied in error."
"Se negó por equivocación."
057 TPs 40, 43, 44, 45, 48, and 55 without spenddown
Use when opening a case instead of transferring from TP 01 or 61 in order to prevent the automated systems from counting a month(s) toward a individual's time limit.
"Person(s) meet Medicaid eligibility requirements."
"Persona(s) llena los requisitos de elegibilidad de Medicaid."

 

C—232 Denial Codes

Revision 09-3; Effective July 1, 2009

 

Medical Programs

059 Death of Child (TPs 43, 45, 44, and 48) — A-500
"You no longer have children in your home who are eligible for assistance."
"Ya no hay niños en su casa que califican para asistencia."
Earnings (TPs 43, 44, 47, 48, and 55)
060 Earnings of Father — A-1323.5
"Earnings of father meet needs that can be recognized by this agency."
"El padre gana suficiente para cubrir las necesidades reconocidas por esta agencia."
061 Earnings of Mother — A-1323.5
"Earnings of mother meet needs that can be recognized by this agency."
"La madre gana suficiente para cubrir las necesidades reconocidas por esta agencia."
062 Earnings of Child – A-1323.1
"Earnings of child meet needs that can be recognized by this agency."
"Su hijo/hija gana suficiente para cubrir las necesidades reconocidas por esta agencia."
063 Earnings of Non-Parent Caretaker — A-1323.5
"Earnings of other person in your home meet needs that can be recognized by this agency."
"Una persona que vive en su casa gana suficiente para cubrir las necesidades reconocidas por esta agencia."
Financial Support (TPs 43, 44, 47, 48, and 55)
064 Support from Absent Father — A-1300
"Income from children's father who is outside the home meets needs that can be recognized by this agency."
"El padre que no vive en la misma casa manda suficiente dinero para cubrir las necesidades reconocidas por esta agencia."
065 Support from Relative in Household
"Income from relative in your household meets needs that can be recognized by this agency."
"El dinero que recibe de un pariente que vive en su casa es suficiente dinero para cubrir las necesidades reconocidas por esta agencia."
066 Support from Person Outside the Home
"Income available to you from a person outside the home meets needs that can be recognized by this agency."
"El dinero que recibe de un pariente fuera de su casa es suficiente para cubrir las necesidades reconocidas por esta agencia."
067 RSDI (TPs 40, 43, 44, 47, and 48) — A-1324.15
"Income available to you from social security benefit meets needs that can be recognized by this agency."
"El cheque que usted recibe ahora, o va a recibir, del seguro social es suficiente para cubrir las necesidades reconocidas por esta agencia."
068 Other Federal Benefits (TPs 43, 44, 47, 48, and 55) —A-1324.19
"Income available to you from Federal benefit or pension meets needs that can be recognized by this agency."
"El dinero que usted recibe ahora de beneficios o pensiones Federales es suficiente para cubrir las necesidades reconocidas por esta agencia."
069 State and Local Pensions or Benefits (TPs 43, 44, 47, 48, and 55) —A-1300
"Income available to you from state or local benefit or pension meets needs that can be recognized by this agency."
"El dinero que usted recibe de beneficios o pensiones del gobierno local o del estado es suficiente para cubrir las necesidades reconocidas por esta agencia."
070 Non-Governmental Pensions or Benefits (TPs 43, 44, 47, 48, and 55) —A-1326.9
"Income available to you from pension or benefit meets needs that can be recognized by this agency."
"El dinero que recibe usted de pensiones o benficios es suficiente para cubrir las necesidades reconocidas por esta agencia."
071 Excess Assets Income (TPs 40, 43, 44, 47, and 48) — A-13XX (See chart in C-241 for appropriate reference codes.)
"Income available to you meets needs that can be recognized by this agency."
"El dinero recibe ustedes suficiente para cubrir las necesidades reconocidas por esta agencia."

(TPs 55 and 30) — A-13XX (See chart in C-241 for appropriate reference codes.)
"Income available to you exceeds the medically needy needs allowance and you have no medical expenses to spend down your income."
"Usted dispone de ingresos que sobrepasan el limite para ser elegible para beneficios por necesidad médica yusted no tiene gastos médicos que se pudieran desontar de sus ingresos."
072 Excess Assets — Resources (TPs 43, 44, 47, 48, and 55) — A-12XX (See chart in C-241 for appropriate reference codes.)
"Resources available to you from other property meets needs that can be recognized by this agency."
"Los recursos que tiene usted en propiedades o dinero son suficientes para cubrir las necesidades reconocidas por esta agencia."
074 Fewer Members in Certified Group (TPs 40, 43, 44, 47, 48, and 55) —A-1341
"No unmet need for the current family size."
"Ahora, que usted tiene meno familia, sus entradas son suficientes para cubrir las necesidades reconocidas por esta agencia."
075 Conflicting Information on Management (TPs 40, 43, 44, 47, 48, 55, and 30)— A-1700
"Information on management indicates additional income."
"Según la información que tenemos, acerca de su situacióneconómica, parece ser ue usted no reportó toda su entrada."
076 Refusal to Furnish Information (TPs 40, 45, 43, 44, 47, 48, 55, and 30)— B-100
"You did not wish to furnish enough information for this agency to establish eligibility for assistance."
"Usted no quiso darnos suficiente información para poder establecer su calificación para asistencia."
077 Refusal to Follow Agreed Plan (TPs 40, 43, 44, 47, and 48) —A-1311
"You did not wish to follow agreed plan so that eligibility for assistance could be continued."
"Usted ya no califica para asistencia porque no quiso utilizar, según el plan que hablamos, otros posibles recursos."
078 Automatic Denial (TP 40)
Automatic denial because of anticipated pregnancy termination.
079 Refusal to Obtain Medical Information for Pregnancy or Disability Determinations (TPs 40, 55, and 30) — A-800
"You did not wish to obtain required medical verification."
"Usted no quiso obtener la verificación médica requerida."
080 Parent Not Incapacitated (TPs 55 and 30) — A-1000
"You do not meet the agency's definition of incapacity."
"Según la definición de 'incapacidad' de esta agencia, usted no califica."
082 Legal Marriage (TPs 40 and 55)
"Your children are not deprived of parental support. The primary wage earner does not meet the employment or work history requirements."
"A sus niños no les falta el sostenimineto paterno. El sostén principal de la casa no cumple con los requisitos con respecto a desempleo."
086 Child Admitted to Institution (TPs 40, 45, 43, 44, 47, 48, 55, and 30)— A-900
"Your child has been admitted to an institution."
"Su niño ha sido admitido a un hospital u otra institución."
087 No Eligible Child (TPs 40, 45, 43, 44, 47, 48, and 55) —A-900
"You no longer have children in your home who are eligible for assistance."
"Usted ya no tiene niños en su casa que califican para asistencia."
088 Residence (TPs 40, 45, 43, 44, 47, 48, 55, and 30) —A-700
"Residence requirements are not met."
"Sus niños no califican para asistencia porque no complen con el requisito de residencia en el estado."
089 Citizenship or Acceptable Alien Status (TPs 40, 45, 43, 44, 47, 48, 55, and 30) — A-300
"Citizenship or acceptable alien status requirements are not met."
"No cumplen con los requisitos de ciudadanía ni de inmigrante elegible."
090 Open/Close Coverage (TPs 40, 45, 43, 44, 47, 48, 55, and 30)
"Assistance was granted during a prior period, but you are not eligible now for medical assistance."
"Usted calificó anteriormente para asistencia pero ahora ya no califica para beneficios médicos."
091 Failure to Furnish Information (TPs 40, 45, 43, 44, 47, 48, 55, and 30)— B-100
"You failed to complete and return the necessary eligibility form."
"Usted no ha entregado la form completa que necesitamos para determinar su elegibilidad."
092 Other Eligibility Requirements (TPs 40, 45, 43, 44, 47, 48, 55, and 30)— A-100
Use for denying TP 45 because
  • the certified child becomes one year old, or
  • the child's mother is no longer eligible for Medicaid.
"You do not meet eligibility requirements for assistance."
"Usted no califica para asistencia."
094 Appointment Not Kept (TPs 40, 45, 43, 44, 47, 48, 55, and 30) —B-100
"You failed to keep your appointment."
"Usted no vino a la cita que le dimos."
095 Unable to Locate (TPs 40, 45, 43, 44, 47, 48, 55, and 30) —A-700
"You cannot be located."
"No lo podemos localizar a usted."
096 Refugee Exceeds Eight-Month Limit (TP 55) — R-430
097 Filed In Error (TPs 40, 45, 43, 44, 47, 48, 55, and 30) — No Notice
Use to deny a Notice of Application (NOA) that was created erroneously.
098 Voluntary Withdrawal (TPs 40, 45, 43, 44, 47, 48, 55, and 30) —A-100
"You have requested that your application for assistance be withdrawn."
"Usted nos pidió que fuera retirada su solicitud osu concesión para asistencia."
099 Other Miscellaneous (TPs 40, 45, 43, 44, 47, 48, 55, and 30) —A-100
"You do not presently meet eligibility requirements."
"Usted presentemente no califica para asistencia."
134 TP 55 without spenddown
"You did not wish to assign support rights to the state."
"No quiso usted conceder al estado el derecho de cobrar sostenimineto."
135 Provide AP's Info or Location — (A-1100)
Use to deny an application or an ongoing case because the caretaker's needs are removed for refusal to provide information on the absent parent or cooperate in locating the absent parent, and income meets the needs of the remaining members.
"You did not supply information on the absent parent or assist support officer in locating the absent parent."
"Usted no dio información sobre el padre o la madre ausente, o no ayudó al funcionario de manutención de niños a localizar a dicha persona."
136 Provide Verification of Citizenship — (A-350)
Use to deny an application or ongoing case because all members in the certified group failed to provide verification of citizenship.
"You did not provide proof of U.S. Citizenship."
"Usted no presentó prueba de ciudadanía estadounidense."
137 TP 55 without spenddown
"You chose not assist in establishing paternity."
"No quiso usted ayudar a establecer la paternidad."
195 Monthly Income Exceeds Maximum Limits (TPs 40, 43, 44, 47, and 48)
"You are ineligible because your monthly income exceeds the needs recognized by this agency."
"Usted no es elegible porque sus ingresos mensuales sobrepasan las necesidades reconocidas por esta agencia."

 

C—233 Reinvestigation Codes

Revision 01-7; Effective October 1, 2001

 

Medical Programs

110 (TPs 40, 45, 43, 44, 47, 48, and 55 without spenddown)
"You remain eligible for medical coverage."
"Sigue siendo elegible para asistencia médica."
120 (TPs 45, 43, 44, 47, 48, and 55 without spenddown)
"You will now receive the medical coverage on behalf of the children."
"Ahora usted va a recibir los beneficios médicos para sus hijos."
Use the following codes to clear Form H1708, Report of Noncooperation:
126 (TPs 45, 43, 44, 47, 48, and 55 without spenddown)
"Child support activities do not affect your TANF or Medicaid benefits."
"Las actividades con respecto a sostenimiento para niños no afectan sus beneficios de TANF y los de Medicaid."
132 (TPs 45, 43, 44, 47, 48, and 55 without spenddown)
"You chose not to cooperate with the child support officer."
"No quiso usted colaborar con el encargado de los cobros de sostenimiento para niños."

 

C—240 Expanded Denial Code Reference Charts

Revision 02-3; Effective April 1, 2002

 

 

C—241 TANF and Medical Programs Chart

Revision 02-3; Effective April 1, 2002

 

TANF and Medical Programs

Action Code GWS Screen New Reference
060 Earnings of Father Earned Income A-1323.5 Wages, Salaries
061 Earnings of Mother Earned Income A-1323.5 Wages, Salaries
062 Earnings of TANF Child Earned Income A-1323.1 Earnings of Child
063 Earnings of Non-parent Caretaker Earned Income A-1323.5 Wages, Salaries
064 Support from Absent Father Contributions, Child Support, or Vendor Payments A-1326.1
A-1326.2
A-1334
Gifts or Contributions
Child Support
Vendor Payments– Legally Obligated
066 Support from Other Person Outside the Home, Including Mother Contributions or Vendor Payments A-1326.1

A-1334
Gifts or Contributions

Vendor Payments– Legally Obligated
067 RSDI RSDI A-1324.15 RSDI
068 Other Federal Benefits VA A-1324.19 VA Benefits
069 State and Local Pensions or Benefits Retirements
Workers' Compensation

Unemployment
A-1326.9
A-1321.4

A-1324.18
Pensions
Workers' Compensation
Unemployment Benefits
070 Non-Governmental Benefits Retirements A-1326.9 Pensions
071 Income Not Codes 060 - 070
Excess Assets – Income
All Types of Countable Income A-1324.17
A-1326.1
A-1326.2
A-1326.6
A-1322.2
A-1331
A-1326.9
A-1324.15
A-1326.9
A-1323.4
A-1324.18
A-1334

A-1324.19
A-1323.5
A-1321.4
A-1310
Non-Generic TANF
Gifts or Contributions
Child Support
Interest – Bank Account
Unearned – WIOA
Lump Sum Income
Pensions
RSDI
RR Retirement
Self Employment Income
Unemployment Benefits
Vendor Payments –
Legally Obligated
VA Benefits
Wages, Salaries
Workers' Compensation
Other types of income which do not have a designated GWS screen.
072 Resources
Excess Assets – Resources
All Countable Resources A-1210

A-1210

A-1232.2
A-1242
A-1231.4
A-1238
A-1200
Cash-on-Hand, Stocks,
Bonds, Bank Accounts
Land, Oil, and Mineral
Rights, PASS Accounts
Prepaid Burial
Lump Sum Payments
Retirement – Pensions
Vehicles
Includes all other types of resources which do not have adesignated GWS Screen.

 

C—242 SNAP Chart

Revision 01-7; Effective October 1, 2001

SNAP

Action Code GWS Screen New Reference
601 Excess Income Income – Earned or Unearned A-1324.17
A-1326.1
A-1326.2
A-1322.1

A-1326.6
A-1322.2
A-1331
A-1326.9
A-1324.15
A-1324.16
A-1323.4
A-1324.18
A-1334

A-1324.19
A-1323.5
A-1321.4
A-1310
TANF Grant
Gifts or Contributions
Child Support
Educational Assistance –
Non Title IV
Bank Accounts– Interest
Unearned – WIOA
Lump Sum Income
Pensions
RSDI
SSI
Self Employment
Unemployment Benefits
Vendor Payments–
Legally Obligated
VA Benefits
Wages and Salaries
Workers' Compensation
Other income which does not have a designated GWS screen.
602 Excess Resources Resources – Countable A-1210

A-1210

A-1242
A-1236.4
A-1231.4
A-1238
A-1200
Cash-on-Hand, Stocks,
Bonds, Bank Accounts
Land, Oil, and
Mineral Rights
Lump Sum Payments
Real Property
Retirement Accounts
Vehicles
Other resources not listed in this section because they do not have a designated GWS screen.

C-300, County Charts

Revision 19-4; Effective October 1, 2019

 

 

C—310 Full and Minimum Service Choices Counties by Region

Revision 12-3; Effective July 1, 2012

 

TANF

The following is a list of full and minimum service Choices counties.

Region Full Service Counties Minimum Service Counties
Region 1 Armstrong, Bailey, Briscoe, Carson, Castro, Childress, Cochran, Collingsworth, Crosby, Dallam, Deaf Smith, Dickens, Donley, Floyd, Garza, Gray, Hale, Hall, Hansford, Hartley, Hemphill, Hockley, Hutchinson, Lamb, Lipscomb, Lubbock, Lynn, Moore, Motley, Ochiltree, Oldham, Parmer, Potter, Randall, Roberts, Sherman, Swisher, Terry, Wheeler, Yoakum King
Region 2 Archer, Baylor, Brown, Callahan, Clay, Coleman, Comanche, Cottle, Eastland, Fisher, Foard, Hardeman, Haskell, Jack, Jones, Knox, Mitchell, Montague, Nolan, Runnels, Scurry, Shackelford, Stephens, Stonewall, Taylor, Throckmorton, Wichita, Wilbarger, Young Kent
Region 3 Collin, Cooke, Dallas, Denton, Ellis, Erath, Fannin, Grayson, Hood, Hunt, Johnson, Kaufman, Navarro, Palo Pinto, Parker, Rockwall, Somervell, Tarrant, Wise Not applicable
Region 4 Anderson, Bowie, Camp, Cass, Cherokee, Delta, Franklin, Gregg, Harrison, Henderson, Hopkins, Lamar, Marion, Morris, Panola, Rains, Red River, Rusk, Smith, Titus, Upshur, Van Zandt , Wood Not applicable
Region 5 Angelina, Hardin, Houston, Jasper, Jefferson, Nacogdoches, Newton, Orange, Polk, Sabine, San Augustine, San Jacinto, Shelby, Trinity, Tyler Not applicable
Region 6 Austin, Brazoria, Chambers, Colorado, Fort Bend, Galveston, Harris, Liberty, Matagorda, Montgomery, Walker, Waller, Wharton Not applicable
Region 7 Bastrop, Bell, Blanco, Bosque, Brazos, Burleson, Burnet, Caldwell, Coryell, Falls, Fayette, Freestone, Grimes, Hamilton, Hays, Hill, Lampasas, Lee, Leon, Limestone, Llano, Madison, McLennan, Milam, Mills, Robertson, San Saba, Travis, Washington, Williamson Not applicable
Region 8 Atascosa, Bandera, Bexar, Calhoun, Comal, DeWitt, Dimmit, Edwards, Frio, Gillespie, Goliad, Gonzales, Guadalupe, Jackson, Karnes, Kendall, Kerr, Kinney, LaSalle, Lavaca, Maverick, Medina, Real, Uvalde, Val Verde, Victoria, Wilson, Zavala Not applicable
Region 9 Andrews, Coke, Concho, Crane, Crockett, Dawson, Ector, Gaines, Glasscock, Howard, Irion, Kimble, Martin, Mason, McCulloch, Menard, Midland, Pecos, Reagan, Reeves, Schleicher, Sterling, Sutton, Terrell, Tom Green, Upton, Ward, Winkler Borden, Loving
Region 10 Brewster, Culberson, El Paso, Hudspeth, Jeff Davis, Presidio Not applicable
Region 11 Aransas, Bee, Brooks, Cameron, Duval, Hidalgo, Jim Hogg, Jim Wells, Kenedy, Kleberg, Live Oak, McMullen, Nueces, Refugio, San Patricio, Starr, Webb, Willacy, Zapata Not applicable

 

C—320 TANF State Time Limit County Hardship Lists

Revision 12-3; Effective July 1, 2012

 

 

C—321 Current TANF State Time Limit County Hardship List

Revision 19-4; Effective October 1, 2019

 

TANF

Benefits Issued for October 2019 Through December 2019
Region County County Code
11

Starr

214

 

C—322 Previous TANF State Time Limit County Hardship Lists

Revision 19-4; Effective October 1, 2019

 

TANF

 

Benefits Issued for July 2019 Through September 2019
Region County County Code
11

Starr

214

 

Benefits Issued for April 2019 Through June 2019
Region County County Code
8 Zavala 254
11

Starr

Willacy

214

245

 

Benefits Issued for January 2019 Through March 2019
Region County County Code
8 Zavala 254
11

Starr

Willacy

214

245

 

C—330 SNAP ABAWD Work Requirement Waiver Counties

Revision 16-2; Effective April 1, 2016

 

 

 

C—331 Current SNAP ABAWD Work Requirement Waiver Counties

Revision 18-4; Effective October 1, 2018

 

SNAP

Effective October 2018
Region County County Code
None None None

 

C—332 Previous SNAP ABAWD Work Requirement Waiver Counties

Revision 18-4; Effective October 1, 2018

 

SNAP

Effective October 2017
Region County County Code
None None None

 

C—340 SNAP Employment and Training Counties

Revision 18-4; Effective October 1, 2018

 

Region SNAP Employment and Training Counties
Region 1: High Plains Bailey, Castro, Childress, Deaf Smith, Garza, Hale, Hockley, Hutchinson, Lamb, Lubbock, Moore, Ochiltree, Potter, Randall, Terry
Region 2: Northwest Texas Archer, Baylor, Brown, Clay, Coleman, Comanche, Cottle, Eastland, Foard, Hardeman, Haskell, Jack, Mitchell, Montague, Nolan, Runnels, Scurry, Stephens, Taylor, Wichita, Wilbarger, Young
Region 3: Metroplex Collin, Cooke, Dallas, Denton, Ellis, Erath, Fannin, Grayson, Hood, Hunt, Johnson, Jones, Kaufman, Navarro, Palo Pinto, Parker, Rockwall, Somervell, Tarrant, Wise
Region 4: Upper East Texas Anderson, Bowie, Camp, Cass, Cherokee, Delta, Franklin, Gregg, Harrison, Henderson, Hopkins, Lamar, Marion, Morris, Panola, Rains, Red River, Rusk, Smith, Titus, Upshur, Van Zandt, Wood
Region 5: Southeast Texas Angelina, Hardin, Houston, Jasper, Jefferson, Nacogdoches, Orange, Polk, Sabine, San Jacinto, Shelby, Trinity, Tyler
Region 6: Gulf Coast Austin, Brazoria, Chambers, Colorado, Fort Bend, Galveston, Harris, Liberty, Matagorda, Montgomery, Walker, Waller, Wharton
Region 7: Central Texas Bastrop, Bell, Blanco, Bosque, Brazos, Burleson, Burnet, Caldwell, Coryell, Falls, Fayette, Freestone, Grimes, Hamilton, Hays, Hill, Lampasas, Lee, Leon, Llano, Madison, McLennan, Milam, Robertson, San Saba, Travis, Washington, Williamson
Region 8: Upper South Texas Atascosa, Bandera, Bexar, Calhoun, Comal, DeWitt, Dimmit, Edwards, Frio, Gillespie, Goliad, Gonzales, Guadalupe, Jackson, Karnes, Kendall, Kerr, Kinney, LaSalle, Lavaca, Limestone, Maverick, Medina, Real, Uvalde, Val Verde, Victoria, Wilson, Zavala
Region 9: West Texas Coke, Concho, Crockett, Dawson, Ector, Howard, Irion, Kimble, Mason, McCulloch, Menard, Midland, Pecos, Reagan, Reeves, Schleicher, Sterling, Sutton, Tom Green, Ward
Region 10: Upper Rio Grande Brewster, Culberson, El Paso, Presidio
Region 11: Lower South Texas Aransas, Bee, Brooks, Cameron, Hidalgo, Jim Hogg, Jim Wells, Kleberg, Nueces, Refugio, San Patricio, Starr, Webb, Willacy, Zapata

 

C—341 SNAP Non-Employment and Training Counties

Revision 18-4; Effective October 1, 2018

Region SNAP Non-Employment and Training Counties
Region 1: High Plains Armstrong, Briscoe, Carson, Cochran, Collingsworth, Crosby, Dallam, Dickens, Donley, Floyd, Gray, Hall, Hansford, Hartley, Hemphill, King, Lipscomb, Lynn, Motley, Oldham, Parmer, Roberts, Sherman, Swisher, Wheeler, Yoakum
Region 2: Northwest Texas Callahan, Fisher, Kent, Knox, Shackelford, Stonewall, Throckmorton
Region 4: Upper East Texas None
Region 5: Southeast Texas Newton, San Augustine
Region 7: Central Texas Mills
Region 9: West Texas Andrews, Borden, Crane, Gaines, Glasscock, Loving, Martin, Upton, Winkler
Region 10: Upper Rio Grande Hudspeth, Jeff Davis
Region 11: Lower South Texas Duval, Kenedy, Live Oak, McMullen

 

C—350 County Lists

Revision 12-2; Effective April 1, 2012

 

All Programs

C-400, Reserved for Future Use

C-500, Form H1000-A, Form H1000-B and Form H1000-C Instructions (Retired as of July 1, 2013)

Revision 10-4; Effective October 1, 2010

 

 

C—510 General Information

Revision 05-4; Effective August 1, 2005

 

General Information

All Programs

Form H1000-A, Notice of Application, Form H1000-B, Record of Case Action, and Form H1000-C, Secondary Client Input, are manual forms used in all programs to report applications, the subsequent denial or certification of eligibility, and changes and deletions to information for certified and denied cases. Use a separate Form H1000-A, Form H1000-B or Form H1000-C to report actions taken in each individual program.

Form H1000-A is a four-part form. Each part has the same control number.

  • Part 1, Notice of Application (NOA) is a short form that
    • indicates that an application was filed and the date filed, and
    • gives information for an NOA report to field staff about individual information already in the computer file.
  • Part 2, Input Document, is a page advisors use for handwritten entries during the decision process. Use the input document to
    • report the final disposition of an application,
    • correct Items 01 through 38 already sent on the NOA,
    • authorize the issuance of benefits, or
    • establish a central file on all individual data.
  • Part 3, Case Record Copy, is a carbon copy of Part 2. It contains information on the NOA and the disposition of an application for audits.
  • Part 4, Case Index Card, is a carbon copy of the NOA used to
    • make a central file of pending applications in the local office, and
    • report changes on pending applications.

Form H1000-B is a three-part form. The assigned case number and sequence number appears on all copies of the form. To request Form H1000-B, use Form H1004, Request for Form H1000-B.

  • Part 1, Record of Case Action, is a computer-generated form that shows current case information.
  • Use the Part 2, Input Document, to
    • update information;
    • report the disposition of a redetermination; or
    • authorize, adjust, or cancel benefits.
  • Part 3, Case Record Copy, is identical to Part 2, Input Document. All items entered on the input document appear on the Case Record Copy.

Form H1000-C is a one-part form. Use this form to enter

  • start and end dates for PRA penalties and good cause,
  • finger image code and vun, and
  • disqualifications and Supplemental Nutrition Assistance Program (SNAP) work requirement countable months.

Advisors must submit Form H1000-A or Form H1000-B with Form H1000-C.

 

C—511 Form H1000-A

Revision 05-4; Effective August 1, 2005

 

All Programs

Correct any errors made on Part I, Notice of Application (NOA), before submitting the form for processing.

You must process the NOA before entering the input document information. Batch and submit the NOA before, or on the same day as, the input document.

If staff damage or lose Form H1000-A, Notice of Application, substitute the same form from another set. Block out the preprinted application number and enter the application number of the original NOA.

If the number of applicants listed on Form H1010-B, Application for Assistance - Part B: Information We Need to Know, exceeds 11 people, complete an additional set of forms. Complete Item 04, Page, on the first NOA. Block out the preprinted application number on the additional NOA forms and enter the original application number of the first NOA. Make entries in

Item 04, Page;
Item 06, Budgeted Job Number;
Item 07, Mail Code;
Item 09, Case Name; and
Items 33-38. Make sure to begin with line "b" in Items 33-38.

Staple the NOAs together and batch as one.

When an applicant moves and the move requires the transfer of a pending application to another office, forward all material, including Form H1031, Case Record Transfer. The receiving office is responsible for updating the new budgeted job number, mail code, and county number.

 

C—512 Form H1000-B

Revision 02-3; Effective April 1, 2002

 

All Programs

The Form H1000-B, Record of Case Action, input document is identical to the Form H1000-A, Notice of Application input document. The following items appear on the record of case action, input document, and case record copy:

Item 01, Case number;
Item 02, Category;
Item 03, Sequence;
Item 09, Case name; and
Item 32, Client number.

Enter changes in the case information in red ink. To report a change or correction:

  • circle the section number.
  • circle the individual line indicator in the section where the change is entered. If a change is made in Section III only, circle the individual line indicator in both Sections II and III.
  • enter the new information.
  • enter the client number in Item 50, Client Number Validation, if changing the name and date of birth of the same client.

You may not change:

Item 08, Date Filed;
Item 32, Client Number;
Item 37, Social Security Number (SSN) validated with an asterisk;
Item 38, Social Security Claim Number validated with acode 1 or 3;
Item 48, PA – Refugee; and
Item 129, Grant Effective Date(TANF only).

Additionally for TANF Medicaid Programs you may not change

Item 02, Category; and
Item 46, Medical Effective Date (over six months old).

To delete income amounts and social security account numbers without asterisks (Item 37), enter azero in the item. Delete all other information (including the social security claim number, Item 38) by entering a pound sign (#) in the first position of the item. Do not use a pound sign as an abbreviation for number.

To delete an individual name and individual information, enter a pound sign in Item 33, Client Name. If deleting a TANF or Medical Programs individual due to death, re-enter the original status-in-group code for the deceased individual plus status-in-group code X in Item 40, Status in Group. Enter the individual's date of death in Item 47, Death/Denial Date.

If you delete a

  • TANF certified member, adjust the total needs amount in Item 66.
  • Medical Programs budget group member, adjust the total needs amount in Item 66, and the number of adults/children included in the budget group in Items 125, and 126.

 

C—520 Form H1000-A and Form H1000-B Completion Instructions

Revision 02-3; Effective April 1, 2002

 

 

C—520.1 Section I, Items 01 - 31

Revision 02-3; Effective April 1, 2002

 

All Programs

Items 01 through 39 are listed on the Notice of Application. On the NOA, complete all items except Items 32 and 39. Items 02, 06, 07, 08, 09, 13, 15, 16, 17 and 25 cannot be deleted, but may be updated.

 

ITEM 01: Case Number

All Programs

If known, enter the previously assigned case number. To reassign a number, ensure that the case name is identical to the name as it appeared at the time of denial. The reassigned case number must have been active within the past year for non-public assistance (PA) Supplemental Nutrition Assistance Program (SNAP) and within the past two years for PA SNAP, TANF and Medical Programs for Families and Children.

 

ITEM 02: Category

TANF and Medical Programs

On the NOA, enter the code in the left-hand box that describes the type of assistance. Enter changes or corrections in the right-hand box.

2 — TANF/Medical Programs

5 — Refugee Cash Assistance (RCA)

 

SNAP

On the NOA, enter the code in the left-hand box that describes the type of assistance. Enter changes or corrections in the right-hand box.

6 — PA SNAP

8 — All members are refugees, other than Cuban/Haitian entrants, receiving TANF or RCA (Aid Type 5)

9 — Non-PA SNAP

 

ITEM 03: Sequence No. (SEQ)

All Programs

For a TANF/Medical Programs NOA, enter code Y if the case name received TANF/Medical Programs within the past two years.

The sequence is computer-printed on 1000-B turnaround. The initial Form H1000-B from the Form H1000-A input document is always sequence 02. Use only the most current sequence to update information. The sequence number cannot exceed the number 99. After 99 the sequence begins at 02 again.

 

ITEM 04: Page

All Programs

If more than one form is required, enter the page number in the first space and the total number of pages in the second space.

 

ITEM 05: Print Date

All Programs

Computer printed on 1000-B turnaround. This is the date the information from the input form is entered into SAVERR.

 

ITEM 06: Budgeted Job Number

All Programs

Enter the first eight alphanumeric characters of the budget job number assigned to the application.

 

ITEM 07: Mail Code

All Programs

Enter the mail code of the budgeted job number assigned to the application.

 

ITEM 08: Date Filed

All Programs

Enter the file date of application for assistance. Use month, day, year sequence.

Note: When adding a child to a new program, the file date is the date of the reported change.

 

SNAP

Also enter the date on the SNAP Form H1000-B, Record Of Case Action, when a new Form H1010-B, Application for Assistance - Part B: Information We Need to Know, is received.

 

Medical Programs

For reopened three months prior applications, enter the date the applicant requests the application be reopened. Enter the month and year of the original file date in Item 134, Three Months Prior Application Date.

 

ITEM 09: Case Name

All Programs

Enter on the NOA the individual's last name, comma, first name, space, middle name, or initial until the name is complete or the maximum of 22 positions is reached. The 22 positions include alphanumeric characters, commas, and spaces. If the last name includes Jr, Sr, etc., enter this after the last name(Example: SmithJr,Robert).

 

ITEM 10: Case Name Change

All Programs

To report a change or correction in case name, enter the complete name in the 22 positions provided in the format described in Item 9, Case Name. If the case name is on a line other than "a," Section II, of the NOA, enter

  • the correct name in Item 10; and
  • a pound sign (#) on line "a" of Section II, Item 33, Client Name, if you are removing the person reported on line "a."
If the person reported on line "a" remains a part of the ... then enter the appropriate status-in-group code ...
TANF case, for this person on line "a" of Section III, Item 40, Status-in-Group, and the appropriate entry in Item 41, ESP Code.
SNAP case, if any, or a pound sign in Item 40, Status-in-Group to delete a code that is no longer applicable.
Medical Programs case, for this person on line "a" of Section III, Item 40, Status-in-Group.

If the new case name is not reported on the NOA, add the person's name and information on the first available line of Section II, Item 33, Client Name. Enter the appropriate codes in Item 40 for all programs and in Item 41 for TANF and SNAP on the line where the new case name is listed.

The computer automatically realigns names to ensure the correct name is on line "a." Do not attempt to move names from line to line on Form H1000-A orForm H1000-B.

 

ITEM 11: Reserved

 

ITEM 12: Employee Number

All Programs

Enter the employee number of staff assigned the application.

 

ITEM 13: Mailing Address, First Line

All Programs

Enter the street number and name, rural free delivery, or post office box number using these abbreviations:

Ave — Avenue

Blvd — Boulevard

Cir — Circle

CT — Court

Dr — Drive

Gen Del — General Delivery

Hwy — Highway

Ln — Lane

PO Box — Post Office Box

Rd — Road

RFD — Rural Free Delivery

RR — Rural Route

St — Street

Do not use a pound sign (#) as a part of an address. See example in B-222.1, Mailing Addresses for Issuing Benefits, for cases with P.O. Box addresses.

TANF

When a TANF case has a guardian or protective payee, use their mailing address in Items 13-17.

 

ITEM 14: Mailing Address, Second Line

All Programs

Use this space if additional lines are required for the mailing address.

 

ITEM 15: City

All Programs

Enter the name of the city or town used in the mailing address.

 

ITEM 16: State

All Programs

Enter the two-letter postal abbreviation of the state used in the mailing address. Allowed abbreviations are:

TX — Texas

AR — Arkansas

LA — Louisiana

NM — New Mexico

OK — Oklahoma

 

ITEM 17: ZIP Code

All Programs

Enter the ZIP code of the mailing address.

 

ITEMS 18 - 24 ARE NOT PRINTED ON THE NOA.

TANF and Medical Programs

Use Items 18-23 to mail Form H3087, Medicaid Identification, to a temporary address. To change any of these items on a Form H1000-B, Record of Case Action, input document, re-enter all items. Use a pound sign (#) to delete items.

 

ITEM 18: Temporary Address, First Line

TANF and Medical Programs

Enter the temporary mailing address.

 

ITEM 19: Temporary Address, Second Line

TANF and Medical Programs

Use this space if additional lines are required for the temporary address.

 

ITEM 20: Temporary Address, City

TANF and Medical Programs

Enter the name of the city or town.

 

ITEM 21: State

TANF and Medical Programs

Enter the two-digit postal abbreviation of the state.

 

ITEM 22: ZIP Code

TANF and Medical Programs

Enter the ZIP code.

 

ITEM 23: Temporary Address; Months; Begin Month

TANF and Medical Programs

Months: Enter the number of months, not to exceed three, that Form H3087, Medicaid Identification, is to be sent to atemporary address.

Begin Month: Enter the month the temporary address becomes effective.

 

ITEM 24: Residence Address

All Programs

Enter the residence address, street, and city only if different from the mailing address. Always enter the entire address.

TANF and TP 40

Enter the telephone number, if provided, for an application from a pregnant woman.

 

ITEM 25: County

All Programs

Enter the three-digit code for the county associated with advisor's BJN.

Note: For TANF and Medical Programs, enter the individual'sresidence code in Item 164. See C-350 for the county codes.

Items 26 - 27 are not printed on the NOA.

 

ITEM 26: Protective Payee (TANF/Medical Programs); Authorized Representative (FS)

Enter the last name, comma, first name, space, middle name or initial until the name is complete or the maximum of 22 positions is reached. Enter the name of the institution in usual word order omitting commas, if the guardian is an institution (such as, First National Bank), or the representative payee is alicensed residential child care facility. The 22 positions include alphanumeric characters, comma, and space. If staff make an entry in this item, they must also make an entry in Item 27, Modifier.

TANF and Medical Programs

Enter the name of the legal guardian (exactly as shown on guardianship papers), protective payee, or representative payee.

SNAP

Enter the name of the authorized representative. If the authorized representative is an institution such as a halfway house, enter the name of the employee designated by the institution to act as authorized representative on its behalf.

 

ITEM 27: Modifier (M)

All Programs

Enter the code that identifies the person listed in Item 26.

TANF and Medical Programs

P — Protective Payee

Note: Also use P for those cases in which a representative payee is designated to receive and manage the benefits for an individual who is incompetent or incapacitated.

R — Representative Payee

SNAP

I — Authorized representative is a member of household (under the same roof).

O — Authorized representative is not a member of household (not under the same roof).

F — Authorized representative is an employee of a drug and alcohol treatment/group living arrangement facility.

 

ITEM 28: Indicator (I) Code

TANF

Enter on NOA. Enter only changes or corrections on Form H1000-A, Form H1000-B and Form H1000-C.

For TANF, enter code M in this item if potential eligibility is based on an incapacity determination.

For TANF-SP, make no entry. SAVERR prints U when TP 61 transfers to TP 07, 20, or 37.

SNAP

1 — Streamlined reporting (SR) household with total gross monthly income that is less than or equal to 130% FPIL.

2 — SR household with total gross monthly income that is greater than 130% FPIL.

3 — Non-SR household.

 

ITEM 29: Action Notice (MMDDYY)

All Programs

On Form H1000-A/B, enter the date you give the individual Form H1017, Notice of Benefit Denial or Reduction. This entry is mandatory for all denials except for Application Filed in Error, denials. For Medical Program individuals, enter the date you give the individual Form H1122, Medicaid Action Notice.

 

ITEM 30: Medical Delay

Medical Programs

Use for emergency medical conditions. Make an entry, using four alphanumeric characters, when more than 10 days elapse between giving/mailing a request for medical information and the date the local office receives the information. Enter code E and the number of days over 10. Example: E015.

TANF

Use when a TANF applicant applies in pay for performance and must demonstrate cooperation. Aperiod of up to 40 days is excluded from the timeliness calculation. Enter Code E and the number of days after the interview date needed to demonstrate cooperation. Example: E030. Do not allow more than 40 days.

 

ITEM 31: Medical Programs Application Indicator

Medical Programs

Make an entry only on the NOA. Enter

  • W to identify a TP 40 application or TANF application with a pregnant woman; or
  • Y to distinguish Medical Programs applications from other Category 02 applications. Do not enter on Form H1000-B.

 

C—520.2 Section II, Items 32 - 39

Revision 10-4; Effective October 1, 2010

 

All Programs

This section contains identifying information for each person listed on the form. Always use line"a" to enter information about the head of household (case name). Items 32, 33, 34, 35, 36, and 39 cannot be deleted, but may be updated.

 

ITEM 32: Client Number

All Programs

When certifying a case, for each person listed in Section II, enter

  • the nine-digit individual number or
  • Code 2. This code tells SAVERR to check for an existing client number. If a number exists, SAVERR will reassign the client number. If a number does not exist, SAVERR will assign a number.

If Form H1000-A, Notice of Application, or Form H1000-B, Record of Case Action, will not process because of error message 307, "client is already active in same program on another case," research the case to determine if the individual is currently active in another case in the same program.

If the individual is ... then ...
not currently active in the same program or is entitled to dual SNAP participation as aresident of a shelter for battered persons, follow procedures in B-454.1, Duplicate Participation Procedures.
currently active in the same program and is not entitled to dual benefits, take appropriate action to prevent duplicate participation. Process an overpayment, if applicable. The advisor who discovers duplicate participation is responsible for notifying the other offices involved.

SAVERR does not assign a client number on denied initial applications.

See C-800, Automated Support Systems, for individual merge/separate information.

To reassign a client number without an entry in Item 50, Client Number Validation, enter Code 2 in Item 32 and the person's name, birth date, social security account number, and social security claim number so that they match the information already in the computer file.

To correct biographical information enter:

  • up to three corrections on the input document. Ensure that at least one item matches the information already on file.
  • the client number in Item 32 and Item 50, Client Number Validation.

Using Item 50 allows the client number to be reassigned, but hierarchy may still prevent using the biographical data.

 

ITEM 33: Client Name

All Programs

Enter the name(s) of the people listed on Form H1010-B. Type the last name, comma, first name, space, middle name or initial until the name is complete or you reach the maximum 22 positions. The 22 positions include alphanumeric characters, comma, and spaces.

The only spaces allowed are after the first name. Do not use spaces within a last or first name. If the name includes a Jr., Sr., II, III, etc., it must follow the last name. Example: SmithJr, John Z. Enter the individual's name from line a in Item 09, Case Name, instead of Item 33.

Some eligible non-U.S. citizens traditionally use a name order that is different from the customary U.S. order (first name, middle name, last or family name). Advisors should determine name order according to U.S. custom, and enter it appropriately on Form H1000-A and Form H1000-B. Example: Vietnamese name on I-94: Nguyen(last) Thi(first) Mai(middle) Enter on Form H1000-Aand Form H1000-B: Nguyen,Thi Mai.

Medical Programs

Enter the names of all persons in the budget group. This group includes all the eligible and ineligible people whose needs, income, resources, and medical expenses are used to determine eligibility and/or spend down.

 

ITEM 34: Birth Date

All Programs

Enter the birth date for each person listed.

 

ITEM 35: Sex

All Programs

Enter the sex for each person listed.

M — Male

F — Female

 

ITEM 36: Race

All Programs

Enter the code that describes the race, color, national origin for each person listed:

1 — White (not Hispanic) – People whose origins derive from the original people of Europe, North Africa, or the Middle East.

2 — Black (not Hispanic) – People whose origins derive from the black racial groups of Africa.

3 — Hispanic – People of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin.

4 — American Indian or Alaskan Native – People whose origins derive from the original people of North America.

5 — Asian or Pacific Islander – People whose origins derive from the original people of the Far East, Southeast Asia, the Indian subcontinent, or the Pacific Islands. This area includes China, Japan, Korea, the Philippine Islands, and Samoa.

6 — State Office Use Only – A code entered by the computer if the worker makes no entry or enters an inappropriate code. Staff must take action to correct.

 

ITEM 37: Social Security Number (SSN)

All Programs

Enter the social security number (SSN) for each person listed. Following the nine-digit entry is aspace used to indicate the verification status of the SSN. A computer printed asterisk (*) indicates Social Security Administration verified the SSN. A verified SSN cannot be changed on Form H1000-B and Form H1000-C. If you determine the number is incorrect, send a memorandum with the correct SSN to State Office Data Integrity (SODI), to make a change:

SODI Section, Data Base Support Unit
P.O. Box 14930, MC Y92-2
Austin, TX 78714-9030

Or fax to the Data Base Support Unit at 512-706-7140.

SODI Section notifies the staff by memo when the change is made.

A blank space following the SSN indicates the SSN was entered by the advisor but is not verified.

 

ITEM 38: Social Security Claim Number

All Programs

Enter the benefit claim number for people enrolled in Medicare or for people who receive social security or Railroad Retirement (RR) benefits. If a person is receiving benefits under more than one number, use the number shown on the Medicare card. If there is no claim number assigned, leave blank.

Note: If entering a RR benefit claim number in Item 38, total the household's RR benefits in Item 55, not in Item 43.

Following the claim number is a code indicating whether the state is paying Medicare premiums for the individual or the individual has private medical insurance. The codes apply to all cases, but are not printed on the SNAP Form H1000-B and Form H1000-C. Reports that include biographical information have these codes. They are

0 — No insurance.

1 — Medicare premium paid by state.

2 — Private medical insurance.

3 — Private medical insurance and Medicare premium paid by state.

The presence of a code 1 or 3 indicates SSA validated the number and the number cannot be changed on Form H1000-B and Form H1000-C. If you determine a verified number is incorrect, send a memorandum with the correct number to Data Control Section, Special Programs Support Unit, State Office, Y-922, to make achange.

THIS COMPLETES THE ALLOWABLE ENTRIES ON THE NOTICE OF APPLICATION.

 

ITEM 39: Education/Service Code

TANF

Enter an education code for each person in the certified group who is 16 or older (including achild who will be 16 during the month of certification). Note: Do not change the code unless it was incorrect at the time the initial tier level was set or the individual has been denied for at least one complete month before reapplying.

SNAP

Enter an education code for each person with a Code 2, 3, 4, R, V, W, X, or Y in Item 41, Work Registration. Note: Education codes entered for TANF individuals will be printed on the next Form H1000-B that processes, whether registered for SNAP ESP or not.

TANF and SNAP

Enter a code in the first digit of Item 39 to indicate the highest educational level/grade each person has completed. Do not consider vocational/technical schools when determining education level.

Educational Level Code
1st grade 1
2nd grade 2
3rd grade 3
4th grade 4
5th grade 5
6th grade 6
7th grade 7
8th grade 8
9th grade 9
10th grade A
11th grade B
High school graduate/completed general equivalency diploma C
Attending college or completed some college but has not graduated from a four-year college E
Graduate of a four-year college F
No formal education N

 

C—520.3 Section III, Items 40 - 50

Revision 11-3; Effective July 1, 2011

 

All Programs

Section III (a-k) is an extension of Section II (a-k). Each line in Section III relates to the corresponding line in Section II and is used to provide additional information about the people listed. Example: The status-in-group code for the case name in Section II, line a, is reported in Section III, line a. Items 40 and 46 for Temporary Assistance for Needy Families (TANF) and Medical Programs, and Item 41, for TANF and the Supplemental Nutrition Assistance Program (SNAP), cannot be deleted but may be updated.

If an active case is denied, all monetary amounts for the case are kept in the System for Applications, Verifications, Eligibility Reports and Referral (SAVERR) files until the case is purged. The amounts kept in SAVERR files are those budgeted for the latest month of eligibility.

The same is true for individual income amounts. The amount shown, however, is the latest amount of income budgeted in any program. If the individual is moved to another case, the individual income amounts can be updated. Staff can change individual income amounts if denying an active case. This action does not update the TANF case income but does update the SNAP case income.

TANF and Medical Programs

When a certified recipient becomes a payee or case name, medical effective date is automatically deleted. For TANF, the ESP code is also deleted.

 

ITEM 40: Status-in-Group

All Programs

Status-in-group (SIG) codes identify the people's relationship to the case. Enter all codes that describe the people listed on Form H1000-A, Notice of Application, Form H1000-B, Record of Case Action andForm H1000-C, Secondary Client Input. A maximum of six codes may be used for one person.

TANF and Medical Programs

Assign each person listed one primary code. Use secondary codes only in combination with a primary code. Use secondary codes when required or to provide additional information. Note: For TP 30 case, include only one person with an eligible primary code (SIG 8 or 4) per case.

SNAP

Always enter a code to identify the head of household. Use other codes when appropriate. Use the head of household codes with any of the other codes listed under other codes. Only one person in the case, however, may be given a code indicating head of household.

TANF

Primary Codes

2 – Disqualified/Ineligible Child or Second Parent— Identifies a child or second parent who would be a required member of the certified group but who is disqualified or ineligible for another reason, including noncompliance with the unmarried minor parent domicile requirement.

3 – Noncertified child – Identifies the only deprived child of the certified caretaker/second parent.

If the child receives ... then enter SIG Code ...
SSI 3
Foster Care Payments 3F
Adoption Assistance payments 3A

 

5 – Certified Child – Identifies a child included in the certified group for TANF or refugee cash assistance (RCA) cases.

7 – Second Parent — Identifies the second parent in a TANF-SP case.

Do not use Code 7 for a Supplemental Security Income (SSI) recipient, to identify the case name, or for more than one member.

8 – Caretaker — Identifies the caretaker in TANF cases.

Do not use Code 8 for an SSI recipient or for more than one member.

9 – Payee – TANF payee only includes:

  • SSI recipients (legal parents and other caretaker relatives), or
  • other caretaker relatives who act as head of the TANF household and who are not eligible for TANF or do not want to be included as a caretaker (See A-222, Who is Not Included).

0 – Case Name Only — Identifies a legal parent disqualified for:

  • intentional program violation;
  • alien status/citizenship requirements;
  • failure to comply with employment services, child support, SSN or third-party resource (TPR) requirements;
  • failure to timely report the temporary absence of a certified child;
  • being a fugitive;
  • noncompliance with the unmarried minor parent domicile requirement; or
  • a felony drug conviction (not deferred adjudication) for an offense committed on or after April 1, 2002. This disqualification is permanent. See A-222, Who is Not Included.

Secondary Codes

E – Federally Recognized Tribe or Unaccompanied Refugee Minor(URM) — Identifies individuals who are either members of a federally recognized Indian tribe or a URM. These individuals are exempt from mandatory enrollment in Medicaid managed care.

G – Reached End of State Time Limit — Identifies a person who used the maximum number of TANF months in a time limit and has a five year freeze out date on SAVERR. This code can be used with all primary SIG codes.

H – Eligible Refugee — Identifies a person identified as an eligible Amerasian, refugee, asylee, victim of severe trafficking or Cuban/Haitian entrant by the U.S. Citizenship and Immigration Services (USCIS) on Form I-94 or other USCIS document. Continue using Code H until the individual has resided in the U.S. for five years. Code H may be combined with any primary codes. Note: Entry of Code H requires an entry in Item 48.

I – Ineligible Child – Identifies a child who is ineligible for TANF for a reason other than being disqualified or being an SSI recipient. Use Code Ionly with Code 2.

K – Child of a Minor Child – Identifies the child of a minor parent who is also included in the TANF grant. Use Code K only with Code 5.

L – Minor Parent with a Dependent Child – Identifies a minor parent who has a dependent child on the same case. Use Code L with Codes 5, 7, 8, 9 or 0.

M – Eligible Only for Three Months Prior Medical Assistance— Identifies a person who is eligible for medical assistance during any or all of the three months before the month of application, but who is not currently eligible for medical assistance. Use Code M with Codes 5, 7 or 8.

N – Ineligible for Retroactive Medical Assistance and Current Assistance — Identifies a member of the dependent group who must be reported to certify a case for three months prior Medicaid coverage. Use this code for a member of the dependent group who is ineligible for retroactive medical assistance and current assistance. Use Code N with Codes 5, 7 or 8 to identify members of an OTTANF case. Note: If all people in a case are status-in-group N, the case must be Type Programs 11, 71 or 72.

O – Department of State Health Services (DSHS) Child with Special Health Care Needs— Identifies a child who is exempt from mandatory enrollment in Medicaid managed care.

P – Private Health Insurance — Identifies acertified person who has private health insurance other than Medicare or Medicaid benefits. Use Code P with Codes 5, 7 and 8.

Q – Proof of THSteps Screening — Identifies a child who the automated system indicates as delinquent in screening, but for whom the individual has provided proof of THSteps screening. This code does not remain on SAVERR. Use Code Q only with Code 5.

R – HHSC Employee — Identifies a person who is an HHSC employee. Use Code R with all primary codes.

S – Alien with Acceptable Alien Status — Identifies a noncitizen whose alien status allows him to receive TANF. Use Code S with all primary codes.Note: Do not use this code for refugees (SIG H).

T – Ineligible Alien — Identifies a person ineligible due to alien status. Use Code T with Codes 9, 0 and 2Y.

U – Ineligible — No U.S. Citizenship Proof— Identifies a person ineligible due to no proof of U.S. citizenship. Use Code U with Codes 0, 2I or 2Y.

V – Living in Nursing Home — Identifies aperson who is temporarily in a nursing home. Use Code V with Codes 0, 3, 5, 6, 7 and 8.

W – Disqualified Child – Identifies a child disqualified for failure to comply with employment services or SSN requirements. Also identifies a minor parent certified as a child, who is disqualified for not cooperating with child support requirements. Use Code W only with Code 2.

X – Deceased – Identifies a deceased person. Use Code X with Codes 5, 6, 7 and 8. Enter the date of death in Item 47 when using Code X.

Y – Disqualified Second Parent — Identifies a legal parent who would be required to be included as a second parent but who is disqualified. Use Code Yonly with Code 2.

Z – Migrant — Identifies members of amigrant household. Use Code Z with all primary codes.

SNAP

Head of Household Codes

A — The head of household is a household member.

G — The head of household is a nonmember.

GK — The head of household is disqualified for areason other than an intentional program violation (IPV).

GT — The head of household is disqualified for an IPV.

Other Codes

B – Student — Identifies a member who is eligible to participate even though he is a student enrolled at least half time in a curriculum that requires a high school diploma or equivalent for entrance.

C – ABAWD not meeting the work requirement — Identifies an able-bodied adult without dependents (ABAWD) who is not meeting the 18-50 work requirement.

D – ABAWD meeting the work requirement — Identifies an ABAWD who is working 20 or more hours per week or is in a work program that meets the 18-50 work requirement.

F – Treatment Facility Residents — Identifies a

  • participating resident of an approved drug and alcohol treatment/group living arrangement facility; or
  • resident of a public institution who jointly applies for SSI and SNAP.

H – Eligible Refugee — Identifies a person identified as an eligible Amerasian, refugee, asylee, victim of severe trafficking, or Cuban/Haitian entrant by the U.S. Citizenship and Immigration Services (USCIS) on Form I-94 or other USCIS document. Continue using Code H until the individual has resided in the U.S. for five years. Note: If the Category is 8 and Aid Type is 5, all household members must be coded H.

K – Disqualified for a reason other than an IPV— Identifies a member who is disqualified for any reason other than an IPV. Even though this person is not eligible to receive SNAP, enter his biographical data.

M – Migrant, Out of Work Stream — Farm workers who travel to work in agriculture or a related industry during part of the year but who are presently residing at their permanent or home base.

R – HHSC Employee — Identifies a person who is currently an HHSC employee.

S – Eligible Alien — Identifies a noncitizen whose alien status allows him to receive SNAP. Use Code S with all primary codes. Note: Do not use this code for refugees.

T – Disqualified for Intentional Program Violation— Identifies a person who is disqualified for intentional program violation. This person is not eligible to receive SNAP; however, all biographical data, income, and expenses are entered. When using Code T, make an entry in Item 49, Disqualification Code and Date.

U – Seasonal Farm Worker — Farm workers who do not leave their permanent residence to work in agriculture or a related industry.

W – Migrant, in Work Stream — Farm workers who are presently employed away from their permanent residence or home base.

Medical Programs

Primary Codes

2 – Disqualified/Ineligible Child or Second Parent— Identifies a child or adult who is not eligible for Medicaid, but who is included in the budget group. Do not use SIG Code 2 for an ineligible person who is the case name. On GWS, the SIG labeled "Other Rel Spouse" also results in this SIG. The "Other Rel Spouse" label is used to identify the spouse of the "Caretaker/Other Rel." This individual is not eligible for Medicaid but is included in the budget group.

4 – Eligible child – Identifies a child who meets the Medicaid eligibility requirements for the current period and/or prior period or who would meet those requirements if still alive.

7 – Second Parent — Identifies either the

  • eligible spouse of a dependent child's natural or adoptive parent, or stepparent; or
  • second adult in an RMA case.

Do not use Code 7 for an SSI recipient, to identify the case name, for more than one member, or unless a caretaker is certified.

8 – Caretaker — Identifies the

  • eligible pregnant woman;
  • eligible caretaker in the home;
  • independent child who applied for himself, and, if applicable, his siblings; or
  • first adult or single adult in RMA cases.

Do not use Code 8 for an SSI recipient (see Code 9-Payee) or for more than one member.

On GWS, the SIG labels "Caretaker/Parent" and "Caretaker/Other Relative" result in this SIG if the individual is eligible for Medicaid on the case.

9 – Payee — Identifies the ineligible case name/payee only. Use SIG Code 9 when the person with the case name is not part of the budget group. Use this code when SSI recipients act as case names/payees.

0 – Case Name Only — Identifies the ineligible caretaker who is part of the budget group and is the case name. On GWS, the SIG labels"Caretaker/Parent" and "Caretaker/Other Rel" result in this SIG if the individual is not eligible for Medicaid on the case. Only one person per case may be coded 0.

Use SIG 0Y for legal parents who are disqualified for TPR, SSN or Child Support noncooperation. On GWS, the SIG label will remain "Caretaker/Parent."

Secondary Codes

E – Federally Recognized Tribe or Unaccompanied Refugee Minor(URM) — Identifies individuals who are either members of a federally recognized Indian tribe or a URM. These individuals are exempt from mandatory enrollment in Medicaid managed care.

H – Eligible Refugee — Identifies a person who is a refugee. Use Code H with all primary codes in Categories 1 through 5.

I – Ineligible Child – Identifies a child disqualified for Medical Program. Use Code I only with Code 2.

K – Child of a Minor Child – Identifies the child of a young mother who is also included in the budget group. Use Code K only with Code 4.

L – Minor Child with a Child of Her Own — Identifies a mother 18 years old or younger who has a child of her own in the same budget group. Use Code Lwith Codes 4, 7, 8 or 0.

M – Eligible Only for Three Months Prior Medical Assistance— Identifies a person who is eligible for medical assistance during any or all of the three months before the month of application, but who is not currently eligible for medical assistance. Use Code M with Codes 4, 7 or 8.

N – Ineligible for Retroactive Medical Assistance and Current Assistance — Identifies an ineligible member of the budget group who must be reported to certify a case for three months prior Medicaid coverage. Use this code for a member of the budget group who is ineligible for retroactive medical assistance and current assistance. Use Code N only with Code 2.

O – DSHS Child with Special Health Care Needs— Identifies a child who is exempt from mandatory enrollment in Medicaid managed care.

P – Private Health Insurance — Identifies acertified person who has private health insurance for hospitalization, accidental injury or sickness, other than Medicare or Medicaid benefits. Use Code P with Codes 2, 4, 7, 8 or 0.

Q – THSteps, Family Planning, or Other Service Needs— Identifies a Medicaid recipient, from birth through 18, who does not want THSteps or family planning services or who does not require assistance with other health or income-related needs. Use Code Q only on applications with Codes 4, 7 or 8.

R – HHSC Employee — Identifies a person who is an HHSC employee. Use Code R with all primary codes.

S – Alien with Acceptable Alien Status — Identifies a noncitizen whose alien status allows him to receive Medicaid. Use Code S with all primary codes. Note: Do not use this code for refugees (SIG H).

T – Ineligible Alien — Identifies anoncitizen whose alien status makes him ineligible for program benefits. Use Code T with Codes 2, 9 or 0.

U – No U.S. Citizenship Proof — Identifies aperson ineligible due to no proof of U.S. Citizenship. Use Code U with Codes O, 2I or 2Y.

V – Living in Nursing Home — Identifies aperson who is temporarily in a nursing home. Use Code V with Codes 4, 7 or 8.

W – Disqualified Child – Identifies a child disqualified for failure to comply with or SSN requirements, or a minor parent who is disqualified for not cooperating with child support requirements. Use Code W only with Code 2.

X – Deceased – Identifies a deceased person. If using Code X, enter the date of death in Item 47, Death/Denial Date. Use Code X with Codes 4, 7 or 8.

Y – Disqualified Caretaker or Second Parent— Identifies a legal parent who would be required to be included as a caretaker or second parent but who is disqualified for citizenship, TPR, SSN or Child Support noncooperation. Use Code Y only with Codes 2 and 0.

Z – Migrant — Identifies members of amigrant household. Use Code Z with all primary codes.

 

ITEM 41: (W)

TANF and SNAP

Enter an employment services code for each person listed in Item 33. The form will not process if this item is left blank.

If Form H1000-A, Form H1000-B or Form H1000-C is processed for ongoing benefits at application or complete review/recertification, SAVERR only allows a code in Item 41 that corresponds to the appropriate age, based on Item 34, Birthdate. Forms H1000-A (Form H1000-B for SNAP recertifications processed after cutoff of the last benefit month) are edited based on the date the form processes. Other Forms H1000-B are edited based on the form effective date.

For TANF, SAVERR has age edits for codes A and F.

For SNAP, SAVERR has age edits for codes 2, 3, 4, A, F, R, V and W. If Item 78, Type Review, is coded N or I, SAVERR only edits new entries in Item 41 for correctness.

TANF

Codes Explanation
A Child (SIG 5 or 5L).
B A caretaker or second parent, age 18 or younger attending school.
C Caring for an ill or disabled child in the household, even if the child is not a member of the certified group.
E Unable to work due to a disability expected to last more than 180 days.
F 60 years of age or older.
G Caring for a child (SIG 2, 3 or 5) under age 1. Do not use this code if another member is Code G or R.
H Presence required in the home because of illness or incapacity of another adult member of the household and the disability is expected to last more than 180 days.
J Not subject to participation – not a certified TANF individual. Use this code with SIG 3and 9, or with SIGs 0 or 2 who are disqualified for a reason other than ESP noncompliance.
K Pending during appeal of denial or disqualification. Use only for currently certified TANF individuals.
L County Hardship Exemption – Identifies an individual who has used the maximum number of TANF months allowed in the state time limit but who is certified for TANF because HHSC state office has designated the county as economically deprived.
M Mandatory registrant.
N Employment Hardship Exemptions – Identifies an individual who has used the maximum number of TANF months allowed in a state time limit but who is certified for TANF due to lack of employment.
P Mandatory registrant employed or self-employed 30 or more hours per week and earning at least$700 a month. Do not use this code if the individual qualifies for exemption codes A, B, F, G, R, C, J, N, Q, W or L.
Q Severe Personal Hardship Exemption – Identifies an individual who has used the maximum number of TANF months allowed in a state time limit but who is certified for TANF due to a disabling illness or injury of self or a close family member in the home.
R Caring for a child under age 1 who is not listed on Form H1000-A, Form H1000-B and Form H1000-C. Do not use this code if another member is coded G or R.
T Pregnant and unable to work.
U A single grandparent age 50 or over caring for a child under age three.
V An SSI recipient parent.
W Identifies an client who noncomplies with the Choices program. There must be financial penalty of F, S or T entered on Form H1000-C.
X A parent who has exhausted state time limits.
Y A parent who is disqualified due to third party resource (TPR) requirements, Social Security number requirements, intentional program violation, failure to report a child’s absence, being a fugitive, having a felony drug conviction, failure to cooperate with Quality Control or noncompliance with the unmarried minor parent domicile requirement.

SNAP

Codes Explanation
A Child age 16 years of age, or child age 16 or 17 who attends school at least half-time, or is not the head of household.
D Three to nine-months pregnant.
E Physically or mentally unfit for employment.
F 60 years of age or older.
G Caring for a child under age 6.
H Presence in home required for care of an incapacitated person.
J Person in drug addiction or alcoholic treatment and rehabilitation program.
N Receiving or applying for unemployment compensation.
P Employed or self-employed 30 hours or more a week.
Q Individual resides in a Choices county and is mandatory or has volunteered for TANF employment services.
R Registered again, after previously serving the E&T noncompliance penalty period.
S Student exemption (age 18 or older)/person in a training program.
T Disqualified household member (or nonmember head of household).
U Primary wage earner failed to comply with SNAP employment services.
2 Registered, employed less than 30 hours a week.
3 Registered, not working.
4 Registered, job attached (temporarily laid off).
5 Registration postponed, expedited service.

TP 40, TP 43, TP 44, TP 48 and TP 55

Enter a citizenship verification code for each person in the ceritified group who is a U.S. citizen. The codes specify what level of citizenship verification was used to verify citizenship, if an affidavit was used, or if good cause was allowed. When using an affidavit, a fourth level verification, enter 5 instead of 4. The levels of verification sources are found in A-358.1, Citizenship.

Codes Explanation
1 Primary level verification source used to verify citizenship
2 Level 2 verifcation source used to verify citizenship
3 Level 3 verifcation source used to verify citizenship
4 Level 4 verifcation source used to verify citizenship
5 Affidavit used to verify citizenship
6 Good cause allowed for citizenship verification

ITEMS 42 - 45:

All Programs

Enter income information in Items 42-45, 55 and 56 as appropriate for each individual listed in Item 33. Leave an item blank if the household does not have that type income.

TANF

Do not enter income for persons whose status-in-group is

3 – an SSI child,
9 – a payee, or
2I – an ineligible child.

Note: Enter the deductible amount of any diverted income in Item 58, Deductions, for any individual whose gross income is entered on Form H1000-A, Form H1000-B and Form H1000-C. No individual's deductions should exceed his income.

SNAP

For people disqualified for citizenship, 18-50 work requirement or SSN, enter the prorated amount of income attributed to the household.

Medical Programs

Enter income information for SIG Codes 2, 4, 7, 8 and 0. For TP 45 cases, make no entry in Items 42-44, 55 and 56.

ITEM 42A: Type Income

All Programs

Enter one of the following codes to indicate the type of income entered in Item 44.

A Veterans Affairs (VA) benefits
C Unemployment Insurance benefits
P Pension benefits (other than RSDI, SSI, VA or RR)
M Combination of unemployment benefits with benefits from a pension, VA, or both
W Combined income from VA and a pension

ITEM 42B: Gross Earned

All Programs

Enter the monthly amount of countable gross earned income and net self-employment income, up to seven numeric characters. Also make an entry in Item 118, and in Items 119-122, if appropriate.

ITEM 43: RSDI

All Programs

Enter the monthly amount of Social Security (RSDI) benefits for each person whose income is considered. Note: If you enter an amount in this item, you must also make an entry in Item 38.

ITEM 44: VA

All Programs

Enter the monthly amount of VA benefits, unemployment insurance benefits, pension, or any combination of these.

When entering an amount in Item 44, also make entries in Item 42A and Item 118.

ITEM 45: SSI

All Programs

SAVERR will print the active penalty codes for each individual on the Form H1000-A, Form H1000-B and Form H1000-C turnaround.

SNAP

Enter the monthly SSI benefit amount.

ITEM 46: Medical Effective Date

TANF and Medical Programs

Enter the beginning date of Medicaid coverage for each person certified for cash and/or medical coverage. Leave blank for status-in-group Codes 0, 2, or 9 and 3 for TANF.

There are many edits associated with the medical effective date. If the correct medical effective date cannot be entered, submit Form H1107, Request for Forced Change of Medical Coverage, to State Office Data Integrity (SODI) Section, SDX Eligibility Unit, State Office, Y-922.

If a recipient has previous medical coverage with HHSC, enter the nine-digit client number or Code 2 in Item 32, Client Number.

TP 55 and 30

For applications with spend down, enter the earliest possible Medicaid eligibility date (MED) for each SIG 4, 7 and 8.

TP 30

Enter the date the emergency conditions started. Use the date the practitioner entered on Form H3038, Emergency Medical Services Certification.

ITEM 47: Death/Denial Date

TANF and Medical Programs

If appropriate, enter the date of denial (always the last day of the month) or date of death(always the actual date of death) for each person.

The following situations require an entry for certified group members.

  • A case is released from hold to deny benefits. If the members of the certified group are not eligible for Medicaid benefits for the hold effective month, enter the last day of the month before the hold effective month.
  • A case is released from hold and an eligible individual's SIG is changed to an ineligible SIG.

If the case is active and the individual's status-in-group code is changed from eligible to ineligible, do not enter a date in Item 47.

If an active case is denied, this item shows the effective date of denial of Medicaid coverage for all individuals who have medical coverage.

TP 55 and 30

Edits for cases with spend down will not allow a date in this item that is later than the application month.

TP 30

Make an entry only for the certified member (open/close code 090).

ITEM 48: FS-Med Cost; PA-Refugee

TANF and Medical Programs

Enter the code that indicates Voluntary Resettlement Agency (VOLAG), nationality, and U.S. entry date for each refugee. The first digit is the VOLAG code, the second and third digits are the nationality code, and the fourth through seventh digits are the two-digit month and the last two digits of the year of U.S. entry.

Codes Voluntary Resettlement Agency (VOLAG)
0 Tolstoy Foundation or American Fund for Czechoslovak Refugees
1 YMCA
2 United States Catholic Conference (USCC)
3 Church World Services (CWS)
4 Lutheran Immigration Aid Society (LIRS)
5 Hebrew Immigrant Aid Society (HIAS)
6 International Rescue Committee (IRC)
7 World Relief Services
8 American Council for Nationalities Services (ACNS)
9 Persons Granted Asylum
Codes Nationality Codes Nationality
01 Cuban 17 Chinese
02 Cuban/Haitian Entrant 18 Chilean
03 Soviet Jew 19 El Salvadoran
04 Romanian 20 Brazilian
05 Hungarian 21 Colombian
06 Iranian 22 Palestinian
07 Iraqi/Kurd 23 East German
08 Afghan 24 Pakistani
09 Argentinean 25 Bulgarian
10 Nicaraguan 26 Yugoslavian
11 Ethiopian 27 Armenian
12 Somali 28 Turkish
13 Other African 29 Portuguese
14 Polish 30 Peruvian
15 Czechoslovakian 99 State office use only (do not enter)
16 Indochinese — Vietnamese, Cambodian, Laotian, Khmer, Hmong -

Example: An Indochinese resettled by World Relief Services who entered the U.S. in June 1979 is entered 7160679.

Note: Information recorded in Item 48 cannot be changed viaForm H1000-A, Form H1000-B and Form H1000-C. To change this item, send a memorandum requesting the change to State Office Data Integrity, Special Programs Support Unit, Y-922.

SNAP

Enter the total monthly amount of medical costs of each person who is eligible for the deduction. Allowable expenses of a person who is no longer a household member are entered on line "a" of this item and credited to the head of household. Do not reduce this amount by $35. If none, leave blank.

ITEM 49: Disq. Code and Date

SNAP

Only the State Office Claims Investigation Unit (SOCIU) can enter, change or authorize deletion of entries in this item. Use this item in active or denied SNAP cases if a member has been disqualified for an intentional program violation (also see Item 40). The entry must always be six full characters. Contact the SOCIU if changes must be made in this field.

The first character SOCIU enters is:

T administrative disqualifications for offenses that occurred prior to Sept. 22, 1996;
S administrative disqualifications for offenses that occurred on or after Sept. 22, 1996, or disqualifications for convictions due to trafficking;
C court-ordered disqualifications; or
M disqualifications due to receipt of multiple benefits in one month.

The second digit SOCIU enters is:

  • 1, 2 or 3 depending on whether this is the person's first, second, or third disqualification for intentional program violation (see B-912, IPV Disqualification Penalties, for lengths of penalties associated with each violation); or
  • 4 if the disqualification is a permanent disqualification for trafficking in SNAP benefits or program access devices of $500 or more.

The remaining characters SOCIU enters are:

  • the last month of the disqualification period entered in the MMYY format, or
  • PERM if the disqualification is permanent.

SOCIU enters the same information whether the case is active or denied, and the penalty period is the same regardless of case status.

Example: For an offense that occurred after Sept. 22, 1996, a person is disqualified for an intentional program violation through May 1999. This is the person's second disqualification. SOCIU enters "S20599" to show that the disqualification is his second and that he is disqualified through May 1999. If the disqualification is his third, SOCIU enters "S3PERM" to show the disqualification is permanent.

ITEM 50: Client Number Validation

All Programs

Enter the client number if validation of the number entered in Item 32 is required. See instructions for Item 32. Use the validation only if reassigning a client number or changing individual biographical information.

Warning Messages

All Programs

SAVERR prints warning codes if the last input document is incomplete, questionable or invalid. If the head of household has had a name change because of hierarchy, the old name is printed after any warning messages in Item 50. The following format is used for all error messages: AAABBCCC

AAA — Form item number 001-191; client items 32-50 will be shown A32-K32, through K50. When a client item is shown without line indicator, 032-050, then the comparison of all entries within that item caused the error.

BB — One of the following two-digit qualifiers:

EC – ERROR CODE NUMBER "CCC"
EQ – EQUAL
GE – GREATHER THAN OR EQUAL
GT – GREATHER THAN
LE – LESS THAN OR EQUAL
LT – LESS THAN
NA – NOT ALLOWABLE WITH THE ENTRY OR LACK OF ENTRY IN"CCC"
NE – NOT EQUAL

CCC — Form item number 001-191; or error code number 300-999; or one of the following "KEY" words:

ALP – ALPHABETIC
BLK – BLANK
CUR – CURRENT PROCESS MONTH
DAT – VALID DATE
FIL – VALUE ALREADY ON FILE
N-3 – today minus 3 months
N-6 – today minus 6 months
N12 – today minus 12 months
N24 – today minus 24 months
N45 – today minus 45 days
NAM – NAME FORMAT
NOW – PROCESS DATE OF FORM
NUM – NUMERIC
NXT – NEXT PROCESS MONTH
VAL – VALID

TANF

If at application or complete review the advisor assigns a ... SAVERR prints the message ...
three-month periodic review, "ERRPRONE."
12-month periodic review, "EXTENDRV."

 

C—520.4 Section IV, Items 51 - 59

Revision 08-4; Effective October 1, 2004

 

ITEM 51: Total Earned

All Programs

This computer-printed item is the sum of the entries in Column 42B, Gross Earned.

ITEM 52: Total RSDI

All Programs

This computer-printed item is the sum of the entries in Column 43, Retirement, Survivors, and Disability Insurance (RSDI).

ITEM 53: Total VA

All Programs

This computer-printed item is the sum of the entries in Column 44, VA.

ITEM 54: Total SSI

SNAP

This computer-printed item is the sum of the entries in Column 45, SSI.

ITEM 55: Total RR

All Programs

Enter the total monthly railroad retirement benefits for people whose income is considered. Include any railroad retirement benefits received by a person disqualified because of SSN or citizenship policy and attributed to the household. If none, leave blank.

ITEM 56: Other Income

All Programs

Enter the total monthly unearned income from all sources not included in other data boxes. If none, leave blank.

TANF

This may include applied income, countable child support, or alien sponsor's income.

SNAP

This includes the portion of other income of a disqualified person, or a sponsor's income, attributed to the household.

Medical Programs

This may include the TANF grant, total gross child support, and countable income from an alien'ssponsor.

ITEM 57: Total Income

All Programs

This computer-printed item is the sum of the entries in Items 51 through 56.

ITEM 58: Deductions

TANF

Enter the standard work related expense deductions for SIG 2W, 2Y, 5, 7, 8 and 0 members with earned income counted against recognized needs. The deductions cannot exceed the members' monthly earnings. Also enter any amounts diverted from the income of a:

  • caretaker,
  • disqualified legal parent (SIG 0), or
  • disqualified second parent (SIG 2Y).

If there are no deductions, leave blank.

Note: Do not enter child care expenses or the 90% earned income deduction in this item. See instructions for Items 149-152.

SNAP

Enter the household's total monthly dependent care costs, the amount of legally obligated child support paid to or for a nonhousehold member and the remaining farm loss.

Medical Programs

Enter income deductions for everyone whose income is considered in the case, including ineligible people. Enter work-related expenses, child support disregard and any diversions for everyone. If there are no deductions, leave blank. Note: Do not include child care expenses (seeinstructions for Items 149-152).

ITEM 59: Adjusted Gross Income

All Programs

Enter the adjusted gross income. Enter 0 if there is no adjusted gross income.

TANF

The total case income, minus Item 58 equals Item 59, unless child care costs are entered in Item 152 or the automated 90% earned income deductions is used. For these exceptions, the total income minus Items 58, and 152 (child care and 90% earned income deduction amounts) equals Item 59.

Medical Programs

The total case income minus Items 58 and 152 (child care) must equal Item 59.

 

C—520.5 Section V, Items 60 - 77B

Revision 05-4; Effective August 1, 2005

 

ITEM 60: Shelter

SNAP

Enter the total amount of the household's monthly shelter costs. Enter zero, if there are no shelter expenses. Coordinate this item with Item 90, Utility Standard Code.

ITEM 61: Adj Gross Income

SNAP

Computer printed on Form H1000-B and Form H1000-C. Make no entry.

ITEM 62: Excess Shelter

SNAP

Computer printed on Form H1000-B and Form H1000-C. Make no entry.

ITEM 63: Net Income

SNAP

Enter the household's rounded net income. Enter zero, if there is no net income.

ITEM 64: Blank

ITEM 65: Benefits

SNAP

Computer printed on Form H1000-B and Form H1000-C. Make no entry.

ITEM 66: Total Needs

TANF

Enter the total budgetary needs figure for all members of the TANF group. Enter a new figure each time the certified group size changes.

Medical Programs

Type Program Enter on Form H1000-A
40 185% Federal Poverty Income Limit (FPIL).
43 185% FPIL.
44 100% FPIL.
45 Leave Blank.
47 TANF budgetary needs (100%) allowance figure for all members of the budget group.
48 133% FPIL.
55 Medically Needy Income Limits for all members of the budget group.
For TP 30 cases, if Item 137 has an entry of: Enter
40 185% FPIL
43 185% FPIL
44 100% FPIL
48 133% FPIL
55 Medically Needy Income Limits

Enter a new figure on Form H1000-B and Form H1000-C each time the household size changes. Item 66 must agree with Items 40, 125, and 126.

ITEM 67/67A: Recog/Max (Recognizable Needs/Maximum Grant)

TANF and Medical Programs

These figures are computer printed. There is no 67A entry for Medical Programs.

ITEM 68/68A: AGI (Adjusted Gross Income)

TANF and Medical Programs

These figures are computer printed. Item 68 equals the entry in Item 59. For TANF, Item 68A is the rounded down figure of Item 68. There is no Item 68A entry for Medical Programs.

ITEM 69: Unmet

TANF and Medical Programs

This figure is computer printed and is the balance of Item 68 subtracted from Item 67.

TANF

This item shows an unmet need of

  • at least one cent for active TP 01, 11, and 61 cases; and
  • zero cents for TP 07 and 37 cases.

Medical Programs

For ... this item ...
TP 40, 43, 44, 47, and 48 cases, shows an unmet need of at least one cent.
TP 55 and 30 cases that are not subject to spend down, shows an amount greater than or equal to zero will be shown.
TP 55 and 30 cases that are subject to spend down, shows a negative amount, which represents the monthly spend down.
TP 45 will be blank

ITEM 70: Recommended Grant Amount

TANF

This figure is computer printed and is the balance of Item 68A subtracted from Item 67A. The minimum grant of $10 is printed in Item 70 if the balance is less than $10. This item indicates benefit amount, less recoupment, if applicable. This amount is printed only for TP 01 and 61 cases.

Medical Programs

This item is computer printed. SAVERR prints a spend down amount in Item 70 if the amount in Item 69 is a negative amount. Otherwise, Item 70 will be blank.

ITEM 71 - 77-B: MAO Only

Make no entry.

 

C—520.6 Section VI, Items 78 - 110

Revision 10-2; Effective April 1, 2010

 

SNAP

Items 78, 83, 84, and 90 cannot be deleted, but may be updated. Items 86, 87, 88, 89, and 93 may be deleted with a pound sign.

ITEM 78: TR (Type Review)

SNAP

Make no entry on Form H1000-A, Notice of Case Action. SAVERR returnsForm H1000-B, Record of Case Action, and Form H1000-C, Secondary Client Input, sequence 02 with Code C. Enter one of the following codes on later Form H1000-B and Form H1000-C:

C — Complete review

I — Incomplete review

N — Non-review activity (case maintenance)

State Office Review Codes

M — SNAP "end-of-month" conversion

O — SNAP conversion that occurs at September cutoff effective October (Example: SNAP allotment conversion)

1 — SNAP annual RSDI/SSI conversion

ITEM 79: App. Codes (Application Codes)

SNAP

Enter the three-digit code from the list below that describes the type of application, the referral, and the number of months since the previous application or certification period.

The first digit is the type application:

1 — Eligibility Determination – individuals who are not currently certified or individuals submitting untimely reapplications.

2 — Redetermination (Reapplication) – individuals submitting timely applications for continued benefits.

3 — Application reopened after denial using the same Form H1010-B.

The second digit is always "X."

The third digit is

0 — All initial applications, reapplications within 30 days from previous application, or later applications within 30 days after the end of the previous certification period.

1-8 — For one month, enter 1, for two months, enter 2, etc.

9 — Nine months or longer.

ITEM 80: Certification Date

SNAP

Enter the month, day, and year the certification period begins. The day is always 01, even if the whole allotment is prorated.

ITEM 81: MOS. CERT. (Months Certified)

SNAP

Enter the number of months of the certification period. This must be a two-digit number.

ITEM 82: Last ATP Date (Last Benefit Month)

SNAP

Enter the month and year that the individual receives his last benefits for the current certification period. This must correspond to Items 80 and 81.

ITEM 83: HH NO. (Household Number)

SNAP

Enter the number of certified persons in the household. This is the same as the number of eligible persons listed in Section II. Do not include status-in-group Codes G, K, or T. This must be a two-digit number.

ITEM 84: AID (Aid Type)

SNAP

Enter the code that refers to the type of SNAP case.

1 — NPA only. No members receive TANF. (Category 9)

2 — NPA mixed. Some members receive TANF or RCA and others do not. (Category 9)

3 — PA. All members receive TANF or some receive SSI and other others receive TANF. (Category 6)

5 — All members are refugees, other than Cubans or Haitians, receiving TANF or RCA. (Category 8)

ITEM 85: Test

SNAP

Enter a code to indicate the household's categorical eligibility/income test/shelter deduction..

B — Gross and net income tests and capped shelter deduction.

C — Categorically eligible household with capped shelter deduction.

E — Gross and net income test and uncapped shelter deduction. Use this code only if the member who is entitled to uncapped shelter costs is disqualified for intentional program violation.

M — Net test only, uncapped shelter deduction.

T — Categorically eligible household with uncapped shelter deduction.

SNAP-CAP

S — Supplemental Nutrition Assistance Program Combined Application Project (SNAP-CAP), entered by Centralized Benefits Services.

ITEM 86: PR (Intentional Program Violation Referral)

SNAP

Make no entry. A "Y" is printed during OIG's investigation to prevent the case from being purged.

ITEM 87: NON (Non H/H Members)

SNAP

Enter the code that identifies the non-participating or non-household member(s).

A — Attendant

B — Boarders

C — Ineligible alien

D — Ineligible student

E — Any combination of two or more of A, B, C, or D

If an attendant, boarder, or roomer is an ineligible alien, code him here and in Item 88.

ITEM 88: INELIG. (Ineligible)

SNAP

Enter the total number of persons living in the SNAP household who are not eligible for participation because they are ineligible aliens.

ITEM 89: SSI

SNAP

Advisors enter an "X" if every household member receives SSI. If one or more household members do not receive SSI, leave blank.

SAVERR enters an "A" when a case transfers to Centralized Benefits Services (CBS). CBS enters an"R" when transferring a case to the field.

ITEM 90: UTIL (Utility Expense Code)

SNAP

Enter the appropriate code to describe utility and telephone costs.

Code Description
1 Household claiming the Standard Utility Allowance.
2 Household claiming the telephone standard only.
4 Household without utility costs.
8 Households claiming the homeless shelter standard.
9 Households claiming the homeless shelter standard with one member who is disqualified for not meeting citizenship, 18-50 work and/or SSN requirements.
A Households claiming the Basic Utility Allowance.

Do not prorate the utility and telephone standards for households with disqualified members or households sharing expenses.

ITEM 91: Action Code

SNAP

Enter the appropriate denial code. Leave blank unless the case is denied or is opened and closed on the same document. If an entry is made in Item 91, the advisor must also make an entry in Item 92. See C-221, Denial Codes, for denial codes.

ITEM 92: Action Date

SNAP

Enter the effective date of denial. If denying an application, enter the date you determine the case is ineligible. If the application is opened and closed or an active case is denied, enter the last day of the last month in which the household receives its final benefits. When making an entry in Item 92, also make an entry in Item 91.

ITEM 93: Texas Driver's License Number

SNAP

Enter the head of household's Texas driver's license number or Texas Department of Public Safety(DPS) ID number. If the head of household does not have a Texas driver's license or DPS ID, leave blank. Enter a leading zero for seven-digit license numbers.

ITEM 94: Reserved

ITEM 95: Code/Hold Date

SNAP

Enter the appropriate hold or release code under CD. Make no entry under DATE. SAVERR enters the month after cutoff as the hold effective month.

Hold Benefits

Advisor Hold Code

2 — Use to prevent SAVERR from issuing the next month's benefits. The hold is effective the first of the next SAVERR process month. Use code 2 when

  • a change must be made effective the next month and the notice of adverse action expires between cutoff and the end of the month;
  • an individual cannot be located;
     
  • the second or subsequent month's benefits must be held because of expedited certification pending verification; or
  • a household member receives benefits pending receipt of a social security number.

Note: Entry of Code 2 does not prevent entry of information in other sections, including Section XI, to cancel benefits or issue benefits for the current processing month.

State Office Hold Codes:

A — Form H1000-B, submitted to deny a case, contains afatal error that is not cleared by cutoff. The case remains on hold until the erroneous Form H1000-B is corrected and processed.

Z — The EBT account is dormant because the household has not accessed benefits for three consecutive months or six consecutive months when the most recent monthly issuance is less than$20.

Release Codes

O — Releases benefits effective the first of the next SAVERR process month. Release any held benefits, as necessary, by completing Section XI. Note: In case actions involving a hold Code A, enter a release code only if the case will not be denied.

ITEM 96: (Late Determination/Rescheduled Appointment Date)

SNAP

Make an entry if

  • someone files an application, untimely reapplication or a timely application for a recertification, misses the first appointment, and schedules a subsequent appointment. Enter the date (mmddyy) of the latest appointment.
  • expedited benefits are delayed because of a late determination caused by the applicant. Enter the date (mmddyy) that all the following have been completed:
    • Form H1010-B, Application for Assistance - Part B: Information We Need to Know, completed and signed,
    • individual or authorized representative interviewed, and
    • identification verified.

SSI/SNAP Prerelease Joint Application

If SSA does not notify HHSC of an individual's release until after the actual release date, enter the date (mmddyy) of notification.

ITEM 97: PASS Account Amount

SNAP

Enter PASS account amount.

ITEM 98A/B: Verification Requested/Received

SNAP

Make an entry in this item when:

  • processing a timely recertification,
  • the individual missed the first appointment,
  • verification can be requested up to the 15th day of the month following the last benefit month, and
  • Form H1020, Request for Information or Action, due date is after the last benefit month.

Use 98A to enter the date (mmddyyyy) the verification is requested.

Use 98B to enter the date (mmddyyyy) the verification is received. If no verification is received, do not enter a date.

The paper Form H1000-A, Notice of Application, Form H1000-B, Record of Case Action, orForm H1000-C, Secondary Client Input, does not correctly reflect the two separate items; however, advisors are able to enter both dates in Item 98.

Example: Item 98 09252000 10052000

ITEM 99: Ineligible Month/Combined Allotments

SNAP

Enter the appropriate code if the household is ineligible for the month of application or the second month.

1 — No benefit issued for month of application due to proration, but eligible for the second month as a combined allotment.

2 — Eligible for month of application but ineligible for the second month.

ITEM 100: PASS Account Code

SNAP

Enter the appropriate PASS account code.

E — Exempt from earned income

U — Exempt from unearned income

ITEM 101: (Prepared Meals Services Code)

SNAP

Enter the appropriate code to identify a household that qualifies to use SNAP benefits to purchase prepared meals from one of the following authorized meal providers:

C — SSI/elderly member authorized to purchase from communal dining facilities, meal delivery service, or contracted restaurant.

E — Homeless and either elderly or SSI recipient; authorized to purchase from every service(communal dining, meal delivery services, or homeless meal providers/contracted restaurants).

H — Authorized to purchase from homeless meal providers/contracted restaurants.

M — Household/disabled member authorized to purchase from meal delivery services.

ITEM 102: Reserved

ITEM 103: (Special Review Date)

SNAP

Enter the month and year for the special review (Example: 08-96).

ITEM 104: (Special Review Code)

SNAP

Enter the appropriate code to show the type of special review needed.

0 — State office assigned

1 — Employment Services/Work Registration

2 — School Attendance

3 — Reserved

4 — Management

5 — Income/Expense changes anticipated

6 — Living arrangement change anticipated

7 — Medical review

8 — Household change anticipated

9 — Other

To delete Items 103 and 104, enter pound (#) in 104.

ITEM 105 - 110: Reserved

 

C—520.7 Section VII, Items 111 - 126

Revision 02-6; Effective July 1, 2002

ITEM 111: Reserved

ITEM 112: First Case Number

All Programs

Enter the associated TANF, SNAP or Medical Programs case number.

ITEM 113: Second Case Number

All Programs

If Item 112 has an entry and there is another associated case, enter the second case number in Item 113.

ITEMS 114 - 117: Reserved

ITEMS 118 - 122

All Programs

State office uses Items 118-122 to determine discrepancies between income reported to the advisor and income reported by other agencies for the same person. Complete Items 119-122 when the earned income for a former month is not the same as the earned income entered in Item 42B for the ongoing budget.Note: Do not report unearned income that differs from entries in Item 44. If entries are made in Items 119-122 for TP 30 or 55 cases, make appropriate entries in Section XI for the Spend Down history file.

ITEM 118: Mo. Earned (Month Income Is Received)

All Programs

Make an entry in Item 118 only when making or changing an entry in Item 42-B or 44.

Enter a two-digit number to identify the earliest month of certification in which the amounts entered in Items 42B and 44 were received Example: If certification date is May 1, the ongoing budget is effective June 1, and income for May is the same as June, then enter "05."

Note: If zero is entered on Form H1000-B, Items 42B or 44, because income currently shown in these items terminates, enter the two-digit number to identify the first month the income was not received.

ITEM 119: First Budget Mo.

All Programs

Make a two-digit entry to identify the first month earned income was different than the current earned income entered in Item 42B. Make this entry even if earned income for this month totals zero.

ITEM 120: Earned Income First Month

All Programs

Enter the total amount of countable gross earnings for the household that corresponds to the month entered in Item 119. Make an entry even if the earned income for this month totals zero.

Exception: Enter the total amount of a disqualified person'searnings, even if budgeting only a prorated amount of his income.

ITEM 121: Earned Income Second Month

All Programs

Enter the total amount of countable gross earnings for all household members corresponding to the month entered in Item 122. Make an entry even if the earned income for this month totals zero.

Exception: Enter the total amount of a disqualified person'searnings, even if budgeting only a prorated amount of his income.

ITEM 122: Second Budget Mo.

All Programs

Enter the two-digit number to identify the second month in which total earned income received is different from the total of the amounts entered in Item 42-B. Make an entry even if the earned income for this month totals zero.

ITEM 123: Face-to-Face for HCO

TP 43, TP 44, TP 47 and TP 48

SAVERR enters code "N" for a caretaker required to have a Health Care Orientation (HCO). Acaretaker who does not comply with the HCO requirement must have a face-to-face interview to renew Medicaid eligibility for the child. When a caretaker has a face-to-face interview to clear non-compliance, enter code "F" in Item 123.

ITEM 124: Reserved

ITEM 125: (Adults)

Medical Programs

Enter the number of adults included in the budget group. Include a minor parent who is SIG 0 on aTP 47 case. Make no entry for TP 45.

ITEM 126: (Children)

Medical Programs

Enter the number of children included in the budget group. Make no entry for TP 45. Include the unborn child in this entry for

  • TP 40 cases; and
  • TP 43, 44, 47, 48, 30, and 55 cases with "01" entries in Item 128 (B.P.).

Entries in Items 125 and 126 must agree with Item 66.

 

C—520.8 Section VIII, Items 127 - 152

Revision 10-3; Effective July 1, 2010

 

TANF and Medical Programs

Section VIII shows case information for TANF, foster care, Refugee Cash Assistance (RCA), and medical programs cases.

ITEM 127: T.P. (Type Program)

TANF

Enter the appropriate code to identify the type program for certifications and denials.

01 — Cash and medical assistance.

04 — Medical Assistance Only - Deceased – Medical assistance only because the applicant(s) dies after the date of application but before certification. Do not use this type program if surviving applicants are eligible to receive cash assistance.

07 — Medical Assistance Only - 12 or 18 Months – TANF or refugee cases that are denied cash assistance because of increased earnings, but are eligible for Medicaid coverage for 12 or 18 months after the last month of TANF eligibility.

11 — Medical Assistance Only - Three Months Prior, not currently eligible or a gap in coverage– TANF individuals eligible for three months prior medical assistance, but who are ineligible in the month of application and later months, or have a gap in coverage.

20 — Medical Assistance Only - Child Support – TANF cases that are denied cash assistance because of child support, but are eligible for Medicaid for four additional months.

29 — Medical Assistance Only – 12 or 18 months post Medicaid following the end of TANF state time limit.

37 — Medical Assistance Only - 12 or 18 Months – TANF cases that are denied cash assistance because of the loss of the 90% earned income deduction, but are eligible for Medicaid coverage for 12 or 18 consecutive months after the last month of TANF eligibility.

61 — TANF-SP cash and medical assistance.

71 — OTTANF – One parent household is eligible to receive OTTANF benefits.

72 — OTTANF – Two parent household is eligible to receive OTTANF benefits.

Note: To change the type program and case name, two transactions must be processed.

Category 05 is the RCA program. TP 08, 09, and 10 are foster care programs.

Medical Programs

Enter the appropriate code to identify the type medical program for certifications and denials.

40 — Pregnant woman

43 — Children under age one

44 — Children age six through 18

45 — Newborn children

47 — Dependent children ineligible for TANF because of applied income

48 — Children ages one through five

55 — Medically Needy (with or without spend down)

30 — Nonimmigrants and undocumented aliens

ITEM 128: B.P. (Base Plan)

Medical Programs except TP 40

Enter 01 to identify cases with a pregnant woman in the budget group.

ITEM 129: Grant Eff. Date

TANF

Enter the first day of the earliest month and year the individual is eligible for and is authorized to receive benefits in the same amount as shown in the ongoing budget. Use this item to authorize benefits for the current and previous months.

ITEM 130: RSDI Increase Reserved

ITEM 131: T.R. (Type Review)

TANF and Medical Programs

Enter one of the following codes on Form H1000-A, Form H1000-B and Form H1000-C.

C — Complete

I — Incomplete

N — Nonreview activity (case maintenance)

ITEM 132: Action Code

TANF and Medical Programs

Enter the code that describes the reason for the action taken on the case. See C-200 for Item 132 codes.

ITEM 133: 3 MO. I (Three Months Prior Indicator)

TANF and Medical Programs

Enter the total number of unduplicated calendar months of three months prior Medicaid eligibility. Not applicable for TP 45.

ITEM 134: 3 MOS. PRIOR APP. DATE (Three Months Prior Application Date)

TANF and Medical Programs

When providing prior coverage enter the month and year of the original file date. This date cannot be later than the medical effective date (Item 46) by more than three calendar months. Not applicable for TP 45.

TANF

Use Form H1000-B and Form H1000-C when the requested medical effective date (Item 46) is within six months of the current process month.

ITEM 135: Reserved

ITEM 136: 4 MOS. POST/End Date

TANF

Enter the last month and year for TP 07/20 Medicaid coverage.

TP 40

Enter the second month and year following the expected delivery date.

TP 45

State Office Data Control enters the last month of forced coverage.

TP 43, TP 44, TP 47 and TP 48

Make no entry. This is a computer-calculated end date. If a one or two-month Medicaid extension is needed, update the end date for two months or less in this item, and enter "I" in Item 131.

ITEM 137: SAV (Budget TP)

TP 30

Enter the Budget TP indicator used to determine income eligibility. This is a required entry when processing three months prior or simultaneous open and close situations. Do not make an entry when processing denials.

Enter For cases that include a
40 pregnant woman who meets the 185% FPIL income criteria.
43 child under age one who meets the 185% FPIL income criteria.
48 child age one through five who meets the 133% FPIL income criteria.
44 child age six through 18 who meets the 100% FPIL income criteria.
55 caretaker/second parent who meets MNIL income criteria.

If the income exceeds the limits and the case is eligible based on TP 55 income criteria with spenddown, enter 55.

ITEM 138: (Child Support Cooperation/Reason for Transfer to TP 07/20)

Enter the appropriate code to indicate child support cooperation or noncooperation.

R — Refusal without good cause to cooperate with child support for one or more absent parents.

C — Cooperation. Enter this code if Code R does not apply.

T — No proration when reinstating TANF after PRA cooperation.

Enter Code If the case transfers to TP 07/20 because ...
E of new or increased earned income or earnings of a returning absent parent who is added to the certified group.
S of new or increased child support collections.
B TANF denial results from a reason listed under Code E, and new or increased child support collections.
P of PRA noncooperation.

ITEM 139: SPECIAL REVIEW

TANF and Medical Programs (except TP 40, TP 30 and TP 55 with Spend Down)

Enter the date of any contact planned before the date of the next periodic review, or the end of the budget period. For cases with a pregnant woman, enter the first day of the month following the month the pregnancy is anticipated to terminate.

ITEM 140: CODE

TANF and Medical Programs (except TP 40, TP 30 and TP 55 with Spend Down)

Enter the code for the type of special review needed.

1 — Employment Services/Work Registration (TANF only)

2 — School attendance

3 — (Reserved)

4 — Management

5 — Income/Expense changes anticipated

6 — Living arrangement change anticipated

7 — Medical review

8 — Household change anticipated. Note: Use to designate a review for cases with a pregnant woman

9 — Other

Q — Disability Hardship Exemption (TANF only)

To delete a special review date in Item 139, enter a pound sign in Item 140. This entry deletes the information in Items 139 and 140.

ITEM 141: PERIODIC REVIEW

TANF and TP 07, TP 20, TP 37 and TP 55 without Spend Down

Make no entry. This is a computer calculated and printed date of the next periodic review date. If incorrect, enter a new periodic review date in this item and "N" in Item 131.

TP 43, TP 44, TP 47 and TP 48

Make no entry. This is a computer-calculated date that reflects the next required periodic review. If the date is incorrect, enter a periodic review date in this item and "N" in item 131.

ITEM 142: HOLD CD: DATE

TANF and Medical Programs

Enter the appropriate hold or release code under CD. Make no entry under DATE. SAVERR enters the month after cutoff as the hold effective month.

Hold/Release Codes

Advisor

Hold Code 1

Use when the advisor cannot locate the individual and an investigation of the individual's location is pending. This code automatically denies the grant and Medicaid at cutoff of the hold month effective the first day of the hold month. Fiscal cancels any returned warrants and SODI cancels returned Form H3087, Medicaid Identification.

Release: Use Code 8 if the household does not have a new address. Use Code 9 if the household has a new address. Enter the new address on Form H1000-B.

Hold Code 2

Use when appointment of guardian is pending. SAVERR does not produce TANF benefits and Form H3087 until the advisor submits Form H1000-B releasing the hold.

Release: 9 – Enter the name of the guardian on Form H1000-B.

Hold Code 3

Use if changing the payee. SAVERR does not produce TANF benefits and Form H3087 until the advisor submits Form H1000-B releasing the hold.

Release: 0 – Enter the new payee information and complete Section XI on Form H1000-B to issue benefits for hold months.

Hold Code 4

Use when lowering benefits and the adverse action notice period expires between cutoff and the end of the month. SAVERR does not produce TANF benefits and Form H3087 until the advisor submits Form H1000-B releasing the hold.

Release: 0 – Use to release the hold after the adverse action expires. Enter the new budget and/or household composition and complete Section XI on Form H1000-Bto issue benefits for hold months.

Hold Code 5

Use when denying a case or transferring a case to TP 07 or TP 20 and Form H1000-B cannot be submitted because the adverse action period expires between cutoff and the end of the month.

When denying a case, SAVERR does not issue TANF benefits or Form H3087. SAVERR automatically denies the benefit and Medicaid at cutoff of the hold month effective the first day of that month. Fiscal cancels returned warrants and Data Control cancels returned Form H3087.

SAVERR automatically transfers a TP 01 case to TP 07 or TP 20 effective the first day of the next month. SAVERR produces Form H3087 when a case pending transfer is placed on Hold Code 5.

Release: Use Code 8 if the household does not have a new address, responds during the adverse action period, and qualifies for continued benefits. Use Code 9 if the household has a new address, responds during the adverse action period, and qualifies for continued benefits. Enter the new address on Form H1000-B.

State Office Use Only:

Computer-generated Codes

Hold Code A

Form H1000-B submitted to deny a case contains a fatal error not cleared by cutoff. The case remains on hold until the fataled Form H1000-B is corrected and processed. When the form is corrected and the case is denied, enter the correct Death/Denial Date in Item 47.

Release: Use Codes 8, 9 or 0 if the case is not denied.

Data Control Codes

Hold Code C

Form H3087 is returned with postal message: individual moved out of state. State office sends the advisor an RP-24B and sends the individual Form H1029, Notice of Case Action. Automatic denial of the grant occurs at cutoff of the hold month, effective the first day of the hold month. Automatic denial of Medicaid occurs effective the last day of the month before the hold. Apply this hold only when the message on the returned form H3087 indicates the individual has moved out of state.

Release: Use same release procedures described for Hold Code 1.

Hold Code D

Form H3087 is returned with postal message: deceased. State office sends the advisor RP-24B and holds returned warrants and Form H3087 until the advisor takes action to deny assistance or select a new payee.

Release: Use same release procedures described for advisor Hold Code 3.

Hold Code E

RESERVED

Formerly used when Form H3087 returned with postal message: unclaimed.

TANF

Advisor Codes

Hold Code 2

Use when appointment of a guardian is pending. SAVERR does not produce TANF benefits and Form H3087 until the advisor submits Form H1000-B releasing the hold.

Release: 9 – Enter the name of the guardian on Form H1000-B.

Hold Code 4

Use when lowering benefits and the adverse action notice period expires between cutoff and the end of the month. SAVERR does not produce TANF benefits and Form H3087 until the advisor submits Form H1000-Breleasing the hold.

Release: 0 – Use to release the hold after the adverse action period expires. Enter the new budget and/or household composition and complete Section XI on Form H1000-B to issue benefits for hold months.

State Office Use Only:

Computer-generated Codes

Hold Code 3

At least one refugee in a Category 05 case entered the United States more than eight months ago.

State office sends the advisor a RP-24B and holds warrants and Form H3087 until the advisor takes action to deny the case or delete the person(s) over the eight-month limit.

Release: 0 – Release benefits when deleting all people over the eight-month limit. Deny the case if all members are over the eight-month limit.

Hold Code 6

Case is automatically being denied or transferred to TP 20 because of receipt of child support.

Release: 0 – Use to release and make required entries in Section XI.

Hold Code H

Status-in-group Code 5 individual is age 19 or older. The effect is the same as Hold Code C.

Release: The release procedures are the same as Hold Code 1.

Hold Code L

Individual's state time limit is expiring and SAVERR cannot rebudget the TANF case. Advisor action to rebudget the case is required.

Release: 0 – Release hold and make required budget and Section XI entries.

Hold Code Z

The EBT account is dormant because the household has not accessed it for three consecutive months or six consecutive months when the most recent monthly issuance is less than $20.

Release: The release procedures are the same as Hold Code 1.

Fiscal Codes

Hold Code F

Warrant returned as undeliverable. The effect is the same as Hold Code C.

Release: The release procedures are the same as Hold Code 1.

Hold Code G

Warrant returned with message: deceased. The effect is the same as Hold Code D.

Release: The release procedures as the same as for advisor Hold Code 3.

Hold Code J

Warrant charged back.

Release: Hold is released only by Fiscal Division.

Data Control Codes

Code R

SDX Hold

SDX Release Codes

Code S

Mail benefits using address on SDX.

Code T

Denied

Code X

Deceased

Medical Programs

Advisor Codes

Hold Code 4

Pending assignment of protective payee.

Release: 0 – Release hold and enter protective payee information.

State Office Use Only

Computer-generated Codes

Code 3

Occurs at cutoff in the month:

  • a SIG Code 4 child on a TP 44 case becomes age 19, and each following month until the advisor denies TP 44 coverage for the child;
  • a SIG Code 4 child on a TP 47 or 55 case becomes age 19; or
  • the corresponding case for the mother of the TP 45 child is placed on hold.

Release: Use Code 0.

TP 40

State Office Use Only

Computer-generated Codes

Code H

Occurs at cutoff in the month entered in Item 136. If the advisor does not take action, automatic denial will occur at the cutoff in the following month.

ITEM 143: F. ACT (Future Action)

TANF and Medical Programs

Enter the appropriate action code if placing the case on hold with Code 5.

ITEM 144 - 148: Reserved

ITEM 149: CODE

TANF and Medical Programs

Use on earned income cases only. Enter C for a child care deduction. This entry requires an entry on the same line in Item 152.

To delete this entry, enter "C" in Item 149 and 0 in Item 152 on the appropriate line.

TANF

Enter 9 for

  • a 90% earned income deduction up to $1400 per employed member. This entry requires entries on the same line in Items 151 and 152.
  • 12 or 18 months additional Medicaid coverage. This entry requires an entry on the same line in Item 151.

ITEM 150: FROM Reserved

ITEM 151: THRU

TANF

Enter the last month of the four-month period of the 90% earned income deduction on the line with Code 9. This also contains the TP 37 end date.

ITEM 152: AMOUNT

TANF and Medical Programs

Enter the last month of the four-month period of the 90% earned income deduction on the line with Code 9. This also contains the TP 37 end date.

TANF

Enter the allowable amount of actual child care costs on the Code C line.

SNAP

Complete only for cases in which an individual receives or anticipates receiving a TANF child support disregard payment from the Office of the Attorney General (OAG). Enter an amount anytime you

  • certify these cases for ongoing benefits, or
  • make a change to Form H1000-B that will affect the budget, including disqualifications, changes in household composition, or shelter costs.

Enter six numbers indicating the amount of child support received from the OAG to be budgeted.(Example: $25 as 002500.) Enter 000000 if payments were previously reported and have now terminated.

These entries are no longer required if, for the two previous months, the OAG has not reported payments to the individual.

Always enter an amount in Item 56 if you enter an amount in this item.

 

C—520.9 Section IX, Items 153 - 160

Revision 02-3; Effective April 1, 2002

 

ITEM 153 - 160

All Programs

Make no entries in these items.

 

C—520.10 Section X, Items 161 - 178

Revision 02-3; Effective April 1, 2002

CC (Case Classification)

All Programs

The codes in Section X are not stored in the computer file. They are kept for individual transactions only and are used to complete management reports.

ITEM 161 - 163: Reserved

ITEM 164: Case County/Home Telephone No.

All Programs

Enter the three-digit code for the individual's residence county, followed by a space. After the space, enter the individual's ten-digit telephone number, including the area code.

Notes:

  • See C-350 for the county codes.
  • Enter the county associated with the worker's BJN in Item 25.
  • Enter only the individual's home telephone number. If the individual has no home telephone number, leave blank.

ITEM 165 - 167: Reserved

ITEM 168 - 170: Program Combination Code(s)

All Programs

Use program codes to indicate whether the case action associated with the Form H1000-A, Form H1000-B and Form H1000-C is worked alone or generically with other programs.

PROGRAMS PROGRAM CODE
TANF only A
TANF-SP only U
FS only F
MP only M
TANF/FS AF
TANF-SP/FS UF
FS/MP FM
TANF/MP AM
TANF-SP/MP UM
TANF/FS/MP AFM
TANF-SP/FS/MP UFM

ITEMS 171 - 178: Reserved

 

C—520.11 Section XI, Items 179 - 187

Revision 04-3; Effective April 1, 2004

 

TANF

Use this section instead of Form H1008, Authorization for Cancellation or Issuance of Public Assistance Warrants, to request benefits in situations described in the instructions for Item 180. Use Form H1008 to process all other requests for warrant actions. Use this section only for Category 2, TP 01 or 61 cases, or cases being transferred to TP 01 or 61.

Recoupment cannot be done on a benefit requested in Section XI.

SNAP

Use this section to request the issuance and cancellation of benefits.

When reporting a SAVERR or ATA issuance timely on Form H1000-A, Form H1000-B andForm H1000-C, complete Items 118-122 (if appropriate), 179, 180, 183, 184, 185, 186 (if appropriate), and 187.

When reporting an ATA issuance untimely, complete Items 118-122 (if appropriate), 179, 180, 181, 182, 183, 184, 185, 186 (if appropriate), and 187.

TP 55 and 30

Use this section on Form H1000-A with Item 46 to identify any eligible (non-spend down) or potentially eligible (spend down) prior coverage month(s). Use one line for each prior month. Use this section only for consecutive months, with or without spend down. A separate Form H1000-A will be required for any prior coverage months followed by a gap in eligibility. For this section, months with spend down are not considered gaps in eligibility.

Entries in this section for prior coverage cannot precede:

  • the third month before the month in Item 08;
  • the earliest month of medical coverage entered in Item 46 for any person.

ITEM 179: ISS/CAN (Issue/Cancel)

TANF

Enter one of the following codes to indicate the type of benefit being requested:

1 — Full month's amounts

2 — Additional benefits for a month; Form H1000-B use only

SNAP

Enter one of the following codes to indicate the method of issuance or to request a cancellation:

S — Untimely reporting EBT issuance via ATA to clear a discrepancy report RF-07E-1. This code can only be used with Code 1 or 3 in Item 180.

E — Requesting EBT issuance or timely reporting EBT benefits issued via the ATA.

N — Requesting cancellation of benefits.

5 — Historical Information: State-office entered. Used to identify a CCDMI as a certified mail issuance. No longer in use effective April 1, 2004.

C — Historical Information: State-office entered. Used to identify a CCDMI that was cancelled. No longer in use effective April 1, 2004.

TP 55 and 30

Enter the appropriate code for each prior month in which a case is eligible or potentially eligible.

N — Not eligible for Medicaid until spend down is met

E — Eligible for Medicaid without spend down

Make no entry for ineligible months. The months reported in this section must be consecutive months of eligibility, with or without spend down.

ITEM 180: TYPE ISS.

TANF

Enter the reason for authorization:

9 — Action Code 090, simultaneous open and close on Form H1000-A only. Use to request allowable warrants from Item 129, Grant Effective Date, through Item 47, Denial Date, if the amount equals Item 70, Recommended Grant.

B — Change in both household composition and money reflected in the budget

F — Additional benefits issued due penalty imposed in error

H — Change in household composition

M — Change in money reflected in the budget

Note: Use B, H, and M for certifications and reinstatements, action Codes 57 or lower, to request allowable benefits for the month(s) before the Item 129 entry. These codes identify why the prior amount is different from Item 70, Recommended Grant, amount.

Also use B, F, H, and M to issue additional amounts for months in which benefits have already been produced. These codes identify why the additional amount is requested.

Use these codes to issue a benefit for the current or previous month when releasing hold with Code 0 or 7 in Item 142.

O — Retroactive and/or current month's benefit when releasing a case from hold with release Code 0or 7 in Item 142. Use for a benefit amount equal to the grant amount to be printed in Item 70.

P — Budgeting process requires different payment month benefits. Enter Code 1 in Item 179. Use for a benefit amount different than the amount to be printed in Item 70.

R — (State office use only.) Identifies on the history file benefits produced when release Code 8or 9 is used to release a case from hold. These benefits will always be for the recommended grant amount previously on file, not a recommended grant amount changed at the time the hold is released on Form H1000-B andForm H1000-C.

T — Transfer from TP 07, 20 , 29, or 37 to TP 01 or 61 (Form H1000-B and Form H1000-C use only).Use to issue a benefit of the same amount for the previous month, if needed. The advisor must ensure that the benefit amount requested is equal to the new grant amount that is printed in Item 70. Use Form H1008 to request a benefit for a different amount or an earlier month.

SNAP

Enter one of the following codes to indicate the type of benefit requested:

Full Regular Ongoing Benefits or Replacement of These Benefits

A — Initial benefit (regular ongoing benefit).

E — Initial expedited benefit issued through

  • SAVERR to meet timeliness requirements, or
  • the ATA and reported timely in Section XI.

Also use for the second month on an expedited case when issuing the second month's benefits as a combined allotment and the first month's benefit cannot be issued because it prorates to less than$10.

H — Use to issue a benefit through SAVERR as a priority issuance to meet timeliness for a hearing officer decision. Do not use when timeliness can be met using another applicable code.

L — Restored full month's benefit for a past month.

1 — Use only to clear discrepancy report RF-07E-1, generated because the benefit was issued via the ATA and was not reported timely in Section XI. On inquiry, an issuance coded E by the advisor displays as a Code 1 if the benefit was issued via the ATA.

2 — Priority benefits issued through

  • SAVERR to meet non-expedited application timeline requirements, or
  • the ATA to meet non-expedited application timeliness requirements and reported timely in Section XI.

3 — Use only to clear discrepancy report RF-07E-1, generated because the benefit was issued via the ATA and was not reported timely in Section XI. On inquiry, an issuance coded 2 by the advisor displays as Code 3 if the benefit was issued via the ATA.

All issuances coded A, E, 2, or L in Item 180 must balance using Items 184, 185, 186 (if applicable), and 187.

Potential Item 180 code combinations for applicants receiving combined allotments are:

First Month Code Second Month Code
E (Expedited) 2
2 (Timely) 2
No issuance* E
A (Regular) A
No issuance* 2
No issuance* A
1 (Expedited-ATA; reported untimely) 3
3 (Expedited-ATA; reported untimely) 3
No issuance* 1
No issuance 3
*1st month not issued due to proration

Additional Benefits for a Month

C — Supplemental benefits. Use when providing benefits in addition to initial benefits for the current month or following month if submitting Form H1000-A,Form H1000-B andForm H1000-C after cutoff.

D — Restoration benefits. Use when restoring partial benefits for a past month.

F — Supplemental or restoration benefits. Use when providing additional benefits for a month in which the household has already received one issuance coded C and/or one coded D.

P — Restore an erroneously expunged EBT benefit.

Destroyed Food

T — Replacement of destroyed food, that was purchased with SNAP benefits.

Historical Information: State office also uses this code to replace CCDMIs that are lost/stolen within the postal system. No longer in use effective April 1, 2004.

Every month must have an uncanceled A, E, 1, 2, 3, or L before an issuance coded C, D, F, P, or Tin Item 180 can be processed. To replace a canceled issuance, always use the same code in Item 180.

Only one type issuance Code C or D is allowed per month. Codes C and D issuances are allowed for the same month. Code C cannot be used for month already having a type code L issuance. Code F cannot be used unless type code C or D has been issued for the month.

Advisor entered cancellation

G — Use to cancel EBT benefit because the household has moved out of state. Use code N in Item 179.

State Office-entered

4 — Historical Information: CCDMI mailed out of state as a result of converting EBT benefits to coupons. No longer in use effective April 1, 2004.

5 — Historical Information: Benefits placed back in an EBT account after a CCDMI was returned and cancelled. No longer in use effective April 1, 2004.

These codes do not appear on Form H1000-B. These are in the benefit history file that is available through inquiry.

ITEM 181: ATP/BENEFIT NUMBER

TANF and SNAP

Issuance numbers issued via EBT have two leading alpha characters (Example: AA12345).

TANF

Make no entry. SAVERR assigns issuance numbers.

SNAP

Make no entry if requesting an issuance or reporting an ATA issuance timely.

SAVERR assigns an issuance number when authorizing an issuance or when the EBT system reports an issuance.

Priority Issuance Numbers:

  • Issuance numbers beginning with ZX indicate priority issuances processed via the ATA that were not reported on Form H1000-A, Form H1000-B andForm H1000-C within five days.
  • A code X after an issuance number indicates SAVERR sent the benefit record to the vendor system as a priority issuance. SAVERR sends benefits as priority issuances only if the advisor uses code E in Item 179 and code E, H, or 2 in Item 180.

ITEM 182: ISSUE DATE

TANF

Enter only on Form H1000-B and Form H1000-C when requesting a prorated benefit resulting from the transfer of a case from TP 07, 20, 29, or 37 to TP 01 or 61.

SNAP

Enter the date benefits were issued if canceling an issuance.

Enter the issue date if reporting an ATA issuance untimely to clear an RF-07/37E-1.

In the Issue Date (ISSUE DT) column, SAVERR inquiry displays an asterisk (*) for the second month's benefit of a combined allotment if it is issued before cutoff of the application month. This information does not appear on Form H1000-B. It is in the benefit history file that is available through inquiry.

ITEM 183: BENEFIT MONTH

TANF and SNAP

Enter the month and year for which the benefits are requested. Use a separate line for each benefit month entered.

SNAP

Historical Information: In the EFF column, SAVERR inquiry displays the date a CCDMI was processed instead of the benefit month. This information does not appear on Form H1000-B. It is in the benefit history file that is available through inquiry. No longer in use effective April 1, 2004.

TP 55 and 30

Enter the month and year for the prior coverage month in which a case is eligible or potentially eligible.

ITEM 184: NET INCOME

TANF, SNAP, TP 55 and 30

Enter the whole dollar amount of net income that applies to the benefit month in Item 183.

ITEM 185: BENEFIT AMOUNT

TANF

Enter the benefit amount requested.

SNAP

Enter the amount of the benefit being issued. If recouping $8 from a $10 allotment, enter $2.00

TP 55 and 30

Enter the spend down amount for that month. Enter 0 if there is no spend down.

ITEM 186: OTHER DATA (Initial Month and Code)

TANF

When issuing a benefit (prorated, full, or supplemental) in Section XI that is reduced because of a financial penalty, enter the penalty amount and penalty code in Item 186. If the benefit is reduced because of multiple penalties, enter the amount and Code U (multiple penalties). Enter the adjusted benefit amount (the benefit amount minus the penalty amount) in Item 185.

If a supplement is issued because a penalty was imposed in error, enter Code F in Item 180 and code (supplemental restored benefit) in Item 179.

SNAP

Do not recoup on a Section XI issuance or a prorated initial month's benefits. Enter the appropriate initial month code in this item and record the dollar amount.

If you are not prorating the initial month's benefits, leave this item blank. Make the following entries if you are prorating benefits:

Issuance Type Cents Field Dollar Field
SAVERR or ATA issuance reported timely on Form H1000-A, Form H1000-B and Form H1000-C. P No entry.
ATA issuance reported untimely (code S entered in Item 179). P Enter the amount subtracted from the whole monthly benefit because of proration. Example: A $100 allotment prorates to $60. Enter $60 in Item 185, P in Item 186 cents field, and $40 in the dollar field.

For all issuances coded C, D, F, H, P, or T in Item 180, enter in the cents field the range code below that corresponds to the issuance amount in Item 185. Do not make an entry in the dollar field.

Range Code Issuance Dollar Amount Range Code Issuance Dollar Amount
A $1 - 49 H $350 - 399
B 50 - 99 J 400 - 449
C 100 - 149 K 450 - 499
D 150 - 199 L 500 - 549
E 200 - 249 M 550 - 599
F 250 - 299 X 600 or over
G 300 - 349 -

These codes are not needed for benefits coded A, E, L, or 2 since these type of benefits must correspond to entries in Item 184, Net Income and Item 187, Household Size.

ITEM 187: H.H. NO. (Household Number)

TANF

Enter the household composition for the benefit requested.

Digit Number of individuals with status in group Code
1st 7 and 8. The maximum number is two. If none, enter 0.
2nd and 3rd 5. If none, enter 00. If there are less than ten members with SIG 5, enter 0 for the 2nd digit and number SIGs 5 in the 3rd digit.

Example: One adult and three children – 103.

SNAP

Enter the number of people in the SNAP household whose benefits are included in the issuance reported.

TP 55 and 30

Enter the household composition for the month.

Digit Number of
1st adults in the budget group.
2nd and 3rd children in the budget group. Include the unborn child in this entry for cases with an 01 entry in Item 128, base plan.

For budget group with less than 10 children, enter 0 for the second digit.

These entries must correspond with Items 184 and 185.

 

C—520.12 Section XII

Revision 02-3; Effective April 1, 2002

 

All Programs

SAVERR completes this section to report the status of a denied application, the case status and the form effective date.

ITEM: (App. Code) (Action Code) (Action Date)

SNAP

SAVERR prints the denied application information in this section. This information appears only in Section XII, and not in Items 79, 91, and 92.

ITEM: CASE STATUS

All Programs

This item shows the current status of the case: active, denied, or hold.

ITEM: FORM EFF. DATE

All Programs

This item shows the form effective date of the previously submitted Form H1000-A, Form H1000-B andForm H1000-C.

On Form H1000-B and H1000-C with Sequence 02, the form effective date is the first of the month that the input document was entered on SAVERR.

On Form H1000-B and Form H1000-C with sequences 03 and above, the form effective date is the date the action reported on the previous Forms H1000-B and Form H1000-C becomes effective according the SAVERR cutoff cycles.

 

C—520.13 Section XIII

Revision 02-3; Effective April 1, 2002

 

TANF and SNAP

SAVERR records on the Form H1000-B turnaround the monthly benefit issuance history for the current and past 11 months.

TP 55 and 30 with Base Plan of 55

SAVERR prints the three months prior spend down on Form H1000-B turnaround.

ITEM: ISS./CAN./RESULTS

TANF

This item records the authorization code from Item 180 and the benefit amount from Item 185.

SNAP

This item records the advisor entries from Items 179 and 185.

ITEM: DATE

TANF

This item lists the month of eligibility for which the benefit was issued.

SNAP

This item records the month and year for which benefits are authorized (benefit month).

ITEM: ISSUED/NO.

TANF

This item lists the number of issuances for the month of eligibility.

SNAP

This item records the number of issuances the household is issued for the month.

ITEM: ISSUED/PERSONS

SNAP

This item records the household size listed on the last benefit issued for the month.

ITEM: ISSUED/AMOUNTS

TANF

This item lists the amount of benefits issued for the month.

SNAP

This item records the household's cumulative benefit allotment, including supplemental benefits and replacement issuances, less any cancelled benefits.

ITEM: REDEEMED/NO.

SNAP

This item records the cumulative number of issuances for the household.

ITEM: REDEEMED/PERSONS

SNAP

This item is not used.

ITEM: REDEEMED/AMOUNT

SNAP

This item is a record of the amount of benefits issued monthly.

ITEM: CD

TANF

The code in this column indicates deductions made from recognizable needs. (R = Recoupment deduction)

SNAP

This item records the type of the last issuance processed in the month.

 

C—520.14 Section XIV, Items 188 - 191

Revision 02-3; Effective April 1, 2002

 

ITEM 188: SIGNATURE

All Programs

The advisor completing Form H1000-A, Form H1000-B andForm H1000-C signs and enters his unit number in this space.

ITEM 189: DATE SIGNED

All Programs

Enter the date Form H1000-A, Form H1000-B or Form H1000-C is signed.

TANF

Exception: When certifying a TANF application, enter the certification date. This should be the date entered on the TANF worksheet. SAVERR prorates benefits for the first month of eligibility from this date or the 30th day after the file date, whichever is earlier.

ITEM 190: EMP NO

All Programs

Enter the employee number of staff signing Form H1000-A, Form H1000-B and Form H1000-C.

ITEM 191: TP ONLY

All Programs

Data Communications Unit use only. Make no entry.

Medical Programs

When the record of case action is received, the advisor or clerical reviewer edits, initials, and dates the form. If the turnaround document contains an error or warning message, the clerical reviewer must not initial and file it, but must immediately send it to the advisor.

 

C—530 Form H1000-C, Secondary Client Input Instructions

Revision 05-4; Effective August 1, 2005

 

TANF and SNAP

UseForm H1000-C to enter start and end dates for PRA penalties and good cause. Form H1000-A and Form H1000-B must be submitted with Form H1000-C, but Form H1000-C is not always required when submitting Form H1000-A and Form H1000-B. SAVERR does not produce a turnaround for Form H1000-C.

 

C—530.1 Section I, Items 01 - 07

Revision 08-4; Effective October 1, 2008

 

ITEM 01: App./Case No.

TANF and SNAP

Enter the application or case number.

ITEM 03: Seq. No.

TANF and SNAP

Enter the same sequence number from Form H1000-A andForm H1000-B.

ITEM 04: Pg. No.

TANF and SNAP

Enter the same page number the individual is listed on Form H1000-A and Form H1000-B.

ITEM 06: BJN

TANF and SNAP

Enter the employee's BJN.

ITEM 07: Mail Code

TANF and SNAP

Enter the office mail code.

ITEM 09: Case Name

TANF and SNAP

Enter the same case name from Form H1000-A and Form H1000-B.

 

C—530.2 Section II, Items 201 - 213

Revision 05-5; Effective October 1, 2005

 

ITEM 201: PAR. SKILLS

TANF

When an individual is referred or has completed Parenting Skills training, enter code

R — Eligibility referred the individual to parenting skills training, or

C — Eligibility verified that the individual completed parenting skills training.

SAVERR stores Code R or C on Client Screen A, Welfare Reform Data, under Parenting Skills status. In addition, the status of J appears in this SAVERR field when the Choices system verified that the individual completed parenting skills training as a Choices component.

ITEMS 202, 205, 208, and 211: TYPE

TANF

When starting or ending a penalty or good cause, enter the following codes in these items

  • Penalty Codes

    T — Third or subsequent noncooperation with Choices

    S — Second noncooperation with Choices

    F — First Noncooperation with Choices

    C — Child Support

    V — Voluntary Quit

    E — Texas Health Steps

    G — Immunizations

    A — School Attendance - child

    M — School Attendance - minor parent

    P — Parenting Skills Training

    D — Alcohol or Drugs

    U — Unidentifiable penalty - Use this code when making Section XI entries only and the benefit is being reduced by more than one penalty.

  • Good Cause Codes

    1 — Individual is on an alternate schedule for immunizations

    2 — Good cause for immunizations due to medical reasons

    3 — Good cause for immunizations due to conscientious objection

    4 — Grace period

    6 — Good cause for noncooperation with Texas Health Steps

    7 — Good cause for noncooperation with Parenting Skills Training

    Note: Good cause Code 5 is sent through the Choices automated system.

ITEMS 203, 206, 209, and 212: Start

TANF

Enter the month and year the penalty starts. At application, start a child support or voluntary quit penalty beginning the application month.

On incomplete and complete reviews, the start date cannot be earlier than three months before the current cutoff month or later than the next SAVERR effective month.

ITEMS 204, 207, 210, and 213: End

TANF

Enter the month and year the penalty ends.

SAVERR does not allow entry of future end date. The end date cannot be later than the SAVERR effective month.

 

C—530.3 Section III, Items 214 - 215

Revision 09-4; Effective October 1, 2009

 

ITEM 214: FIC (R/E) (Finger Image Code)

TANF and SNAP

Enter finger image codes for required individuals at application and at complete review/recertification, including simultaneous open and close transactions. Finger image codes are not required on denials or Temporary Assistance for Needy Families (TANF) complete reviews with a future action code of a denial.

If the correct finger image code is not already on the System for Applications, Verifications, Eligibility Reports and Referral (SAVERR), enter a finger image code for each household member who is:

  • age 18 or older as of the interview date;
  • a minor parent (secondary SIG L) on a TANF case with a dependent child on the same case; or
  • a minor head of household (SIG A) on a Supplemental Nutrition Assistance Program (SNAP) case.

Enter one of the following finger imaging codes:

  • Y — all available images have been taken

  • Z — one image has been taken (Note: This includes a finger image that Lone Star Image System (LSIS) determines to be temporarily unavailable because of low quality.) or

  • one of the following exemption codes:

    A — appeal pending (TANF related)

    B — low quality image/physically unable to image/equipment failure

    C — certified out of office or unable to travel to the LSIS site to be imaged

    D — undue burden for disabled individual

    E — undue burden for elderly individual

    F — disqualified (SNAP only) Note: If SAVERR has no finger imaging code andForm H1000-C, Secondary Client Input, has no entry, the finger imaging code defaults to F for individuals with SIG G, or SIG K or T when the individual is over 18.

On expedited SNAP cases for required members:

  • present at the interview, enter the appropriate
    • finger image code and vendor unique number (VUN); or
    • finger imaging exemption code.
  • not present at the interview, allow Code C until the next recertification or reapplication.

Automated Changes

The advisor cannot change Codes I or Y on Form H1000-C. SAVERR performs this automated conversion as described in the following chart.

If the individual's status changes from ... and SAVERR has code ... then SAVERR ...
inactive to active I
  • changes the code to Y, and
  • sends a message to LSIS to remove the archive date.
active to inactive Y
  • changes the code to I, and
  • sends a message to LSIS to set the archive date.

SAVERR also sends a message to LSIS to set the archive date on inactive individual records with Code Z, but does not change the code.

SAVERR automatically deletes the finger Code I or Z when LSIS notifies SAVERR that it purged the finger image record. The LSIS purges the finger image record after the individual is inactive for 12 months.

Changing, Correcting or Deleting Finger Image Codes

Finger image exemption codes remain on SAVERR until it purges the individual record.

If the advisor needs to change ... to ... then ...
Code Z Code Y, enter the new code on Form H1000-C.
an exemption code Code Y, enter the new code and VUN, on Form H1000-C.
an exemption code another exemption code, enter the new code on Form H1000-C.
Codes Y or Z an exemption code,
  • deletes the Y or Z through the force change process using Form H1075, Welfare Reform Force Change Request, for TANF individuals or Form H1074, SNAP Force Change Request, for food benefit individuals, and
  • enter the new code on Form H1000-C after the forced change processes.
Code I an exemption code
  • follow the procedures listed above for Codes Y and Z, or
  • allow the vendor's automated purge process to delete the code if the LSIS record is approaching its archive date.

ITEM 215: Vendor's Unique Number

TANF and SNAP

If the entry in Item 214 is Y or Z, enter the nine-digit VUN.

The VUN contains a "check digit," an automated aid for validating data. If the check digit indicates the advisor did not enter the VUN correctly, Form H1000-C will not process.

SAVERR does not store the VUN, but uses it to associate the SAVERR client number with the finger image record on the vendor's system.

 

C—530.4 Section IV, Items 216 - 223

Revision 07-4; Effective October 1, 2007

 

ITEM 216: ADD

SNAP

Enter the code(s) to indicate that an individual is being disqualified for one or more of the following reasons, even if the disqualification results in case denial. Once entered, these codes remain on the System for Applications, Verifications, Eligibility Reports and Referral (SAVERR) until removed by an entry in Item 217.

B — Ineligible alien without a U.S. Citizenship and Immigration Services (USCIS) document

C — Ineligible aliens with USCIS document

D — Felony drug conviction

F — First offense failure to comply with Employment Services Program (ESP) requirements (employment and training/voluntary quit/reducing work hours to less than 30)

J — Fugitive

N — Failure to meet the Social Security number (SSN) requirement

S — Second offense failure to comply with ESP requirements

T — Third or subsequent offense failure to comply with ESP requirements

W — Failure to comply with the 18-50 work requirement

Note: Send Form H1074, SNAP Force Change Request, to correct SAVERR information on:

  • active individuals to delete the drug disqualification code; or
  • denied individuals to add or delete a disqualification code or change the employment and training/voluntary quit counter.

ITEM 217: Remove

SNAP

Enter a code below to remove a code, end a specific type of disqualification or change a Supplemental Nutrition Assistance Program (SNAP) time-limited benefit code. Enter one of the following codes to indicate the action needed.

1 — Delete the first countable month

2 — Delete the second countable month

3 — Delete the third countable month

4 — Delete the fourth countable month (first month of second three month period)

B — End the ineligible alien (undoc) disqualification

C — End the ineligible alien (doc) disqualification

F — End the first offense SNAP ESP disqualification

J — End the fugitive disqualification

L — Subtract one offense from the ESP offense counter (when entering code L, do not enter Code F, S or T in Item 216 on the same Form H1000-A, Notice of Application, Form H1000-B, Record of Case Action andForm H1000-C, Secondary Client Input, transaction)

N — End of the SSN disqualification

S — End the second offense SNAP ESP disqualification

T — End the third offense SNAP ESP disqualification

W — End the 18-50 work requirement disqualification

ITEMS 218 - 223

SNAP

Make entries in these fields to report that HHSC has authorized a SNAP benefit for acountable month of the initial or second three-month period of time-limited benefits in a 36-month period for an individual age 18-50. Make entries of Code(s) 1-4 in Items 218 and the corresponding month(s) in Item 219.

Items 220-223 can be used on the same Form H1000-A,Form H1000-B andForm H1000-C transaction when necessary to simultaneously report up to three months of countable issuances. If the advisor needs to report four months simultaneously, the fourth month (first month of second three-month period) must be reported on a subsequent Form H1000-C.

SAVERR does not automatically update the months of countable time-limited SNAP benefits received by an individual age 18-50. The advisor must update SAVERR each time when submitting Form H1000-A, Form H1000-B and Form H1000-C.

Staff do not have to enter the last month of the 36-month period. SAVERR computes it based on the months entered by the advisor as the first countable month of the initial three-month period of time-limited benefits, and displays it on inquiry.

On the same Form H1000-C, staff can delete months using Item 217 and enter corrected months in Items 218-223.

ITEM 218: CODE (Countable Month Code)

SNAP

Enter one of the following codes and a corresponding month in Item 219:

1 — Benefit authorized for the first month of the initial three-month period

2 — Benefit authorized for the second month of the initial three-month period

3 — Benefit authorized for the third month of the initial three-month period

4 — Benefit authorized for the first month of the second three-month period

ITEM 219: MONTH (Countable Month MMYYYY)

SNAP

Enter the month and year corresponding to the code entered in Item 218. The month cannot be greater than the SAVERR effective month.

ITEM 220: CODE (Countable Month Code)

SNAP

If more than one month needs to be reported on the same Form H1000-A, Form H1000-B amdForm H1000-C, enter the appropriate code (2, 3 or 4) to indicate that HHSC has authorized a SNAP benefit for a second, third, or fourth (first month of second three-month period) countable month. Enter a corresponding code in Item 221.

ITEM 221: MONTH (Countable Month MMYYYY)

SNAP

Enter the month and year corresponding to the code entered in Item 220. The month cannot be greater than the SAVERR effective month.

ITEM 222: CODE (Countable Month Code)

SNAP

If more than two months needs to be reported on the same Form H1000-A, Form H1000-B, Form H1000-C, enter the appropriate Code 3 or 4, to indicate that HHSC has authorized a SNAP benefit for a third or fourth countable month. Enter the corresponding month in Item 223.

ITEM 223: MONTH (Countable Month MMYYYY)

SNAP

Enter the month and year corresponding to the code entered in Item 222. The month cannot be greater than the SAVERR effective month.

 

C—530.5 Section V

Revision 02-3; Effective April 1, 2002

 

ITEM 190: Emp. No.

TANF and SNAP

Enter employee number of staff member completing form.

 

C—540 Code Summary

Revision 08-4; Effective October 1, 2008

 

TANF and SNAP

This section contains a Form H1000-A, Notice of Application, Form H1000-B, Record of Case Action, andForm H1000-C, Secondary Client Input, instructions code summary.

ITEM 02: Category

TANF

2 — TANF

5 — Refugee Cash Assistance (RCA)

SNAP

6 — Public Assistance (PA) SNAP Case

8 — Refugee, PA SNAP

9 — Non-PA SNAP Case

ITEM 03: Sequence No. (SEQ)

TANF and SNAP

Y — Yes

Item 27: Modifier (M)

TANF

P — Protective Payee

R — Representative Payee

SNAP

I — Authorized representative (AR) is a member of household (under the same roof).

O — AR is not a member of household (not under the same roof).

F — AR is an employee of a drug and alcohol treatment/group living arrangement facility.

ITEM 28: Indicator Code

TANF

M — Incapacity

TANF-UP

U — (system entered when TP 61 transfers to TP 07, 20 or 37)

SNAP

1 — Streamlined reporting (SR) household with total gross monthly income that is less than or equal to 130% of the Federal Poverty Income Limits (FPIL).

2 — SR household with total gross monthly income that is greater than 130% FPIL.

3 — Non-SR household.

ITEM 32: Client Number

TANF and SNAP

2 — Check for an existing number.

ITEM 35: Sex

TANF and SNAP

M — Male

F — Female

ITEM 36: Race

TANF and SNAP

1 — White

2 — Black

3 — Hispanic

4 — American Indian or Alaskan Native

5 — Asian or Pacific Islander (includes Indochinese)

6 — Computer entered code indicating inappropriate or omitted code. Must be corrected.

ITEM 39: Education/Service Code

TANF and SNAP

1 — First Grade

2 — Second Grade

3 — Third Grade

4 — Fourth Grade

5 — Fifth Grade

6 — Sixth Grade

7 — Seventh Grade

8 — Eighth Grade

9 — Ninth Grade

A — Tenth Grade

B — Eleventh Grade

C — High School Graduate/completed general equivalency diploma

E — Attending college or completed some college but has not graduated from a four-year college

F — Graduate of a four-year college

N — No formal education

ITEM 40: Status in Group

TANF

Primary Codes

2 — Disqualified/ineligible child or second parent

3 — Noncertified child: Identifies the only deprived child of the certified caretaker/second parent

If the child receives ... then enter SIG Code
SSI 3
Foster Care Payments 3F
Adoption Assistance payments 3A

5 — Certified Child

7 — Second Parent

8 — Caretaker

9 — Payee

0 — Case Name Only:

Secondary Codes

G — Reached End of Time Limit

H — Eligible Refugee

I — Ineligible Child

K — Child of a Minor Child

L — Minor Parent with a Dependent Child

M — Eligible Only for Three Months Prior Medical Assistance

N — Ineligible for Retroactive Medical Assistance and Current Assistance

P — Private Health Insurance

Q — Proof of THSteps Screening

R — HHSC Employee

S — Alien with Acceptable Alien Status

T — Ineligible Alien

U — Ineligible - No Citizenship Proof

V — Living in Nursing Home

W — Disqualified Child

X — Deceased

Y — Disqualified Second Parent

Z — Migrant

SNAP

Head of Household Codes

A — Household head

G — Household head is nonmember

GK — Head of household disqualified for a reason other than an IPV

GT — Head of household is disqualified for intentional program violation (IPV)

Other Codes

B — Student

C — ABAWD not meeting 18-50 work requirement

D — ABAWD meeting 18-50 work requirement

F — Resident of drug and alcohol treatment/group living arrangement facility

H — Eligible Refugee

K — Disqualified for a reason other than IPV

M — Migrant, out of work stream

R — HHSC Employee

S — Eligible Alien (not a refugee)

T — Disqualified for Intentional Program Violation

U — Seasonal Farm Worker

W — Migrant, in work stream

ITEM 41: Employment Services/Work Registration

TANF

Codes Explanation
A Child (SIG 5 or 5L)
B Caretaker or second parent, age 18 or younger attending school
C Caring for an ill or disabled child in the household, even if the child is not a member of the certified group
E Unable to work due to a disability expected to last more than 180 days
F 60 years of age or older
G Caring for a child (SIG 2, 3, or 5) under age 1
H Presence required in home due to illness or incapacity of another adult household member and the disability is expected to last more than 180 days
J Not subject to participation – not a certified TANF individual
K Pending during appeal of denial or disqualification
L County Hardship Exemption
M Mandatory registrant
N Employment Hardship Exemptions
P Mandatory registrant employed or self-employed 30 or more hours per week and earning at least $700 a month
Q Severe Personal Hardship Exemption
R Caring for child under age 1 who is not listed on Form H1000-A, Form H1000-B andForm H1000-C
T Pregnant and unable to work
U A single grandparent age 50 or over caring for a child under age three
V An SSI recipient parent.
W Identifies a individual who noncomplies with the Choices program
X A parent who has exhausted state time limits.
Y A parent who is disqualified due to third party resource (TPR) requirements, Social Security number requirements, intentional program violation, failure to report a child’s absence, being a fugitive, having a felony drug conviction, failure to cooperate with Quality Control or noncompliance with the unmarried minor parent domicile requirement.

SNAP

Codes Explanation
A Child age 16 years of age or child age 16 or 17 who attends school at least half-time, or is not the head of household
D Three to nine-months pregnant
E Physically or mentally unfit for employment
F 60 years of age or older
G Caring for a child under age six
H Presence in home required for care of an incapacitated person
J Person in drug addiction or alcoholic treatment and rehabilitation program
N Receiving or applying for unemployment compensation
P Employed or self-employed 30 hours or more a week
Q Individual resides in a Choices county and is mandatory or has volunteered for TANF employment services
R Registered again, after previously serving the E&T noncompliance penalty period
S Student exemption (age 18 or older/in a training program)
T Disqualified household member or nonmember head of household
U Primary wage earner failed to comply with SNAP employment services
2 Registered, employed less than 30 hours a week
3 Registered, not working
4 Registered, job attached (temporarily laid off)
5 Registration postponed, expedited service

 

ITEM 42A: Type Income

TANF and SNAP

A — Veteran's Administration (VA) benefits

C — Unemployment Insurance benefits

P — Pension benefits (other than RSDI, SSI, VA, or RR)

M — Combination of unemployment benefits with benefits from a pension, VA, or both

W — Combined income from VA and a pension

ITEM 49: Disqualification Code (Intentional Program Violation)

SNAP

1st digit T – Administrative disqualification for offense which occurred prior to September 22, 1996

S – Administrative disqualification for offense which occurred on or after September 22, 1996, or disqualification for conviction due to trafficking

C – Court-ordered disqualification

M – Disqualification due to receipt of multiple benefits in one month.

2nd digit 1 – 1st disqualification

2 – 2nd disqualification

3 – 3rd disqualification

4 – permanent disqualification for trafficking in SNAP benefits or program access devices of $500 or more.

3rd – 6th digits MMYY – last month of disqualification

PERM – disqualification permanent

ITEM 50: Error Messages

TANF and SNAP

The following format is used for all error messages: AAABBCCC

AAA — Form item number 001-191; client items 32-50 will be shown A32-K32, through K50. When a client item is shown without line indicator, 032-050, then the comparison of all entries within that item caused the error.

BB — One of the following two-digit qualifiers:

EC – ERROR CODE NUMBER"CCC"
EQ – EQUAL
GE – GREATER THAN OR EQUAL
GT– GREATER THAN
LE – LESS THAN OR EQUAL
LT – LESS THAN
NA – NOT ALLOWABLE WITH THE ENTRY OR LACK OF ENTRY IN "CCC"
NE– NOT EQUAL

CCC — Form item number 001-191; or error code number 300-999; or one of the following "KEY" words:

ALP – ALPHABETIC
BLK – BLANK
CUR – CURRENT PROCESS MONTH
DAT – VALID DATE
FIL – VALUE ALREADY ON FILE
N-3 – today minus 3 months
N-6 – today minus 6months
N12 – today minus 12 months
N24 – today minus 24 months
N45 – today minus 45 days
NAM – NAME FORMAT
NOW – PROCESS DATE OF FORM
NUM – NUMERIC
NXT – NEXT PROCESS MONTH
VAL – VALID

Error Codes

300 — Either the first digit of application number is not A or the last eight digits are not numeric

301 — By changing the A of the application number to zero, it was found that a case already on file has been assigned that number.

304 — Application already disposed

305 — BJN was incorrect

307 — The case or individual indicated is already active in the same program area for the benefit period requested.

308 — The client number entered cannot be reassigned due to a mismatch of client information.

309 — Multiple entries for this item contained the same value.

320 — A SNAP denial cannot precede a benefit issuance month.

321 — The ATA issuance exceeded the maximum allotment for household size.

400 — The individual's SSI coverage was changed to SUSPENSE

402 — Hierarchy of individual information prevented the use of the client entries on the transaction.

403 — The entry made in Adjusted Gross Income is zero. Determine if the correct income was entered.

404 — Valid entries for case number reassignment are required.

500 — The rejection of this attempted denial caused the case to be placed on hold.

ITEM 78: Type of Review

SNAP

C — Complete review

I — Incomplete review

N — Non-review activity (case maintenance)

ITEM 79: Application Codes

SNAP

First Digit – Application Type 1 – Eligibility Determination
2 – Redetermination
3 — Application reopened after denial
Second digit Enter X
Third digit – Number of Months 0 – All initial applications, reapplications within 30 days from previous application, or later applications within 30 days after the end of the previous certification period.
1-8 – Enter the number of months, as appropriate, since the last application or certification period.
9 – Nine months or longer since the last application or certification period.

ITEM 84: AID

SNAP

1 — NPA Only

2 — NPA Mixed

3 — TANF-PA

5 — Refugee, PA

ITEM 85: Test (Income Test/Shelter Deduction Identifier)

SNAP

B — Gross and net income tests with capped shelter deduction.

C — Categorically eligible household with capped shelter deduction.

E — Gross and net income test and uncapped shelter deduction. Use this code only if the member who is entitled to uncapped shelter costs is disqualified for intentional program violation.

M — Net test only, uncapped shelter deduction.

T — Categorically eligible household with uncapped shelter deduction. Note: This code is also used in situations where a household member, disqualified for any reason, is the only elderly or disabled member.

ITEM 87: NON (Non H/H Members)

SNAP

A — Attendant

B — Boarders

C — Ineligible alien

D — Ineligible student

E — Any combination of two or more of A, B, C, or D

ITEM 89: SSI

SNAP

X — Every household member receives SSI

ITEM 90: Util (Utility Expense Code)

SNAP

Code Description
1 Household claiming the Standard Utility Allowance.
2 Household claiming telephone standard only, or telephone standard plus actual utilities.
3 Household claiming actual utility costs only (even if some members are disqualified).
4 Household without utility costs.
5 Two households live together and share the standard utility allowance.
6 Households claiming the standard utility allowance with member(s) disqualified for not meeting the citizenship, 18-50 work, and and/or SSN requirements.
7 All other proration situations. A combination of households described in Codes 5, 6, B, and C, aprorated telephone standard, and all other situations in which the utility allowance is prorated (such as a proration involving three or more households, or more than one disqualified member).
8 Household claiming the homeless shelter standard
9 Household claiming the homeless shelter standard with one member who is disqualified for not meeting the citizenship, 18-50 work and/or SSN requirements
A Households claiming the basic utility allowance.
B Two households live together and share the basic utility allowance.
C Households claiming the basic utility allowance with member(s) disqualified for not meeting the citizenship, 18-50 work, and/or SSN requirement.
Codes 1, 2, 3, 4, 5, 7, A, and B are allowed for household containing member(s) disqualified for an intentional program violation, felony drug conviction, E&T non-compliance, and/or being a fugitive.

Codes 3, 4, 6, 7, 9, and C are allowed for households containing member(s) disqualified for not meeting the citizenship requirement, 18-50 work requirement, or SSN requirement. Also, these codes are allowed for household containing member(s) disqualified for an intentional program violation, felony drug conviction, E&T non-compliance, and/or being afugitive and member(s) disqualified for citizenship, 18-50 work requirement, and/or SSN requirements. Note: Utility, homeless, and telephone standards, if used, are prorated for these kinds of disqualifications.

ITEM 91: Action Code

SNAP

See C-221, Denial Codes.

ITEM 95: Code/Hold Date

SNAP

Hold Codes

2 — Hold benefits

A — Form H1000-B has fatal error not cleared by cutoff

Z — Dormant EBT account (state office use)

Release Codes

0 — Do not hold future benefits.

ITEM 101: Prepared Meals Services Code

SNAP

C — SSI/elderly member authorized to purchase from communal dining facilities, meal delivery service, or contracted restaurant

E — Homeless and either elderly or SSI recipient; authorized to purchase from every service (communal dining, meal delivery services, or homeless meal providers/contracted restaurants)

H — Authorized to purchase from homeless meal providers/contracted restaurants

M — Household/disabled member authorized to purchase from meal delivery services

ITEM 104: Special Review Code

SNAP

Enter the appropriate code to show the type of special review needed

0 — State office assigned

1 — Employment Services/Work Registration

2 — School Attendance

3 — Reserved

4 — Management

5 — Income/Expense changes anticipated

6 — Living arrangement change anticipated

7 — Medical review

8 — Household change anticipated

9 — Other

ITEM 127 Type Program

TANF

01 — Cash and medical assistance

04 — Medical Assistance Only – Deceased

07 — 12 or 18 months medical assistance only

11 — Three months prior medical assistance only not currently eligible

20 — Medical assistance only – Child Support

37 — 12 or 18 months medical assistance only

61 — TANF-UP cash and medical assistance

71 — OTTANF – One parent household

72 — OTTANF – Two parent household

ITEM 131: Type Review

TANF

C — Complete review

I — Incomplete review

N — Non-review activity (case maintenance)

ITEM 132: Action Code

TANF

See C-200 for Item 132 Codes.

ITEM 138: (Child Support Cooperation/Reason for Transfer to TP 07/20)

TANF

R — Refusal without good cause to cooperate with child support for one or more APs

X — Exempt from child support requirements, or claiming good cause for all APs

C — Cooperation. Enter this code if Codes R or X do not apply

E — new or increased earned income or earnings of a returning absent parent who is added to the certified group

S — new or increased child support collections

B — TANF denial results from a reason listed under Code E and new or increased child support collections

ITEM 140: CODE

TANF

1 — Employment Services/Work Registration (TANF only)

2 — School attendance

3 — (Reserved)

4 — Management

5 — Income/Expense changes anticipated

6 — Living arrangement change anticipated

7 — Medical review

8 — Household change anticipated

9 — Other

Q — Disability Hardship Exemption (TANF only)

ITEM 142: HOLD CD: DATE

TANF

Advisor Hold Codes

1 — Unable to locate

2 — Guardianship pending

3 — New payee pending

4 — Notice of adverse action to lower benefits that expires between cutoff and the end of the month

5 — Notice of adverse action expires between cutoff and end of month (case denial or transfer to TP 07 or TP 20)

State Office Hold Codes

A — Hold, Form H1000-B has fatal error not cleared by cutoff

C — Form H3087 returned, moved

D — Form H3087 returned, deceased

E — Form H3087 returned, unclaimed

F — Warrant Undeliverable and returned by post office

G — Warrant undeliverable because individual is deceased

H — TANF case has SIG 5 member age 19 or over

L — State time limit expiring and SAVERR cannot rebudget TANF

J — Warrant charged back

R — SDX hold

Z — Dormant EBT account

3 — RCA case has a member who entered the United States eight months ago

6 — TANF case pending denial or transfer to TP 20

Advisor Release Codes

8 — Release benefits as originally authorized

9 — Release benefits as originally authorized using the new address on this Form H1000-B

0 — Release future benefits. Use Form H1008 to release any returned benefits. Use Section XI to issue benefits for months on hold.

ITEM 149: Code

TANF

C — Dependent care deduction

9 — A 90% earned income deduction up to $1400 per employed member or 12 or 18 months additional Medicaid coverage. This entry requires an entry on the same line in Item 151.

Item 179 - Type of Warrant Requested

TANF

1 — Full months amount

2 — Additional amount for a month; Form H1000-B use only

SNAP

S — Reporting ATA issuance untimely

E — Requesting issuance or timely reporting benefits issued via the ATA

N — Requesting cancellation of benefits

ITEM 180: Type Issuance

TANF

Reason for authorization of benefits

9 — Action Code 090, simultaneous open and close on Form H1000-A only

B — Change in both household composition and money reflected in the budget

H — Change in household composition

M — Change in money reflected in the budget

O — Retroactive and/or current month's benefit when releasing a case from hold with release Code 0 or 7 in Item 142

P — Budgeting process requires different payment month benefits. Enter Code 1 in Item 179

R — (State office use only) Identifies on the history file benefits produced when release Code 8 or 9is used to release a case from hold

T — Transfer from TP 07, 20, 29, or 37 to TP 01/ 61 (Form H1000-B andForm H1000-C use only)

SNAP

Full Regular Ongoing Benefits or Their Replacements

A — Initial benefit (regular ongoing benefit)

E — Initial expedited benefit issued*

H — Priority benefits issued to meet hearing officer decision timeliness

L — Restoring benefits for a past month

1 — Initial expedited benefits issued through ATA*

2 — Priority benefits issued through SAVERR or ATA to meet timeliness

3 — Initial priority benefits issued through ATA*

4 — Historical Information: CCDMI mailed out of state as a result of converting EBT benefits to coupons (state office use only). No longer in use effective April 1, 2004.

5 — Historical Information: Benefits replaced in EBT account when CCDMI was returned (state office use only). No longer in use effective April 1, 2004.

*See details in C-500, Item 180 instructions.

Additional Benefits for a Month

C — Supplemental benefits. Use when providing benefits in addition to initial benefits for the current month, or following month if submitting Form H1000-A,Form H1000-B andForm H1000-C after cutoff.

D — Restoration benefits. Use when restoring partial benefits for a past month.

F — Supplemental or restoration benefits. Use when providing additional benefits for a month in which the household has already received one issuance coded C and/or D.

P — Restore an erroneously expunged EBT benefit.

Destroyed Food

T — Replacement of destroyed food, which was purchased with SNAP benefits

Advisor enter cancellation

G — Use to cancel EBT benefit because the household has moved out of state

ITEM 186: OTHER DATA (Range Code)

SNAP

P — Initial month benefit prorated

Benefit Range Code for all issuances coded C, D, F, H, P, or T in Item 180

Range Code Issuance Dollar Amount Range Code Issuance Dollar Amount
A 1 - 49 H 350 - 399
B 50 - 99 J 400 - 449
C 100 - 149 K 450 - 499
D 150 - 199 L 500 - 549
E 200 - 249 M 550 - 599
F 250 - 299 X 600 or over
G 300 - 349 -

ITEM 187: Household Composition for Benefit Requested

TANF

1st digit Number of individuals with status-in-group (SIG) code 7 and 8 (maximum of two). If none, enter 0.
2nd and 3rd digits Number of individuals with status-in-group Code 5 (maximum of nine). Always enter as two-digit number. If none, enter 00. If there are more than nine Code 5s, use Form H1008.
Note: See C-500 for additional codes and instructions toForm H1000-C. A Form H1000-C cannot be submitted without Form H1000-A or Form H1000-B.

ITEM 214: FIC (R/E) (Finger Image Code)

TANF and SNAP

Enter individual's finger image enrollment or exemption code

Y — If all available images have been taken

Z — If one image has been taken

A — Appeal pending (TANF related)

B — Low quality image/physically unable to image/equipment failure

C — Certified out of office or unable to come to office

D — Undue burden for disabled individual

E — Undue burden for elderly individual

F — Disqualified (FS only)

ITEM 215: LSIS Vendor's Unique Number (VUN)

TANF and SNAP

If the entry in Item 214 is Y or Z, enter the nine-digit VUN.

ITEM 216: Disqualification Type

SNAP

Enter the code(s) to indicate that an individual is being disqualified for one or more the following reasons.

B — ineligible alien without BCIS document

C — ineligible aliens with BCIS document

D — felony drug conviction

F — first offense failure to comply with ESP requirements (E&T /voluntary quit/reducing work hours to less than 30 )

J — fugitive

N — failure to meet SSN requirement

S — second offense failure to comply with ESP requirements

T — third or subsequent offense failure to comply with ESP requirements

W — failure to comply with the 18-50 work requirement

ITEM 217: Remove

SNAP

Enter a code below to end a disqualification or change a time-limited benefit code.

1 — delete the first countable month

2 — delete the second countable month

3 — delete the third countable month

4 — delete the fourth countable month (first month of second three month period)

B — end the ineligible alien (undoc) disqualification

C — end the ineligible alien (doc) disqualification

F — end the first offense SNAP ESP disqualification

J — end the fugitive disqualification

L — subtract one offense from the ESP offense counter (when entering Code L, do not enter Code F, S, or T in Item 216 on the same Form H1000-A, Form H1000-B andForm H1000-C transaction)

N — end of the SSN disqualification

S — end the second offense SNAP ESP disqualification

T — end the third offense SNAP ESP disqualification

W — end the 18 - 50 work requirement disqualification

ITEMS 218-223

SNAP

Make entries in these fields to report that HHSC has authorized a SNAP benefit for a countable month of the initial or second three-month period of time-limited benefits in a 36 month period for an individual age 18-50. Make entries of Code(s) 1-4 in Items 218 and the corresponding month(s) in Item 219.

ITEMS 218, 220, and 222 - Countable Month Code

SNAP

Enter one of the following codes and a corresponding month in Item 219, 221, and 223:

1 — benefit authorized for the first month of the initial three-month period

2 — benefit authorized for the second month of the initial three-month period

3 — benefit authorized for the third month of the initial three-month period

4 — benefit authorized for the first month of the second three-month period

Additional Codes

TANF

Benefit History Codes

A — Mailed warrant/EBT benefit issued

C — Warrant held

D — Warrant or EBT issuance cancelled

E — Warrant charged back

P — Warrant paid by state treasure

R — Warrant returned

S — Warrant stop payment in effect

L — Warrant stop payment lifted

Y — Duplicate EBT benefit or warrant issued

Z — Duplicate warrant returned

Read benefit history codes on inquiry from right to left. The most recent code/action appears on the far left.

C-600, Form H1000-A and Form H1000-B Entries (Retired as of July 1, 2013)

Revision 10-1; Effective January 1, 2010

 

 

C—610 General Information

Revision 02-3; Effective April 1, 2002

All Programs

This section contains Form H1000-A, Notice of Application, and Form H1000-B, Record of Case Action, entries for certifications, actions taken during certification periods, and denials. For transfer entries, refer to C-700, Transfer Guidelines.

 

C—620 Certification Entries

Revision 02-3; Effective April 1, 2002

 

 

C—621 Minimum Entries for Certification

Revision 02-3; Effective April 1, 2002

 

 

C—621.1 TANF Minimum Entries

Revision 02-3; Effective April 1, 2002

TANF

Section I
Item 02
Item 07
Item 08
Item 09
Item 13
Item 15
Item 16
Item 17
Item 25
Category
Mail Code
Date Filed
Case Name
Mailing Address
City
State
ZIP Code
County
Section II
Item 32
Item 33
Item 34
Item 35
Item 37
Item 38
Client Number
Client Name
Birth Date
Sex
Social Security Number (if known)
Social Security Claim Number (if enrolled in Medicare or receiving benefits)
Section III
Item 40
Item 41
Items 42-44
Item 46
Status in Group
ESP Code (unless Category 5)
Individual Income, if applicable
Medical Effective Date
Section IV
Item 55
Item 56
Item 58
Item 59
Total Railroad Retirement (if appropriate)
Total Other (Income) (if appropriate)
Dependent Care Deductions (if appropriate)
Adjusted Gross Income
Note: Total income minus deductions must equal adjusted gross income
Section V
Item 66 Total Needs
Section VIII
Item 127
Item 129
Item 132
Item 133

Item 134
Item 138
Items 149, 151, and 152
Type Program
Grant Effective Date
Action Code
Three Months Prior Indicator (only if eligible for three months prior medical assistance)
Three Months Prior Application Date (if entry made in Item 133)
Child Support Cooperation
For cases with earned income, enter dependent care and 90% earned income deduction information if these deductions are used in determining the adjusted gross
Section XIV
Item 188
Item 189
Item 190
Signature
Date Signed
Employee Number

 

C—621.2 SNAP Minimum Entries

Revision 02-3; Effective April 1, 2002

 

SNAP

Section I
Item 02
Item 04
Item 06
Item 07
Item 08
Item 09
Item 13
Item 15
Item 16
Item 17
Item 25
Category
Page number and the number of pages if there are more than 11 individuals
Budgeted Job Number
Mail Code
Date Filed
Case Name
Mailing Address – first line
City
State
ZIP Code
County
Section II
Item 32
Item 33
Item 34
Item 35
Item 36
Item 37
Item 38
Item 39
Client Number
Client Name
Birth Date
Sex (if known)
Race (if known)
Social Security Number
Social Security Claim Number (if visually verified)
Education Level (if Item 41 is 1, 2, 3, or 4)
Section III
Item 40
Item 41
Items 42-45
Item 48
Item 49
Status in Group
Work Registration
Individual Income, if applicable
Medical Cost of eligible members as appropriate
Disqualification Code and Date, if applicable
Section IV
Item 55
Item 56
Item 58
Item 59
Total Railroad Retirement (if appropriate)
Total Other (Income) (if appropriate)
Dependent Care Deduction (if any)
Adjusted Gross Income
Section V
Item 60
Item 63
Shelter
Net Income
Section VI
Item 78
Item 79
Item 80
Item 81
Item 82
Item 83
Item 84
Item 85
Item 89
Item 90
Item 91
Item 92
Item 96
Items 103 and 104
Type Review
Application Codes
Certification Date
Months Certified
Last Benefit Month
Household Number
Aid Type
Test (Gross/net income eligibility test identifier codes)
SSI Code (if applicable)
Utility Code
Action Code (if case is opened and closed on same document)
Action date (if entry made in Item 91)
Late Determination/Rescheduled Appointment Date, if applicable
(if appropriate)
Section VII
Items 112 and 113
Items 118-122
Associated TANF case numbers, if appropriate
(if appropriate)
Section VIII
Item 152 Child Support Disregard, if applicable
Section XI
Items 179-187 As appropriate to request or report benefits
Section XIV
Item 188
Item 189
Item 190
Signature
Date Signed
Employee Number

 

C—621.3 Minimum Entries for Medical Programs

Revision 02-3; Effective April 1, 2002

 

Medical Programs except TP 45

NOA Entries
Section I
Item 01
Item 02
Item 03
Item 06
Item 07
Item 09
Item 12
Item 13
Item 15
Item 16
Item 17
Item 25
Item 31
Case Number
Category
Prior Recipient
Budgeted Job Number
Mail Code
Case Name
Employee Number
Mailing Address
City
State
ZIP Code
County
Medical Programs Application Number
Section II
Items 33-38 Client Names and Biographical Data
Certification Entries
Section I
Item 02
Item 07
Item 08
Item 09
Item 13
Item 15
Item 16
Item 17
Item 25
Item 29
Item 30
Category
Mail Code
Date Filed
Case Name
Mailing Address
City
State
ZIP Code
County
Notice Date
Medical Delay (if appropriate)
Section II
Item 32
Item 33
Item 34
Item 35
Item 37
Item 38
Client Number
Client Name
Birth Date
Sex
Social Security Account Number (if known)
Social Security Claim Number (if enrolled in Medicare or receiving benefits)
Section III
Item 40
Items 42-44
Item 46
Status in Group
Individual Income, if applicable
Medical Effective Date
Section IV
Items 55, 56, and 58
Item 59
Case Income, if applicable

Adjusted Gross Income
Note: Total income minus deductions must equal adjusted gross income.
Section V
Item 66 Total Needs
Section VII
Item 125
Item 126
Number of Adults
Number of Children
Section VIII
Item 127
Item 132
Item 133

Item 134
Item 136
Type Program
Action Code
Three Months Prior Indicator only if eligible for three months prior medical assistance
Three Months Prior Application Date (if entry is made in Item 133)
Medicaid Termination Date
Section XIV
Item 188
Item 189
Item 190
Signature
Date Signed
Employee Number

 

C—621.3.1 TP 45 Minimum Entries

Revision 02-3; Effective April 1, 2002

 

TP 45

Section I
Item 02
Item 07
Item 08
Item 09
Item 13
Item 15
Item 16
Item 17
Item 25
Item 29
Category
Mail Code
Date Filed
Case Name
Mailing Address
City
State
ZIP Code
County
Notice Date
Section II
Item 32
Item 33
Item 34
Item 35
Item 37
Client Number
Client Name
Birth Date
Sex
Social Security Account Number (if known)
Section III
Item 40
Item 46
Status in Group
Medical Effective Date
Section VIII
Item 127
Item 132
Type Program
Action Code
Section XIV
Item 188
Item 189
Item 190
Signature
Date Signed
Employee Number

 

C—622 Entries for Three Months Prior

Revision 02-3; Effective April 1, 2002

 

 

C—622.1 Three Months Prior Medicaid – Currently Eligible – No Gap in Coverage

Revision 02-3; Effective April 1, 2002

 

TANF

Complete Form H1000-A, Notice of Application, using TANF entry requirements.

Item 46 – Enter prior medical effective dates for applicants eligible for three months prior medical coverage.

Item 133 – Enter the number of months of prior eligibility.

Item 134 – Enter three months of prior application date.

Note: For three months prior with a gap in coverage, see C-623.2.

 

C—622.2 Three Months Prior Entries for a Medically Needy Case

Revision 02-3; Effective April 1, 2002

 

TP 55 and 30

Make minimum certification entries for a case with or without spend down. For a TP 30 case, do not make entries in Items 179-187 if Item 137 has an entry of 40, 43, 44, or 48. Refer to Form H1000-A and Form H1000-B instructions for Items 133 and 137.

Make the following entries in Section XI when there is no gap in eligibility during the prior period:

Item 179 – Enter N if the prior month has spend down or E if the prior month does not have spend down. This code corresponds with the month entered in Item 183.

Item 183 – Enter the month to correspond with the code in Item 179.

Item 184 – Enter the net income to correspond with the month in Item 183. Round down to the whole dollar amount.

Item 185 – Enter the spend down amount to correspond with the month entered in Item 183. Enter 0 if there is no spend down.

Item 187 – Enter the household size to correspond with the month entered in Item 183. Enter the number of adults in the budget group in the first digit and the number of children in the budget group in the second digit.

If there is a gap in eligibility during the three-month prior period, process a separate Form H1000-A for the eligible months.

 

C—623 Entries for Open and Close Certifications

Revision 02-3; Effective April 1, 2002

 

 

C—623.1 TP 04, Medical Assistance Only – Deceased

Revision 02-3; Effective April 1, 2002

 

TANF

Make TANF minimum entries except for Items 41 and 129

Item 40 – Enter X with status in group code for deceased individual.

Item 46 – Enter the medical effective date for each eligible person.

tem 47 – Enter the appropriate dates.

Item 132 – Enter action code 090.

Item 133 – Enter three months prior indicator, if eligible.

 

C—623.2 TP 11, Three Months Prior Medical Assistance – Not Currently Eligible; Gap in Coverage; or Reopened Applications

Revision 02-3; Effective April 1, 2002

 

TANF

Make all TANF minimum entries except Items 41 and 129.

For reopened applications,

Item 08 – Enter the date the applicant requests the application be reopened.

Item 134 – Enter the month and year the original application was filed.

Item 140 – Enter M with primary Codes 5, 6, 7, or 8 for applicants eligible for retroactive coverage. Enter N with primary Codes 5, 7, or 8 for applicants who are not eligible for retroactive coverage but are included to show need.

Item 47 – Enter last day of medical coverage for all applicants with Code M in Item 40.

Item 132 – Enter Code 090.

Notes:

  • Enter MX with primary codes for an applicant who dies during the three month prior period or if the person died before the application was made on his behalf.
  • For Three Months Prior Currently Active – In addition to the above entries, enter the existing case number in Item 01 and the existing client number in Item 32.

 

C—623.3 Simultaneous Open and Close for TANF

Revision 02-3; Effective April 1, 2002

 

TANF

Use this procedure to process applications for

  • denied households eligible for restored benefits (See B-800, Restored Benefits),
  • applicants eligible for TANF for the current month but ineligible for future months,
  • applicants eligible for OTTANF, or
  • applicants eligible for TANF Medicaid for the application month but ineligible for the months following the application month.Note: Form H1000-A, Notice of Application, can be processed only if the month after the application month is entered in Item 129.

Make all minimum entries for the appropriate type program.

Note: Do not reassign an old case number.

Item 40 – Enter secondary status in group Code N for OTTANF applicants.

Item 47 – Enter last month of eligibility for each certified person. If an applicant is deceased, enter date of death.

Item 127 – enter Type Program 71 or 72 for OTTANF cases.

Item 132 – Enter Code 090.

Items 179, 180, 183, 184, 185 and 187 (Section XI) – Enter information to authorize benefits for Type Program 01 and 61 certifications. Exceptions: Do not make entries in Section XI for OTTANF cases. When the form processes, benefits are automatically issued.

 

C—623.4 Simultaneous Open and Close for Medical Programs

Revision 02-3; Effective April 1, 2002

 

Medical Programs

Use this procedure to process applications for

  • TP 55 and 30 with spend down in the application month;
  • TP 30 when the applicant is a caretaker or a second parent with an emergency condition; or
  • three months prior only including
    • TPs 30 and 55 with or without spend down, and
    • applications for TPs 30, 40, 43, 47, 48, and 55 reopened within two years after the original application was filed.

Make minimum certification entries for a case (with or without spend down) including the file date of the application. Note: Do not reassign an old case number.

Item 40 – Enter the appropriate SIG codes. For three months prior, only include in the certified group members who have Title XIX-reimbursable bills for the prior period. For TP 30, include only one member in the certified group.

Item 46 – Enter the Medical Effective Date (MED) or earliest possible MED. For TP 30 cases, enter the start date of the emergency condition taken from Form H3038, Emergency Medical Services Certification.

Item 47 – Enter the last day of medical coverage. For TP 30 cases enter the earliest of either

  • the end date of the emergency condition, or
  • the last day of the application month.

    Note: For TP 55 cases with spend down, computer edits will not allow a date later than the last day of the application month.

Item 66 – Enter the correct needs allowance for the month(s) entered in Items 46 and 47.

Item 127 – Enter the correct type program (30, 40, 43, 44, 47, 48, or 55).

Item 132 – Enter code 090.

Item 133 – For three months prior only, enter the total number of unduplicated calendar months of three months prior.

Item 137 – For TP 30 cases, enter the appropriate TP. Refer to Form H1000-A and Form H1000-B instructions for this entry.

Section XI – For three months prior only, make appropriate entries for each of the prior months. For TP 30 cases, do not make these entries if Item 137 has an entry of 40, 43, 44, or 48.

For reopened three months prior applications,

Item 08 – Enter the date the applicant requests the application be reopened.

Item 134 – Enter the month and year the original application was filed.

 

C—624 Entries for Reinstatements

Revision 02-6; Effective July 1, 2002

 

 

C—624.1 TANF

Revision 10-1; Effective January 1, 2010

 

Make all Form H1000-A minimum entries.

Item 01 – Enter the previous case number.

Item 08 – Enter first day of the month of reinstatement.

Item 46 – Enter each individual's medical effective date.

Item 131 – Enter type review Code C.

Item 132 – Enter Code 054 or 055.

Item 164 – Enter the three-digit code for the individual's county of residence. See C-350.

Note: SAVERR edits prevent household additions when Code 054 is used in Item 132. Use Form H1000-B turnaround to make this change.

 

C—624.2 SNAP

Revision 10-1; Effective January 1, 2010

 

SNAP

Item 08 – Enter the original file date.

Item 79 – Enter 3X0.

Item 80-82 – Reenter the information from the certification period when the case was denied.

Section XI – Make entries as appropriate to order benefits.

 

C—624.3 TP 07/20 (Four, 12, or 18 Months Medicaid) for a Case Previously Denied in Error

Revision 10-1; Effective January 1, 2010

 

TANF

Make all TANF minimum entries except Items 41 and 129.

Item 01 – Enter case number of the case denied in error.

Item 32 – Enter each individual's previous client number.

Item 46 – Enter each individual's medical effective date as the day after the date the erroneous denial became effective.

Item 132 – Enter

  • Code 090 if the Medicaid end date is before the current process month, or
  • Code 055 if the Medicaid end date is during or after the current process month.

Item 136 – Enter the Medicaid end date.

Item 138 – Enter the reason for transfer to TP 07 or TP 20.

Item 164 – Enter the three-digit code for the individual's county of residence. See C-350.

 

C—624.4 TP 37 (12 or 18 Months Medicaid) for a Case Previously Denied in Error

Revision 10-1; Effective January 1, 2010

 

TANF

Make all TANF minimum entries except Items 41 and 129.

Item 01 – Enter case number of the case denied in error.

Item 32 – Enter each individual's previous client number.

Item 46 – Enter each individual's medical effective date as the day after the date the erroneous denial became effective.

Item 132 – Enter

  • Code 090 if the Medicaid end date is before the current process month, or
  • Code 050 if the Medicaid end date is during or after the current process month, or
  • Code 054 to reinstate a denied household that meets the requirements in A-800.

Item 149 – Enter Code 9 for the 90% Earned Income Deduction (EID).

Item 151 – Enter the original date of the 90% EID. Do not enter a dollar amount in Item 152.

Item 164 – Enter the three-digit code for the individual's county of residence. See C-350.

 

C—624.5 Reinstatement for Post Medicaid (TP 20), Transitional Medicaid (TP 07 or 37), or TP 29

Revision 10-1; Effective January 1, 2010

 

TANF

Make all TANF minimum entries.

Item 01 – Enter the previous case number.

Item 08 – Enter the first day of the month of reinstatement.

Item 46 – Enter each individual's medical effective date.

Item 131 – Enter Type Review Code C.

Item 132 – Enter Code 054 or Code 090.

Item 136 – TP 07, TP 20, or TP 29: Enter

  • the original end date as shown on SAVERR, or
  • an earlier end date, when applicable, when using Code 090.

Item 138 – Enter

  • S for TP 20, or
  • E or B for TP 07.

Item 151 – Enter the original date of the 90% EID. Do not enter a dollar amount in Item 152.

Item 164 – Enter the three-digit code for the individual's county of residence. See C-350.

Note: SAVERR edits prevent the actions listed below when Code 054 is used in Item 132. Therefore, use Form H1000-B turnaround to

  • add a person.
  • correct the end date of the original TP 07, TP 29, or TP 37 period. Change the end date only if it was incorrect when the case originally transferred to transitional Medicaid.

 

C—625 Miscellaneous Certification Entries

Revision 02-3; Effective April 1, 2002

 

 

C—625.1 Certifying Benefits for the Month After Certification

Revision 02-3; Effective April 1, 2002

 

TANF

Make all minimum TANF entries.

Item 46 – Enter first calendar day of the month after the application month.

Item 129 – Enter first calendar day of the month after the application month.

Note: Do not make future grant or medical effective dates for TANF more than one month past the future cutoff month.

 

C—625.2 Certifying a TP 29 Case

Revision 02-3; Effective April 1, 2002

 

TANF

Certify only one individual on each TP 29 case.

Item 40

  • For the individual being certified on TP 29 enter
    • SIG 8G if the individual was SIG 8 on the TANF case, or
    • SIG 7G if the individual was SIG 7 on the TANF case.
  • For other household members listed on the case enter
    • SIG 0 or 2Y for an adult, or
    • SIG 2, 2I, 2IT, 2IU, 2W, or 3 for a child.

Note: The case must be include a SIG 2, 2W, or 3 for the caretaker or second parent to be certified.

Item 127 – Enter Type Program 29.

Item 132 – Enter opening Code 057 on Form H1000-A, Notice of Application, or code 121 on Form H1000-B, Record of Case Action.

Item 136 – Enter the Medicaid end date.

 

C—625.3 Independent Child as the Case Name When a Representative from a Child Care Facility Applies for the Child

Revision 02-3; Effective April 1, 2002

 

Medical Programs

Make all minimum entries for the appropriate type program.

Item 13 – Enter the child's residence or, upon request, the address of the child care facility located near the child.

Item 25 – Enter the BJN's county code.

Item 26 – Enter the name of the child care representative as representative payee.

Item 271 – Enter Code R.

Item 40 – Enter SIG Code 8 to designate the child as case name.

Item 164 – Enter the child's residence county code.

 

C—630 Entries for Actions Taken During the Certification Period

Revision 02-3; Effective April 1, 2002
 

 

C—631 Entries for Case Name Changes

Revision 02-3; Effective April 1, 2002

 

 

C—631.1 Case Name Changes with Same Household Members

Revision 02-3; Effective April 1, 2002

 

SNAP

Item 10 – Enter new case name.

Item 40 – Enter # to remove former head of household status.

Item 40 – Enter A for new head of household.

Item 78 – Enter type review.

 

C—631.2 Case Name Changes When Head of Household Leaves

Revision 02-3; Effective April 1, 2002

 

SNAP

Item 10 – Enter new case name.

Item 33 – Enter # to remove former head of household.

Item 40 – Enter A for new head of household.

Item 78 – Enter type review.

Item 83 – Enter new household number, if applicable.

 

C—632 Entries for Households Becoming Eligible for SSI

Revision 02-3; Effective April 1, 2002

 

 

C—632.1 TANF Caretaker Becomes Eligible for SSI

Revision 08-4; Effective October 1, 2008

 

TANF

Item 40 – Enter Code 9.

Item 41 – Enter Code V.

Item 66 – Enter new needs amount.

Item 131 – Enter type review code.

Item 132 – Enter Code 105.

Remove any income entries for the caretaker.

 

C—632.2 TANF Child Becomes Eligible for SSI

Revision 02-3; Effective April 1, 2002

 

TANF

Item 40 – Enter Code 3.

Item 41 – Enter Code J.

Item 66 – Enter updated budget entries.

Item 131 – Enter type review.

Item 132 – Enter action code.

Note: SAVERR will not allow a SIG 5 child on the same case a SIG 3 child.

 

C—633 Entries for Adjusting Certification Periods

Revision 02-3; Effective April 1, 2002

 

 

C—633.1 Extending the Certification Period of an Active SNAP Case

Revision 02-3; Effective April 1, 2002

 

SNAP

Item 78 – Enter Code I.

Item 81 – Enter the new number of months certified.

Item 82 – Enter the new last benefit month.

 

C—633.2 Shortening the Certification Period of an Active SNAP Case

Revision 02-3; Effective April 1, 2002

 

SNAP

Item 78 – Enter type review Code I.

Item 81 – Enter the new number corresponding to the original certification date in Item 80 and the new last benefit month in Item 82. Example: If the certification date was 06/01/01, and the new last benefit month is 9/01, enter 04 in this item.

Item 82 – Enter the new last benefit month.

 

C—634 Miscellaneous Action Entries

Revision 02-3; Effective April 1, 2002

 

 

C—634.1 Death of an Active Client

Revision 02-3; Effective April 1, 2002

 

TANF

Item 40 – Reenter the original status in group codes for the deceased individual plus code X.

Item 47 – Enter the individual's date of death.

Item 131 – Enter the type review code.

Item 132 – If the case is also being denied because of death, enter Code 058 or 059.

 

C—634.2 Canceling a Previous SNAP Issuance

Revision 02-3; Effective April 1, 2002

 

SNAP

Item 179 – Enter Code N.

Item 180 – Enter cancellation Code G.

Item 181 – Enter number of the issuance being cancelled.

Item 182 – Enter the issuance date of the benefit being cancelled.

Item 183 – Enter the benefit month of the issuance being cancelled.

Item 185 – Enter the benefit value of the issuance being cancelled.

Item 186 – Enter the recoupment amount (if appropriate).

 

C—634.3 Households with Disqualified Members

Revision 02-3; Effective April 1, 2002

 

 

C—634.3.1 Households with Members Disqualified for Citizenship, or 18-50 Work Requirement, or Noncompliance with SSN Requirements

Revision 02-3; Effective April 1, 2002

 

SNAP

Make the following entries for the disqualified person:

Item 40 – Enter status in group Code K.

Item 41 – Enter Code T.

Items 42B-45 – Enter prorated income of disqualified person.

Item 60 – Enter appropriate shelter expenses.

Item 83 – Enter number of household members not disqualified.

Item 87 – Enter Code C if household has member disqualified as ineligible alien.

Item 88 – Enter number of household members disqualified as ineligible aliens.

Item 90 – Enter code for prorated shelter expense, if applicable.

Also make corresponding entries onForm H1000-C, Secondary Client Input, in Item 216 to identify the reason for disqualification.

 

C—634.3.2 Households with Members Disqualified for SNAP Employment Services Noncompliances, Felony Drug Convictions, Refusing to Cooperate with the Quality Control Process, or Being a Fugitive

Revision 08-3; Effective July 1, 2008

 

SNAP

Make the following entries for the disqualified person:

Item 40 – Enter status in group Code K.

Item 41 – Enter Code T.

Items 42B-45 – Enter total income of disqualified person.

Item 60 – Enter total shelter expenses.

Item 83 – Enter number of household members not disqualified.

Item 90 – Enter appropriate code for shelter expense.

Also make corresponding entries onForm H1000-C, Secondary Client Input, in Item 216 to identify the reason for disqualification.

 

C—634.4 Reinstating a Person Disqualified for Intentional Program Violation When the Disqualification Expires

Revision 02-3; Effective April 1, 2002

 

SNAP

Make minimum entries for certification or changes.

Item 40 – Enter the appropriate code.

Item 41 – Enter the appropriate code.

Item 49 – Make no entry.

Item 83 – Enter number of eligible household members including the person who is no longer disqualified.

 

C—634.5 Reporting Increases in Household Composition with More than 11 Persons

Revision 02-3; Effective April 1, 2002

 

All Programs

Use more than one set of forms. In addition to the standard entries on the first Input document, complete Item 04, page 1.

Use a Form H1000-A, Notice of Application, packet. Separate the NOA and the Case Index Card from the packet and destroy, leaving the H1000-A Input and case record copy intact. White out the preprinted application number, enter the case number in Item 01, and make the following entries:

Item 03 – Sequence Number

Item 04 – Page

Item 06 – Budgeted Job Number

Item 07 – Mail Code

Item 09 – Case Name

Items 32-50 – Begin with line "b"

Staple the Input document together and batch as one.

 

C—634.6 Change of Payee or Caretaker

Revision 02-3; Effective April 1, 2002

 

TANF

Item 10 – Enter new case name.

Items 32-37 – Enter information about case name if the person was not previously included in the case.

Items 40-41 – Enter code for new case name.

Item 46 – Enter medical effective date for new case name if the person is certified as a caretaker and was not previously included in the case.

Item 33 – Enter # to remove previous individual if the individual is to be removed from the case.

Items 40-41 – Enter new codes if the previous case name is to remain in the case.

Item 131 – Enter type review code.

Item 132 – Enter Code 120.

Enter budget and Item 66 entries for situations with these changes.

 

C—634.7 Three Months Prior Medicaid – No Gap in Coverage on an Active Case

Revision 05-4; Effective August 1, 2005

 

TANF

Item 46 – Enter new medical effective date.

Item 131 – Enter the type review code.

Item 132 – Enter reinvestigation Code 107 if sustaining or other codes if raising or lowering.

Item 133 – Enter number of months of prior eligibility.

Item 134 – Enter three months prior application date.

To change a medical effective date for more than six months before the current process month, send a memo with supervisor'sapproval to State Office Data Integrity (SODI) Section, Systems Control Division, State Office, Y-922, explaining why the information needs to be processed.

 

C—634.8 Entering the 90% Earned Income Deduction and Child Care to Ensure Automatic Removal of the Deduction

Revision 05-4; Effective August 1, 2005

 

TANF

Item 42B – Enter gross earned income.

Item 58 – Enter standard work expense deduction. Do not enter childcare or 90% deduction.

To report child care deduction:

Item 149, line 1 – Enter C.

Item 152, line 1 – Enter total child care deduction.

To report the 90% earned income deduction:

Item 149, line 2 – Enter 9.

Item 151, line 2 – Enter the last month of the four month eligibility period.

Item 152, line 2 – Enter the total allowable 90% earned income deduction.

Item 59 – Enter the remainder of Item 57 minus Items 58 and 152.

SAVERR automatically removes the 90% deduction after cutoff in the month before the month entered in Item 151. If the case is denied, SAVERR transfers assistance to Type Program 37 and adds 12 or 18 months to the month in Item 151.

When processing the automatic removal of the 90% deduction, SAVERR notifies the individual and sends the advisor an updated H1000-Bsequence.

SAVERR will not automatically remove the 90% deduction or transfer the case to TP 37 when a case is on hold. If a Form H1000-B, Record of Case Action, is submitted to remove the hold, remove the 90% deduction by entering

  • 9 in Item 149, and
  • 0 in Item 152.

If denying the case, process a transfer to TP 37.

 

C—640 Denial Entries

Revision 02-3; Effective April 1, 2002

 

 

C—641 Denial of a TANF/Medical Programs Application

Revision 02-3; Effective April 1, 2002

 

TANF and Medical Programs

Item 29 – Action Notice

Item 127 – Type Program

Item 132 – Action Code

 

C—642 Denial of a SNAP Application

Revision 02-3; Effective April 1, 2002

SNAP

To deny an application of Form H1000-A, Notice of Application, make the following entries:

Item 29 – Enter date Form H1017, Notice of Benefit Denial or Reduction, is sent to applicant.

Item 79 – Enter application code.

Item 91 – Enter denial code.

Item 92 – Enter date of denial.

To deny an application on Form H1000-B, Record of Case Action, make these additional entries:

Item 08 – Enter date applied.

Item 78 – Enter C.

 

C—643 Hold Code 5 Actions Pending Automatic Grant Denial

Revision 02-3; Effective April 1, 2002

 

TANF

Item 131 – Enter the type review code.

Item 132 – Enter Code 107. Use Code 110 for Type Program 07 cases.

Item 142 – Enter hold Code 5.

Item 143 – Enter denial code.

Do not enter any budgetary changes

If the hold is not released in the hold effective month, an updated sequence Form H1000-B, Record of Case Action, is produced at cutoff of the hold effective month showing the grant denial.

 

C—644 Denial of an Active Case Because of Failure to Comply with Employment Services

Revision 02-3; Effective April 1, 2002

 

SNAP

Item 41 – Enter U for the primary wage earner who did not comply.

Item 78 – Enter type review.

Item 91 – Enter Code 610.

Item 92 – Enter last day of month the denial is effective.

C-700, Reserved for Future Use

C-800, Automated Support Systems

Revision 19-4; Effective October 1, 2019

 

 

C—810 Texas Integrated Eligibility Redesign System (TIERS)

Revision 14-1; Effective January 1, 2014

 

 

C—811 Case Number and Eligibility Determination Group (EDG) Number

Revision 15-4; Effective October 1, 2015

 

All Programs

A case is defined as a group of persons who are seeking benefits together for at least some, if not all, of the members of the group. Members included on the case may or may not be certified to receive benefits. Each case is identified by a 10-digit case number. A TIERS case can include multiple EDGs. An EDG is defined as members of a household whose needs, resources, income, and deductions, as applicable by program, are considered in determining eligibility for benefits. Each EDG is identified by a nine-digit EDG number.

Example: If a household is approved for Temporary Assistance for Needy Families (TANF) and the Supplemental Nutrition Assistance Program (SNAP), assign one EDG number for TANF and another EDG number for SNAP.

Case numbers are kept indefinitely and should be reassigned when the household reapplies for any program.

Note: There may be instances when a new case number may be required, such as for a person leaving a drug treatment facility or for foster care cases.

Related Policy
Supplemental Nutrition Assistance Program Combined Application Project (SNAP-CAP), B-475

 

C—812 Individual Number

Revision 15-4; Effective October 1, 2015

 

All Programs

The first time a person is approved for Texas Health and Human Services Commission (HHSC) services or benefits, TIERS assigns an individual a unique number. Advisors use the same number, called the individual number, for that person for all programs.

Individual numbers are kept indefinitely and should be reassigned when the individual reapplies for any program.

 

C—813 Hierarchy of Individual Identification Data

Revision 15-4; Effective October 1, 2015

 

All Programs

Before approving an applicant who already has an individual number, advisors must compare information in TIERS inquiry to the information in the case record. Advisors should note and clear any discrepancies with the individual.

TIERS retains only one set of identification information for each individual. The advisor must make changes according to the hierarchy. The following priority applies:

  • A program area providing benefits to an individual takes precedence over a program area not providing benefits. For example, TANF caretaker information takes precedence over TANF payee information, and an active case takes precedence over a denied case.
  • For name and birth date identification data:
Priority is given to ... over ...
Medical Programs TANF
TANF Supplemental Security Income (SSI), SNAP, SAS*
SNAP SAS*
  • For sex and race identification data:
Priority is given to ... over ...
Medical Programs TANF, SSI, SNAP, SAS*
TANF SSI, SNAP, SAS*
SNAP SSI, SAS*
SSI SAS*

* SAS is Long Term Care's Service Authorization System. Long Term Care authorizes payments to its service providers using this system.

Note: If the Social Security Administration (SSA) validates the Social Security number (SSN) or claim number, the advisor cannot change the number in TIERS. Document the incorrect SSN in the Request Merge/Separate record, if requesting a merge/separate. Use the existing number on file and report the correct number by memorandum to State Office Data Integrity (SODI) Section, Long Term Care, State Office, Y-922.

Before approving an applicant in another program area, check TIERS for accuracy of identifying information. If the identifying information is incorrect, enter the correct information in the Individual Household Logical Unit of Work (LUW) or other applicable LUW in TIERS.

 

C—814 Merge and Separate

Revision 14-1; Effective January 1, 2014

 

All Programs

Advisors use the functional area on the left navigation bar titled Merge/Separate to request a merge or a separate.

Select Request Merge if an individual has been assigned more than one individual number. Follow the steps below.

  • Enter a minimum of two and up to 10 individual numbers to be merged. Enter mandatory comments explaining the reason for the merge request.
  • Click the Add button. The demographic information associated with that individual number will be displayed in the Selected Individuals section. If it is not the correct person, delete the entry using the Delete icon or use the Binoculars icon to search for the individual using the demographic data, similar to the individual search in Inquiry.
  • Once the individual numbers and mandatory comments are entered, click the Submit button to send the request to State Office Data Integrity.

Select Request Separate when more than one person is assigned to a single individual number. Follow the steps below.

  • Enter one shared individual number and up to three individual numbers to be separated. Enter mandatory comments explaining the reason for the separate request.
  • Enter the individual number or demographic information and click Add. The demographic information associated with the individual number will be displayed in the Selected Shared Individuals and Shared ID above is to be separated to these individuals sections. If it is not the correct person, delete that entry using the Delete icon or use the Binoculars icon to search for the individual using demographic data, similar to the individual search in Inquiry.
  • Once all the individual numbers and mandatory comments are entered, click the Submit button to send the request to State Office Data Integrity.

TIERS will not allow a merge or separate request to be submitted for an individual number when a merge or separate request already exists and will display a validation message. When TIERS displays a validation message, correct the information if entered incorrectly or use the Search Merge/Separate to determine if the individual numbers requested are associated with the same individual number.

Use Search Merge/Separate to track the progress of the request. Some requests will take longer than others. Some individual numbers have to age off of an EDG due to the denial effective date. State Office Data Integrity staff can mark an individual number as a Potential Duplicate (PD) when a merge or separate request is made. Staff cannot select an individual number for addition to new cases if it is marked as PD, which limits the potential for the wrong individual number to be awarded benefits or coverage in error.

Questions concerning a merge or separate request should be sent to the State Office Data Integrity mailbox at tiers_statepaidmedicaid@hhsc.state.tx.us.

 

C—815 TIERS Case Modes

Revision 14-1; Effective January 1, 2014

 

A TIERS case mode is a particular mode that TIERS uses to determine the sequence of LUWs it presents during Data Collection. The case mode is typically determined by the type of action being taken on the case, for example, Intake (new application), Complete Action (redetermination), Change Action (processing a change), and so on. Staff set the case mode in the Data Collection – Initiate Interview page. Staff should check the case mode prior to starting a case by performing inquiry. Inquiry displays the current case mode and the employee number of the advisor currently assigned the case. The current case mode is also displayed at the top of each page in Data Collection.

 

C—815.1 Case Mode Definitions

Revision 15-4; Effective October 1, 2015

 

All Programs

There are 16 case modes.

Mode Definition

Case Reading

Authorized staff use this mode to examine certain information for a case and record results online.

Change Action

Used to make changes to a case when no application is required.

Complete Action

Used for redeterminations and reviews or applications for a new program for an individual in an existing case.

Continue Previously Selected Mode

Allows staff to access Data Collection in the mode previously used.

Conversion

The case mode that System for Application, Verification, Eligibility, Referrals, and Reports (SAVERR) cases and Children's Health Insurance Program (CHIP) cases were converted to if there was mismatched data. This mode is utilized by authorized staff.

Intake

Used when the household is requesting assistance for the very first time or for an existing case when all of the EDGs are denied.

Ongoing

Ongoing mode provides read-only access to all LUWs. Exception: Changes can be made in Ongoing mode to the Household Address – Details page and the Initiate Interview – Initiate Review page. In these two areas, updates can be made without running Eligibility Determination Benefit Calculation (EDBC) and then having to dispose all EDGs. Used with start date and end date fields on the Initiate Interview page to view historical records for a specific time period.

Periodic Income Check (PIC)

Used when a client returns information requested in a missing information request during a PIC.

Reopen

Used when an advisor reopens a case (no active EDGs) and it has been more than 30 days since the last denial action.

Reopen-Left Navigation

Used when the advisor reopens a case (no active EDGs) and it has been 30 days or less since the last denial action.

SSI Certification

This mode is used by State Office Data Integrity staff to approve SSI Medicaid.

SSI Manual Create

Allows authorized staff to establish SSI eligibility in TIERS for an individual when the individual is newly eligible for SSI, or when an SSI-eligible individual has moved from another state and the record is not yet available through the TIERS interface with State Data Exchange (SDX).

Second Level Review

Used when a second level review is required. The staff member must be authorized to perform second level reviews on TIERS cases.

Special Review

Used when a case or EDG requires a review or reauthorization of services that falls outside the normal redetermination time frames.

Spousal PRA

Allows authorized staff to record information and determine the Spousal Protected Resource Amount (SPRA) for institutional and waiver programs.

 

C—816 Case Mode Hierarchy

Revision 14-1; Effective January 1, 2014

 

All Programs

Complete Action and Intake modes have hierarchy over all other modes. When an advisor is working on a case in Complete Action or Intake mode, other staff can enter information in TIERS, but they cannot send notices or dispose the case. Their actions are disposed only when the advisor working in Complete Action or Intake mode disposes the case. If an advisor has the case in Change Action mode and subsequently a different advisor accesses the case in Complete Action mode, the Change Action advisor can continue to enter information in the case, but the Complete Action advisor is the only one who can dispose the case and send notices.

Once an advisor accesses a case in Complete Action mode, all individual-initiated changes go to that advisor until the case is disposed. In addition, once an advisor begins an individual-initiated change, all subsequent individual-initiated changes will go to that advisor until the case is disposed. However, outstanding alerts assigned to someone else do not automatically transfer to an advisor who begins a new action on a case.

Note: TIERS routes agency-generated changes based on the office profile.

 

C—817 Electronic Data Sources (ELDS)

Revision 15-4; Effective October 1, 2015

 

All Programs

Information from ELDS, such as State Online Query (SOLQ), is presented to advisors in TIERS during Data Collection to allow the advisor to use it as verification. If verification is not available through ELDS in Data Collection, advisors must attempt to verify using other electronic sources (i.e., Data Broker) before requesting additional information or documentation from the applicant.

Advisors must receive written or verbal consent for any adult age 19 or older that is included on an application or renewal and whose information is needed to make an eligibility determination before:

  • requesting information from electronic data sources, such as Data Broker or SOLQ; or
  • using the individual’s information from TIERS, if that adult has a case with HHSC (SNAP, TANF, Medicaid or CHIP).

When consent is given, advisors may use ELDS, a Data Broker report, and/or information from a known case.

If the advisors cannot obtain consent to use ELDS, Data Broker, or existing HHSC data, advisors must deny the application for the individual whose eligibility is being determined.

SNAP and TANF

The signature of the person submitting the application or renewal provides permission for all household members.

Medical Programs

The signature of the person submitting the application or renewal provides permission for any adult listed in A-121, Receipt of Application. For individuals not listed in A-121, advisors must attempt to contact the individual whose permission is needed by phone or via Form H1213, Children’s Health-Care Benefits: More Facts Needed from the Parent Who Has Custody.

Example: If a non-custodial parent applies on behalf of a child, information, such as income from the custodial parent, may be needed from the custodial parent to determine that child’s eligibility. Advisors must call and obtain verbal consent from the custodial parent before pulling electronic data on that individual, even if the custodial parent’s information is available in the system. If the advisor cannot get consent from the custodial parent, the advisor must request the missing information needed from the custodial parent using Form H1213. If the custodial parent does not provide consent to use electronic data, the advisor must deny the child’s application.

Related Policy
Verification Requirements, A-1370
How to Use Texas Workforce Commission (TWC) Quarterly Wage Information to Budget Earned Income, A-1355.2

 

C—820 Data Broker

Revision 19-4; Effective October 1, 2019

 

All Programs

HHSC contracts with a Data Broker vendor to provide financial and other background information about SNAP, TANF, and Medical Program applicants and recipients. The vendor collects and combines information from several data sources into one report. This report is called a Data Broker Combined Report and includes information such as residential address, persons living at that address, vehicle ownership, employment, income verification and other information. Within each Data Broker Combined Report, there is an option to request a credit report on the person for whom the Data Broker report was requested.

The Data Broker Combined Report can be requested using TIERS in the Individual Household LUW in any mode other than Ongoing, which is the preferred method for eligibility staff when determining eligibility. The Data Broker Combined Report and individual data searches are accessible using the Data Broker Portal.

Follow policy in C-920, Questionable Information, to resolve discrepancies between Data Broker information and information the applicant/recipient provides. To clear discrepant information:

  • contact the household and allow the person the chance to explain the discrepancy; or
  • send the household Form H1020, Request for Information or Action, asking for information or verification to resolve the discrepancy.

Federal law limits the use of credit reports. See C-824, Permissible Purpose, for information about these limits. Permissible purpose means the person whose credit report is requested must be:

  • an applicant or a certified TANF, SNAP or Medical Program household member (or a member who would be certified but is disqualified); or
  • a Medical Program Modified Adjusted Gross Income (MAGI) household member.

Note: Do not request a credit report before the initial interview if applicable, on the person who signed the application or on persons for whom assistance is requested on the application. The request must be made during the interview.

Use the charts below to determine when to request a Data Broker Combined Report, with or without credit information:

Request a Data Broker Combined Report Without a Credit Report

For TANF, SNAP, One-Time TANF, TP 08, TP 33, TP 34, TP 35, TP 43, TP 44, TP 48 and CHIP

Applications and Redeterminations

for household members age 16 and up.

For SNAP

At change when adding a household member Age 16 or Older

for household members age 16 and up.

 

Request a Data Broker Combined Report With a Credit Report

All Programs

Applications, Redeterminations, Changes – New Household Members

Request a Data Broker Combined Report with a credit report for household members age 16 and up on any EDG when permissible purpose exists (see C-824, Permissible Purpose) and a credit report is needed to:

  • authenticate a caller;
  • help clear questionable information; or
  • clear discrepant information in the EDG, for example, when a person has more than two months of negative management.

Use the prudent person principle in deciding the need for a Data Broker report or credit report in these instances.

 

Notes:

  • Data Broker Combined Reports with or without credit reports are not required for households that apply for or receive SNAP-CAP or SNAP-SSI. However, staff may request a Data Broker Combined Report if needed for verification or a Combined Report with a credit report if needed to resolve discrepancies in reported information (such as negative management, as in the chart above).
  • For independent children or child-only EDGs, request a Data Broker report on the child only if staff believe there are unreported assets (as applicable by program), income or other information that would affect the child's eligibility.
  • For reported changes, use the interactive search feature in the Data Broker Portal to request a specific type of report according to the change (for example, The Work Number (TWN) and Texas Workforce Commission (TWC) for earned income or Office of Attorney General (OAG) for child support information).

Use the Data Broker Portal to access the following acceptable verification sources:  

  • Department of Public Safety (DPS)
  • United States Citizenship and Immigration Services (USCIS)
  • Texas Division of Motor Vehicles (DMV)
  • OAG
  • TWC
  • TWN
  • Texas Lottery Winnings
  • Department of State Health Services (DSHS)
  • SNAP Electronic Disqualified Recipient System (eDRS)
  • Electronic Benefits Transfer (EBT)
  • Texas Department of Criminal Justice (TDCJ).

These verification sources provide information on:   

  • People search information (name, address, driver license/ID and neighbors)
  • Alien verification
  • Vehicle search (name, address, license plate, vehicle identification number, vehicle valuation)
  • Income search (new hire, quarterly wages and unemployment insurance benefits, child support, current earned income, and Texas lottery winnings)
  • Marriage and divorce
  • SNAP disqualifications
  • Out of state shopping via EBT card transactions for SNAP, TANF or both  
  • Texas criminal history

Staff must view the Data Broker reports to accurately determine eligibility and clear any found discrepancies. Failure to view the report may result in eligibility errors that can lead to quality control errors.

 

C—821 Access Permission

Revision 19-4; Effective October 1, 2019

 

All Programs

New Users — Through the HHS Enterprise Portal, supervisors or managers complete and submit Form 4743, Request for Applications and System Access, for each employee who needs access to the Data Broker system. Managers obtain a signed Data Broker Security Agreement, TWC Security Agreement, and OAG Security Agreement form for each employee who needs access. In the comment field of Form 4743, the supervisor or manager notes the dates each of the three Security Agreements were signed. Once added to the system, staff receives an email with a temporary password link and further instructions. The Data Broker temporary password link expires within 48 hours from receipt of provisioning email. If the temporary password link expires before staff creates an initial password, staff can request a new temporary password link by selecting the “Forgot Password” link in the Data Broker Portal login screen.

Note: New staff must access the Data Broker system within 45 days of the Data Broker account creation or the system automatically deactivates the account.

Inactive Users — All provisioned staff must access the Data Broker system via the Data Broker Portal or through TIERS at least every 90 days, or the system deactivates access. Once the system has deactivated access, staff must submit a new Data Broker request through the HHS Enterprise Portal. Once staff has been reactivated, they must again complete the required User Access and Fair Credit Reporting Act (FCRA) trainings to use the Data Broker system.

 

C—822 Data Broker Passwords

Revision 19-4; Effective October 1, 2019

 

All Programs

Users are directed to the User Options page to create a unique password. Staff can change their password at any time by clicking on the “User Options” field located on the left navigation section in the Data Broker Portal. Staff are required to enter their current password, new password, and confirmation of their new password.

Staff who have forgotten their password can use the “Forgot your Password?” link located on the sign-in page of the Data Broker Portal. A temporary password link is emailed to the address associated with the staff’s account.

 

C—823 Login Procedures - Data Broker Portal System

Revision 19-4; Effective October 1, 2019

 

All Programs

This is where you can access the stand-alone Data Broker Portal system. To log on, the staff must enter their User ID which is their 11-digit employee identification number, and a unique password and then click “Login.”

Staff must complete the following steps before gaining access to the Data Broker System:

  • create a new password for the Data Broker system;
  • log in to the Data Broker system; and
  • complete the User Access and Fair Credit Reporting Act (FCRA) trainings.

Notes: The User Access and FCRA trainings are located within the Learning Management System. Staff are directed to these trainings when they login for the first time.

Once the required trainings are completed and staff logs into the Data Broker system, they must read the information and click "I understand the above and agree" to acknowledge that they understand the Data Broker information can only be used for business purposes and is confidential.

Staff must also read the agreement and click "I understand the above and agree" in the “Authorization for Access to Request Credit Report” to acknowledge that they have been adequately trained on the FCRA and agree to only request a credit report when permissible purpose exists.

If staff clicks "I disagree" to either screen, they will not gain access to the Data Broker system or credit reports.

 

C—823.1 Frequently Asked Questions and Data Broker User Guide

Revision 19-4; Effective October 1, 2019

 

The Data Broker Frequently Asked Questions (FAQs) and the Data Broker User Guide are located under the “Training” section on the left navigation menu within the Data Broker Portal. These documents provide answers to frequently asked questions about Data Broker. The documents include instructions and sample screens to assist staff with understanding the different types of reports available in the Data Broker system.

The FAQs and Data Broker User Guide can be found in the Data Broker Portal.

 

C—824 Permissible Purpose

Revision 19-4; Effective October 1, 2019

 

All Programs

The Fair Credit Reporting Act (FCRA) covers access to and use of credit reports. The FCRA permits staff to request credit information for persons to determine eligibility.  Staff may not request credit information for purposes other than to determine eligibility. The FCRA requires permissible purpose before staff can legally request a credit report.

Permissible purpose means the person whose credit report is requested must be:

  • an applicant or a certified TANF, SNAP or Medical Program household member (or a member who would be certified but is disqualified); or
  • a Medical Program MAGI household member.

Note: Do not request a credit report:

  • on a payee EDG unless the responsible relative is the child's parent; or
  • using an invalid Social Security number.

The FCRA makes a clear distinction between requesting credit reports and other types of inquiries made through Data Broker. Under legal statutes, staff may request identifying information such as address, employment and vehicle registration on any person.

Permissible purpose is not required when requesting non-credit identifying information. For example, if staff suspect an absent parent is in the home, staff do not have permissible purpose to request a credit report on the absent parent. However, it is appropriate to request identifying information available through the Data Broker system.

Note: Those who request information without permissible purpose are in violation of federal law and are subject to fines.

 

C—825 Data Broker Combined Report Sources

Revision 19-4; Effective October 1, 2019

 

All Programs

This section describes the various data sources in the Data Broker Combined Report that are not subjected to permissible purpose requirements noted in C-824, Permissible Purpose.

 

C—825.1 Driver License Information

Revision 19-4; Effective October 1, 2019

 

All Programs

Data Broker matches information from the Combined Report Search screen against the Texas Department of Public Safety (DPS) data. When a match is found, DPS data is pulled into the report. Information in this report may identify discrepancies in the identity and residence address of the person. This report includes a person’s sex, race, height, hair color, eye color, name, date of birth, address, and any previous names or addresses. Because DPS re-issues driver’s licenses and ID numbers approximately two years after the driver license and ID number expires, previous names and addresses associated with that number are listed in this section when applicable.

The Validated field displays the date DPS last updated the driver’s license or ID information.

Note: DPS updates information on this report only when the person with a Texas driver license (TDL) or DPS ID provides updated information to DPS.

 

C—825.2 Persons at Entered Address

Revision 19-4; Effective October 1, 2019

 

All Programs

Data Broker searches the DPS database and pulls records for all persons listed at the address entered on the Combined Report Search screen. The information pulled includes each person's name, address, and date of birth (DOB). Previous residents may appear if they have not changed their address with DPS.

Information on this report is useful in providing case clues about household composition and exploring parental absence for deprivation.

 

C—825.3 Neighborhood People Search

Revision 19-4; Effective October 1, 2019

 

All Programs

This report lists residents located in the 20 addresses nearest the address entered on the Combined Report Search screen. This information may be useful as a case clue for locating absent parents or other case-related activities.

Data Broker pulls this information from the DPS database. The information is only as current as DPS's most recent update. Some persons may have both a Texas ID and a Texas Driver’s License (TDL). These persons appear on the report for each Texas ID and TDL.

Note: Staff may contact a neighbor on the Data Broker report only when:

  • the person has allowed staff to do so; or
  • information is received from another source that contradicts the person's statement(s).

See C-920, Questionable Information, and C-930, Providing Verification, for information regarding contacting a collateral source not allowed by the person.

 

C—825.4 Out-of-State Shopping (OSS) Report

Revision 19-4; Effective October 1, 2019

 

TANF and SNAP

The Out-of-State Shopping (OSS) Report lists households receiving SNAP or TANF benefits in Texas that:

  • shopped out of state in the last 60 days;
  • did not shop in Texas within a 60-day period; and
  • have active EDGs.

The OSS Report is included on the Data Broker Combined Report and is considered a case clue that Texas residency may be questionable. Address OSS information at renewal, reapplications and at a change.

Related Policy
Advisor Action on OSS Report Activity, B-353.1
Out-of-State Shopping (OSS) Reports, B-353
Verification Requirements, A-760
Verification Sources, A-761

 

C—825.4.1 Clearing Non-Border OSS Report Activity at a Complete Action

Revision 19-4; Effective October 1, 2019

 

TANF and SNAP

 

At a Change Action

Send the household Form H1020, Request for Information or Action, to request verification of the household’s address.

Exception: It is not required to clear Non-Border OSS activity when the household’s most recent OSS activity occurred in the:

  • month prior to the periodic review month or the periodic review month for TANF; or
  • next to the last benefit month or the last benefit month for SNAP.

At a Complete Action

The household must provide verification of their address if the:

  • most recent OSS activity occurred within six months before the interview/desk review month, and
  • OSS activity listed in the report was not previously cleared.

Refer to chart in B-353, Out-of-State Shopping (OSS) Reports, for appropriate action after a household has been asked to provide verification of address.

Note: Take action on any associated Medical Program EDG when clearing any OSS report activity.

Related Policy
Out-of-State Shopping (OSS) Reports, B-353
Verification Requirements, A-760
Verification Sources, A-761

 

C—825.4.2 Clearing Border OSS Report Activity at a Complete Action

Revision 19-4; Effective October 1, 2019

 

TANF and SNAP

This report must be cleared when a household submits an application or redetermination or at a change action and the OSS activity in the report makes the household’s address questionable. Clearance depends on the facts in the situation.

Example: A household living in Texas near the Arkansas border and shopping in Arkansas may not cause residency to be questionable. A household living in Austin and shopping only in Arkansas in the past 60 days could be considered questionable.

Note: Act on any associated Medical Program EDG when clearing any OSS report activity.

 

Related Policy
Out-of-State Shopping (OSS) Reports, B-353
Verification Requirements, A-760
Verification Sources, A-761
Questionable Information, C-920

 

 

C—825.5 Texas Vehicle

Revision 19-4; Effective October 1, 2019

 

TANF, SNAP, Children on TP 32, and Children on TP 56

The Data Broker searches the Texas Department of Motor Vehicles’ (DMV) database and obtains information for all vehicles listed at the address entered on the Combined Report Search screen. Information obtained includes the:

  • owner of each vehicle;
  • Texas vehicle license tag number;
  • year, make, and model of each vehicle;
  • average wholesale value of the vehicle; and
  • vehicle's lien holder (when available on DMV records).

This information is useful when exploring a household's resources. The information provides case clues on vehicle ownership, value and household composition. Staff must explore and clear discrepancies.

Except for vehicle values, Data Broker receives updated information weekly from the Texas DMV database. Data Broker updates vehicle values monthly. Vehicle values are obtained through the National Automobile Dealers Association (NADA) book. Texas DMV updates its database when a person renews a vehicle's registration, retitles a vehicle, or reports a change of address to Texas DMV. It is possible for vehicles not owned by the household to appear on this report. This can happen when a person does not complete a title transfer or does not update an address with the Texas DMV.

Vehicles registered at an address, other than where the person lives, do not appear on this report. When a person has a vehicle not shown on the report, staff can use the owner's name, the vehicle license plate number, or the vehicle identification number (VIN) to obtain information by using the Vehicle Search option listed on the left navigation menu of the Data Broker Portal.

The value field lists the average wholesale value of the vehicle and can be used as verification to determine the countable value of the vehicle. See A-1251, Verification Sources, for other acceptable methods of verification.

 

C—825.6 Reserved For Future Use

Revision 19-4; Effective October 1, 2019

 

 

 

 

C—825.7 Reserved For Future Use

Revision 19-4; Effective October 1, 2019

 

 

 

 

C—825.8 Reserved For Future Use

Revision 19-4; Effective October 1, 2019

 

 

 

C—825.9 Texas Marriage and Divorce

Revision 19-4; Effective October 1, 2019

 

All Programs

This report is pulled from marriage and divorce records from the Texas Department of State Health Services (DSHS) Texas Vital Statistics Unit. It is only available via an interactive inquiry in the Data Broker Portal. Although this report is updated annually, the marriage and divorce data is delayed by three years. The records do not contain information for the most recent three years.

The report provides the dates and names of people married and divorced in Texas. The names shown on the marriage and divorce reports are the names provided to DSHS on the marriage and divorce documents.

If a person changes their name, staff may need to search using the prior held name to find records. Information from this report is not included on the combined report.

 

C—825.10 Texas Criminal Convictions

Revision 19-4; Effective October 1, 2019

 

TANF, SNAP and One-Time TANF

 

The Texas Criminal Conviction report contains a list of all convictions and felony deferred adjudications that are contained in the digital criminal history system maintained by Texas Department of Public Safety (DPS).

The information included in the report depends on the authority reporting the offense and is considered a case clue only.

In most cases, the report includes the classification of the offense (felony, misdemeanor, deferred adjudication, etc.).

The report lists several pieces of identifying information including DOB, sex, race, hair and eye color, height and weight. When a criminal record is found, check each factor to ensure the person on the report is the person on the EDG.

When the report reveals information that indicates the person may have committed an offense subject to action by HHSC, explore the situation with the person. If the person acknowledges they are the person on the report, take the appropriate action.

If staff have reason to believe that the person is the person indicated on the report, but the person disagrees or disagrees with other information contained within the report (such as the type of conviction or whether it was a felony or misdemeanor) staff:

  • document the person's response in the case comments;
  • proceed with the appropriate EDG action without acting on the criminal history report;
  • contact the Office of Inspector General (OIG) by emailing the HHSC OIG Benefits Program Integrity Policy and Quality Control Unit at oig_gi@hhsc.state.tx.us; and
  • document the reason for contacting OIG in the case comments.

Once OIG obtains information to clear the discrepancy, the assigned OIG investigator provides the response by responding to staff via email and by creating a task within the Task List Manager (TLM). Staff must process and document the results of the OIG's findings in case comments and, if appropriate, make an overpayment referral.

This report is updated monthly; however, since it contains records reported to DPS by various Texas courts, the report may not be complete. When it is incomplete, staff must investigate further.
 

Related Policy
SNAP — Budgeting for Persons Disqualified for Intentional Program Violations, SNAP Employment Services Noncompliances, Felony Drug Convictions or Being a Fugitive, A-1362.4
Alcohol or Drugs, A-2128
Filing an Overpayment Referral, B-770
When the Individual Signs Form H1073, A-2128.1 

 

C—825.11 The Work Number

Revision 19-4; Effective October 1, 2019

 

All Programs

Income information is received from The Work Number (TWN) and provides employment and income information for more than 1,000 employers which represent all industries, such as fast food chains, retail stores, health care organizations, temporary staffing agencies and others. Employers provide employees' salary information to TWN each payroll period. The requested information can be located in the combined search or the interactive inquiry search in the Data Broker Portal.

The following information may be found in the report:

  • employer name and address;
  • Social Security number;
  • employment status (active or inactive as reported by TWN);
  • most recent start date or end date;
  • total time with employer;
  • job title;
  • rate of pay;
  • average hours per pay period;
  • year-to-date (YTD) wages; and
  • pay periods of gross earnings:
    • for the time selected from the interactive search drop-down list (i.e., two months, four months, six months, one year, two years, three years or all available) in the Data Broker Portal; or
    • in a Data Broker Combined report, the current month of the TWN request and the previous two months.

Note: Each employer decides what information is reported to the TWN database. Staff may see blank areas of information if an employer chooses not to report the data.

 

C—825.11.1 Using The Work Number as Verification

Revision 15-3; Effective July 1, 2015

 

All Programs

The Work Number is an acceptable source of verification. Staff must attempt to verify wage information using Data Broker before asking for verification from the individual. If the Data Broker report does not provide wage verification or the verification is not sufficient to prove current eligibility, use an alternate source to get the verification. See A-1371, Verification Sources, for other sources of acceptable wage verification.

 

C—825.12 Employer New Hire Report (ENHR) and National Directory of New Hires (NDNH) Report

Revision 19-4; Effective October 1, 2019

 

All Programs

The ENHR and NDNH reports contain information used as an indicator of unreported earned income. Data Broker displays new hire data from 180 days prior to the date the report was requested up to the current date.

The ENHR contains employer information for people whose employers are based in Texas. The NDNH contains employer information from all 50 states, four territories, and all federal agencies.

These reports provide information such as hire date, employer name and address, and employee name, date of birth and address.

The ENHR and NDNH reports may list the corporate name and address instead of the local business name and address. Consider that the commonly known name of a business may be different from the corporate name.
 

Related Policy
Changes, B-600
Verification and Documentation, C-900
Questionable Information, C-920

 

C—825.13 Texas Workforce Commission (TWC) Wages/Benefits

Revision 19-4; Effective October 1, 2019

 

All Programs

TWC Wages/Benefits information is available through the interactive and combined Data Broker report options and includes information on wages, claimants and unemployment benefit records. Claimant and unemployment benefit payments will display only if the person has applied, is receiving or has received unemployment benefits from TWC.

The TWC information is obtained in Data Broker using one of two methods.

1. Interactive Search allows the user to search TWC information using the TWC Quarterly Wages and Unemployment Insurance Benefits (UIB) link from the left navigation bar in the Data Broker Portal. Four search criteria are identified:

  • Claimant Status
  • Wage Details
  • Benefits
  • Combined Wages, Status, Benefits Report

Individual searches can be completed using any of the first three criteria. Selecting the Combined Wages, Status, and Benefits Report search criteria will return a combined report of all three TWC inquiries.

The date filter option is available for the user to request TWC inquiries for any of the four search criteria. Date filter options include two months, four months, six months, one year, two years, three years or all available.

2. The Standard Combined Report includes the TWC information along with all other reports available. See C-825, Data Broker Combined Reports Sources, for other sources.

TWC information returned on the Standard Combined Report defaults to the last two years of data available for wage detail, claimant and benefit payments. If the user needs more than two years of data, the interactive search in the Data Broker Portal can be used.

The following codes appear within the Claimant Status Search and the Combined Wages, Status, Benefits Report:

  • Clm Sta — current status of the claim
    • COMPLETE = is valid and complete
    • INCOMPLETE = is missing required information
    • VOID = is voided
    • BATCH = claimant must complete and activate the claim
  • Clm Sta DT — date the claim status last changed
  • Pgm — the program under which this claim is filed
    • EUC = emergency unemployment
    • EXB = extended benefits
    • REG = regular unemployment insurance
    • TRA = trade affected unemployment insurance
    • TRX = extended trade affected
    • TUC = temporary unemployment
  • Clm Dt — the Sunday effective date of this claim
  • Pay St — the two initials of paying state
  • File Dt — the date the claimant filed his/her claim
  • Last employer's name and address
  • WBA — the weekly benefit amount
  • MBA — the maximum benefit amount
  • Balnc — the current benefits remaining
  • PaiD – the total amount of benefits paid
  • Pend Invstn — if TWC is investigating this claim. If yes, the person's benefits may be delayed. Y = Yes, N = No
  • BWE — ending date of this benefit week (will always be a Saturday because TWC begins a new week on Sunday)
  • OP — amount overpaid that week
  • Status — the status code of each certification
    • AA = bad address
    • AG = agent state certification
    • AR = system error – notify te
    • CV = converted benefit week
    • DQ = disqualified
    • EE = excessive earnings
    • EH = excessive hours
    • FP = first payment
    • FR = fraud
    • FV = fraud voided by appeals
    • GM = good money/accounting
    • IC = open investigation
    • IE = ineligible
    • IN = incomplete investigation
    • IW = waiting week identified
    • NC = response not certified
    • OP = overpaid
    • OR = overpayment reversed
    • OV = overpayment voided
    • PD = processed
    • PP = pending processing
    • PR = pending employer response
    • RC = recovered
    • RP = partial recovery
    • SP = suppression period
    • VC = voided claim
    • WW = served waiting week
    • XX = forced pay
    • YY = offline pay
    • ZZ = pay old claim
  • TotDist — sum of any recovered overpayments, child support payments and all other distributions for that week
  • TotDedc — sum of any child support deductions and all other deductions for that week
  • PmtAmt — amount of benefits issued to the claimant after any withheld for an overpayment recovery, child support or income tax. This amount may be less than the WBA.

The following codes appear within the Benefit Payments Search:

  • BWE — ending date of this benefit week (will always be a Saturday because TWC begins a new week on Sunday.)
  • File Date — the date the claimant filed the claim
    • V = filed by phone
    • P = filed by paper
  • Week Sts — the status code of each certification
    • CV = convert benefit week
    • DQ = disqualified
    • EE = earning adjustment
    • FP = first pay
    • IC = payment flag is "NO"
    • IE = ineligible (will not receive benefits)
    • IN = investigation pending, no payment
    • IW = identified waiting week; will not be paid until claimant receives three times the weekly benefit amount
    • NC = not certified
    • PD = paid
    • PP = pending payment
    • PR = pending for employer's response
    • PROCESSED = this claim is processed
    • WW = waiting week served and paid
  • Op Amt — amount of UI overpayment, if any
  • Erngs — amount of wages the claimant earned during this week, if any
  • Pgm — program under which this claim is filed.
    • EUC = emergency unemployment
    • EXB = extended benefits
    • REG = regular unemployment insurance
    • TRA = trade affected unemployment insurance
    • TRX = extended trade affected
    • TUC = temporary unemployment
  • Ddct — sum of any child support deductions and all other deductions for that week. A deduction is a reduction in the weekly entitlement or amount benefiting the claimant. An example would be a reduction in benefit payment because the claimant receives retirement payment from a qualifying employer.
  • Dist — sum of any recovered overpayments, child support payments and all other distributions for that week. A distribution is a benefit to the claimant but distributed to an entity other than the claimant. Examples of a distribution would include child support payments, IRS withholdings or overpayment absorption.
  • Amt — amount of benefits issued to the claimant, after any withheld for an overpayment recovery, Child Support or income tax.
  • Date — date the benefits were issued to the claimant.
  • ID – warrant number of this benefit payment. Payment is made by warrant, direct deposit and debit card. The method of payment is indicated by the first character of the payment ID. Codes include:
    • B = direct deposit
    • D = debit card
    • W = TWC warrant

If no information is available for a person, a message with "No records found" displays.

 

C—825.13.1 TWC Error Messages

Revision 19-4; Effective October 1, 2019

 

All Programs

An error message may appear when a request is made and the TWC database is unavailable.

When a TWC inquiry is requested and an error is returned, the Table of Contents of the Data Broker Combined Report will display the following message next to the TWC header:

“Request timed out. Please click here to retry again.”

By clicking on this link, staff can re-request the report without re-entering the person’s information. Staff should continue to retry until the information becomes available.

 

C—825.14 Office of the Attorney General (OAG) Child Support

Revision 19-4; Effective October 1, 2019

 

All Programs

This report contains child support data from the OAG's database. Data Broker searches the OAG database and pulls records for the person entered on the Combined Report Search screen and displays all people receiving and paying support payments associated with that person.

The OAG information available through Data Broker allows staff to obtain child support income that may not be listed on Form H1010, Texas Works Application For Assistance – Your Texas Benefits, or otherwise reported, reducing the risk of fraud and quality control payment errors. Additionally, Data Broker offers household composition case clues by listing an address for each member, if available, on the combined report associated to a particular OAG case.

This report is also available via an interactive inquiry in the Data Broker Search Options menu to conduct a member or financial search.

  • A member search is used when the case name or adult household member's Social Security Number (SSN) is not available.
  • A financial search can be done for specific financial information for a period not found on the Combined Report Search.

Note: The Texas Child Support Enforcement System (TXCSES) web-based system is available for limited use, if needed, to obtain information not found within the Data Broker system.

Related Policy
Accessing Texas Child Support Enforcement System (TXCSES), C-832.1

 

C—825.14.1 OAG Child Support Data

Revision 19-4; Effective October 1, 2019

 

All Programs

Child support data may be provided in some or all of the six fields below for each report:

  • Collections – current child support, medical support, dental support, spousal support, and arrears from the person for whom the Data Broker inquiry was requested.
  • Disbursements – current child support, medical support, dental support, spousal support, and arrears to the person for whom the Data Broker inquiry was requested.
  • Obligated Support – reported for both collections and disbursements.
  • Member Details – includes all members associated with the child support case.
  • Unknown Payments – payments made to a person when the type of payment is unknown.  When unknown payments exist, explore the payment type with the person.
  • Family Violence Indicator – the child support record in Data Broker will have a family violence indicator when family violence is indicated by OAG.

Note: If staff discover payments or the person states they have received payments not listed in Data Broker, access the Texas Child Support Enforcement System (TXCSES) to verify these payments and obligations. If the necessary information is not available in TXCSES, pend for verification.

Case is a 'registry-only' case, which means that not all obligations nor dependents may be listed.

The Data Broker OAG screens contain a detailed breakdown of the following information:

  • The reports are member-oriented instead of case-oriented. The report contains details from all child support cases associated with the person (member), including both collections and disbursements. If the person receives disbursements from multiple absent parents (AP), the payments from each AP are displayed separately within each report.
  • The report displays collections and disbursements. Payments from all child support cases associated with a particular person will be displayed in the report.
  • Support order obligations are sorted per dependent. Legal obligations typically reflect a monthly amount. The Obligated Support section is displayed to inform staff of the legally obligated amount.

    The Per Period Amount column under the Obligated Support section displays the total obligated amount for all children of an absent parent. The Per Child Amount displays each child's portion of legally obligated support. If there is only one child, then the amounts in the Per Child Amount and Per Period Amount columns will be the same. If there are more children, the sum of all the Per Child Amounts will be reflected in the Per Period Amount column.

    The Duration column displays the period for which the legal obligation applies. The child support order establishes the begin date and end date of the legal obligation. Orders normally end once the child turns 18 or graduates from high school, if later, although obligations may continue past this date due to a child's disability. When the obligation includes more than one child of a different age and the obligation ends for a child, a new duration period will be reflected in the duration field. If at any time the AP becomes delinquent in payments, child support and medical arrears can be ordered in addition to the amount the AP is originally ordered to pay, and this may prolong the AP's obligation duration period.

Note: Payments (collections and disbursements) are sorted by support type (e.g., child support vs. medical support).

  • Disbursement Payments are sorted by dependent. The Data Broker child support function automatically calculates and sorts the payment information for each dependent on the case when a single payment is made for more than one dependent.

    The Per Child Amount column displays the amount to be entered into TIERS for each dependent listed in the Dependents column. Data Broker reports payments disbursed for a child under the dependent's name even if the child is not in the household. 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, count it as unearned income as required by policy in A-1326.2, Child Support. Staff must not count the amount used for or provided to the nonmember for whom it is intended to cover. Verify what the person is doing with the payments and what amount must be counted.

Note: Legal obligations are typically established as a monthly obligation. Wages are typically garnished based on the pay frequency of the AP's job. Therefore, the amounts shown on the screens for collections and disbursements reflect the frequency for which the OAG receives the payments, which is usually other than monthly.

For additional policy information on child support payments and how they are allocated for members and non-members, refer to A-1326.2, Child Support.

  • Disbursement Received dates are calculated by Data Broker and displayed in the report. Data Broker automatically applies the policy in A-1326.2.1, Counting Child Support, to estimate the date a child support payment is received by adding five days from the date a warrant was mailed or by adding two business days from the date an electronic transfer was initiated, excluding weekends and bank holidays. Therefore, when using Data Broker to verify child support, use the Receive Date as the estimated date the person receives a child support payment disbursed by the OAG.
  • Only payments disbursed to the person will be displayed to assist in reduction of calculation and payment errors. All collections will be displayed in the Collections screen. Because all collections are potentially a deductible expense, only payments that were disbursed to the person will be displayed in the Disbursements screen to help reduce errors (e.g., payments given to HHSC as repayment services will not be displayed). If the OAG disbursed additional payments to an entity other than the person, disbursement information will be listed in the additional payments section of the report and will include the name of the entity that received the payment. This is displayed for informational purposes.

Note: If a person reports receiving child support via the Texas OAG and those payments are not being reflected on the Data Broker Portal, check the TXCSES Web portal to verify the payment(s). Infrequently, staff may also be unable to verify using the TXCSES Web portal. In this situation, pend the case for proof of the child support payment.

Example: A person is receiving child support payments for a dependent from an out-of-state order and the Texas OAG does not yet have the child support order but is receiving payments on behalf of the person.

  • Arrears payments are separated in the report to help ensure staff count them properly. Enter arrears payments as income for the person to whom the payments are disbursed, not for the dependent.
  • Member addresses are displayed as a case clue to determine household composition and to aid in determining if an absent parent has moved back into the same home as the custodial party. The Member Details section will display all members associated with the person for whom the report was requested. The report will display the person and all members associated with that OAG case.

Note: If an absent parent is making child support payments but moves back into the home of the caretaker and child, do not count the child support as income nor allow the child support as a deduction.
 

Related Policy
Child Support, A-1326.2
Medical Support Payments, A-1326.2.3
Reimbursements, A-1332
Child Support Deductions, A-1421

 

C—825.14.2 OAG Error Messages

Revision 19-4; Effective October 1, 2019

 

All Programs

Error messages may appear when a request is made and the OAG database information is unavailable. When the OAG information is requested and unavailable, a feature in the table of contents of the Standard Combined Report will display the following message:

“Request timed out. Please click here to retry again.”

By clicking on this link, staff can re-request the report without reentering all the person's information. Staff should continue to retry until the information becomes available.

 

C—825.15 SNAP Out-of-State IPV Disqualifications

Revision 19-4; Effective October 1, 2019

 

SNAP

This report lists Intentional Program Violation (IPV) disqualification information from other states applicable to the person for whom the report was requested. Follow policy in B-941, Disqualifying a Household Member with a Current SNAP Out-of-State IPV Disqualification, when this is reported.

 

C—825.15.1 Texas Lottery Winnings

Revision 19-4; Effective October 1, 2019

 

All Programs

This report contains Texas Lottery Commission verification of winnings and is displayed on the data broker combined report.  

The report contains the following information:

  • winner’s full name, date of birth and Social Security number;
  • paid date;
  • gross, net, and taxes withheld amounts;
  • check ID, claim number and date claim created;
  • debt offset (also known as a recoupment);
  • reason for the offset;  
  • the agency names the offset is for;
  • withholding amount;
  • withholding number;
  • withholding sequence number;
  • check ID and agency ID; and
  • void date.
    • The void date will be provided only if the Texas Lottery Commission voids a check.
    • If the Texas Lottery Commission voids a check, the winnings must not be counted as income.

Related Policy
Texas Lottery Commission, A-1326.28

 

C—825.16 Alien Status/Systematic Alien Verification for Entitlements (SAVE)

Revision 19-4; Effective October 1, 2019

 

All Programs

Data Broker provides a verification of alien status using SAVE.

Staff verify the immigration status of each non-citizen applying for benefits by accessing the:

  • Data Broker Combined Report in TIERS; or
  • Data Broker Portal.

When using TIERS, staff select Individual ID in the Individual Information LUW (only for people 16 years old or older), an Alien Status option appears at the top of the Data Broker Combined Report page with options:

  • Alien Status — Sends a Request for Initial Verification to the Department of Homeland Security (DHS).
    • By clicking on the Alien Status option, the last name, first name and birthdate fields are prepopulated based on the information in TIERS Data Collection.
    • Enter the alien registration number per the U.S. Citizenship and Immigration Services (USCIS) document.
  • Case History — Displays prior SAVE inquiry responses.

When using Data Broker Portal (All people including children under age 16 years old):

  • Alien Status — Sends a Request for Initial Verification to the Department of Homeland Security (DHS).
    • By clicking on the SAVE option, staff will be required to enter the last name, first name and birthdate fields are prepopulated based on the information.
    • Enter the alien registration number per the U.S. Citizenship and Immigration Services (USCIS) document.
  • Case History — Displays prior SAVE inquiry responses.

By clicking on the Verification SAVE Status option, the last name, first name and birthdate fields are prepopulated based on the information in TIERS Data Collection. Enter the alien registration number per the U.S. Citizenship and Immigration Services (USCIS) document. Staff should only access Data Broker reports for people 16 and older. Staff must continue to use the stand-alone SAVE Web-based system for people younger than 16.

 

Related Policy
Verifying Alien’s USCIS Documents, A-355
Providing Verification of the Alien's Sponsor Income and Resources, A-316.1

 

C—825.16.1 Alien Status Historical Data

Revision 19-4; Effective October 1, 2019

 

All Programs

This feature searches alien status history for up to the last six months to determine if a previously submitted inquiry, with a valid document, is available.  A new alien status inquiry will not display if any inquiry with a valid unexpired document has been completed within the last six months. A message will display along with the historical record when this occurs.

If the document on file is expired, a request to perform a new initial verification automatically occurs.

 

C—825.16.2 Alien Status Initial Verification

Revision 19-4; Effective October 1, 2019

 

All Programs

Choose the noncitizen’s document type from a drop-down menu. The Document Type drop-down menu lists the most common types of documents used to verify alien status. If the document type is not listed, choose “Other.” Depending on the type of document, staff must complete certain fields before submitting the request.

The card number from the I-551, Permanent Resident Card, that must be entered in SAVE is 13 alphanumeric digits and begins with three letters. I-551s issued between May 2004 and May 2010 have the card number on the front, and I-551s issued beginning in May 2010 have the card number on the back.

Note: To verify whether SAVE was completed, staff should use Data Broker > Case History in the Data Broker Portal.

 

C—825.17 Inmate/Parolee Match

Revision 19-4; Effective October 1, 2019

 

All Programs

The Inmate/Parolee Match displays prisoner information for people who are incarcerated.

The following identifying information is displayed, if applicable, for the incarcerated person:

  • name;
  • SSN;
  • DOB;
  • last known address;
  • incarceration sentence date (first day of incarceration);
  • earliest release date;
  • prison unit;
  • offense; and
  • date of offense.

Treat prisoner match information as a case clue when Data Broker shows the person is currently incarcerated and the current date is more than 30 days after the incarceration sentence date.

For applications and renewals with an interview (and at a change when applicable), if the person identified as incarcerated is not present or available by phone, staff must ask whether the person is still incarcerated.

If the household:

  • Agrees that the person is not in the home, remove the person from the EDG and process the case action.
  • Disagrees and states that the person is in the home, pend for verification of household composition. For applications and renewals that require an interview and at a change, attempt to contact the household to inquire about the person shown as incarcerated in Data Broker.

If contact can be made, follow the appropriate steps above for households who agree or disagree with the report of incarceration.

  • If contact cannot be made, pend for verification of household composition using the sources explained above.

Document the following information in case comments:

  • the household’s response regarding whether they agreed or disagreed with the incarceration information in Data Broker;
  • when a household member is not included because of incarceration information in Data Broker;
  • if applicable, attempts made to verify and explain how questionable information was cleared (C-940, Documentation); and
  • if applicable, when a fraud referral is sent to OIG (B-720, When to File an Overpayment Referral).
     

Related Policy
Questionable Information, C-920
Verification Sources, A-251

 

C—825.18 Texas Lottery Commission

Revision 18-2; Effective April 1, 2018

 

All Programs

The data broker report contains Texas Lottery Commission verification of winnings and is displayed on the combined report, if applicable.  The report contains the following:

  • winner’s full name, date of birth and Social Security number;
  • paid date;
  • gross, net and taxes withheld amounts;
  • check ID, claim number and date claim created;
  • debt offset (is the same as recoupment), reason for the offset, and the agency name the offset is to, withholding amount, withholding number, withholding sequence number, check ID and Agency ID; and
  • void date.
    • The void date will only be provided if the Texas Lottery Commission voids a check.
    • In the situations where the Texas Lottery Commission voids a check, the winnings will not be counted as income.

Related Policy
Texas Lottery Commission, A-1326.28

 

C—826 Entry Instructions

Revision 12-4; Effective October 1, 2012

 

 

 

C—826.1 Requesting Data Broker Reports in the Stand-alone System

Revision 19-4; Effective October 1, 2019

 

Use the Data Broker Portal to pull specific data element searches, such as TWC, OAG, etc. Staff can also use the Data Broker Portal if TIERS is experiencing technical issues.

 

All Programs

DL Number: Enter the TDL number or Texas ID card number. This is not a mandatory entry, but when staff enter this number and click the Lookup button, the system automatically pulls data for all fields except SSN and Case Number. If DPS data is incorrect or obsolete, enter the correct data over the incorrect data.

Inquire On: Click on the appropriate description for the person on whom you are making the inquiry.

  • Applicant — New applicants or household additions.
  • Recipient — Currently active recipients.
  • None of the Above — Anyone who is not an applicant or recipient.

SSN: Enter the SSN of the person for whom you need Data Broker information. Do not enter an incorrect or false SSN. If an incorrect SSN is entered, an erroneous file may be created or information for the wrong person may be pulled.

Case Number: Enter the TIERS application/case number. Never enter a false TIERS application/case number or one belonging to another person.

Enter information in the remaining fields marked with an asterisk when the Texas ID or TDL number is unknown. These fields are self-explanatory.

 

C—826.2 Requesting Data Broker Reports in TIERS

Revision 19-4; Effective October 1, 2019

 

Staff must request and view the Data Broker Combined Report for applicable household members to accurately determine eligibility and clear any discrepancies. Failure to view this report may result in eligibility errors that can lead to quality control errors.

In the TIERS Regular or Customized Redetermination driver flow, submit a Data Broker request for each individual household member 16 and older, including members without an SSN.

In the Redetermination Summary logical unit of work, each page has a DB icon DB Icon.

  • Click the DB icon DB Icon at the top of the page to access the Data Broker window.
  • The Data Broker Combined Report link will display.
  • Click on the Data Broker Report link to view the Data Broker Combined Report for the person.

Follow the same process for each additional household member for whom a Data Broker Combined Report is needed. The Data Broker Report Link expires after 15 minutes if not clicked.

Data Broker in TIERS cannot do interactive searches on specific data; it only produces the Combined Report. For example, if staff only needs OAG information, staff go to the Data Broker Portal instead.

Requesting a Data Broker Combined Report with Credit Information

A credit report may be requested after a Data Broker report has been displayed. At the bottom of each Data Broker report is a section that allows a credit report to be requested on the person for whom the Data Broker report was run. There is a message displayed that states, “Click here to request and view a credit report.” Clicking on the link is a request for a credit report.

 

Related Policy
Data Broker, C-820

 

C—827 Data Broker Combined Report Sources With Credit Report

Revision 19-4; Effective October 1, 2019

 

All Programs

The credit information provided in Data Broker Combined Report with credit information is received from Experian. It also includes all the sources found in C-825, Combined Data Broker Report Sources.

 

Related Policy
Data Broker, C-820
Permissible Purpose. C-824

 

C—827.1 Credit Report

Revision 19-4; Effective October 1, 2019

 

All Programs

Information provided on this screen is provided to the credit reporting agencies by creditors. Use the information as a case clue only when determining:

  • household management;
  • vehicle ownership;
  • employment; and
  • other potential causes of case errors.

Verify credit report information before taking any action on an EDG.

 

C—827.1.1 Reserved For Future Use

Revision 19-4; Effective October 1, 2019

 

 

 

C—827.1.2 Reserved For Future Use

Revision 19-4; Effective October 1, 2019

 

 

 

 

C—827.1.3 Reserved For Future Use

Revision 19-4; Effective October 1, 2019

 

 

 

 

C—827.1.4 Credit Summary

Revision 13-3; Effective July 1, 2013

 

All Programs

This screen is a record of information creditors provide to the credit reporting agencies. Use the information as a case clue in determining:

  • household cash flow,
  • vehicle ownership,
  • employment, and
  • other potential causes of case errors.

The information is generally accurate; however, it cannot be considered verification for any action taken by HHSC. The advisor must verify credit report information before taking any action on an EDG.

 

C—827.2 Active and Inactive Accounts

Revision 19-4; Effective October 1, 2019

 

All Programs

This report contains detailed information from creditors which includes corresponding payment records.

This information should be used as a case clue for the household’s management. For example, if all credit cards are paid yet the household’s management is negative, staff should ask how the household is able to pay all bills with reported income.

 

C—827.3 Lender Information

Revision 19-4; Effective October 1, 2019

 

All Programs

This report provides the name, address and phone number of the creditor.

 

C—827.4 Client Income

Revision 19-4; Effective October 1, 2019

 

All Programs

This report includes information the person reported to lenders regarding their income. This information is not available on every report and is based only on the person’s statement.

Compare employers and income listed to information received during the interview or from the application. Explore any other income or discrepancies reported by the person to lenders.

 

C—827.5 Inquiries for New Credit

Revision 19-4; Effective October 1, 2019

 

All Programs

This report lists the names and dates of credit inquiries for the person. Each time a credit report is requested, the name of the requestor and the date of the request is added to the person’s credit report.

An inquiry may indicate the need to further explore the person’s income and resources. For example, inquiries from auto dealers or auto lending institutions are case clues to a possible vehicle purchase.

 

C—828 Providing Copies of Data Broker Reports

Revision 19-4; Effective October 1, 2019

 

All Programs

Do not print a Data Broker report unless a person:

  • Requests a copy of the Data Broker (DB) report, staff must provide a copy of the DB report.
  • Requests a fair hearing and staff used a Data Broker report (including a credit report) to determine eligibility, mail a copy of the Data Broker report, including the credit information, to the hearing officer with the other case information.
  • Questions the credit report information, explain that eligibility was based on several sources, including a credit report obtained from the consumer reporting agency.

For most inquiries, historical DB information is retained for five years from the initial inquiry date.  Staff can retrieve and view previously pulled Data Broker inquiries through the Data Broker Portal.

A person has the right under the Fair Credit Reporting Act (FCRA) to obtain a free copy of the person’s credit report within 60 days from the notice of adverse action. To obtain a free copy, the person can contact Experian at:

701 Experian Parkway
P.O. Box 4500
Allen, TX 75013
888-397-3742
www.experian.com

Related Policy
Permissible Purpose, C-824

 

C—829 Case Actions

Revision 19-4; Effective October 1, 2019

 

All Programs

When information on any report and the person’s statement are discrepant, offer the person an opportunity to verify the information.

When staff discover questionable information, treat it as any other questionable information. Provide the individual Form H1020, Request for Information or Action, and pend for verification.

When staff request Data Broker information during a SNAP certification period and the report reveals information regarding anything other than vehicles, follow procedures in B-125.1, Due Dates.

When HHSC takes adverse action on an EDG based on information gained either directly or indirectly through the use of a credit report, the FCRA requires HHSC to notify the person. Staff must indicate in TIERS the action taken was based on credit report information and the TF0001 notice contains specific information about client rights mandated by the FCRA.

Related Policy
Permissible Purpose, C-824
Notice to Applicants, A-2310

 

C—830 Child Support Systems

Revision 01-7; Effective October 1, 2001

 

 

C—831 Grant in Jeopardy Process

Revision 15-4; Effective October 1, 2015

 

TANF

The OAG sends the TANF recipient child support collection interface after the close of business on the last day of each month. HHSC uses the interface to determine if child support collections exceed the TANF grant plus the disregard and processes grant in jeopardy.

The TANF recipient child support collection interface includes the:

  • TANF case information;
  • amount of collections from each absent parent; and
  • amount of excess payments.

HHSC automation staff:

  • compare the OAG collection information to the current TIERS information;
  • send a notice of excess payment to the advisor, if applicable;
  • determine if any member of the certified group was certified for TP 01 or TP 61 in at least three of the last six months; and
  • determine if the collection still exceeds the TANF grant plus the disregard.

If the collection amount exceeds the TANF grant plus the disregard, the system:

  • places the EDG on hold, pending denial;
  • produces a notice reflecting automated action to the advisor and individual; and
  • denies the EDG if the EDG is still on hold at cutoff in the hold effective month.

Examples

November – The OAG receives child support collections on TANF EDGs. At the end of the month, the OAG sends the collection information to HHSC. HHSC determines:

  • whether the collection causes grant in jeopardy; and
  • if there is an excess payment.

December – HHSC receives the collection information the first week of the month. TIERS compares the collection to the grant plus disregard. If it exceeds the grant plus disregard, TIERS:

  • places the TANF EDG on hold effective January 1;
  • produces a notice to the advisor;
  • produces a notice to the individual; and
  • sends the updated tape to the OAG at cutoff.

The OAG repeats the process shown in November for any December child support collections received.

January – The TANF EDG is on hold. In the first week of the month, the OAG sends:

  • the disregard to the individual (from the December child support collection);
  • any excess payment to the individual (from the December child support collection); and
  • any January child support collections (as they are received) to the individual.

At cutoff, TIERS denies the case.

February – The OAG sends any collected child support to the individual.

 

C—832 Office of the Attorney General (OAG) Inquiry

Revision 05-5; Effective October 1, 2005

 

All Programs

The Texas Child Support Enforcement System (TXCSES) is the OAG computer inquiry system. Staff access TXCSES for verification of child support information. In order to access TXCSES, staff must have an OAG user identification number. Obtain a user ID by:

  • completing OAG security Form 08.010, Office of the Attorney General Child Support Division Information Access Statement of Responsibility, and HHSC security Form 4743, Request for Applications and System Access; and
  • mailing both forms to the Regional Security Officer (or designee), who forwards them to the state office security officer. The state office security officer coordinates assignment with the OAG.

Staff must use their security IDs at least every 30 days or the ID becomes dormant and must be reset through the security system.

This section contains information about entering and exiting the system and an explanation of the screens. Refer to the user guide for detailed information.

 

C—832.1 Accessing Texas Child Support Enforcement System (TXCSES)

Revision 05-5; Effective October 1, 2005

 

All Programs

Download the system from www.tx.net/download/oag. Use the following steps to access the system.

  1. Click on the designated icon or click on the Start button and then click Qws3270.Exe.
  2. At the ENTER LOGON prompt (Texas map screen), type TXAGCNTY, press Enter.
  3. On the same screen, click on the Reset button, and then click on the Clear button. These buttons are at the bottom of the application window.
  4. The OAG Child Support Enforcement screen appears.
  5. Follow the standard logon procedures:
    1. In the Application ID field, type "CSES."
    2. Tab to the User ID field and type in your User ID.
    3. Tab to the Password field. The first time you sign on, type your temporary password assigned on Form 4743.
    4. Tab to the New Password field and type in a new password. The new password must:
      • be exactly eight characters in length;
      • be a combination of alpha, numeric and allowable special characters(allowable characters are @, # and $);
      • contain at least one special character that must not be located in the first or last positions;
      • contain only one set of repeating characters;
      • be changed every 32 days;
      • not be shared, written down or posted; and
      • not be reused for periods of up to one year.

      When you press Enter, the system will ask you to retype your new password. The next time you sign on you will use your new password.

    5. The Child Support Enforcement Menu appears. To access a screen, you may type the number corresponding to a screen shown on the menu or you may go directly to the screen by typing the four-letter screen ID in the Command line. Press Enter.

 

C—832.2 TXCSES Menu Screens

Revision 08-4; Effective October 1, 2008

 

All Programs

The following is a partial list of available inquiry screens in the Texas Child Support Enforcement System (TXCSES):

  • Member Search Selection Screen (MSCH) — Use to search for a member with a minimum amount of identifying information.
  • Member to Cases Inquiry (MCAS) — Identifies all cases a member is associated with and other members related to these cases.
  • Case Information (CINF) — Displays basic information about a case.
  • Case Profile (CPRF) — Displays high level information on a case, such as case type, status of case, number of dependents, grant amount, custodial parent (CP) and non custodial parent (NCP) name and their member ID number and current addresses, NCP earnings, and whether health insurance is available through the employer.
  • Grant History Screen (GRNT) — Displays the monthly detail of the grant history and Prior Months Unrecovered Assistance (PMUA) by HHSC Case No..
  • Monthly Receipt Summary (MRSM) — Displays the distribution of the collections for a CP on a monthly basis.
  • Warrant Status History (WHIS) — Displays the disbursement status for a specific warrant or electronic fund transfer (EFT) identifying a direct deposit. The date the warrant was disbursed, issued, mailed, or cancelled. The dollar amount of the warrant and warrant number. The CP's current address and the address where the warrant was mailed.
  • Child Support Office Directory (CSOD) — Provides general information about a child support office.
  • Child Support Staff Directory (CSSD) — Use to search for a specific employee or group of employees. Also, use to identify the name, current address, and telephone number of the child support officer who initiated asanction request.

 

C—832.3 Exiting TXCSES

Revision 04-7; Effective October 1, 2004

 

All Programs

To exit TXCSES:

  • press F3 when the main menu (CSEM) displays;
  • type exit or end in the Command line; or
  • click on the windows X or close while in any of the screens and then click on Exit, located on the top bar menu.

 

C—833 TXCSES Web Child Support Portal Inquiry

Revision 08-4; Effective October 1, 2008

 

All Programs

The TXCSES Web is an Internet-based application developed by the OAG. The TXCSES Web is a comprehensive verification source that allows users to view child support collection, distribution and support obligation records.

TXCSES Web replaces the TXCSES OAG computer inquiry system as the primary verification source for child support payment information.

 

C—833.1 Requesting Access to TXCSES Web

Revision 08-4; Effective October 1, 2008

 

All Programs

Advisors with access to the TXCSES OAG computer inquiry system will use a USER identification (ID) and password to access TXCSES Web. New users must obtain a USER ID by completing:

  • the OAG security Form 08.010, Office of Attorney General Child Support Division Information Access Statement of Responsibility; and
  • the HHSC security Form 4743, Request for Applications and System Access.

Mail both forms to the Regional Security Officer (or designee), who forwards the forms to the state office security officer. The state office security officer coordinates assignment with the OAG.

 

C—833.2 Logging On to TXCSES Web

Revision 08-4; Effective October 1, 2008

 

All Programs

Advisors must have an active USER identification (ID) to access the TXCSES Web. The USER ID and password for TXCSES Web is the same logon as the one used to access the TXCSES OAG computer inquiry system. To log on to TXCSES Web:

  1. Open the link to the TXCSES Web application in the browser (https://portal.cs.oag.state.tx.us/wps/portal).
  2. Type your USER ID in the User ID field.
  3. Type your password and click Login.
  4. Read the Statement of Responsibility and click I Agree.
  5. Read the Account Policy and click I Agree.
  6. Click TXCSES Web located at the top under the header Child Support Online. This will bring up the Main Search Income Verification Screen.

 

C—833.3 Procedures for Obtaining Payment Information

Revision 08-4; Effective October 1, 2008

 

All Programs

The Texas Child Support Enforcement System (TXCSES) Web Main Search Income Verification Screen includes four member search options:

  • Last Name and/or First Name
  • DOB, MMDDYYYY
  • SSN, 123456789
  • Member ID (OAG Member ID)

Note: Advisors should use an SSN for inquiry when possible for a more accurate method of locating an applicant's information.

From the Search Results section, click on the case ID number with an "active status" to retrieve the child support payment information such as collections, distributions and support order obligations.

Note: By clicking on the + icon on the Disbursement Summary Details column, the advisor can view the payment type such as warrant, direct deposit/electronic transfer and Texas debit card. See A-1326.2.1, Counting Child Support, for assistance in determining when to consider the payment type available to the custodial parent.

 

C—833.4 Logging Off of TXCSES Web

Revision 08-4; Effective October 1, 2008

 

All Programs

Click Logout to exit the Texas Child Support Enforcement System (TXCSES) Web application. Users are automatically logged off the application after 30 minutes of inactivity. Three unsuccessful logon attempts or 30 days of inactivity in either TXCSES or TXCSES Web suspends the USER identification (ID). Contact the regional security officer to reset the password if this occurs.

It is important to keep the user name active by logging on periodically. If staff do not logon to TXCSES or TXCSES Web within 90 days of the last logon, the user name is deleted.

 

C—834 Child Support Noncooperation (CSNC) Online System

Revision 05-5; Effective October 1, 2005

 

TANF and Medical Programs

The OAG provides HHSC a weekly interface indicating when anindividual fails to cooperate with child support or medical support requirements. The Office of Family Services receives the interface, processes and maintains the data on the Child Support Noncooperation (CSNC) online system. The online system replaces the manual process for clearing reports of noncooperation.

 

C—834.1 Requesting Access to CSNC

Revision 05-5; Effective October 1, 2005

 

TANF and Medical Programs

Texas Works staff responsible for assigning, clearing, reviewing and/or monitoring child support noncooperation data may request access to the system.

Supervisors/managers complete Form 4743, Request for Applications and System Access, for each employee needing access to the CSNC system and writes CSNC in Box 14. The supervisor/manager sends the completed Form 4743 to their regional security officer (or designee). The regional security officer forwards it to the state office security officer.

 

C—834.2 CSNC Passwords

Revision 05-5; Effective October 1, 2005

 

TANF and Medical Programs

Once Form 4743 is approved, the initial password is returned on the form. Staff may change their password at anytime. For password changes, click "Tools" on the CSNC home page and enter the old and new password information in the appropriate fields. For forgotten passwords, contact the HHSC help desk to have the password reset.

 

C—834.3 Logging on to CSNC

Revision 05-5; Effective October 1, 2005

 

TANF and Medical Programs

After accessing the HHSC Intranet, enter http://opi-pa.dhs.state.tx.us/1708-Online/1708.aspx for the CSNC website. To log on, select Search/Login from the main menu header. Enter username and password. Click "OK" to complete the login.

 

C—834.4 Procedures for Requesting CSNC Data

Revision 05-5; Effective October 1, 2005

 

TANF and Medical Programs

The CSNC system searches the database to locate information by:

  • mail code;
  • region; or
  • case number.

When searching by mail code or region, staff may request data by report run date and download the data to Excel. Click "OK" to obtain the request.

When a match is found, CSNC generates a list of noncooperation data meeting the inquiry criteria.

 

C—834.5 CSNC Field Descriptions

Revision 05-5; Effective October 1, 2005

 

TANF and Medical Programs

The following is a list of data fields and descriptions:

  • MC_WKR — Mail code found on SAVERR for the case record.
  • MC_SUP — Supervisor's mail code for the BJN associated with the case record on SAVERR.
  • TANF_CASE — TANF case number.
  • TP — Type program. Reports are generated for both TANF and medical type program cases.
  • CARETAKER_PARENT — Identifies the person who is noncooperating with the child support requirements.
  • CARETAKER_PARENT_ADDRESS — Caretaker/parent's address.
  • ABSENT_PARENT — Name of the absent parent.
  • REASON_CODE — Reason code associated with the noncooperation.
    1. Failed to keep appointment and did not make another appointment.
    2. Failed to appear for court.
    3. Failed to respond to AFDC questionnaire.
    4. Failed to appear for blood testing scheduled.
    5. Failed to submit payments received directly from NCP to OAG.
    6. Failed to return a URESA-O testimony or paternity affidavit.
    7. Failed to adhere to the terms of a repayment agreement.
    8. Failed to submit or sign legal documents.
    9. AF named by CP excluded by blood test, CP failed to provide info.
    1. (Alpha) Form Text.
  • REASON_DESCRIPTION — Reason code description.
  • ACTION_CODE — Indicates the action the person must take to clear the noncooperation.
    1. Schedule and keep appointment with the child support officer.
    2. Appear in court on set date.
    3. Complete and return questionnaire to child support officer.
    4. Appear with child/children and submit to blood testing when rescheduled.
    1. Free form text.
  • ACTION_DESCRIPTION — Action code description.
  • AG_ADDRESS — Local OAG child support office address.
  • AG_PHONE — Local OAG child support office telephone number.
  • AG_MC — Local OAG child support office mail code.
  • AG_BJN — Local OAG child support officer's BJN.
  • BJN — SAVERR case budgeted job number.
  • REG — HHSC region where the case is located.
  • RUN_DATE — Indicates the date OAG sends the file to HHSC.
  • POST _DATE — Date the Office of Family Services Business Support posted the data to the website.

 

C—834.6 Exiting CSNC

Revision 05-5; Effective October 1, 2005

 

TANF and Medical Programs

To exit CSNC Inquiry, click "Logout" on the menu bar, then:

  • click the "X" in the upper right-hand corner; or
  • select "File" on the browser tool bar, then select "Close."

 

C—840 DataMart

Revision 15-4; Effective October 1, 2015

 

All Programs

DataMart provides a series of online reports, accessed through the State Portal. The reports are used as monitoring tools for various case action activities within Texas Works.

Instructions for accessing and using the various reports may found at the following Texas Works Policy page on the Loop:

http://oss.txhhsc.txnet.state.tx.us/sites/tw/TW%20Data%20Mart%20Instructions/Forms/AllItems.aspx

 

C—841 DataMart Reports

Revision 19-3; Effective July 1, 2019

 

Number The Report …
DF-001a Felony Drug Conviction (FDC) Disqualification for SNAP
Provides a monthly count of people previously disqualified for an FDC occurring on or after August 22, 1996 who are now receiving SNAP benefits on an approved SNAP EDG.
DF-001b EDGs Denied for Parole/Community Supervision Compliance Verification
Provides data on SNAP EDGs denied for failure to provide verification of compliance with parole or community supervision.
DF-001c SNAP FDC Disqualifications
Provides data on the number of people who have a two-year or permanent SNAP disqualification related to FDC.
DG-001 Reviews and Recertifications Due by Office
Allows managers and appropriate field staff to identify TANF, Texas Works (TW) Medicaid, CHIP and SNAP Redeterminations that are due in a month specified by the user.
DG-002 Pending Applications
Allows managers and appropriate field staff to identify pending TANF, SNAP, TW Medicaid, CHIP, CHIP perinatal and Healthy Texas Women (HTW) applications on a daily basis.
DG- 003 Work In Progress (WIP)
Allows managers and appropriate field staff to identify open TANF, SNAP, TW Medicaid, CHIP, CHIP perinatal, and HTW actions on a daily basis.
DG-004R Delinquency Analysis Data Report
Provides detailed data that is consolidated to aid in the analysis of causal factors contributing to each delinquency.
DG- 006 Task List Manager (TLM) Task Aging by Past Due Date
Allows managers and appropriate field staff to identify all the tasks that are not closed by the TLM task due date.
DG-007 Appointment No Show
Gathers all the details for an appointment with a No Show (NS) status to ensure TLM No Show task actions are completed timely.
DG-008 Appointment Slots Utilization
Allows managers and appropriate field staff to identify all the appointment slots published for a specific office or group of offices using State Portal Scheduler and the number of appointments slots already scheduled for an interview for a selected office and reporting period.
DG-009 Tickets/Service Request Status Report
Provides a consolidated source for viewing all open Remedy and Project and Portfolio Management Center (PPM) tickets or recently closed PPM tickets.
DG-010 Disposition Timeliness Report
Assists management to efficiently monitor the timeliness percentage, total dispositions for all applications and redeterminations, timely and untimely dispositions and the number of disposing employees for TANF, SNAP, TW Medicaid, CHIP, CHIP perinatal, and Medicaid for the Elderly and People with Disabilities (MEPD) programs. This report will display the timeliness based on the disposition date.

Note: This report provides timeliness for redeterminations disposed timely or untimely. Types of Assistance (TOAs) that have a passive renewal will be included if a recertification package is received and processed.
DG-011 Review Timeliness Report
Assists managers to efficiently monitor the number of delinquent reviews, the age of the delinquent reviews and the percentage of the total caseload that is delinquent for the following three types of assistance in TIERS:
  • MA - Parent and Caretaker Relatives
  • TANF Basic
  • TANF State Program
Note: This report provides information on past due redeterminations that have not been processed and/or disposed. Timeliness for other programs is monitored through other reporting mechanisms. TOAs that have a passive renewal will not be included on this report.
DG-012 Pending Applications and Redeterminations over 60 Days
Assists management to identify and monitor applications and redeterminations pending over 60 days for SNAP, TW Medicaid, CHIP, CHIP perinatal, TANF, and MEPD on a daily basis, and to identify the current employee assigned with pending applications and redeterminations.
DG-014 Merge/Separate (M/S) WIP Report
Assist management and Data Integrity staff to identify and monitor pending M/S TLM request tasks on a daily basis.
DG-015 M/S Timeliness Report
Assist management to efficiently monitor the number of completed M/S TLM requests, and the number and percentage of timely completed M/S TLM requests.
DG-016 M/S Daily Potential Duplicate Report
Provides Data Integrity staff a daily list of potential TIERS duplicate individual IDs created and/or updated on any given day and an individual summary and potential match detailed level reports.
DG-017 Office of Eligibility Services (OES) Community Based Organization (CBO) Data Report
Assists with statistics for federal reporting on the Community Partner project. The report provides the number of CBO applications and redeterminations:
  • submitted;
  • pending;
  • disposed; and
  • percentage of total EDGs processed timely.
DG-020 Community Partner Case Action and Status View Report
Case Action Summary report provides CBOs with the ability to track the volume of applications, redeterminations, and changes submitted by their organization. Case Status View Activity report tracks the inquiries completed.
DG-021 Request for Review Report
Allows managers and appropriate field staff to view the CHIP and CHIP perinatal request for review report by region, status, manager and employees. The report captures the number of requests for review pending, completed, and requests for retro coverage.
DG-022 Automated Electronic Reminders
Provides the status of the total number of current subscriptions to electronic reminders at the end of each month and provides the number of electronic reminders sent to people for each reminder type.
DG-038 EDG-Level Processing for Medicaid Renewals
Provides EDG-level information for EDGs completed through the automated Medicaid Renewal Process.
DG-039 ACA Periodic Income Check Report
Provides EDG-level information for EDGs eligible for the periodic income check.
DF-040 Eligibility Performance Report
Provides a method for managers to measure productivity at the Employee and Manager Levels; provides daily and monthly statistics for employees and managers; monitors applications, redeterminations, and changes for SNAP, TANF, Texas Works Medical Assistance (including Children's Medicaid, CHIP and CHIP p), MEPD, and State Paid coverage for a selected time period; and presents the average processing time from the file date to date disposed for applications and redeterminations.
DM-002 Qualified Hospital/Qualified Entity Presumptive Eligibility Report
Provides Community Access Services (CAS) staff with statistical data on Presumptive Eligibility (PE) regarding the number of approved and denied PE determinations. It also provides the number of Medicaid-assisted approved or denied applications. Allows CAS staff to determine if an error should be counted toward a qualified hospital based on the accuracy and timely submission of a PE determination.
DM-005 Reasonable Opportunity Report
Provides the total number of people receiving a period of reasonable opportunity to provide verification of alien status or citizenship and the number of times a person was given a period of reasonable opportunity to provide verification of alien status or citizenship.
DM-007
HB 839 Reinstatement of Medicaid
Provides Centralized Benefit Services (CBS) staff a listing of children whose TP 44 eligibility has been suspended upon notification from Texas Juvenile Justice Department (TJJD)/Juvenile Probation Department (JPD) of placement in a juvenile facility, or reinstated upon notification from TJJD/JPD of release from a juvenile facility.
DM-008 FFCC Ongoing Monitoring Reports
Allows management and appropriate staff to track and review various data regarding people who may be eligible for or are currently receiving Former Foster Care Children's (FFCC) Medicaid (TA 82). There are six sub-reports:
  • People Certified for Non-FFCC Program, Lower than FFCC Hierarchy
    • Provides a list of people who are age 18 through 25, received Foster Care - Federal Match - No Cash (TP 93) or Foster Care - Federal Match - With Cash (TP 94) on their 18th birthday or later, and are certified for a Medicaid program that is below TA 82 in the Medicaid hierarchy.
  • People Certified for Non-FFCC Program, Higher than FFCC in Hierarchy
    • Provides a list of people who are age 18 through 25, received TP 93 or TP 94 on their 18th birthday or later, and are certified for a Medicaid program that is above TA 82 in the Medicaid hierarchy.
  • People Terminated Ongoing Medicaid or Denied at Application
    • Provides a list of poeple who are age 18 through 25, received TP 93 or TP 94 on their 18th birthday or later, applied for non-TA 82 coverage and were denied, or who were on a non-TA 82 Medicaid program and were denied coverage at application or denied on-going Medicaid coverage.
  • Active FFCC Individuals Denied
    • Provides a list of people who received TA 82 and were denied TA 82 coverage in the report month.
  • Active FFCC Individuals
    • Provides a list of all active people on TA 82.
  • TP 93 and TP 94 Denied
    • Provides a list of people age 18 through 20 who were receiving TP 93 or TP 94 in the report month but are not receiving Medicaid in the month following the report month.
DM-011 TP40 Transition Report
Identifies enrollment patterns and transitions between TP 40 and other programs. The DM-011 TP 40 Transition Report also allows staff to review cases when women enrolled in TP 40 do not transition to other coverage and when Alert 824s are not processed timely.
DM-012 HB 337 County Jail Reporting
Identifies persons suspended, terminated, or reinstated due to county jail confinement or release.

 

 

C—850 One-Time Grandparent Payment System

Revision 10-4; Effective October 1, 2010

 

TANF

The Grandparent Payment System (GPS) is designed to:

  • list the history of One-Time Grandparent payments, and
  • allow SODI staff to enter One-Time Grandparent payment requests.

 

C—851 Sign-On Screen

Revision 10-4; Effective October 1, 2010

 

TANF

Users request access to the GPS application by:

  • registering on the Health and Human Services (HHS) Enterprise Portal, then
  • requesting access to the GPS application in the HHS Enterprise Portal.

Users must register and have access to the HHS Enterprise Portal before access to the GPS application is requested and granted.

First-time portal users must register on the HHS Enterprise Portal at https://hhsportal.hhs.state.tx.us/wps/portal and follow prompts to receive log-in credentials.

Returning portal users do not have to register again. Every 90 days, the user's HHS Enterprise Portal password expires and a prompt will appear to change it.

 

C—851.1 GPS Application Access

Revision 10-4; Effective October 1, 2010

 

Once in the HHS Enterprise Portal, users must request access to the GPS application by clicking on the Request Application Access tab at the top of the page. Select GPS Account from dropdown list of applications. A request is sent to the user's supervisor for approval and is automatically forwarded to the regional security officer for final approval. An email notification is sent to the user when the request is approved.

After permission to access the GPS application is granted, a tab labeled GPS appears on the HHS Enterprise Portal home page when the user is logged in. A message indicating Sign-On Successful appears on the GPS home page after the user clicks on the GPS tab.

 

C—852 GPS Inquiry Screen

Revision 10-4; Effective October 1, 2010

 

TANF

This screen allows you to search by case or search by individual. To search by case, enter the case number and click on Search by Case. To search by individual, enter the client number, client name or client SSN and click on Search by Client. When inquiring by name, enter the last name. The first name is optional.

 

C—852.1 Case Inquiry

Revision 10-4; Effective October 1, 2010

 

TANF

This screen lists case information. It includes the:

  • case number,
  • case name (last,first),
  • address,
  • benefit effective date,
  • data entry date,
  • advisor name,
  • advisor BJN, and
  • advisor telephone number.

There are three additional options on the screen, View Case Members, View Case Warrants and Return to Inquiry Results. View Case Members lists household members who were included in the One-Time Grandparent certified group. View Case Warrants lists warrants and when they were issued, including the:

  • primary client number (PCN),
  • SSN,
  • employee number,
  • entry date,
  • pay date,
  • issued by comptroller date,
  • warrant number,
  • amount, and
  • status.

 

C—852.2 Client Inquiry

Revision 05-5; Effective October 1, 2005

 

TANF

When you search by client and enter the client number, name, or SSN, you get the Client Inquiry screen that lists the:

  • primary client number (PCN),
  • client name,
  • client DOB,
  • client SSN,
  • client sex, and
  • case number.

You must click on the case number to get the Case Inquiry screen. See C-852.1.

 

C—860 Birth Verification System

Revision 12-3; Effective July 1, 2012

 

All Programs

The Birth Verification System (BVS) is a system developed and maintained by the Department of State Health Services (DSHS). The BVS database includes birth records of people who were born in Texas.

Advisors access BVS as a source to verify age, relationship and citizenship. Perform a separate request for each individual.

 

C—861 Accessing BVS in TIERS

Revision 12-3; Effective July 1, 2012

 

All Programs

BVS inquiry can only be performed when the TIERS case is in read/write mode. From the left navigation bar select Individual from Data Collections to access birth verification information. This displays the Individual Household page, which lists all household members. Click the Edit icon for the appropriate individual. This displays the Individual Information page.

A BVS icon appears on the Individual Information page, near the page title. The icon consists of a circle with the letters BV in it. Click the icon to display the page. TIERS displays the Birth Verification – Details page, displaying the initial demographic information for the individual, individual’s first, middle and last name, gender, and date of birth. Select the Birth County (if available) and enter Mother’s full Maiden Name (if available), then click the Submit button.

TIERS sends an online request to BVS. BVS conducts an online real-time verification of birth information and displays the information on the details page.

Note: TIERS does not display historical birth verification information. If staff make another BVS request for an individual, TIERS generates a new request to the BVS system.

 

C—861.1 BVS Field Entries and Descriptions

Revision 13-1; Effective January 1, 2013

All Programs

TIERS displays the Birth Verification – Details page, displaying the initial demographic information for the individual:

  • child's last, first and middle name,
  • date of birth, and
  • gender.

Birth County — Select the birth county from the drop-down menu. Note: Although not a required field, entering the county code shortens the search.

Mother's Maiden Name (optional field) — Enter mother’s full maiden name if available; this is an optional field. Do not enter a single letter, numerical value, spaces or special characters.

Once the BVS request is submitted, the request is transmitted to DSHS. DSHS returns the following response information when there is response from DSHS indicates a positive match:

  • mother’s maiden name,
  • certificate no.,
  • father's name, and
  • birth county.

Status — This field displays one of the following responses to the request submitted.

Y = Match Found

M = Multiple Records Exist

N = No Match Found

F = Fraudulent Record

D = Individual is Deceased

S = Birth File Read Error

T = Invalid Date of Birth

X = Unknown Error. Call Help Desk

When a match is not received, staff must review entries for accuracy and resubmit the BVS request.

Message — The following exception messages are displayed when a response is not received and the request and response have caused some type of exception. This means there is an error with the system or the data. Call the HHSC Help Desk if problems persist at 512-438-4720.

Message Codes Descriptions

20745

Unable to send MQ message. Please try again later and contact Help Desk if problem persists.

20732

Invalid data received in the response. Please try again later and contact Help Desk if problem persists.

20731

Response timed out. Please try again later and contact Help Desk if problem persists.

20730

An unexpected error has occurred. Please try again later and contact Help Desk if problem persists.

 

C—870 Other Systems

Revision 13-3; Effective July 1, 2013  

 

 

C—871 Wire Third-Party Query (WTPY)

Revision 15-4; Effective October 1, 2015

 

All Programs

WTPY is an SSA automated system that verifies Social Security benefits, SSI, 40 quarters information and citizenship verification for Medicaid. WTPY is a Windows application. Staff obtain information by using the individual's name, SSN or Social Security claim number (SSCN) (not applicable for Medicaid citizenship verification), and DOB. If staff transmit the request by 2:30 p.m., the response is received the following business day. If staff transmit the request after 2:30 p.m., the response is delayed one additional day.

When an inquiry match occurs, the response provides all available benefit information. If the individual has entitlement under more than one SSCN, those SSCNs and benefits are identified. Staff may have to submit separate inquiries to obtain data related to those claims.

The WTPY system provides the following types of responses:

  • Standard Response: individual name, DOB, verified SSN, and error messages regarding any discrepancies between inquiry and response match.
  • Title II (Retirement, Survivors and Disability Insurance [RSDI]): individual demographics, enrollment in Medicare Part A and/or Part B, supplementary medical income benefits (SMIB) premium deduction, benefit amounts and dates, unearned income, disability onset dates, etc.
  • Title XVI (SSI): individual demographics, Medicaid, SSI payment history, benefit amount, payment status code, and resource and earned income leads, etc.
  • 40 Quarters: Use to verify quarters for legal permanent residents, their spouse or parents. Response provides employment history, coverage of quarters, and the type of income the individual has received during that period (wages, agricultural, self-employment, etc.). Note: Response time for this data is within two days of transmittal.
  • Medicaid Citizenship Verification: Use to verify SSN and citizenship for Medicaid applicants. Response codes of A or C indicate citizenship is verified. However, response code C means there is an indication of death. If this response code is received, treat this as a report of change using policy in B-600, Changes. Response codes of B or D or any other error code indicate citizenship is not verified. If one of these responses is received, follow the steps outlined in A-351.2, Using State Online Query (SOLQ) or Wire Third-Party Query (WTPY) to Verify Citizenship.

 

C—872 Accessing Wire Third-Party Query (WTPY)

Revision 13-3; Effective July 1, 2013

All Programs

Supervisors complete Form 4743, Request for Applications and System Access, for employees who need access to the system. Staff must sign the WTPY User Information Security Agreement. Send both forms to the regional security officer. A user may access WTPY after hardware and software requirements are met and they have a password.

To access the system, staff:

  1. Double click the LONG TERM CARE or WTPY icon or http://portal.hhs.state.tx.us/wps/portal. The sign-on screen appears.
  2. Enter employee's username and password.
  3. Click on LOGON or press ENTER.
  4. Click on LOGOUT to close the WTPY system.

You must change your password every 90 days or the system automatically revokes your access. If this occurs, contact your regional security officer.

The WTPY Reference Guide provides details regarding menus, screen and data field references for all SSA response screens. Access the user guide via Training & Curriculum Eligibility Support's Reference Guides website at https://oss.txhhsc.txnet.state.tx.us/sites/eo/support/tdd/WTPY/Forms/WTPY%20Guides.aspx.

 

C—873 Texas Works Automated Systems Problem Reporting Guide

Revision 13-4; Effective October 1, 2013

 

All Programs

TEXAS WORKS AUTOMATED SYSTEMS PROBLEM REPORTING GUIDE
IEE/TIERS Technical Help Desk
1-800-214-4175 (Option 1)
8 am to 8 pm CST, Monday - Friday
For all TIERS/State Portal-related issues, call 1-800-214-4175 (Option 1)
For Problems With Examples of problems the Help Desk handles
Security Security/permissions/lockout problems for TIERS and State Portal only
Management Reports TIERS and DataMart report problems

Prepare to have the following information available:

  • State Portal User ID
  • Office or cubicle number (desk location)
  • Supervisor's name and phone number
  • Full computer name
  • Report number trying to view
  • Screens within the report attempting to view
  • Exact steps attempting to make
  • TIERS Case number (if applicable)
TIERS
  • Application problems
  • System availability
  • Errors messages and functionality issues

Prepare to have the following information available:

  • Contact name
  • Contact employee ID
  • Contact phone number
  • Contact email address
  • Last time access TIERS
  • Office/region
  • ART name
  • ART phone number
  • ART email address
  • Alt contact/supervisor name
  • Alt contact/supervisor phone number
  • Alt contact/supervisor email address
  • Case name
  • Case number
  • Individual number (if problem is specific to an individual)
  • EDG number and EDG name (if specific to an EDG)
  • Current case mode
  • Programs
  • URL of site
  • Number of people having this issue
  • Description of the error or issue
  • Be prepared to email screen shot when reporting an error

Note: Individuals call 2-1-1 for issues with the Self-Service Portal.

Caller Contact Information
  • Contact information (phone number, email address, office/cubicle number, street address)
  • Supervisor's contact information (full name, phone number, email address)
Error
  • Exact error message and sequence of events leading to problem
  • Detailed description of the problem
  • Application type (application, redetermination)
  • Specific screen in TIERS/State Portal the error is or was on prior to the error message

Note: Make a screen shot of error message and be prepared to email screen shot as a Microsoft Word attachment.

Impact Identify impact as:
  • Affects multiple advisors, programs or cases.
  • Prevents staff from continuing their work.
  • Single person impacted.

Note: Have specific examples of others impacted.

Note: Contact your local help desk to report non-TIERS and non-State Portal related issues

Or

PROBLEM REPORTING VIA EMAIL
IEE_Help@HHSC.state.tx.us
For Problems With Examples of problems the Help Desk handles
Security Report all security or password-related issues by calling the IEE/TIERS Technical Help Desk.
Management Reports TIERS and DataMart report problems

Prepare the same information as required above.

Note: Make a screen shot of the error message and attach it to the email as a Microsoft Word document.

TIERS
  • Application problems
  • System availability
  • Errors messages and functionality issues

Make a screen shot of the error message and attach it to an email as a Microsoft Word document.

Note: It is highly recommended to report TIERS-related issues

using the TIERS Application Support Email Ticket Submission at http://hhscx.hhsc.state.tx.us/tech/CS/TIERS%20Template%202013%20(revised%202013-02-13-1910).pdf in a secure email.

State Portal
  • Application problems
  • System availability
  • Error messages and functionality issues

Provide the same information as required above.

Note: Make a screen shot of the error message and attach it to an email as a Microsoft Word document.

Self-Service Portal
  • Application problems
  • System availability
  • Error messages and functionality issues

Provide the same information as required above.

Notes:

  • Make a screen shot of the error message and attach it to an email as a Microsoft Word document.
  • Individuals call 2-1-1 for issues with the Self-Service Portal.
Error When describing your error or issue:
  • Explain the exact error message and sequence of events relating to the problem
  • Include a detailed description of the problem
  • Include the Application type (application, redetermination)
  • Identify the specific screen in Self-Service Portal/State Portal the error is on or was on prior to the error message
Impact Identify impact as:
  • Affects multiple advisors, programs or cases
  • Prevents staff from continuing their work
  • Single person impacted

Note: Have specific examples of others impacted.

http://hhscx.hhsc.state.tx.us/tech/CS/TIERS%20Template%202013%20(revised%202013-02-13-1910).pdf

C-900, Verification and Documentation

Revision 19-3; Effective July 1, 2019

 

 

 

C—910 Required Verification

Revision 04-7; Effective October 1, 2004

 

 

 

C—911 Required Verification for TANF

Revision 19-3; Effective July 1, 2019

 

TANF

Mandatory Verifications At Application When a Change Occurs At Redetermination
Household Composition – Out of State Disqualifications for Felony Drug Convictions All household members applying Any new household members applying Any new household members applying
Citizenship All household members applying who claim to be U.S citizens Any new household members applying who claim to be U.S. citizens Any new household members applying who claim to be U.S. citizens
Alien Status Household members identified as aliens New members identified as aliens
  • New members identified as aliens
  • When the U.S. Citizenship and Immigration Services (USCIS) document has expired.
Social Security Number (SSN) Household members who cannot provide an SSN, verify they applied for an SSN New members who cannot provide an SSN, verify they applied for an SSN Household members who cannot provide an SSN, verify they applied for an SSN
Age/Relationship All children applying New children applying New children applying
Identity Person being interviewed If not previously verified If not previously verified
Residence
  • Physical address
  • Intent to remain in Texas
  • New Texas residents applying, verify the last month a member received benefits in another state
New Texas resident applying, verify the last month any new member received benefits in another state
  • Physical address
  • Intent to remain in Texas
  • New Texas residents applying, verify the last month any new member received benefits in another state
Domicile
  • All children applying
  • Unmarried minor parents applying
  • Temporary absence for all household members applying
  • New children applying
  • New unmarried minor parents applying
  • If questionable, all certified children
  • Temporary absence for any new household members applying
  • All certified children
  • Certified unmarried minor parents
  • Temporary absence for all certified household members
Child Support – Good Cause Claims Any good cause claim Good cause claim for new children applying Good cause claim for new children applying
Resources
  • Checking/savings/
    retirement/ education account(s)
  • Other – if within $300 of the maximum
  • New checking/savings/ retirement/education account(s)
  • Other – if within $300 of the maximum
  • New checking/savings/ retirement/education account(s)
  • Other – if within $300 of the maximum
Income – Nonexempt including Lump Sums Total gross amount Total gross amount
  • Total gross amount
  • Accept self-declaration of interest, unless from a new source or the amount changed by more than $50
Income - Terminated When terminated in the application month or prior two months, verify:
  • Source
  • Final gross amount
  • Date received
  • Reason terminated
  • Termination date
Verify source, final gross amount, date received, reason terminated, and termination date for:
  • Any loss of income
  • Loss of income for new member
Verify source, final gross amount, date received, reason terminated, and termination date for:
  • Any loss of income
  • Loss of income for new member
Deductions – Dependent Care Costs Total amount New amount Total amount
Deductions – Child Support Total amount New amount Total amount
Deductions – Alimony and Payment to Persons Outside the Home Total amount New amount Total amount
School Attendance School age children applying New school age children applying
  • Certified school age children
  • New school age children applying
Management If the household's basic expenses are paid or delinquent, when management is questionable Not Applicable If the household's basic expenses are paid or delinquent, when management is questionable
Employment Services All exemptions Any new exemptions All exemptions
Federal Time Limits (FTLs)
  • Out-of-state benefits received on or after October 1999
  • Hardship exemptions for adults applying
  • Out-of-state benefits received on or after October 1999
  • Hardship exemptions for new adults applying
  • Out-of-state benefits on or after October 1999
  • Hardship exemption for new adults applying
Personal Responsibility Agreement (PRA)
  • Child Support cooperation
  • Voluntary quit
  • School Attendance
  • Household was in cooperation with PRA requirements according to policy in A-2131.1, Initial Application
Not Applicable All certified members are complying with all PRA components:
  • Choices
  • Child Support
  • Drug/Alcohol
  • Immunizations
  • Parenting Skills
  • School Attendance
  • Texas Health Steps
  • Voluntary Quit
PRA – When in Pay for Performance All certified members are complying with all PRA components:
  • Choices
  • Child Support
  • Drug/Alcohol
  • Immunizations
  • Parenting Skills
  • School Attendance
  • Texas Health Steps
  • Voluntary Quit
Not Applicable Not Applicable
Workforce Orientation Compliance by caretaker and second parent applying who are not disqualified and reside in a full service Choices county Compliance by any new caretaker or second parent being added who are not disqualified and reside in a full service Choices county. Compliance by any new caretaker and second parent applying who are not disqualified and reside in a full service Choices county
One-Time Temporary Assistance for Needy Families (OTTANF) Crisis criteria Not Applicable Not Applicable

 

 

C—912 Required Verification for SNAP

Revision 17-3; Effective July 1, 2017

 

SNAP

Mandatory Verification At Application When a Change Occurs At Redetermination *
Household Composition
  • household size, if questionable;
  • eligible status of each household member whose individual eligibility is questionable;
  • new Texas residents applying, verify any out-of-state disqualifications for intentional program violation and/or a felony drug conviction;
  • compliance with parole or community supervision for individuals with a felony drug conviction on or after September 1, 2015;
  • whether a felony drug conviction is:
    • subsequent to another felony drug conviction on or after September 1, 2015; and
    • received while the individual was receiving SNAP.
  • if change reported makes household size questionable;
  • new members who are new Texas residents, verify any out-of-state disqualifications for intentional program violation and/or a felony drug conviction;
  • new members with a felony drug conviction on or after September 1, 2015, verify compliance with parole or community supervision;
  • new members with a felony drug conviction, verify whether the conviction is:
    • subsequent to another felony drug conviction on or after September 1, 2015; and
    • received while the individual was receiving SNAP.
  • household size, if questionable;
  • new members who are new Texas residents, verify any out-of-state disqualifications for intentional program violation and/or a felony drug conviction;
  • compliance with parole or community supervision for individuals with a felony drug conviction on or after September 1, 2015;
  • whether a felony drug conviction is:
    • subsequent to another felony drug conviction on or after September 1, 2015; and
    • received while the individual was receiving SNAP.
Citizenship

If questionable, or if a regional requirement.

If questionable, or if a regional requirement.

If questionable, or if a regional requirement.

Alien Status

Household members identified as aliens.

New members identified as aliens.

  • new members identified as aliens; and
  • when the U.S. Citizenship and Immigration Services (USCIS) document has expired.
Social Security Number (SSN)

Household members who cannot provide an SSN, verify they applied for an SSN, unless exempt.

New members who cannot provide an SSN, verify they applied for an SSN, unless exempt.

Household members who cannot provide an SSN, verify they applied for an SSN, unless exempt.

Identity

Individual being interviewed (also, identity of case name if authorized representative is interviewed).

Individual being interviewed, if not previously verified, or if questionable.

Individual being interviewed, if not previously verified, or if questionable.

Residence**
  • physical address; and
  • the last month a member received benefits in another state.

The last month any new member received benefits in another state.

  • physical address; and
  • the last month any new member received benefits in another state.
Resources**
  • checking, savings,
    retirement, education account(s); and
  • other, if within $300 of the maximum.

Note: If the total combined balance for all checking/savings accounts does not exceed $1,000 on the day of the reported change and is not questionable, accept the individual's statement. Pend the Eligibility Determination Group (EDG) only if the reported account balance is questionable or it exceeds $1,000.

  • new checking, savings,
    retirement, education account(s); and
  • other, if within $300 of the maximum.

Note: If the total combined balance for all checking/savings accounts does not exceed $1,000 on the day of the reported change and is not questionable, accept the individual's statement. Pend the EDG only if the reported account balance is questionable or it exceeds $1,000.

  • new checking, savings,
    retirement, education account(s); and
  • other, if within $300 of the maximum.

Note: If the total combined balance for all checking/savings accounts does not exceed $1,000 on the day of the reported change and is not questionable, accept the individual's statement. Pend the EDG only if the reported account balance is questionable or it exceeds $1,000.

Income – Nonexempt including Lump Sums

Verify total gross amount.

Verify total gross amount.

  • Verify total gross amount; and
  • accept self-declaration of interest, unless from a new source or the amount changed by more than $50.
Income – Terminated

If terminated in the application month or prior two months, verify:

  • source;
  • final gross amount;
  • date received;
  • reason terminated; and
  • termination date.

Verify source, final gross amount, date received, reason terminated and termination date for:

  • any loss of income; and
  • loss of income for new member.

Verify source, final gross amount, date received, reason terminated and termination date for:

  • any loss of income; and
  • new member (See A-1370, Verification Requirements, for streamlined reporting requirements).
Deductions – Child Support
  • legal obligation to pay;
  • amount of obligation; and
  • amount actually paid.
  • amount actually paid; and
  • a change in legal obligation.
  • amount actually paid; and
  • a change in legal obligation.
Deductions – Dependent Care Costs

Total amount if verification can be obtained at the interview.
Note: If verification cannot be obtained during the interview and the total expense does not exceed $300 a month, total for the entire EDG, and is not questionable, then accept the individual's statement. Pend the EDG only if the claimed expense is questionable or exceeds $300 a month, total, for the entire EDG.

A new amount.
Note: If the amount cannot be verified and is less than $300, accept the individual's statement. Pend the EDG only if the reported expense is questionable or exceeds $300 a month, total, for the entire EDG.

Total amount if verification can be obtained at the interview.
Note: If verification cannot be obtained during the interview and the total expense does not exceed $300 a month, total for the entire EDG, and is not questionable, then accept the individual's statement. Pend the EDG only if the claimed expense is questionable or exceeds $300 a month, total, for the entire EDG.

Deductions – Actual and Standard Medical Expenses

Refer to A-1428.2, Budgeting Medical Deductions.

Refer to A-1428.2, Budgeting Medical Deductions.

Refer to A-1428.2, Budgeting Medical Deductions.

Deductions – Shelter
  • Rent or mortgage, if questionable, or if this information is a regional requirement.
  • The total amount of shelter cost for an unoccupied home.
  • If change in rent or mortgage is questionable, or if this information a regional requirement.
  • The total amount of shelter cost for an unoccupied home, if amount changed.
  • Rent or mortgage, if questionable, or if this information is a regional requirement.
  • The total amount of shelter cost for an unoccupied home.
Management

If the household's basic expenses are paid or delinquent, when management is questionable.

Not Applicable

If the household's basic expenses are paid or delinquent, when management is questionable.

Employment Services
  • exemptions that are questionable;
  • any member claiming to be physically or mentally unable to work, if not obvious;
  • any member claiming an exemption based on caring for a person with a disability living in the home;
  • at least 30 hours worked if a self-employed individual does not receive earnings equal to 30 hours multiplied by the federal minimum wage (Code P); and
  • a refugee is participating, at least half-time in a training program administered by a refugee contractor or Match Grant Program (Code S).
  • new exemptions that are questionable;
  • any new member claiming to be physically or mentally unable to work, if not obvious; and
  • any new member claiming to be caring for a person with a disability living in the home.
  • exemptions that are questionable;
  • any new member claiming to be physically or mentally unable to work, if not obvious; and
  • any new member claiming to be caring for a person with a disability living in the home.
Federal Time Limits – 18-50 Work Requirement, Able-Bodied Adult Without Dependents (ABAWD)

Individual's exemption from requirement is based on:

  • pregnancy or being physically or mentally unfit to work 20 hours a week;
  • participation in the Workforce Innovation and Opportunity Act (WIOA) or  the Trade Adjustment Act Program;
  • participation in the Supplemental Nutrition Assistance Program (SNAP) Employment and Training (E&T) program using Form H1822, ABAWD E&T Work Requirement Verification
  • that the employee works an average of 20 hours a week, if employed;
  • verify the individual worked or complied with a work program for at least 80 hours in a 30-day period for eligibility of the second three months of time-limited benefits;
  • volunteer employment hours
  • countable months of benefits received in another state.

Individual's exemption from requirement is based on

  • pregnancy or being physically or mentally unfit to work 20 hours a week;
  • participation in WIOA, the Trade Adjustment Act Program, or the SNAP E&T program using Form H1822
  • that the employee works an average of 20 hours a week, if employed;
  • verify the individual worked or complied with a work program for at least 80 hours in a 30-day;
  • volunteer employment hours;
  • countable months of benefits received in another state.
  • individual's exemption from requirement is based on pregnancy or being physically or mentally unfit to work 20 hours a week;
  • participation in WIOA, the Trade Adjustment Act Program, or the SNAP E&T program using Form H1822
  • that the employee works an average of 20 hours a week, if employed;
  • verify the individual worked or complied with a work program for at least 80 hours in a 30-day;
  • volunteer employment hours; and
  • countable months of benefits received in another state.
Elderly or Household Members with a Disability

If not previously verified:

  • household members are age 60 or older; and
  • household members meet the disability criteria in B-432, Definition of Disability.

If not previously verified:

  • household members are age 60 or older; and
  • household members meet the disability criteria in B-432, Definition of Disability.

If not previously verified:

  • household members are age 60 or older; and
  • household members meet the disability criteria in B-432, Definition of Disability.

* Requirements are the same for all redeterminations whether filed timely or untimely.

** Categorically eligible households in which all members receive Temporary Assistance for Needy Families (TANF) cash assistance (TP 01/61) and/or Supplemental Security Income (SSI) are exempt from verification.

Note: Verify the eligible status of the facilities listed below as required in B-400, Special Households:

  • homeless shelters;
  • group living arrangements;
  • drug and alcohol treatment centers; and
  • family violence shelters.

 

C—913 Required Verification for Medical Programs

Revision 15-4; Effective October 1, 2015

 

Medical Programs

Mandatory Verifications At Application When a Change Occurs* At Redetermination
Citizenship (except TA 31, TP 32, TP 33, TP 34, TP 35, and TP 36) All household members applying Any new member applying Any new member applying
Alien Status Exception:
The Systematic Alien Verification for Entitlements (SAVE) procedures do not apply to an alien in TA 31, TP 32, TP 33, TP 34, TP 35, and TP 36 who does not meet citizenship or alien status requirements, unless the individual potentially meets the citizenship or alien status requirement for another program
Any person identified as an alien who wishes to be certified Any new person identified as an alien who wishes to be certified Any new person identified as an alien who wishes to be certified
Social Security Number (SSN) (except TA 31, TP 32, TP 33, TP 34, TP 35, TP 36, and TP 45)
  • All household members who are applying
  • Household members who are applying who cannot provide an SSN, verify they applied for an SSN, unless exempt
  • New members who are applying
  • New members who are applying who cannot provide an SSN, verify they applied for an SSN, unless exempt
  • Household members who are applying
  • Household members who are applying who cannot provide an SSN, verify they applied for an SSN, unless exempt
Age/Relationship All children applying; if not available, accept self-declaration

For TP 08, if not available, follow the policy in A-523.1, How to Make an Evaluative Conclusion.
Newly added children; if not available, accept self-declaration

For TP 08, if not available, follow the policy in A-523.1.
Newly added children; if not available, accept self-declaration

For TP 08, if not available, follow the policy in A-523.1.
Identity (except TA 31, TP 32, TP 33, TP 34, TP 35, and TP 36) All individuals requesting benefits

When an interview is required, the identity of the person being interviewed must be verified.
Any new member requesting benefits Any new member requesting benefits

When an interview is required, the identity of the person being interviewed must be verified.
Residence

Note: Accept self- declaration for Children's Medicaid and TP 56 for a child
  • Physical address
  • Intent to remain in Texas
  • New Texas residents, verify the last month the member received Medicaid in another state
Not Applicable
  • Physical address
  • Intent to remain in Texas
  • New Texas residents, verify the last month any new member received Medicaid in another state
Three Months Prior
  • Unpaid medical bills
  • Income for each of the months of prior coverage (see A-831.2, Eligibility for Three Months Prior Coverage, for TP 40)
Not Applicable Not Applicable
Third-Party Resources
  • Any household member applying who has private health insurance
  • For each certified household member whose coverage has changed
  • New members applying who have private health insurance
  • For each certified household member whose insurance coverage has changed
  • New members applying who have private health insurance
Pregnancy (TP 40 and TP 36) Accept self-declaration for pregnancy, pregnancy start date, number of children expected and the anticipated date of delivery. Not Applicable Not Applicable
Medicaid Eligibility of Mother (TP 45 only) For each certified child For a newly certified child For each certified child
Emergency Medical Condition Treatment (TA 31, TP 32, TP 33, TP 34, TP 35, and TP 36) For each certified undocumented alien or ineligible alien treated for an emergency condition Not Applicable Not Applicable
Resources* (Children on TP 56, Children on TP 32, and TP 02 only)
  • Checking/savings/
    retirement/education account(s)
  • Other – if within $300 of the maximum
  • New checking/savings/
    retirement/education account(s)
  • Other – if within $300 of the maximum
  • New checking/savings/
    retirement/education account(s)
  • Other – if within $300 of the maximum
Income – Nonexempt including Lump Sums*
  • Total gross amount

    Note: Frequency is self-declared for Children's Medicaid***
  • Total gross amount

    Note: Frequency is self-declared for Children's Medicaid***
  • Total gross amount
  • Accept self-declaration of interest, unless from a new source or the amount changed by more than $50

    Note: Frequency is self-declared for Children's Medicaid***
Income – Terminated If terminated in the application month or prior two months, verify:
  • Source
  • Final gross amount
  • Date received
  • Reason terminated
  • Termination date

Note: For Children’s Medicaid***, verify only income that terminated in the month of application.

Verify source, final gross amount, date received, reason terminated, and termination date for:
  • Any loss of income
  • Terminated income of new member
Verify source, final gross amount, date received, reason terminated, and termination date for:
  • Any loss of income
  • Terminated income of new member

Note: For Children’s Medicaid, verify only income that terminated in the application month for new members.

Modified Adjusted Gross Income (MAGI) Expenses Total amount New amount Total amount
School Attendance (TP 08 only)** For the only dependent child(ren), if they are age 18 For the only dependent child(ren), if they are age 18 For the only dependent child(ren), if they are age 18
Child Support — Good Cause Claims (TP 08 only) Any good cause claim Good cause claim for new children applying Good cause claim for new children applying

Note: All good cause claims must be re-evaluated at redetermination.
Domicile (TP 08 only) For a dependent child When a change impacts the living situation or care and control of the dependent child For a dependent child
Household Composition — Family Violence Exemption Any family violence exemption Any new family violence exemption Any new family violence exemption
Management (Except: TP 40 and Children's Medicaid***) If the household's basic expenses are paid or delinquent, when management is questionable Not Applicable If the household's basic expenses are paid or delinquent, when management is questionable
* Children certified on TP 43, TP 44, and TP 48 are continuously eligible for the first six months of the 12-month certification period; children certified on TP 45 are continuously eligible for 12 months. Address changes in income as explained in B-600, Changes.

** School attendance is only verified if the only child that makes the parent or caretaker relative eligible for TP 08 is age 18 years.

*** Children's Medicaid simplified verification requirements also apply when processing a Medically Needy with Spend Down (TP 56) or Medically Needy with Spend Down — Emergency (TP 32) EDG for a child under age 19.

 

C—920 Questionable Information

Revision 15-4; Effective October 1, 2015

 

All Programs

Consider the individual's statements on the application or during the interview questionable if they:

  • are contradictory;

    (Example: The individual states he has had no income for several months, but his application shows $30 cash on hand.)

  • do not agree with information in the case record;

    (Example: The individual states he has no resources. An earlier application was denied because bank accounts and property were over the resource limits.)

  • do not agree with other information the advisor has;

    (Example: The individual provides paycheck stubs showing a 40-hour week in an industry such as construction that has frequent overtime.)

  • do not adequately explain the household's circumstances; or

    (Example: The individual states he has not paid rent or utilities for several months, but he has not been evicted or had his utilities cut off.)

  • do not agree with information obtained from precertification activity, such as information retrieved from the Data Broker System's Employer New Hire Report (ENHR) or another automated source.

Note: The ENHR and other sources in Data Broker may list the corporate name and address instead of the local business name and address. Before denying an EDG, consider that the commonly known name of a business may be different from the corporate name.

Before taking adverse action, allow the individual an opportunity to resolve any discrepancy by providing documentary proof or designating a suitable collateral source.

After the initial application or redetermination interview, if the advisor obtains unverified information from a source other than the individual which contradicts the individual's statement, then the advisor may:

  • allow the applicant an opportunity to resolve the discrepancy, or
  • verify the information by directly contacting a collateral source.

    Example: The individual states on the application and at the interview that the household has no income from wages. The advisor contacts the landlord to verify residence, and the landlord reports the applicant is working. The advisor may either contact the individual or the employer to verify the information.

Sources of verification are listed at the end of each applicable section in the Texas Works Handbook.

 

C—930 Providing Verification

Revision 02-6; Effective July 1, 2002

 

 

C—931 Household Responsibility for Providing Verification

Revision 19-1; Effective January 1, 2019

 

All Programs

Households or the independent child's representative have the primary responsibility for providing documented or collateral evidence needed for proof of their circumstances. Households do not need to designate a collateral source if that source is named on the application form or during the interview or application processing. The advisor may assist the household in designating a collateral contact by suggesting a source that may be reliable.

If documented evidence is not available or not sufficient, the household must:

  • designate an alternate source of verification; or
  • permit a prescheduled home visit.

Exception: Law enforcement have the primary responsibility for providing verification that a person is a fleeing felon, a probation violator or a parole violator. Households are not responsible for providing proof of their fugitive status.

 

C—932 Advisor Responsibility for Verifying Information

Revision 19-1; Effective January 1, 2019

 

All Programs

When verifying information, follow these guidelines:

  • Photocopy and send for imaging all paper documents a person provides as verification. If the household indicates that a document is verification for more than one case, send for imaging for each case.
  • Do not reverify eligibility factors previously verified and not subject to change, if the previous verification is available in the electronic case record. (Examples: relationship, birth or citizenship proof, and deprivation due to death.)
  • Advisors may not request additional information or documentation from applicants or clients unless such information is not available electronically or the information obtained electronically is not consistent with the information on the application.
  • Do not ask a person to provide additional proof if:
    • verification is available through the Texas Integrated Eligibility Redesign System (TIERS) inquiry, Texas Workforce Commission (TWC) inquiry, the Birth Verification System (BVS), TALX, Child Support inquiry, or other automated systems that are acceptable verification sources and accessible to the advisor, or if the person indicates that verification is readily available in the electronic case record; and
    • the information is sufficient to establish current eligibility.
  • Do not verify income information by using 1-900 telephone numbers. Accessing these numbers results in a substantial charge ($2 - $20 per call) to the Texas Health and Human Services Commission (HHSC).
  • Accept any reasonable evidence provided by the household whether it is provided in person, by mail, fax, other electronic device or via an authorized representative. Verification should be reliable and sufficient to prove a person’s statement.
  • Determine what types of verification are readily available to the household and request that verification first if it is anticipated to be sufficient proof. If preferred sources of verification are not readily available, alternate sources of proof must be accepted if they are reliable and provide sufficient proof. Sources of documentary proof and collateral sources are listed at the end of the applicable section of the Texas Works Handbook.
  • Do not disclose any information the household provides when contacting a third party for verification. The advisor cannot disclose that the household has applied for any specific program or suggest the household is suspected of any wrong doing.

    Note: If the collateral source asks why the information is necessary, inform the collateral source that HHSC is required to verify eligibility for assistance. If the collateral source asks for specific information regarding the person, inform the collateral source of the person's confidentiality rights.

  • Evaluate the documented evidence or collateral source the household provides and determine if it is reliable and sufficient to decide eligibility and benefit amount. If a source of verification is unreliable:
    • designate another collateral source;
    • ask the household to designate another collateral source; or
    • schedule a home visit. Do not conduct a home visit solely because the household meets error-prone criteria.

      Note: HHSC may also designate a collateral source if the individual fails to provide one.
       
  • Contact the designated collateral source unless the person claims it will result in negative consequences, such as eviction or loss of job.
  • Offer reasonable assistance in obtaining verification if the person has difficulty in obtaining the required verification. Also, offer assistance if discrepancies exist in the documentary information the individual provides or if they request assistance in clearing the discrepant information.
  • Accept collateral sources or documents from the household that are reliable and provide sufficient proof. Do not deny or delay benefits if this requirement is met, or if:
    • a collateral source refuses to provide verification; and
    • there is no reasonable alternate verification available.
  • There may be unusual circumstances in which an applicant's statement must be accepted as proof if:
    • there is a reasonable explanation why documentary evidence or a collateral source is not available; and
    • the applicant's statement does not contradict other individual statements or other information received by the advisor.

      Exception: For verification of relationship, follow procedures in A-522, Legal Parent-Child Relationship, and A-540, Documentation Requirements.
  • If a person is able to cooperate but clearly indicates orally or in writing that they refuse to take action necessary to complete the certification process, deny the EDG. This also applies to evaluations such as audits, quality control or investigations. See A-1324.18, Temporary Assistance for Needy Families (TANF), for action required on a SNAP EDG when the associated TANF EDG is denied due to any of these reasons.
  • Have the individual sign Form H0003, Agreement to Release Your Facts, for collateral sources that will not release information without the individual's written consent.
    Note: Do not request signatures on blank forms for future use.
  • For people born in Puerto Rico, HHSC can submit a birth verification request by mail, fax or email to the Department of Healthcare Demographic Registry Office of Puerto Rico. Include in the request the applicant's name as it appears on the birth certificate (including both last names if more than one last name), the applicant's date of birth and the applicant's place of birth.

    To submit a request by:
    • email, send the request to Registrodemografico@salud.gov.pr. In the request, indicate the government email address to which the response should be sent.
    • fax, make the request on official letterhead and fax it to the attention of Validation Office at 787-767-8605 or 787-766-1299. Indicate in the fax the government fax number to which the response should be sent.
    • regular mail, make the request on official letterhead and mail it to the attention of Validation Office, Demographic Registry Office of Puerto Rico, Department of Health, P.O. Box 11854, San Juan, Puerto Rico 00910. Indicate in the letter the full mailing address to which the response should be sent.

    The Registry Office will provide findings within two business days that verify the individual's submitted demographic information or will advise that the submitted information is inconsistent with the information in the Registry Office.

Document collateral sources that are designated orally by the individual or by HHSC.

Exception: Staff must not pend for, or attempt to obtain, the verification of fugitive status for fleeing felons or probation or parole violators from the household. Law enforcement provides verification of fugitive status to HHSC when they are actively seeking to apprehend individuals.

Medical Programs except Emergency Medicaid

Assist a person in obtaining documentary evidence of citizenship. Identify if they are unable to provide documentary evidence of citizenship in a timely manner because of incapacity of mind or body or the lack of a representative to assist. Assisting a person consists of referrals to appropriate entities that can assist them. When assisting a person in providing documentary evidence of citizenship and identity, use any available document, regardless of level of evidence.

 

C—940 Documentation

Revision 15-4; Effective October 1, 2015

 

All Programs

Document in TIERS Data Collection and in Case Comments information to support all decisions about eligibility and allotment, whether at application, change, or redetermination. Documentation must be sufficient so that anyone can understand all computations and advisor decisions, including denials.

Always include the following:

  • mandatory verifications;
  • why information is questionable;
  • how questionable information is cleared;
  • why alternate methods are used rather than standard methods;
  • why one collateral contact was rejected in preference for another;
  • name, address, and/or telephone number for all collateral contacts; and
  • documentation in the Agency Use Only section of the application or redetermination forms or change report form for address changes regarding voter registration actions provided to the individual.

Document contacts between redeterminations that may affect eligibility or benefit amount. Note: Documentation requirements are listed at the end in the applicable section in the Texas Works Handbook.

SNAP

Always document why another verification source such as a collateral contact or home visit was necessary (except when using a collateral contact to verify where the household lives or its size).

Related Policy
Registering to Vote, A-1521
The Texas Works Documentation Guide

 

C—941 Texas Works Documentation Guide

Revision 13-1; Effective January 1, 2013

 

All Programs

TIERS Data Collection pages handle the majority of required documentation for a case record. The documentation requirements not captured by these pages have been compiled into a comprehensive documentation guide, The Texas Works Documentation Guide.

C-1000, Procedures for Clearance of Income & Eligibility (IEVS) Reports & Internal Revenue (IRS) Federal Tax Information (FTI)

Revision 18-3; Effective July 1, 2018

 

 

C—1010 Clearance of IEVS Reports by the Office of Inspector General (OIG) that Do Not Include IRS FTI

Revision 11-1; Effective January 1, 2011

 

 

C—1011 OIG IEVS Process

Revision 09-4; Effective October 1, 2009

 

TANF, SNAP and Medicaid

The IEVS module within the Automated System for Office of Inspector General (ASOIG) automates the distribution and clearance of IEVS data for OIG staff. OIG uses the IEVS module to process and clear IEVS reports within 45 days of the secure automated download of the IRS files to ASOIG.

 

C—1012 Review the Case Record

Revision 18-3; Effective July 1, 2018

 

TANF, SNAP and Medicaid

OIG staff review case data in the Texas Integrated Eligibility Redesign System (TIERS) Inquiry screen in the Case Data Change Since Last Disposition and the TIERS Historical Case Report (THCR) located in the ASOIG.  

OIG staff research the complete action that occurred right before the time listed on the IEVS. If the information is not found for the period in question, OIG staff review all actions from the period in question through the current action.

OIG staff:

       •    review Data Broker for sources of income by checking Texas Workforce Commission (TWC) Wage Detail and Unemployment Insurance Benefits (UIB), The Work Number, and the Employer New Hire Report (ENHR); and
       •    document  findings on the worksheet in the IEVS module.

Related Policy:
The Work Number, C-825.11
Using the Work Number as Verification, C-825.11.1
Employer New Hire Report (ENHR) and National Directory of New Hires (NDNH) Report, C-825.12
Texas Workforce Commission (TWC) Wage/Benefits, C-825.13
 

C—1013 Request Verification

Revision 18-3; Effective July 1, 2018

 

TANF, SNAP and Medicaid

OIG staff request verification if the IEVS:

  • wage information was not reported in TIERS; or
  • information on wages was budgeted in the case but the IEVS discrepancy amount for an individual employer is more than $300 per month.

In these situations, verification is required to determine if the income is ongoing and affects current benefits, the income causes an overpayment or both.

OIG staff obtain verification by:

  • calling the employer;
  • accessing Data Broker; or
  • sending a verification letter to the individual and payer.

 OIG staff allow the person 10 days from the print date of the letter to provide verification. The request for verification letter informs people that the information is needed because OIG is reviewing the case to determine if benefits were issued correctly.


 If the person fails to provide verification, the OIG notifies AES Customer Care Center (CCC) through an ASOIG alert.  

 

C—1014 Non-IRS FTI IEVS Income Action Messages

Revision 18-3; Effective July 1, 2018

 

TANF, SNAP and TP 08

OIG staff may create an income action message in the IEVS module for the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF) program and Medicaid programs, except for TP 40, TP 43, TP 44 and TP 48, that requires action by Texas Works staff.

OIG creates an income action message when verification indicates income is ongoing and affects current eligibility or benefits.

OIG staff summarize findings in the comment section of the income action message. View detailed information regarding the income on the automated worksheet within the IEVS module.

 

C—1020 Clearance of IEVS Reports by Texas Works Staff that Do Not Include IRS FTI

Revision 11-1; Effective January 1, 2011

 

 

C—1021 Regional IEVS Coordinator

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

When OIG staff create an action message in the IEVS module, regions have the flexibility to process the report by:

  • having a centralized process for clearing action messages (one designated individual or a group of staff), or
  • designating a regional IEVS coordinator to assign the clearance of action messages to Texas Works staff (supervisors or advisors) throughout the region.

The regional IEVS coordinator is responsible for:

  • the daily review of "IEVS TW Alert Detail" in the IEVS Reports Module;
  • assigning clearance of action messages to centralized staff or Texas Works staff throughout the region, depending on the region's option; and
  • monitoring the clearance of action messages.

 

C—1022 Non-IRS FTI IEVS Action Message Clearance Process

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

After checking IEVS, the regional coordinator assigns for clearance each action message to the appropriate unit supervisor or designated staff. Create a task for clearance of the action message for cases in TIERS. If clearance of the action message is assigned to individual units, the unit supervisor is responsible for assigning the clearance of the action message request to the appropriate advisor. The regional IEVS coordinator has two workdays after receipt to assign the action message.

If the IEVS regional coordinator assigns clearance of the action message to a supervisor/unit, the supervisor or clerk must assign the action message no later than the next workday. The advisor must complete the change within 10 days after the date it is assigned. The date of assignment is day zero.

If the regional coordinator assigns the clearance of the action message to other designated staff, the designated staff must complete the change within 10 days after the date of assignment.

Each worksheet with a message from OIG will indicate the type of action required. OIG staff process action messages if the household did not provide accurate information during the interview or application processing, or if the increase in income identified via IEVS caused the household income to exceed 130% Federal Income Poverty Limits (FPIL) for SNAP streamlined reporting (SR) cases.

Upon receipt of an action message, Texas Works staff must take the following action to clear the message based on the reason the message was issued.

If the ... then Texas Works staff ...
verification provided to OIG indicates income affects current eligibility,
  • send manual Form H1017, Notice of Benefit Denial or Reduction, to deny or reduce the benefits based on income or resources. If the advisor does not receive verification from OIG, then document that OIG has the verification. Copies of verification received by OIG may be provided to Texas Works staff upon request.
  • provide advance notice and process the denial or adjustment after the adverse action period expires.
individual fails to provide verification to OIG,
  • send a manual Form H1017 to deny the benefits for failure to provide the information. Note: A manual notice and denial is required because TIERS will not allow a denial for failure to provide information without previously issuing Form H1020, Request for Information or Action. In the comments section, document the information the individual failed to provide and what the individual can do to re-establish eligibility as specified in the instructions to Form H1017. If the individual fails to provide the requested information within the adverse action time frame, process the denial for failure to provide information.
  • if verification is provided within the adverse action time frame, send an email to the OIG claims investigator notifying the investigator about receipt of the information and forward a copy of the verification. Take action on the case based on new information.
  • determine the benefit/overpayment amount based on verification documentation included in the action message comments.

 

Notes:

  • The investigator's name and telephone number are listed on the automated worksheet in the IEVS module.
  • If Texas Works staff do not provide the case record upon OIG request, OIG staff will contact the regional director.

 

C—1023 TP 40 and Children's Medicaid Clearance Process

Revision 13-4; Effective October 1, 2013

 

Children certified for children’s Medicaid other than TP 45, which is certified for 12 months, receive six months of continuous eligibility, regardless of changes in family income or resources. A pregnant woman certified for TP 40 is continuously eligible regardless of income changes. There is no asset test for TP 40.

OIG staff will create action or information messages for these type programs only if the household did not provide accurate information during the interview or application processing.

At the children's Medicaid renewals, or before certifying a TP 40 recipient for another type program, advisors must inquire in the Income and Eligibility Verification System (IEVS) module to review the reports and handle any information that may affect ongoing eligibility.

Follow normal regional security procedures to request access. To access the ASOIG IEVS module, go to https://hhsportal.hhs.state.tx.us/wps/portal.

 

C—1024 Client Reapplies

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

If the individual reapplies after being denied for failure to provide information to OIG, advisors must obtain the verification requested by OIG before recertifying the case. Exception: If the individual can reasonably explain why the requested information cannot be obtained or provided, use the best available information. See C-920, Questionable Information.

 

C—1025 Appeals

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

If the advisor receives a request for an appeal based on action taken by:

  • OIG, contact the claims investigation supervisor in the region on the same day the request is received.
  • Texas Works as a result of an action message, the advisor files the appeal. Complete Form H4800, Fair Hearing Request Summary, and Form H4800-A, Fair Hearing Request Summary (Addendum). On Form H4800-A, Section 2, Materials Attached, indicate under Other Related Materials, that action messages generated by OIG need to be considered in the appeal. Enter the claims investigator's name and telephone number on Form H4800 and send OIG copies of Form H4800 and Form H4800-A. OIG provides the additional information to the hearing officer.

If OIG receives a request for an appeal based on action taken by the Texas Works advisor, OIG will notify Texas Works the same day.

 

C—1026 Non-IRS FTI IEVS Information Message Clearance Process

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

At the region's discretion, Texas Works staff may review the messages in the IEVS module before certification. Information messages serve as a case clue to Texas Works staff to identify potential resources not reported by the individual.

 

C—1030 Clearance of IEVS Reports by OIG that Includes IRS FTI

Revision 11-1; Effective January 1, 2011

 

 

C—1031 OIG Procedures

Revision 11-3; Effective July 1, 2011

 

TANF, SNAP and Medical Programs

The ASOIG Match module with the sources listed as FTI, Self or Earn contains IRS FTI that requires adherence to FTI safeguarding procedures.

IRS FTI is defined as any information included in ASOIG. This includes:

  • payee's account number,
  • tax year income reported,
  • payer's name and address,
  • payer's employer identification number,
  • pay amount, or
  • type of income.

More information about IRS FTI can be found by reviewing the training, "Safeguarding IRS Tax Sensitive Information," at http://mhmrweb02.mhmr.state.tx.us/cbt/enterprise/Training_login.asp.

 

C—1032 Review Case Record

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

OIG staff follow the procedures in C-1012, Review the Case Record.

 

C—1033 Request Verification

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

OIG staff follow procedures in C-1013, Request Verification. Page one of the IEVS verification letters (KC-63, KC-64, KC-65 and KC-68) is considered IRS FTI when the IEVS source is identified as such and staff must secure it according to IRS safeguarding requirements.

 

C—1034 Types of IRS FTI Action/Information Messages

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

There are three different types of action/information messages that OIG may create in the IEVS module for SNAP, TANF and Medicaid programs, except for TP 40, TP 43, TP 44, TP 47 and TP 48 that require action by Texas Works staff.

OIG creates when
Income Action Message

Note: Action messages created based on IRS FTI are limited to those matches with a source listed as "Self" or "Earn."

  • verification indicates income is ongoing and affects current eligibility or benefits; or
  • the individual fails to provide verification of ongoing income (OIG claims investigation (CI) staff complete an overpayment referral for the time period listed on the IEVS module).
Resource Action Message
  • verification indicates a resource affects current eligibility (OIG completes overpayment referral); or
  • the individual fails to provide verification of ongoing resources (OIG-CI completes an overpayment referral for the time period listed on the IEVS if the report indicates resources affect prior eligibility).
Resource Information Message
  • the resource is ongoing and is under limit or inaccessible;
  • the resource is ongoing and the case is denied; or
  • the individual did not provide the verification and the case is denied.

 

OIG staff summarize findings in the TW comments section of the IEVS worksheet. Detailed information regarding the income may be viewed on the automated worksheet of the IEVS module.

 

C—1040 Clearance of IEVS Reports by Texas Works that Includes IRS FTI

Revision 11-1; Effective January 1, 2011

 

 

C—1041 Regional IEVS Coordinator

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

The regional IEVS coordinator and Texas Works staff use the same procedures and time frames found in C-1021, Regional IEVS Coordinator, to process action messages with IRS FTI.

When an IEVS is generated based on IRS FTI, the action or resource message will be on a screen clearly labeled with a FTI warning. All information on the IEVS module (payer name, account number, pay amounts, etc.) is considered IRS FTI. While printing of IEVS module worksheets with Texas Works or TW messages is not prohibited, staff must secure these worksheets according to safeguarding requirements.

 

C—1042 IRS FTI IEVS Action Message Clearance Process

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

Texas Works staff take the following action to clear the action message.

If the ... then ...
verification provided to OIG indicates income/resource affects current eligibility,
  • send manual Form H1017, Notice of Benefit Denial or Reduction, to deny or reduce the benefits based on income or resources. If the advisor does not receive verification from OIG, then document that OIG has the verification. Copies of verification received by OIG may be provided to Texas Works staff upon request.
  • provide advance notice, and process the denial or adjustment after the adverse action period expires.
individual fails to provide verification to OIG,
  • send a manual Form H1017 to deny the case. Note: A manual notice and denial is required because the TIERS will not allow a denial for failure to provide information without previously issuing Form H1020, Request for Information or Action. In the comments section, document the following message:

    "You failed to provide information to the Office of Investigator General. Contact [OIG investigator's name] at [investigator'sphone number] if you have questions. You may reapply for benefits and will be required to provide the information previously requested."

    "Usted no presentó información a la Fiscalía General. Si tiene alguna pregunta, comuníquese con [OIG investigator's name] al [investigator's phone number]. Puede volver a solicitar beneficios, pero tendrá que presentar la información que se le pidió anteriormente."

  • if the individual fails to provide the requested information within the adverse action time frame, manually process the denial for failure to provide information. Note: A manual notice and denial is required because TIERS will not allow a denial for failure to provide information without previously issuing Form H1020.
  • if verification is provided within the adverse action time frame, send an overpayment referral to the OIG claims investigator indicating receipt of verification and forward a copy of verification, if appropriate. Take action based on the verification provided.
  • determine the benefit/overpayment amount based on verification documentation included in the comments section of the IEVS worksheet.

Reminder: Texas Works staff must not enter any IRS FTI into TIERS (including individual TW comments). Documentation in TIERS case comments is limited to the following language: "IEVS match, action message generated from IEVS requesting denial."

Notes:

  • The investigator's name and telephone number are listed on the online version of the automated worksheet in the IEVS module.
  • If Texas Works staff do not provide the case record in 10 days, OIG staff will contact the regional director.

 

C—1043 Client Reapplies

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

If the individual reapplies after being denied for failure to provide information to OIG, the advisor must verify the IRS FTI. If the individual indicates the verification was provided to OIG, contact the OIG investigator. If the individual self-discloses the information on the application, the information is no longer considered IRS FTI.

If the individual does not have the resource or income for which OIG requested information, the advisor must request verification of the IRS FTI using a manual Form H1020, Request for Information or Action. If the advisor attaches a verification form, such as a bank verification form or Form H1028, Employment Verification, do not include any IRS FTI on the verification form. File the manual Form H1020 in the case record and secure the case according to the IRS safeguarding requirements because the case record now contains IRS FTI.

When the individual provides the information requested on the verification form, the information on the verification form is no longer considered IRS FTI. The file copy of Form H1020 remains IRS FTI and must be kept in the case record for the duration of the retention period.

If the advisor is requesting additional information that does not contain IRS FTI, the advisor may issue a second Form H1020 through TIERS or request the information on a manual Form H1020.

Note: If the advisor completes a manual Form H1020 because the only required verification is IRS FTI, TIERS will not allow a denial based on failure to provide verification, since Form H1020 was not generated via TIERS. The advisor may generate Form H1020 indicating a manual Form H1020 was provided to the individual. Do not provide the notice generated from TIERS to the individual. The advisor must document in the case comments the reason for generating an electronic pending notice and reference the manual Form H1020 that was issued.

If the individual fails to provide the information, issue a manual Form H1017, Notice of Benefit Denial or Reduction, to deny the case for failure to provide information.

 

C—1044 Appeals

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

If the advisor receives a request for an appeal based on action taken by:

  • OIG staff, contact the claims investigation supervisor in the region on the same day the request is received. OIG will process Form H4800, Fair Hearing Request Summary.
  • Texas Works, as a result of the clearance of an action message, the advisor files the appeal. Complete Form H4800 and Form H4800-A, Fair Hearing Request Summary (Addendum).
    • On Form H4800-A, Section 2, Materials Attached, indicate under Other Related Materials that action messages generated by OIG need to be considered in the appeal.
    • Document the claims investigator's name and telephone number on Form H4800 and send OIG a copy of Form H4800 and Form H4800-A. OIG provides the additional information to the hearing officer using the instructions in the annual review of the Internal Revenue Service safeguarding requirements memo.

If OIG receives a request for an appeal based on action taken by the Texas Works advisor, OIG will notify Texas Works the same day. Texas Works staff must file Form H4800.

 

C—1050 Additional IRS FTI Sources and Security Issues

Revision 11-1; Effective January 1, 2011

 

 

C—1051 Retention and Distribution of IRS FTI

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

Retain IEVS reports for three years for SNAP and four years for TANF. Staff may log and destroy the IEVS module records using IRS safeguarding requirements as soon as they are no longer needed, as they are available in ASOIG.

The following list of forms must be retained for five years from the date of the last entry on the form:

  • Form H1861, Federal Tax Information Destruction Log
  • Form H1862, Federal Tax Information Transmittal Memorandum
  • Form H1863, Federal Tax Information Removal Log
  • Form H1864, Federal Tax Information Fax Transmittal
  • Form H1865, Federal Tax Information Transmittal Log

 

C—1052 Discovery of Existing IRS FTI in HHSC Offices and Records

Revision 13-4; Effective October 1, 2013

 

TANF, SNAP and TP 08

Advisors review information in each case record to identify any IRS FTI as cases come up for recertification or review. Examples of IRS FTI include, but are not limited to hard copies of old IEVS alerts, manual Form H1020, Request for Information or Action, and notices requesting verification of IRS FTI. If IRS FTI is found in the case record, the advisor evaluates whether retention periods have been met per IRS FTI retention periods addressed in C-1051, Retention and Distribution of IRS FTI. If information can be destroyed, complete Form H1861, Federal Tax Information Destruction Log, before destroying the information. If the information needs to remain in the case record to support documentation or verification, secure the case record in a two-barrier secure environment until the case can be purged. Regions may elect to separate IRS FTI and place it in a secure centralized location. If the local office does not file the IRS FTI in the case record, note in the case record that IRS FTI exists and is located in the centralized location.

 

C—1053 Purging Records

Revision 13-4; Effective October 1, 2013

TANF, SNAP and TP 08

When Texas Works staff purge case records, review the records for IRS FTI. If information can be removed from the actual file, completeForm H1861, Federal Tax Information Destruction Log, and destroy the information. If the record indicates that IRS FTI is filed separately in a secure location, destroy the IRS FTI when the file is purged. Refer to the IRS FTI retention periods addressed in C-1051, Retention and Distribution of IRS FTI.

Follow regional or local office procedures for storage and purging of IRS FTI.

 

C—1060 Reporting a Security Incident Regarding Internal Revenue Service (IRS) Federal Tax Information (FTI)

Revision 14-4; Effective October 1, 2014

Upon discovery of an actual or possible compromise of an unauthorized inspection or disclosure of IRS FTI, including breaches and security incidents, the individual making the observation or receiving the information must immediately contact the HHSC IRS coordinator. The individual sends a secure email to HHSC_IRS_FTI_Safeguards@hhsc.state.tx.us.

The HHSC IRS coordinator will report the incident by contacting the office of the appropriate special agent-in-charge, Treasury Inspector General for Tax Administration (TIGTA), in addition to the IRS Office of Safeguards, as directed in Section 10.2 of IRS Publication 1075.

C-1100, Other/Miscellaneous

Revision 19-3; Effective July 1, 2019

 

 

C—1110 Medical Information

Revision 05-1; Effective January 1, 2005

 

 

C—1111 State Medicaid Agencies

Revision 13-3; Effective July 1, 2013

 

Medical Programs

For links to all State Medicaid Agencies, go to https://www.medicaid.gov/medicaid/by-state/by-state.html.

 

C—1112 Services Under the Texas Medical Assistance Program

Revision 19-3; Effective July 1, 2019

 

Medical Programs

Benefits provided through health insuring agent:

  • In-patient hospital services*
  • Out-patient hospital services*
  • Laboratory and x-ray services
  • Physician's services
  • Podiatrist's services
  • Optometric services*
  • Ambulance services*
  • Family planning services*
  • Home health services limited to nurse and home health aide visits*
  • Medicare Part A deductible and coinsurance when benefits would otherwise be payable under Medical Assistance and Medicare Part B deductible and coinsurance for assigned claims only
  • Chiropractic treatment — limited to Medicare Part B deductible and coinsurance for assigned claims only
  • Eyeglasses*
  • Rural health clinics*

Services provided through contract or by direct vendor payments from the Health and Human Services Commission (HHSC):

  • Nursing care skilled and intermediate care. Skilled care is limited to recipients age 21 and over. Medicare SNF coinsurance.*
  • Active treatment for recipients or patients of any age in licensed and approved section of institutions for persons with intellectual disabilities.*
  • In-patient hospital care for recipients or patients age 65 and older in contracted mental hospitals and state (tuberculosis) hospitals.*
  • Texas Health Steps screening program and limited dental treatment for eligible persons under age 21.
  • Prescriptions limited to no more than three covered per month if over 18. Unlimited if 18 and under.
  • Prior authorized hearing aid services.*
  • Primary home care for recipients age 18 and over.*
  • Other medical transportation.

*With limitations — see appropriate provider manuals for details.

The benefits of this program do not extend to:

  • Inmates in a public institution. (Recipients in approved medical units in certain contracted institutions are eligible for vendor payments made by HHSC.)
  • Special shoes or other supportive devices for the feet or walking aids.
  • Services in military medical facilities, Veteran's Administration (VA) facilities, or United States Public Health Service Hospitals.
  • Care and treatment related to any condition for which benefits are provided or are available under Workman's Compensation laws.
  • Dental care and services except certain oral surgery or that provided under Texas Health Steps.
  • Any services or supplies provided in connection with a routine physical examination except family planning services.
  • Any care or services payable under Title XVIII (Medicare).
  • Any service provided by an immediate relative of the recipient or member of the recipient's household.
  • Any services or supplies not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of the malformed body member.
  • Custodial care.
  • Any services provided to the recipient after a utilization review or medical review finding that such services are not medically necessary.
  • Any services or supplies that are payable through a third party.
  • Any service or supplies not specifically provided by the Texas Medical Assistance Program.

Disclaimer: This list is for convenient reference and does not have the effect of law, regulation or policy. If there is a conflict between this list and law, regulations, and policy, the latter will prevail. If there is a question, use the appropriate provider manuals or filed releases for clarification.

 

C—1113 Qualified Hospital/Qualified Entity Policy and Procedures for Presumptive Eligibility Determinations

Revision 15-3; Effective July 1, 2015

 

TA 66, TA 74, TA 75, TA 76, TA 83, TA 86 and TP 42

Presumptive eligibility (PE)provides short-term medical coverage to pregnant women, Medicaid for Breast and Cervical Cancer (MBCC) applicants, children under age 19, parents and caretaker relatives of dependent children under age 19, and former foster care children. PE provides full fee-for-service Medicaid with the exception of pregnant women. Pregnant women receive ambulatory prenatal care only.

Qualified hospitals (QHs)determine PE for all groups except MBCC.

Qualified entities (QEs)determine PE for pregnant women and MBCC applicants. For MBCC applicants, only QEs that are also Texas Department of State Health Services (DSHS) Breast and Cervical Cancer Services contractors can make MBCC PE determinations, following the process outlined inX-100, Application Processing.

 

C—1113.1 Eligible Groups

Revision 15-3; Effective July 1, 2015

 

The following groups can receive presumptive eligibility coverage:

  • Children:
    1. MA-Children Under 1 Presumptive — TA 74
    2. MA-Children 1–5 Presumptive — TA 75
    3. MA-Children 6–18 Presumptive — TA 76
  • Former Foster Care Children (MA-FFCC Presumptive —TA 83)
  • Pregnant Women (MA-Pregnant Women Presumptive — TP 42)
  • Parents and Other Caretaker Relatives (MA-Parents and Caretaker Relatives Presumptive — TA 86)

 

C—1113.2 Household Composition

Revision 15-3; Effective July 1, 2015

 

The QH/QE uses the non-taxpayer/non-tax dependent rules to determine the household composition.

 

C—1113.3 Modified Adjusted Gross Income (MAGI) Methodology

Revision 15-4; Effective October 1, 2015

 

The QH/QE uses a simplified MAGI methodology to determine if an individual meets the income requirements for PE. The income limits for each PE type of assistance are the same as the income limits for the associated regular Medicaid type of assistance. For example, MA-Children Under 1 Presumptive has the same income limit as MA-Children Under 1.

 

C—1113.4 Verifications

Revision 15-3; Effective July 1, 2015

 

The individual must attest to being:

  • a Texas resident, and
  • a United States citizen or an eligible immigrant.

For all other PE criteria, the individual's statement is acceptable verification. Additional forms of verification beyond an individual's statement are not required.

 

C—1113.5 Medical Effective Dates

Revision 15-4; Effective October 1, 2015

 

The medical effective date (MED) is the date the QH or QE determines the individual is presumptively eligible for Medicaid. If the individual is presumptively eligible, QH/QE staff give the individual Form H1266, Short-term Medicaid Notice: Approved. It informs the individual when the PE coverage begins and when the PE coverage ends, based on whether the individual applies for regular Medicaid.

Note: An individual is not eligible for PE if they are currently receiving Medicaid, Children's Health Insurance Program (CHIP) or CHIP perinatal.

If the individual does not apply for regular Medicaid, the PE coverage ends the last day of the month after the month of the PE determination (see scenario 1 below).

If the individual submits Form H1205, Texas Streamlined Application, or Form H1010, Texas Works Application for Assistance — Your Texas Benefits, HHSC staff determine whether the individual is eligible for regular Medicaid. If the individual is not eligible for regular Medicaid, the individual’s PE coverage ends the date that HHSC determines the individual is ineligible (see scenario 2 below). If the individual is eligible for regular Medicaid, the individual’s PE coverage ends when HHSC makes the Medicaid eligibility determination, following cutoff rules.

If an individual is Medicaid-eligible during the application month, the individual receives Medicaid from the first of that month through the PE MED. Regular Medicaid coverage for the ongoing period begins once the PE period ends (see scenarios 3 and 4 below). Exception: Since PE for pregnant women provides only limited prenatal services, ongoing Medicaid coverage overlays the PE coverage (see scenario 5 below).

Examples:

PE Scenarios
  1. Individual does not apply for regular Medicaid
A child is determined eligible for MA-Children 6–18 Presumptive on February 2. Her mother does not submit an application for regular Medicaid. The child’s PE coverage ends on March 31.
  1. Individual is ineligible for regular Medicaid
A child is determined eligible for MA-Children Under 1 Presumptive on April 4. Her father submits an application for regular Medicaid on the same date. HHSC determines on April 20 that the child is not eligible for regular Medicaid. Her PE coverage ends on April 20.
  1. Individual is eligible for regular Medicaid (HHSC makes eligibility determination before cutoff)
A child is determined eligible for MA-Children 1–5 Presumptive on March 6. His mother submits an application for regular Medicaid on the same date. HHSC determines on March 15 (before cutoff) that the child is eligible for regular Medicaid. His PE coverage ends March 31. He is certified for regular Medicaid effective March 1 to March 5 and April 1 through ongoing.
  1. Individual is eligible for regular Medicaid (HHSC makes eligibility determination after cutoff)
A former foster care child is determined eligible for MA-FFCC Presumptive on May 9. He submits an application for regular Medicaid on the same date. HHSC determines on May 22 (after cutoff) that the individual is eligible for regular Medicaid. His PE coverage ends June 30. He is certified for regular Medicaid effective May 1 to May 8 and July 1 through ongoing.
  1. Pregnant woman is eligible for regular Medicaid
A woman is determined eligible for MA-Pregnant Women Presumptive on June 4. She submits an application for regular Medicaid on the same date. HHSC determines on June 10 that the woman is eligible for regular Medicaid. Her PE coverage ends on June 30. Regular Medicaid overlays her PE coverage with an effective date of June 1.

 

C—1113.6 Periods of Presumptive Eligibility

Revision 15-3; Effective July 1, 2015

 

Pregnant women are allowed one PE period per pregnancy.

For all other PE groups, an individual is allowed no more than one period of PE per two calendar years.Example:An individual receives MA-Children 6–18 Presumptive in June 2015. He cannot receive another period of PE until January 2017.

 

C—1113.7 Three Months Prior Coverage

Revision 15-3; Effective July 1, 2015

 

Three months prior coverage does not apply to presumptive eligibility. Eligibility for three months prior Medicaid coverage is determined when HHSC eligibility staff make a regular Medicaid determination, if requested.

 

C—1113.8 Application Processing

Revision 15-4; Effective October 1, 2015

 

QH/QE staff first must perform a PE portal inquiry to find out if an individual is currently receiving Medicaid, CHIP or CHIP perinatal or if the applicant has received a period of PE within the PE period limit.

QH/QE staff make the PE determination based on information the individual provides about citizenship/immigration status, Texas residency, income and household composition. To determine whether the individual is presumptively eligible, QH/QE staff fill out Form H1265, Presumptive Eligibility (PE) Worksheet, using the information the individual provides.

If the individual is presumptively eligible, QH/QE staff do the following:

  • Enter the individual’s demographic information and the PE type of assistance for which the individual is eligible into the PE portal. QH/QE staff use the PE portal to conduct limited inquiries and submit PE determinations.
  • Give the individualForm H1266, Short-term Medicaid Notice: Approved. QH/QE staff also help the individual complete and submit the regular Medicaid application viaYourTexasBenefits.comif the individual wants to apply.Note:An individual is not required to submit a regular Medicaid application to receive PE Medicaid.

If the individual is not eligible for PE, QH/QE staff issueForm H1267, Short-term Medicaid Notice: Not Approved, to the individual and tell the individual about the right to apply for regular Medicaid.

 

C—1113.9 Due Dates and Processing Time Frames

Revision 15-3; Effective July 1, 2015

 

Within one business day of the PE determination, the QH/QE must submit the PE determination to HHSC through the PE portal.

 

C—1113.10 How to Become a Qualified Hospital or Qualified Entity

Revision 15-3; Effective July 1, 2015

 

Hospitals or entities that want to become qualified to make PE determinations must (1) submit to HHSC a notice of intent, (2) sign a Memorandum of Understanding, and (3) complete online training at the PE website at www.TexasPresumptiveEligibility.com.

 

C—1113.11 Presumptive Eligibility Forms

Revision 15-3; Effective July 1, 2015

 

Qualified hospital/qualified entity staff use the following forms in the presumptive eligibility process:

  • Form H1265, Presumptive Eligibility (PE) Worksheet—Completed by the QH/QE and used to determine if an applicant is presumptively eligible.
  • Form H1266, Short-term Medicaid Notice: Approved-Completed by the QH/QE and given to an individual determined presumptively eligible. This form notifies the individual about PE coverage and lists the eligibility start date and end date, which is based on whether the individual submits an application for regular Medicaid. If an individual needs proof of Medicaid coverage before receiving their Medicaid identification card, the individual can present this form in an HHSC local eligibility determination office, and HHSC staff will provide the individual withForm H1027-A, Medicaid Eligibility Determination.
  • Form H1267, Short-term Medicaid Notice: Not Approved— Completed by the QH/QE and given to an individual determined ineligible for PE coverage. This form explains the reason for ineligibility and how to apply for regular Medicaid.

Related Policy
Processing Presumptive Eligibility Applications, A-124

 

C—1114 Guidelines for Providing Retroactive Coverage for Children and Medical Programs

Revision 19-2; Effective April 1, 2019

 

Medical Programs

When determining retroactive eligibility for children and pregnant women, use the applicable income, standard MAGI income disregard, and IRS monthly income thresholds charts.

March 2017 through February 2018

Federal Poverty Income Limits (FPIL)
Family Size 133% FPIL
(3-1-17)
TP 44, 34, TA 76
144% FPIL
(3-1-17)
TP 48, 33, TA 75
198% FPIL
(3-1-17)
TP 40, 42, 43, 36, 35, TA 74
1 $1,337 $1,448 $1,990
2 $1,800 $1,949 $2,680
3 $2,264 $2,451 $3,370
4 $2,727 $2,952 $4,059
5 $3,190 $3,454 $4,749
6 $3,654 $3,956 $5,439
7 $4,117 $4,457 $6,129
8 $4,580 $4,959 $6,818
9 $5,043 $5,460 $7,508
10 $5,507 $5,962 $8,198
11 $5,970 $6,464 $8,887
12 $6,433 $6,965 $9,577
13 $6,897 $7,467 $10,267
14 $7,360 $7,968 $10,956
15 $7,823 $8,470 $11,646
For each additional member $464 $502 $690

 

Family Size 200% FPIL
(3-1-17)
TA 41
201% FPIL
(3-1-17)
TA 84
202% FPIL
(3-1-17)
TA 85
400% FPIL
(3-1-17)
TA 77
413% FPIL
(3-1-17)
TP 70
1 $2,010 $2,021 $2,031 $4,020 $4,151
2 $2,707 $2,721 $2,734 $5,414 $5,590
3 $3,404 $3,421 $3,438 $6,807 $7,028
4 $4,100 $4,121 $4,141 $8,200 $8,467
5 $4,797 $4,821 $4,845 $9,594 $9,906
6 $5,494 $5,521 $5,549 $10,987 $11,344
7 $6,190 $6,221 $6,252 $12,380 $12,783
8 $6,887 $6,922 $6,956 $13,774 $14,221
9 $7,584 $7,622 $7,660 $15,167 $15,660
10 $8,280 $8,322 $8,363 $16,560 $17,099
11 $8,977 $9,022 $9,067 $17,954 $18,537
12 $9,674 $9,722 $9,771 $19,347 $19,976
13 $10,370 $10,422 $10,474 $20,740 $21,415
14 $11,067 $11,122 $11,178 $22,134 $22,853
15 $11,764 $11,823 $11,881 $23,527 $24,292
For each additional member $697 $701 $704 $1,394 $1,439

 

Five Percentage Points of FPIL
Family Size 2017 Monthly
Disregard Amount
1 $50.25
2 $67.70
3 $85.10
4 $102.50
5 $119.95
6 $137.35
7 $154.75
8 $172.20
9 $189.60
10 $207.00
11 $224.45
12 $241.85
13 $259.25
14 $276.70
15 $294.10
Per each additional person $17.45

 

IRS Monthly Income Thresholds
Type of
Income
2017
Threshold
Apply Threshold Value in Form H1042,
Modified Adjusted Gross Income (MAGI)
Worksheet: Medicaid and CHIP
Unearned Income $87.50
  • Pages 5-7, Step 3, Line 7
  • Pages 5-7, Step 3, Line 9
Earned Income $525.00
  • Pages 5-7, Step 3, Line 8

 

March 2018 through February 2019

Federal Poverty Income Limits (FPIL)
Family Size 133% FPIL
(3-1-18)
TP 44, 34, TA 76
144% FPIL
(3-1-18)
TP 48, 33, TA 75
198% FPIL
(3-1-18)
TP 40, 42, 43, 36, 35, TA 74
1 $1,346 $1,457 $2,004
2 $1,825 $1,976 $2,716
3 $2,304 $2,494 $3,429
4 $2,782 $3,012 $4,142
5 $3,261 $3,531 $4,855
6 $3,740 $4,049 $5,568
7 $4,219 $4,568 $6,280
8 $4,698 $5,086 $6,993
9 $5,176 $5,604 $7,706
10 $5,655 $6,123 $8,419
11 $6,134 $6,641 $9,132
12 $6,613 $7,160 $9,844
13 $7,092 $7,678 $10,557
14 $7,570 $8,196 $11,270
15 $8,049 $8,715 $11,983
For each additional member $479 $519 $713

 

Family Size 200% FPIL
(3-1-18)
TA 41
201% FPIL
(3-1-18)
TA 84
202% FPIL
(3-1-18)
TA 85
400% FPIL
(3-1-18)
TA 77
413% FPIL
(3-1-18)
TP 70
1 $2,024 $2,034 $2,044 $4,047 $4,179
2 $2,744 $2,758 $2,771 $5,487 $5,665
3 $3,464 $3,481 $3,498 $6,927 $7,152
4 $4,184 $4,205 $4,226 $8,367 $8,639
5 $4,904 $4,928 $4,953 $9,807 $10,126
6 $5,624 $5,652 $5,680 $11,247 $11,613
7 $6,344 $6,376 $6,407 $12,687 $13,099
8 $7,064 $7,099 $7,134 $14,127 $14,586
9 $7,784 $7,823 $7,862 $15,567 $16,073
10 $8,504 $8,546 $8,589 $17,007 $17,560
11 $9,224 $9,270 $9,316 $18,447 $19,047
12 $9,944 $9,994 $10,043 $19,887 $20,533
13 $10,664 $10,717 $10,770 $21,327 $22,020
14 $11,384 $11,441 $11,498 $22,767 $23,507
15 $12,104 $12,164 $12,225 $24,207 $24,994
For each additional member $720 $724 $728 $1,440 $1,487

 

Five Percentage Points of FPIL
Family Size 2018 Monthly
Disregard Amount
1 $50.60
2 $68.60
3 $86.60
4 $104.60
5 $122.60
6 $140.60
7 $158.60
8 $176.60
9 $194.60
10 $212.60
11 $230.60
12 $248.60
13 $266.60
14 $284.60
15 $302.60
Per each additional person $18.00

 

IRS Monthly Income Thresholds
Type of
Income
2018
Threshold
Apply Threshold Value in Form H1042,
Modified Adjusted Gross Income (MAGI)
Worksheet: Medicaid and CHIP
Unearned Income $87.50
  • Pages 5-7, Step 3, Line 7
  • Pages 5-7, Step 3, Line 9
Earned Income $529.17
  • Pages 5-7, Step 3, Line 8

C—1115 Immunization Terms

Revision 13-3; Effective July 1, 2013

 

TANF and Medical Programs

Immunization by inoculation or vaccination protects against childhood diseases. Except for tetanus, these diseases are contagious. Encourage individuals to follow the Texas Department of Health's recommended schedule found on Form H1012, Immunization Record. If a child is on an alternate schedule refer to A-2125, Immunizations.

The following are descriptions of the diseases and symptoms associated with immunizations.

  • Diphtheria — An acute, bacterial illness that causes a sore throat and a fever and sometimes causes more serious or even fatal complications.
  • Haemophilus Influenza Type b (HIB) — A bacterium that can cause meningitis and pneumonia and infect other body systems such as blood, joints, bones and soft tissue under the skin, throat, and the covering of the heart.
  • Hepatitis A — An infection of the liver caused by the Hepatitis A virus.
  • Hepatitis B — An infection of the liver caused by the Hepatitis B virus.
  • Measles — An acute, highly contagious viral disease involving the respiratory tract that causes a characteristic rash, fever, runny nose, sore eyes, and cough.
  • Mumps — An acute viral disease mainly of childhood. It is characterized by a swelling of the parotid (salivary) glands on one or both sides and may cause fever, headache, and difficulty swallowing may develop.
  • Pertussis (Whooping Cough) — An acute highly contagious respiratory disease characterized by a severe attack of coughing that ends in a characteristic "whoop" as breath is drawn in.
  • Poliomyelitis (Polio – once known as "infantile paralysis") — An infectious disease that may lead to extensive paralysis of the muscles.
  • Rubella (German Measles) — A viral infection characterized by a mild fever, swollen glands in the neck and a rash that lasts up to three days.
  • Tetanus (Lockjaw) — A very serious disease of the central nervous system caused by an infection of a wound that makes an individual unable to open his/her mouth or swallow and causes muscle spasms in the jaw, neck, leg or other muscles.
  • Varicella (Chickenpox) — A highly contagious viral infection which presents as a generalized, itchy, vesicular rash. The rash begins as smooth, red spots which develop into blisters that last three to four days before forming crusty scabs.

 

C—1116 Managed Care Plans

Revision 19-1; Effective January 1, 2019

 

Information concerning the medical and dental managed care plans with contact information for each plan is located at hhs.texas.gov/services/health/medicaid-chip/programs/medical-dental-plans.

Related Policy
Managed Care,A-821.2
Releasable Information for Medicaid Providers and Their Contractors, B-1230
Office of the Ombudsman,B-1420

 

C—1118 Health Care Orientation Quick Reference Guide

Revision 19-3; Effective July 1, 2019

 

TP 43, TP 44 and TP 48

Effective 7/1/19

STEPS TO VERIFICATION

Use the following items to verify the person’s identity. See the Expanded Health Care Orientation and Enrollment Script below for verification instructions.

  • Medicaid ID Number or SSN
  • Name
  • Address
  • Phone Number
  • DOB
  • Third-Party Resources (Private Insurance)
  • Primary Language Spoken in Home

ESSENTIAL STEPS to EDUCATION

  1. Introduction (your name, your position, etc.)
  2. Explain managed care including how to enroll and what a primary care provider (PCP) is.
  3. Explain about Primary Care Providers and emergency rooms.
  4. Explain about specialists and referrals.
  5. Explain about preventive medical and dental checkups.
  6. Explain STAR or STAR Kids enrollment will be effective in 15-45 days and traditional Medicaid is in effect until then.
  7. Explain they will receive an ID card from the health plan.
  8. Other education is provided as necessary (i.e., TP40 education script, newborn education).
  9. Managed Care changes – How to change plans or a primary care provider and how often it is allowed. Provide the contact information necessary to call to make changes.
  • Medicaid Program Knowledge – don't pay bills, what Medicaid covers, etc.
  • Your Texas Benefits Medicaid ID card, primary care provider, restrictions.
  • Maintaining Eligibility – reading mail, sending back information, receiving checkups
  • Texas Health Steps Program Knowledge, including checkup schedules, for children through age 20 - Refer to the Texas Health Steps Desk Reference for the information that should be covered (a link to the desk reference may be found below).
  • Medical and Dental Providers – Give choices and handout or give the person the number to call to have a list mailed or, for immediate assistance finding a doctor or dentist, 877-847-8377.
  • How to Schedule an Appointment – offer to help or give the toll-free number, 877-847-8377; keeping and canceling appointments.
  • Case Management for Children and Pregnant Women – health risk or health condition, trouble finding services.
  • Medical Transportation – available benefit, call for transportation assistance, provide contact information.
  • CHIP – any uninsured children in the household?
  • WIC – pregnant women or child in the family who is under 5
  • Summary – Inquire whether the person has any questions or if they would like you to repeat any information, especially any of the contact information given.

Expanded Health Care Orientation Script

(Effective July 1, 2019)

Introduction

Standard greeting to include your name, program and purpose for calling. For example: Hello, may I speak with [case name]: Hello, Mr./Mrs._______________________. My name is _________________. Since your child/children are new to Medicaid, a state law requires that you receive what is known as a Health Care Orientation. This will only take a few minutes and I will give you some valuable information about how to use your child's/children's Medicaid benefits.

Use the following to verify the caller's identity.

Steps to Caller VERIFICATION

  • Medicaid ID Number or SSN-Do you have Your Texas Benefits Medicaid ID card handy? Will you read the number that appears on the card below your child's name?
  • Name-Is this the name of your child?
  • Address-Are you still living at this address?
  • Primary Language Spoken in Home-Ask and document the language
  • Phone Number-Is this the correct phone number?
  • DOB-Is this your child's date of birth?
  • Third Party Resources (Private Insurance)-Does your child have any private health insurance?

Steps to EDUCATION

Essential Information About Medicaid Health Plans (Managed Care)

  1. Explain Managed Care and Primary Care Provider.  "Let me tell you a little about the STAR and STAR Kids program. The STAR and STAR Kids program are Texas Medicaid Managed Care programs. Managed care means that you will receive your Medicaid services through a health plan. You only have 30 days from the date you are certified to select a health plan and a primary care provider. The primary care provider can be a doctor, specially trained nurse, clinic or health center. If you don't choose, the STAR or STAR Kids program will pick a health plan and primary care provider for you. The primary care provider is available 24 hours a day, 7 days a week to coordinate care for you and your child/children. Have you received an enrollment packet? This is a large white envelope with the different health plan booklets, enrollment form and instructions. Have you already enrolled? If not, I can tell you how to enroll (or change plan if they have been defaulted).” If the person has not yet enrolled, refer the person to the enrollment hotline 800-964-2777.   
  2. Explain about primary care providers and emergency rooms. “Your child's primary care provider is the one you contact first when your child/children needs/need any kind of medical health care. Unless it is an emergency, you should contact your primary care provider before you take your child to the emergency room. An emergency would be a problem or condition, including severe pain that is so serious that waiting for routine care might result in serious harm. In an emergency, you may not have time to contact the primary care provider, in that case, call 9-1-1 or take your child to the nearest emergency room.”
  3. Explain referrals: “Referrals to specialists for STAR and STAR Kids recipients must be obtained through the primary care provider. However, families do not need a referral for the following services: family planning, eye exams and glasses, behavioral health and Texas Health Steps medical/dental checkups. The primary care provider will refer your child/children to specialists or hospitals when needed.”
  4. Texas Health Steps Preventive checkups: “Recipients through age 20 are eligible for preventive medical and dental checks-ups through Texas Health Steps.”
  5. Explain the recipients will receive a Your Texas Benefits Medicaid ID card.  “After the recipient is enrolled in the STAR or STAR Kids program, a Your Texas Benefits Medicaid ID card will be mailed. The recipient will also receive a member ID card from the plan.”
  6. STAR and STAR KIDS “Recipients can change their primary care provider up to four times a year. They can have unlimited changes in their health plan (however, there are time restrictions – each health plan change can take 15-45 days). Call the STAR helpline to change the health plan and call the health plan directly to request a primary care provider change.”
  7. Pregnant Women: If applicable, expand education to include TP40 (pregnant women) information. Ask, "Are you currently seeing a provider for your prenatal care?" Pregnant women must choose a plan and primary care provider within 15 days from their Medicaid certification. The enrollment will take effect as soon as the recipient is found eligible for Medicaid. All efforts will be made to expedite the enrollment. If that is not possible, the enrollment will be effective within 15-45 days. Remind the recipient the importance of selecting a plan for herself and the baby since the recipient will not be able to change the baby's plan until the baby is three months old. After the baby is born, the recipient should call the plan to pick a primary care provider for the baby. Explain when the STAR program is effective for pregnant women. If the pregnant woman's managed care enrollment is certified before the 10th of the month, the enrollment is effective the first day of the certification month. If the pregnant woman's managed care enrollment is certified after the 10th of the month, the enrollment is effective the first day of the month following the certification date.

    Note for Pregnant Women: If a pregnant woman has 12 weeks or less remaining in her pregnancy (third trimester), she may choose to remain with her current OB/GYN for the remainder of her pregnancy, delivery, and postpartum checkup, even if the OB/GYN does not participate with the chosen health plan.
  8. Medicaid Program Knowledge
  • “Medicaid pays for you or your child's care when they go to the doctor, if they are in the hospital, if they go to the dentist and if they go to a specialist. It will also pay for prescriptions, vaccines, transportation to any Medicaid covered service, and for behavioral health services. It also pays for Texas Health Steps preventive medical and dental checkups for children through age 20.”
  • “Medicaid pays only providers like doctors, dentists, specialists and hospitals. You should not receive any bills. However, if you receive a bill don't pay it. First call the provider and find out why they did not send the bill to Medicaid. Make sure your provider has the Medicaid ID number needed for billing.” If the recipient is on STAR or STAR Kids direct them to call their health plan. If they are on fee for service direct them to call the number on the back of the Your Texas Benefits Medicaid ID card for billing questions 800-252-8263.


Your Texas Benefits Medicaid ID Card-Process

  • Ask the family if they have received their new Your Texas Benefits Medicaid Id card. If not, explain the new card they will receive is good for as long as they are on Medicaid. Describe the Your Texas Benefits Medicaid ID card.
  • Inform the family that their STAR or STAR Kids health plan should be listed on the Your Texas Benefits Medicaid ID card. 
  • Remind the family to take the Your Texas Benefits Medicaid ID card to the doctor, dentist, pharmacy or every time they obtain a Medicaid service.
  • Explain to the family if they do not receive their Your Texas Benefits Medicaid ID card in the next couple of weeks, they should contact their local HHSC office to confirm eligibility. Once eligibility is confirmed, they can contact the Your Texas Benefits Medicaid ID card Help Desk at 855-827-3748 to check the status of the card order. Inform them they can also print a copy of their card from the YourTexasBenefits.com website while they wait on their permanent card.

Maintaining Eligibility

  • “Follow up with any paper work you receive from the Texas Health and Human Services Commission (also called HHSC). HHSC reviews your case from time to time, usually every 12 months, and so it is very important to complete the paperwork to keep your child/children on Medicaid.”
  • “It is a requirement to receive your health care orientation (we are providing that right now) and for your children to receive their Texas Health Steps preventive checkups to avoid having to go to the office for a face-to-face interview or to be required to return follow-up information at your redetermination.”

Texas Health Steps Program Knowledge

If the parent or caretaker is being interviewed and it is for an initial certification including a reapplication after a break in benefits of 60 days or more, the advisor is responsible for initial Texas Health Steps informing, even if the household does not require a Health Care Orientation.

Refer to the Texas Health Steps Desk Reference for the information that must be covered during the Health Care Orientation or when the parent or caretaker must receive just the initial Texas Health Steps informing.

Refer to the Texas Health Steps Program Desk Reference to educate parents and caretakers about when a child's Texas Health Steps medical and dental* checkups are due and issues a health care provider may address during a Texas Health Steps medical or dental checkup. The health care provider will address specific issues for each age and each child.

* Emergency dental services are available at any age and do not require a check on ID.

Texas Health Steps Desk Reference

  • If the information is being provided in person, give the family a:
    • “Checkups Help Children Stay Healthy!” wallet card
    • “Don't Miss a Beat” brochure
    • "Keep Your Child's Checkups in Check” brochure
  • Advise the family to contact the Texas Health Steps helpline if they would like a medical or dental provider list mailed to them or if they would like immediate assistance: 877-847-8377, available 8 a.m. – 6 p.m. Central Time, Monday – Friday.

Case Management for Children and Pregnant Women

  • Case Management for Children and Pregnant Women is a Medicaid benefit. Case managers help families get medical services, school services, medical equipment and supplies, and other services that are medically necessary.
  • Case managers can help children and young adults age 20 and younger who have a health condition or health risk who are covered by Medicaid. They also can help women of any age with a high risk pregnancy.  The person or family must need help getting services or they must be having trouble finding or connecting with the services that they need related to their health condition or health risk.  The family must want the case management services.
  • Case managers are either licensed social workers or registered nurses and are trained to help get families the services that they have trouble finding on their own.
  • The case manager will meet with the person approved for Medicaid, the person’s parent or guardian.  They will do a full assessment to find out all of the needs a family might have related to the health condition. Then the case manager and family will make a service plan that addresses all the needs. 
  • Anyone can refer someone for case management services by calling the Texas Health Steps helpline toll-free at 877-847-8377, 8 a.m. – 6 p.m. Central Time, Monday - Friday.

Medical Transportation Program (MTP)

  • The Medical Transportation Program provides non-emergency medical transportation (NEMT) services.
  • Explain the Medical Transportation Program is available for all Medicaid-covered health care services to those with full Medicaid (not Qualified Medicare Beneficiary [QMB] or Specified Low-Income Medicare Beneficiary [SLMB]), Children with Special Health Care Needs (CSHCN), and Transportation for Indigent Cancer Patients (TICP), who do not have any other means of transportation.
  • “Call at least two business days before the appointment in the same county or adjacent county and five business days before an appointment outside the county adjacent to your residence and be prepared to provide your:
    • name;
    • Medicaid ID number;
    • address;
    • phone number;
    • doctor's name and address;
    • doctor's phone number;
    • date; and
    • time of appointment.”

Ways to Travel:

  • If you don't have a car and you don't have anyone else to drive you, the Medical Transportation Program will help. This may be by bus tickets or by van.
  • If you have a car, or know someone who can drive you to the appointment, the Medical Transportation Program can pay you or your driver gas reimbursement by the mile.

 

Call to schedule a ride.

Houston/Beaumont area: 855-687-4786

Dallas area: 855-687-3255

Everyone else: 877-633-8747 (877-MED-TRIP)

If you have a complaint or concern, call 877-633-8747 (877-MED-TRIP), Option 2.

 

Children's Health Insurance Program (CHIP)

  • If anyone in the household is under age19 does not have health insurance, explain they may be eligible for some type of state-funded health insurance. They may call 2-1-1 Option 2 to apply for CHIP and Children's Medicaid.

WIC (Women, Infant, and Children's Program)

  • Explain WIC is a supplemental nutrition and education program to provide nutritious foods to help women, infants and children improve on their nutrition. “If you are receiving Medicaid, you are income-eligible for the program, but you will have to complete a nutritional screening to receive benefits.”
  • If pregnant or a postpartum woman or a child under age 5 lives in the household, give the parent the 800-942-3678 number to locate their nearest WIC office.

Summary

  • “Any questions regarding Texas Health Steps or Medicaid?”
  • Inform the person that they have received a "Health Care Orientation."
  • Verify the person’s information, phone number, migrant status, any other children in the household.
  • If enrolled, recap enrollment information including the names of the primary care provider and main dentist, if known, and the name of the health plan.
  • Provide toll free number for future assistance (see below). Thank the person for their time.
  • If in person, provide literature and any numbers needed from the Resource Directory (see below).
Resource Directory
Resource List Toll Free Numbers TTY  LINE
2-1-1-Information and Referral for other types of community resources 2-1-1, Option 1 2-1-1, Option 1
Billing Questions Hotline for Traditional Medicaid, also known as fee-for-service 800-335-8957 800-735-2988
HHSC  512-424-6500 512-424-6597
Medicaid Hotline Number 800-252-8263 800-735-2988
Medical Transportation Program (MTP) Houston/Beaumont area: 855-687-4786
Dallas area: 855-687-3255
Everyone else: 877-633-8747 (877-MED-TRIP)
800-735-2988
Social Security Administration (for Medicare and SSI Medicaid) 800-772-1213 800-325-0778
STAR/STAR+PLUS/STAR Kids/STAR Health Help Line 800-964-2777 800-735-2988
HHS Ombudsman Managed Care Assistance Team 866-566-8989 7-1-1
Texas Health Steps   877-847-8377 800-735-2988
HHSC Case Management for Children and Pregnant Women information and referral assistance 877-847-8377 800-735-2988
Children's Health Insurance Program (CHIP) 877-543-7669 800-735-2988
WIC 800-942-3678 800-735-2988

 

C—1120 IRS Tax Code

Revision 15-4; Effective October 1, 2015

Unauthorized disclosure or unauthorized inspection of an applicant or client’s federal tax information by HHSC staff is punishable by law, including but not limited to:

  • felony charges,
  • imprisonment,
  • fines,
  • employment dismissal, or
  • civil charges.

See United States Code (U.S.C.), Title 26, §7213; 26 U.S.C. §7213A; and 26 U.S.C. §7431 for a complete list of penalties for the unauthorized disclosure or inspection of this information.

 

C—1130 Electronic Benefit Transfer (EBT) Charts and Guides

Revision 15-4; Effective October 1, 2015

 

 

 

C—1131 Advisor Guide for Explaining EBT

Revision 18-1; Effective January 1, 2018

 

TANF and SNAP

Instruct the cardholder to read Form H1185, Important Information About Your Lone Star Card, and to ask questions about any EBT issuance procedures the cardholder does not understand. Advisors must also explain:

  • Procedures for Lone Star Card issuance and PIN issuance/self-selection to access benefits including:
    • primary cardholder and secondary cardholder (including how to establish a secondary cardholder);
    • how access is limited to a person with both the card and the PIN;
    • that there is no charge for using the Lone Star Card for food account purchases; and
    • that to obtain benefits they need to have a card, PIN and available benefits.
  • When applicants will be able to use their initial benefits, if certified, and explain the availability of monthly benefits as specified in Form H1184, Here Is Your Lone Star Card.
  • How and where to use the Lone Star Card including:
    • how to make a purchase (and/or cash withdrawal for TANF), availability of receipts and the need to save EBT receipts to keep track of account balance(s);
    • how to identify stores accepting SNAP/Lone Star Cards and how to ask store personnel if the store provides TANF cash-back services; and
    • the TANF cash-back policy. See B-239.1, Advisor Interview Requirements for Client Training.
  • Card/PIN security including:
    • how to keep their benefits secure;
    • what to do if a card is lost or stolen or the PIN is compromised; and
    • that HHSC will not replace benefits used before a card is reported lost or stolen to the Lone Star Help Desk.
  • The dormant account policy. If the cardholder does not access the EBT account for a limited number of consecutive months, their benefits become dormant. They may still access benefits in their EBT account. See B-361, Dormant Account Policy.
  • Procedures when moving out of Texas including the:
    • use of the Lone Star Card to access:
      • TANF at retailers in other states; or
      • SNAP benefits at retailers; and
    • recommendation to withdraw all available cash benefits from the cash account before leaving the state.

      Note: HHSC may mail a benefit conversion warrant (full month's TANF benefit only) to the household's new address if the:

      • cardholder cannot find a retailer that accepts the Lone Star Card; and
      • household moved out of state on or after the first of the month but before accessing that month's TANF benefits. See B-331, Cancelling Benefits in EBT Accounts.

 

C—1132 Issuance Staff Guide for EBT Issuance and Client Training

Revision 18-1; Effective January 1, 2018

 

TANF and SNAP

After receiving Form H1172, EBT Card, PIN and Data Entry Request, authorizing an initial Lone Star Card and PIN to the primary cardholder, take the following actions:

  • Issue and briefly explain the:
    • Lone Star Card;
    • card sleeve;
    • PIN packet, if applicable;
    • Form H1184, Here Is Your Lone Star Card; and
    • second cardholder form.
  • If giving the Lone Star Card to someone other than the primary cardholder, then:
    • explain the use of each item to the person receiving the card;
    • place a registration sticker on the card; and
    • if applicable, request that the vendor mail a PIN packet to the primary cardholder.
  • If mailing the Lone Star Card to the primary cardholder, then select vendor mail out.
  • Explain:
    • the importance of saving the last receipt for the current account balance(s);
    • card registration, if required;
    • the requirement for the primary cardholder to sign the back of the card;
    • how to protect the card and what to do if it is lost or stolen; and
    • how to protect the PIN and what to do if it is compromised.
  • Advise the individual to call the toll-free Lone Star Help Desk (800-777-7EBT or 800-777-7328) if they have problems accessing benefits or additional questions.

 

C—1140 TANF and SNAP Overpayment Determination Chart

Revision 01-7; Effective October 1, 2001

 

 

 

C—1141 Timely Reported

Revision 13-3; Effective July 1, 2013

 

TANF and SNAP

When the individual reports a change timely (i.e., individual reported within 10 days of knowing of the change), use B-600, Changes, B-752.1.2, Errors After Certification, and the following chart to determine the first month of overpayment.

If the household reported the change... then the first month of potential overpayment is...
January 1-8
January 9-31
February
March
February 1-5
February 6-28 (or 29th)
March
April
March 1-8
March 9-31
April
May
April 1-7
April 8-30
May
June
May 1-8
May 9-31
June
July
June 1-7
June 8-30
July
August
July 1-8
July 9-31
August
September
August 1-8
August 9-31
September
October
September 1-7
September 8-30
October
November
October 1-8
October 9-31
November
December
November 1-7
November 8-30
December
January
December 1-8
December 9-31
January
February

 

Note: The first month of overpayment can be no later than two months from the month the change occurred.

 

C—1142 Untimely Reported

Revision 13-3; Effective July 1, 2013

 

TANF and SNAP

When the individual fails to report a change timely (i.e., does not report a change later discovered by HHSC or untimely reports a change), use B-600, Changes, B-752.1.2, Errors After Certification, and the following chart to determine the first month of overpayment.

If the change occurred... then the first month of potential overpayment is...
January 1-31 March
February 1-28 (29) April
March 1-31 May
April 1-30 June
May 1-31 July
June 1-30 August
July 1-31 September
August 1-31 October
September 1-30 November
October 1-31 December
November 1-30 January
December 1-31 February

 

Note: The first month of overpayment can be no later than two months from the month the change occurred.

 

C—1150 Type Programs (TP) and Type Assistance (TA)

Revision 19-1; Effective January 1, 2019

 

SNAP, TANF and Medical Programs/Assistance

 

SNAP

Code Description Long Description
TA 51 SNAP-CAP/FS-CAP Supplemental Nutrition Assistance Program Combined Application Project
TA 52 SNAP-SSI/FS-SSI Supplemental Nutrition Assistance Program Supplemental Security Income
TP 06 SNAP (PA)/FS-PA Supplemental Nutrition Assistance Program Public Assistance
TP 09 SNAP/FS-NPA Supplemental Nutrition Assistance Program

 

TANF

Code Description Long Description
TP 01 TANF Basic Cash assistance for caretakers and deprived children with income below TANF recognizable needs
TP 60 TANF Grandparent Payment One-time payment for grandparent who is caretaker of their TANF-certified grandchild
TP 61 TANF State Program Cash assistance for two-parent household with income below TANF recognizable needs
TP 71 OTTANF – 1 Adult One-Time TANF (OTTANF) payment for households with one parent
TP 72 OTTANF – 2 Parents OTTANF payment for households with two parents

 

Medical Programs/Assistance — Texas Works

Code Description Long Description
TA 31 MA – Parents and Caretaker Relatives – Emergency Medicaid for an emergency condition for parents and caretaker relatives who do not meet alien status requirements and are caring for a dependent child who receives Medicaid
TA 41 Health Care – Healthy Texas Women Healthy Texas Women (HTW) for women age 15–44 with income at or below the applicable income limit
TA 66 MA – MBCC – Presumptive Medicaid for Breast and Cervical Cancer – Presumptive
TA 67 MA – MBCC Medicaid for Breast and Cervical Cancer
TA 74 MA – Children Under 1 Presumptive Short-term Medicaid for children under age 1 with income at or below the applicable income limit
TA 75 MA – Children 1–5 Presumptive Short-term Medicaid for children ages 1–5 with income at or below the applicable income limit
TA 76 MA – Children 6–18 Presumptive Short-term Medicaid for children ages 6–18 with income at or below the applicable income limit
TA 77 Health Care – FFCHE Health Care for Former Foster Care in Higher Education with income at or below the applicable income limit
TA 82 MA – Former Foster Care Children Medicaid for former foster care children ages 18–25
TA 83 MA – FFCC Presumptive Short-term Medicaid for former foster care children ages 18–25
TA 84 CI – CHIP The Children’s Health Insurance Program (CHIP) is health care coverage for children under age 19 who are ineligible for Medicaid due to income and who have income at or below the applicable income limit
TA 85 CI – CHIP perinatal CHIP perinatal is health care coverage for unborn children whose mother is ineligible for Medicaid or CHIP due to income and/or immigration status and whose income is at or below the applicable income limit
TA 86 MA – Parents and Caretaker Relatives Presumptive Short-term Medicaid for parents and caretaker relatives caring for a dependent child
TP 07 MA – Earnings Transitional Twelve months of transitional Medicaid resulting from an increase in earnings
TP 08 MA – Parents and Caretaker Relatives Medicaid for parents and caretaker relatives caring for a dependent child with income at or below the applicable income limit
TP 20 MA Alimony/Spousal Support Transitional Up to four months of post Medicaid resulting from an increase in alimony/spousal support
TP 32 MA – MN w/Spend Down – Emergency Medicaid for an emergency condition for children or pregnant women who do not meet alien status requirements and who are ineligible for any other type of Medicaid, but who have medical expenses that spend down their income to below the Medically Needy Income Limit (MNIL)
TP 33 MA – Children 1–5 – Emergency Medicaid for an emergency condition for children age 1–5 who do not meet alien status requirements and who have income at or below the applicable income limit
TP 34 MA – Children 6–18 – Emergency Medicaid for an emergency condition for children age 6–18 who do not meet alien status requirements and who have income at or below the applicable income limit
TP 35 MA – Children Under 1 – Emergency Medicaid for an emergency condition for children under age 1 who do not meet alien status requirements and who have income at or below the applicable income limit
TP 36 MA – Pregnant Women – Emergency Medicaid for an emergency condition for pregnant women who do not meet alien status requirements and who have income at or below the applicable income limit
TP 40 MA – Pregnant Women Medicaid for pregnant woman with income at or below the applicable income limit
TP 42 MA – Pregnant Women Presumptive Short-term Medicaid for pregnant women with income at or below the applicable income limit
TP 43 MA – Children Under 1 Medicaid for children under age 1 with income at or below the applicable income limit
TP 44 MA – Children 6–18 Medicaid for children age 6–18 with income at or below the applicable income limit
TP 45 MA – Newborn Children Medicaid for children through age 1 who are born to a Medicaid-eligible mother
TP 48 MA – Children 1–5 Medicaid for children age 1–5 with income at or below the applicable income limit
TP 56 MA – MN w/Spend Down Medicaid for children or pregnant women who are ineligible for any other type of Medicaid, but who have medical expenses that spend down their income to below the MNIL
TP 70 Medicaid for the Transitioning Foster Care Youth Medicaid for Transitioning Foster Care Youth people with income at or below the applicable income limit
TPAL MA – Historical FMA – Emergency N/A
TPDE MA – Deceased Prior Medical Medicaid for a deceased person
TPPM MA/ME – Historical Prior Medical Three months of prior Medicaid – not currently eligible

 

Medical Programs/Assistance — Texas Department of Family and Protective Services

Code Description Long Description
TP 52 MA – State Foster Care – A Medicaid
TP 53 MA – State Foster Care – B Medicaid
TP 54 MA – State Foster Care – 32 Medicaid
TP 57 MA – State Foster Care – D Medicaid
TP 58 MA – State Foster Care – JPC Medicaid
TA 78 PCA Medicaid – Federal Match – No Cash Permanency Care Assistance (PCA) Medicaid – Federal Match – No Cash
TA 79 PCA Medicaid – No Federal Match – No Cash PCA Medicaid – No Federal Match – No Cash
TA 80 PCA Medicaid – Federal Match – With Cash PCA Medicaid – Federal Match – With Cash
TA 81 PCA Medicaid – No Federal Match – With Cash PCA Medicaid – No Federal Match – With Cash
TP 88 MA – Non-AFDC Foster Care – JPC Medicaid
TP 90 MA – State Foster Care Medicaid
TP 91 Adoption Assistance – Federal Match – No Cash Adoption Assistance – Federal Match – No Cash
TP 92 Adoption Assistance – Federal Match – With Cash Adoption Assistance – Federal Match – With Cash
TP 93 Foster Care – Federal Match – No Cash Foster Care – Federal Match – No Cash
TP 94 Foster Care – Federal Match – With Cash Foster Care – Federal Match – With Cash
TP 95 Adoption Assistance – No Federal Match – No Cash Adoption Assistance – No Federal Match – No Cash
TP 96 Adoption Assistance – No Federal Match – With Cash Adoption Assistance – No Federal Match – With Cash
TP 97 Foster Care – No Federal Match – No Cash Foster Care – No Federal Match – No Cash
TP 98 Foster Care – No Federal Match – With Cash Foster Care – No Federal Match – With Cash
TP 99 MA – Non-AFDC Foster Care Medicaid
TPAS MA – Historical Adoption Subsidy Medicaid

 

Medical Programs/Assistance — Medicaid for the Elderly and People with Disabilities

Code Description Long Description
TA 01 ME – Interim SSI Denied Child Medicaid (processed by SSA)
TA 02 ME – SSI Waivers SSI Recipient Waivers
TA 03 ME – Manual SSI Waivers Manual SSI Waivers
TA 04 ME – Manual SSI State Group Home Manual SSI Recipient State Community-based Group Homes
TA 05 ME – Manual SSI Non-State Group Home Manual SSI Recipient Non-State Community-based Group Homes
TA 06 ME – Manual SSI Nursing Facility Medicaid for Nursing Facility Resident
TA 07 ME – Manual SSI State Hospital Medicaid for State Hospital Resident
TA 08 ME – SSI State Group Home SSI Recipient State Community Based Group Home
TA 09 ME – Manual SSI State Supported Living Center Medicaid for State Supported Living Center Resident
TA 10 ME – Waivers Medicaid
TA 12 ME – State Group Home Medicaid for ICF/IID Resident
TA 15 ME – Rider 51 – Non-State Group Home  
TA 16 ME – Rider 51 – State Supported Living Center Medicaid for State Supported Living Center Resident
TA 17 ME – Rider 51 – Nursing Facility Medicaid for Nursing Facility Resident
TA 18 ME – Grandfathered LTC N/A
TA 21 ME – SSI Chest Hospital Medicaid for Chest Hospital Patient
TA 22 ME – Manual SSI Manually certified SSI — processed by SSA
TA 24 ME – Rider 51 – State Group Home  
TA 25 ME – Rider 51 – State Hospital  
TA 26 ME – SSI Non-State Group Home SSI Non-State Community-based Group Homes
TA 27 ME – Prior Medicaid Institutional/Waiver Prior Medicaid for person applying for Institutional or Waiver Medicaid
TA 88 ME – Medicaid Buy-In for Children Medicaid benefits to eligible children with disabilities who are not eligible for Supplemental Security Income (SSI) for reasons other than disability. Individuals must pay a share of the Medicaid premium
TP 03 ME – Pickle RSDI COLA Disregard Programs — considered eligible based on the 1977 Pickle Amendment
TP 10 ME – State Supported Living Center Medicaid for State Support Living Center Resident
TP 11 ME – SSI Prior SSI, two or three months prior, as appropriate
TP 12 ME – Temp Manual SSI Manually certified SSI (processed by SSA)
TP 13 ME – SSI SSI (processed by SSA)
TP 14 ME – Community Attendant Community Attendant Services
TP 15 ME – Non-State Group Home Medicaid for ICF/IID Resident
TP 16 ME – State Hospital Medicaid for State Hospital Resident
TP 17 ME – Nursing Facility Medicaid for Nursing Facility Resident
TP 18 ME – Disabled Adult Child Adult children (at least age 18) who have a disability and who were denied SSI due to an entitlement to or an increase in their RSDI Disabled Adult Child (DAC) benefits and who are eligible for Medicaid to ensure continued coverage
TP 21 ME – Disabled Widow(er) Widows, widowers or surviving divorced spouses age 50 and less than 60 who have a disability and who are ineligible for Medicare and were denied SSI due to an increase in their RSDI widow/widower benefits. They are eligible for Medicaid under TP 21 until they reach age 60 or become eligible for Medicare, whichever occurs first
TP 22 ME – Early Aged Widow(er) Early age widows, widowers or surviving divorced spouses age 50–65 who are ineligible for Medicare and who were denied SSI due to an increase in their RSDI widow/widower benefits. They are eligible for Medicaid under TP 22 until they reach age 65 or become eligible for Medicare, whichever occurs first
TP 23 MC – SLMB Medicare Savings Program — Specified Low-Income Medicare Benefits
TP 24 MC – QMB Medicare Savings Program — Qualified Medicare Beneficiary
TP 25 MC – QDWI Qualified Disabled and Working Individuals — A special Medicare savings program that pays Part A Medicare premiums for certain working people under age 65 who have a disability and are no longer eligible for free Medicare Part A because of earnings
TP 26 MC – QI 1 Medicare savings program — Qualified people
TP 27 MC – QI 2 Medicare savings program — Qualified people (not an active program)
TP 30 ME – A and D Emergency Emergency Medicaid for a nonqualified alien
TP 38 ME – SSI Nursing Facility Medicaid for Nursing Facility Resident
TP 39 ME – SSI State Hospital Medicaid for State Hospital Resident
TP 41 ME – Skilled Nursing Care Skilled Nursing Facility Co-payments
TP 46 ME – SSI State Supported Living Center Medicaid for State Supported Living Center Residents
TP 50 ME – Rider 51J Medicaid for Nursing Facility Resident
TP 51 ME – Rider 51J Waivers Medicaid
TP 87 ME – Medicaid Buy In Working people with disabilities who pay a share of the Medicaid premium to be eligible for Medicaid

C-1200, Reserved for Future Use

C-1300, Reserved for Future Use

C-1400, Reference

Revision 19-4; Effective October 1, 2019

 

 

C—1410 Legal Aid

Revision 13-3; Effective July 1, 2013

 

All Programs

Staff are required to include the address and phone number of legal services available in the area on individual notices.

 

C—1420 SSA Claim Number Suffixes

Revision 13-3; Effective July 1, 2013

A  
B  
B1 Primary beneficiary
B2 Aged wife (1st claimant)
B3 Husband (1st claimant)
B4 Young wife (1st claimant)
B5 Aged wife (2nd claimant)
B6 Husband (2nd claimant)
B7 Young wife (2nd claimant)
B8 Divorced wife (1st claimant)
B9 Young wife (3rd claimant)
BA Aged wife (3rd claimant)
BD Divorced wife (2nd claimant)
BG Aged wife (4th claimant)
BH Aged wife (5th claimant)
BJ Husband (3rd claimant)
BK Husband (4th claimant)
BL Husband (5th claimant)
BN Young wife (4th claimant)
BP Young wife (5th claimant)
BQ Divorced wife (3rd claimant)
BR Divorced wife (4th claimant)
BT Divorced wife (5th claimant)
BY Divorced husband (1st claimant)
BW Divorced husband (2nd claimant)
C1, 2 etc.1  Young husband (1st claimant)
D Young husband (2nd claimant)
D1 Child (including disabled or student child)
D2 Aged widow (1st claimant)
D3 Widower (1st claimant)
D4 Aged widow (2nd claimant)
D5 Widower (2nd claimant)
D6 Widow (remarried after attaining age 60)
D7 Widower (remarried after attaining age 62)
DB Surviving divorced wife (1st claimant)
D9 Surviving divorced wife (2nd claimant)
DA Aged widow (3rd claimant)
DC Remarried aged widow (2nd claimant)
DD Remarried aged widow (3rd claimant)
DG Surviving divorced husband (1st claimant)
DH Aged widow (4th claimant)
DJ Aged widow (5th claimant)
DK Aged widower (3rd claimant)
DL Aged widower (4th claimant)
DM Aged widower (5th claimant)
DN Remarried aged widow (4th claimant)
DP Surviving divorced husband (2nd claimant)
DQ Remarried aged widow (5th claimant)
DR Remarried aged widower (2nd claimant)
DS Remarried aged widower (3rd claimant)
DT Remarried aged widower (4th claimant)
DV Surviving divorced husband (3rd claimant)
DW Remarried aged widower (5th claimant)
DX Surviving divorced wife (3rd claimant)
DY Surviving divorced wife (4th claimant)
DZ Surviving divorced husband (4th claimant)
Surviving divorced wife (5th claimant)
E1 Surviving divorced husband (5th claimant)
E2 Mother (widow) (1st claimant)
E3 Surviving divorced mother (1st claimant)
E4 Mother (widow) (2nd claimant)
E5 Surviving divorced mother (2nd claimant)
E6 Father (widower) (1st claimant)
E7 Surviving divorced father (1st claimant)
E8 Father (widower) (2nd claimant)
E9 Young mother (widow) (3rd claimant)
EA Mother (widow) (4th claimant)
EB Surviving divorced father (2nd claimant)
EC Mother (widow) (5th claimant)
ED Surviving divorced mother (3rd claimant)
EF Surviving divorced mother (4th claimant)
EG Surviving divorced mother (5th claimant)
EH Father (widower) (3rd claimant)
EJ Father (widower) (4th claimant)
EK Father (widower) (5th claimant)
EM Surviving divorced father (3rd claimant)
F1 Surviving divorced father (4th claimant)
F2 Surviving divorced father (5th claimant)
F3 Father
F4 Mother
F5 Stepfather
F6 Stepmother
F7 Adopting father
F8 Adopting mother
G1 – G9 Second alleged father
J1 Second alleged mother
J2 Claimants of lump-sum death payments
J3 Primary PROUTY entitled to HIB (less than 3 Q.C.)2
J4 Primary PROUTY entitled to HIB (3 or more Q.C.)
K1 Primary PROUTY not entitled to HIB (less than 3 Q.C.)
K2 Primary PROUTY not entitled to HIB (3 or more Q.C.)
K3 PROUTY wife entitled to HIB (less than 3 Q.C.)
K4 PROUTY wife entitled to HIB (3 or more Q.C.)
K5 PROUTY wife not entitled to HIB (less than 3 Q.C.)
K6 PROUTY wife not entitled to HIB (3 or more Q.C.)
K7 PROUTY wife entitled to HIB (less than 3 Q.C.) (2nd claimant)
K8 PROUTY wife entitled to HIB (3 or more Q.C.) (2nd claimant)
K9 PROUTY wife not entitled to HIB (less than 3 Q.C.) (2nd claimant)
KA PROUTY wife not entitled to HIB (3 or more Q.C.) (2nd claimant)
KB PROUTY wife entitled to HIB (less than 3 Q.C.) (3rd claimant)
KC PROUTY wife entitled to HIB (3 or more Q.C.) (3rd claimant)
KD PROUTY wife not entitled to HIB (less than 3 Q.C.) (3rd claimant)
KE PROUTY wife not entitled to HIB (3 or more Q.C.) (3rd claimant)
KF PROUTY wife entitled to HIB (less than 3 Q.C.) (4th claimant)
KG PROUTY wife entitled to HIB (3 or more Q.C.) (4th claimant)
KH PROUTY wife not entitled to HIB (less than 3 Q.C.) (4th claimant)
KJ PROUTY wife not entitled to HIB (3 or more Q.C.) (4th claimant)
KL PROUTY wife entitled to HIB (less than 3 Q.C.) (5th claimant)
KM PROUTY wife entitled to HIB (3 or more Q.C.) (5th claimant)
LM PROUTY wife not entitled to HIB (less than 3 Q.C.) (5th claimant)
LW PROUTY wife not entitled to HIB (3 or more Q.C.) (5th claimant)
M Black lung miner (1st claimant)
  Black lung miner's widow (1st claimant)
M1 Uninsured beneficiary — not entitled to free HIB, entitled to SMIB only or premium HIB/SMIB
  Insured or Uninsured beneficiary — qualifies for HIB, but requests only SMIB
T Uninsured beneficiary — entitled to HIB under deemed insured provision or end stage renal disease (ESRD)
  Primary federal beneficiary not entitled to Title 11 or railroad monthly benefits (at time of filing)
TA Same as B (1st claimant)
  Same as B3 (2nd claimant)
TB Same as B7 (3rd claimant)
TG Same as BK (4th claimant)
TH Same as BL (5th claimant)
TJ Disabled child (1st claimant)
TK Same as TC (2nd - 9th claimant)
TC  Aged widow(er) (1st claimant)
T2 – T9 Same as TD (2nd claimant)
TD Same as TD (3rd claimant)
TL Same as TD (4th claimant)
TM Same as TD (5th claimant)
TN Disabled widow(er) (1st claimant)
TP Same as TW (2nd claimant)
TW Same as TW (3rd claimant)
TX Same as TW (4th claimant)
TY Same as TW (5th claimant)
TZ Parent (1st claimant)
TV Parent (2nd claimant)
TF Young widow(er) (1st claimant)
TQ Same as TE (2nd claimant)
TE Same as TE (3rd claimant)
TR Same as TE (4th claimant)
TS Same as TE (5th claimant)
TT Disabled widow (1st claimant)
TU Disabled widower (1st claimant)
W Disabled widow (2nd claimant)
W1 Disabled widower (2nd claimant)
W2 Disabled widow (3rd claimant)
W3 Disabled widower (3rd claimant)
W4 Disabled surviving divorced wife (1st claimant)
W5 Disabled surviving divorced wife (2nd claimant)
W6 Disabled surviving divorced wife (3rd claimant)
W7 Disabled widow (4th claimant)
W8 Disabled widower (4th claimant)
W9 Disabled surviving divorced wife (4th claimant)
WB Disabled widow (5th claimant)
WC Disabled widower (5th claimant)
WF Disabled surviving divorced wife (5th claimant)
WG Disabled surviving divorced husband (1st claimant)
WJ Disabled surviving divorced husband (2nd claimant)
WR  
WT  

 

1 Youngest child is assigned suffix "1." When there are more than nine children in an Eligibility Determination Group (EDG), the 10th child is coded with an A rather than 10, the 11th child is coded with a B, etc.

2 Quarters of covered employment.

 

C—1430 SNAP Allotment Charts

Revision 12-4 Effective October 1, 2012

 

 

 

C—1431 Whole Monthly Allotments by Household Size

Revision 19-4; Effective October 1, 2019

 

SNAP Allotment Charts

The shaded portions on the table in this section indicate monthly (not prorated) allotments available to categorically eligible households, which can be $1 or more.

The minimum monthly (not prorated) Supplemental Nutrition Assistance Program (SNAP) allotment for a one- or two-person household is $16.

Related Policy
How to Determine Monthly SNAP Allotments, C-122

 

C—1432 Prorated SNAP Allotments by Application Date

Revision 19-1; Effective January 1, 2019

 

Prorated Food Snap Allotments

Do not issue prorated benefit allotments of less than $10.

Related Policy
How to Determine Monthly SNAP Allotments, C-122
How to Prorate Benefits, C-123
Whole Monthly Allotments by Household Size, A-2321

 

C—1440 Relationship Charts

Revision 08-1; Effective January 1, 2008

 

 

 

C—1441 Guide for Determining Relationship

Revision 13-3; Effective July 1, 2013

 

TANF and Medical Programs

This guide provides more detailed information about the eligibility requirements for relationship discussed in A-200, Household Composition, and A-520, Relationship. This guide is not all-inclusive.

A B C
When the child no longer lives with the relative listed below ... and the child now lives with ... can the person listed in Column B be a caretaker/payee for the child?
1. Mother 1. Stepfather 1. Yes
2. Father 2. Stepmother 2. Yes
3. Stepfather 3. Stepfather's Spouse 3. Yes
4. Stepmother 4. Stepmother's Spouse 4. Yes
5. Stepfather's Spouse 5. New Spouse 5. No
6. Stepmother's Spouse 6. New Spouse 6. No
*7. Grandmother 7. Step Grandfather 7. Yes
*8. Grandfather 8. Step Grandmother 8. Yes
*9. Step Grandfather 9. New Spouse 9. No
*10. Step Grandmother 10. New Spouse 10. No
11. Brother 11. Sister-in-law 11. Yes
12. Sister 12. Brother-in-law 12. Yes
13. Brother-in-law 13. New Spouse 13. No
14. Sister-in-law 14. New Spouse 14. No
15. Stepbrother 15. Stepbrother's Spouse 15. Yes
16. Stepbrother's Spouse 16. New Spouse 16. No
17. Stepsister 17. Stepsister's Spouse 17. Yes
18. Stepsister's Spouse 18. New Spouse 18. No
*19. Aunt 19. Aunt's Spouse 19. Yes
*20. Uncle 20. Uncle's Spouse 20. Yes
21. Aunt's Spouse 21. New Spouse 21. No
22. Uncle's Spouse 22. New Spouse 22. No
**23. First Cousin 23. First Cousin's Spouse 23. Yes
**24. First Cousin's Spouse 24. New Spouse 24. No
*25. Niece 25. Niece's Spouse 25. Yes
26. Niece's Spouse 26. New Spouse 26. No
*27. Nephew 27. Nephew's Spouse 27. Yes
28. Nephew's Spouse 28. New Spouse 28. No

 

*Extends to the degree of "Great-great" for items 19, 20, 25, and 27 and to the degree of "Great-great-great" for items 7, 8, 9 and 10.

**Extends to the first cousin once removed.

 

C—1442 Guide for Determining Extended Relationships

Revision 06-1; Effective January 1, 2006

 

Extended Relationships Chart

 

C—1450 Guidelines for Clearing Quality Control (QC) Findings

Revision 12-2; Effective April 1, 2012

 

 

 

C—1451 Dropped – Subject to Review but Not Completed

Revision 15-4; Effective October 1, 2015

 

All Programs

Form H1025, Report of Quality Control Assessment Findings Penalty What to do ...
Not reviewed (reason):

 

Refusal to Cooperate1
Yes2 Issue Form TF0001, Notice of Case Action, entering the comments for the appropriate program: "Your SNAP or TANF benefits are denied due to your refusal to cooperate with the Quality Control (QC) review. You will incur this penalty through February 2, yyyy,3 or until you decide to cooperate with the QC review process, whichever occurs first." Include the Texas Health and Human Services Commission's (HHSC's) Spanish translation: "Sus beneficios de SNAP o TANF se negaron porque usted se negó a cooperar con la revisión de Control de Calidad (QC). Esta sanción se le aplicaráá hasta el 2 de febrero de [YEAR] o hasta que decida cooperar con el proceso de revisión de la QC, lo que ocurra primero."

Allow advance notice of adverse action and deny only the EDG for which Form H1025 was received. Do not deny associated EDGs. (See A-2343, Advance Notice.) Call the Texas Integrated Eligibility Redesign System (TIERS) helpdesk before disposing the denied EDG to ensure only the EDG the household refused to cooperate with is denied.

Notes:

  • Refusal to cooperate with QC does not affect Medicaid.
  • The Temporary Assistance for Needy Families (TANF) denial cannot cause SNAP benefits to increase. Do not remove the TANF grant from an associated SNAP budget when denying a TANF EDG for refusal to cooperate with QC. Refer to policy in A-1324.18, Temporary Assistance for Needy Families (TANF).

When the EDG is denied for any other reason by the time the advisor receives Form H1025 (for example, the individual failed to return pending information and the EDG is denied effective September 30, the QC review month was September, and the advisor receives Form H1025 in October), the advisor must still send Form TF0001 to the individual.

Not reviewed (reason):


Failure to Cooperate4
No The advisor needs to analyze any information provided by QC and adjust the EDG, if necessary.

 

Notes:

1 Refusal to cooperate indicates that the individual has refused to cooperate with the QC review process, that is, refused to provide information or refused to be interviewed.

2 Form H1025 contains a checkbox followed by the statement, "Impose a non-compliance penalty due to client refusal to cooperate if this box is checked. The penalty should be imposed through February 2, yyyy, [appropriate year inserted] or until the client agrees to cooperate with QCA, whichever occurs first."

3 The penalty period always expires 125 days after the reporting period. The reporting period ends September 30 each year. The penalty period for federal fiscal year (FFY) is October through September of the following year. QC refusal to cooperate penalties expire February 2, yyyy. Example: The individual's sample month is October 2011. The individual refuses to cooperate and is penalized. The penalty period expires February 2, 2013 (125 days after September 30, 2012).

4 Failure to cooperate indicates the individual has provided all of the information and cooperated with the QC review process; however, the QC analyst is unable to complete the review due to an aspect beyond the individual's control (for example, the employer or landlord refused to provide information).

 

C—1452 Dropped – Not Subject to Review

Revision 15-4; Effective October 1, 2015

 

All Programs

Form H1025, Report of Quality Control Assessment Findings Penalty What to do ...
Not reviewed (reason):


Moved Out of State
No If the individual reports in advance of moving, issue Form TF0001, Notice of Case Action, and deny the EDG simultaneously allowing adequate notice. See A-2344.1, Form TF0001 Required (Adequate Notice). Deny the EDG for which Form H1025 was received.

When the individual reports after they move out of state or it is determined by QC, deny the EDG following A-2344.2, No Form TF0001 Required.

Adjust/deny any other EDGs in which the individual/household members are included.

Not reviewed (reason):


Referred to Fraud, Under Active Fraud Investigation or Intentional
Program Violation (IPV) EDG
No No action is required.

 

If, as of the date the EDG is selected for QC sampling, the EDG meets one of the following:

  • has been referred for investigation to the state's fraud investigation unit, and the investigation is scheduled to begin within five months of sampling;
  • is under active fraud investigation; or
  • has a pending administrative or judicial IPV hearing,

the IPV EDG is not subject to review.

Not reviewed (reason):


Retroactive Benefits
No No action is required. The sample month benefits were issued retroactively; therefore, the EDG is not subject to review. Example: The file date is November 15 and the certification date is December 15. Benefits for November are issued (retroactively) in December; if November is the sample month, the EDG is not subject to review.
Not reviewed (reason):


Unable to Locate
No When Form H1025 indicates that returned mail has been received by QC, the advisor must send Form TF0001 and deny the EDG simultaneously to allow adequate notice. (See A-2344.1.)

When Form H1025 does not indicate that returned mail has been received but that the individual has not been located, advisors must send Form TF0001 to deny for unable to locate allowing advance notice of adverse action. (See A-2343, Advance Notice.)

Adjust/deny any other EDGs in which the individual/household members are included.

Not reviewed (reason):


All Individuals Who Could Be Interviewed Are Hospitalized, Incarcerated or Placed in a Mental Institution
No Information discovered by QC is forwarded to the advisor via this format. The advisor needs to analyze the information and adjust the EDG appropriately, including denial.

Adjust/deny any other EDGs in which the individual/household members are included.

Not reviewed (reason):


EDG Pending a Hearing
No No action is required.
Not reviewed (reason):


Household Did Not Receive Benefits for Sample Month
No No action is required.

TANF

 

Form H1025 QC Findings Penalty What to do ...
Not reviewed (reason):

 

Death of All Available Adult Household Members
No Deny the EDG, allow adequate notice and send Form TF0001 simultaneously. Adjust/deny any other EDGs in which the individual/household members are included. (See A-2344.1.)

The child(ren) may be certified as independent children on appropriate Medicaid EDGs (see A-241.1, Who Is Included) or they may be determined eligible in a new TANF household when all other eligibility requirements are met.

Not reviewed (reason):

 

Dormant Electronic Benefit Transfer (EBT) Account
No No action is required.

SNAP

Form H1025 QC Findings Penalty What to do ...
Not reviewed (reason):


Death of All Household Members
No Deny the EDG. Adjust/deny any other EDGs in which the individual/household members are included. (See A-2344.2.)
Not reviewed (reason):

 

Dormant Account, No Activity in EBT Account, Sample Month and Two Following Months Up To and Including Transmission to Food and Nutrition Services
No No action is required.

 

C—1453 Completed QC Reviews

Revision 15-4; Effective October 1, 2015

 

TANF and SNAP

Form H1025, Report of Quality Control Assessment Findings Penalty What to do ...
Completed – Individual Refused to Cooperate Yes Issue Form TF0001, Notice of Case Action, with the following message: "Your SNAP/TANF benefits are denied due to your refusal to cooperate with the Quality Control (QC) review. You will incur this penalty through February 2, yyyy, or until you decide to cooperate with the QC review process, whichever occurs first." Include HHSC's Spanish translation: "Sus beneficios de SNAP o TANF se negaron porque usted se negó a cooperar con la revisión de Control de Calidad (QC). Esta sanción se le aplicará hasta el 2 de febrero de [YEAR] o hasta que decida cooperar con el proceso de revisión de la QC, lo que ocurra primero."

 

Allow advance notice of adverse action and deny only the EDG for which Form H1025 was received. Do not deny associated EDGs. (See A-2343, Advance Notice.)

Notes:

  • Refusal to cooperate with QC does not affect Medicaid.
  • The TANF denial cannot cause SNAP benefits to increase. Do not remove the TANF grant from an associated SNAP budget when denying a TANF EDG for refusal to cooperate with QC. Refer to policy in A-1324.18, Temporary Assistance for Needy Families (TANF).
Findings and Dollar Amounts of Error:


Information(al) Only
No Information discovered by the QC analyst is forwarded to the advisor via this format. The advisor needs to analyze the information and adjust the EDG appropriately, including denial, if necessary.

 

The advisor must refer all SNAP overissuances identified during the QC review process to the Office of Inspector General (OIG), regardless of the dollar amount. See policy in B-720, When to File an Overpayment Referral, prior to sending the referral to OIG.

Amount Correct No No action is required.

 

Notes:

 

  • “Refusal to cooperate” indicates the individual has refused to cooperate with the QC review process, that is, refused to provide information or refused to be interviewed.
  • Form H1025 contains a checkbox followed by the statement, "Impose a non-compliance penalty due to client refusal to cooperate if this box is checked. The penalty should be imposed through February 2, yyyy, [appropriate year inserted] or until the client agrees to cooperate with QCA, whichever occurs first."
  • The penalty period always expires 125 days after the reporting period. The reporting period ends September 30 each year. The penalty period for the FFY is October through September of the following year. QC reviews expire February 2, yyyy. Example: The individual's sample month is March 2012. The individual refuses to cooperate and is penalized. The penalty period expires February 2, 2013 (125 days after September 30, 2012).

TANF

Form H1025 QC Findings Penalty What to do ...
Findings and Dollar Amounts of Error: Underpayment — $xx.00 No Note: The dollar amount listed is not necessarily the amount of the underpayment.

 

The advisor must adjust the EDG accordingly. (See B-800, Restored Benefits.) The advisor should issue supplemental benefits for the current month if the individual is currently eligible.

Note: Consider all reported changes when determining the amount of supplemental or restored benefits.

Adjust/deny any other EDGs in which the individual/household members are included.

Findings and Dollar Amounts of Error:


Overpayment — $xx.00
No Note: The dollar amount listed is not necessarily the amount of the overpayment.

 

The advisor needs to adjust the EDG accordingly and enter the overpayment referral in TIERS.

Note: Consider all reported changes when determining the amount of the overpayment claim, including changes reported to QC during the exclusionary period and any other information listed by QC as “information only.”

Adjust/deny any other EDGs in which the individual/household members are included.

SNAP

Form H1025 QC Findings Penalty What to do ...
Findings and Dollar Amounts of Error:
Underissuance — $xx.00
No Note: The dollar amount listed is not necessarily the amount of the underissuance.

The advisor must adjust the EDG accordingly. (See B-800, Restored Benefits.)

The advisor should issue supplemental benefits for the current month if the individual is currently eligible.

For agency errors only, issue restored benefits for past months regardless of whether the individual is currently eligible. Do not restore benefits for unreported changes or household errors.

Note: Consider all reported changes when determining the amount of supplemental or restored benefits.

Adjust/deny any other EDGs in which the individual/household members are included.

Findings and Dollar Amounts of Error:

 

Overissuance — $xx.00
No Note: The dollar amount listed is not necessarily the amount of the overissuance.

The advisor needs to adjust the EDG accordingly and enter the overissuance referral in TIERS. The advisor must refer all SNAP overissuances identified during the QC review process to OIG, regardless of the dollar amount. See policy in B-720, When to File an Overpayment Referral, prior to sending the referral to OIG.

Note: Consider all reported changes when determining the amount of the overissuance claim, including changes reported to QC during the exclusionary period and any other information listed by QC as “information only.”

Adjust/deny any other EDGs in which the individual/household members are included.

 

C—1454 Reapplying for Benefits after a Quality Control Penalty

Revision 15-4; Effective October 1, 2015

 

All Programs

When the penalized individual comes in to reapply for benefits after the EDG is closed and the penalty period has ... and the penalized individual is applying with ... then the advisor ...
not expired, the same household composition as was on the EDG reviewed by QC, checks with the QC State Office staff who issued Form H1025, Report of Quality Control Assessment Findings. If the individual has cooperated with the QC review, the advisor proceeds with the application process. When the individual has not cooperated with the QC review, the advisor denies the application and informs the individual to reapply after they comply with the QC review process. Form TF0001, Notice of Case Action, must include the following: "You will need to contact (insert the QC contact designated by QC State Office) at (insert the QC contact designated by QC State Office) to complete the QC review process." Include HHSC's Spanish translation: "Para completar el trámite de revisión de la Valoración de Control de Calidad (QC), tiene que comunicarse con (insert QC contact designated by State Office) al (insert QC contact designated by State Office)."
not expired, another household or moved into another household and is a required member of that household, checks with the QC State Office staff who issued Form H1025. The penalty follows the penalized individual, and the new household is not eligible until the individual complies with QC. When the individual has cooperated with the QC review, the advisor proceeds with the application process. When the individual has not cooperated with the QC review, the advisor denies the application and imposes the disqualification until the individual cooperates or the penalty period expires, whichever comes first, informing the individual to reapply after they comply with the QC review process. Form TF0001 must include the following: "You will need to contact (insert the QC contact designated by QC State Office) at (insert the QC contact designated by QC State Office) to complete the QC review process." Include HHSC's Spanish translation: "Para completar el trámite de revisión de la Valoración de Control de Calidad (QC), tiene que comunicarse con (insert QC contact designated by State Office) al (insert QC contact designated by State Office)".

Do not disqualify other adults or children who were members of the original penalized household when they apply with or enter another household and the penalized individual(s) is not applying with or entering the new household with them.

 

C—1455 Frequently Asked Questions

Revision 15-4; Effective October 1, 2015

 

All Programs

1. Q: What is the difference between refusal to cooperate and failure to cooperate?
- A: "Refusal to cooperate" is a QC response used when the individual has refused to cooperate with the QC review process, that is, refused to provide information or refused to be interviewed. "Failure to cooperate" is used when the individual has provided all of the information and cooperated with the QC review process; however, QC is unable to complete the review because of something beyond the individual's control, for example, employer or landlord refused to provide information. A penalty is incurred when the individual refuses to cooperate; a penalty is not incurred for failure to cooperate.
2. Q: How do I know if a penalty has been imposed on a case?
- A: QC maintains a list of sampled cases with imposed penalties. The list can be viewed from the Eligibility Services portal at https://ofsportal.hhsc.state.tx.us/. To view the list:

 

  • Enter your user name and password.
  • Select Report Manager.
  • Select QC/Case Review List in the Select Report Group.
  • A Drop Case Report will be displayed.
  • Select the appropriate Drop Case List Report.
  • Enter the criteria for the report.
3. Q: What is the "appropriate wording" to include when sending the individual Form TF0001, Notice of Case Action, for refusal to cooperate with QC?
- A: Form TF0001 should contain the following information: "Your SNAP/TANF benefits are denied because of your refusal to cooperate with the Quality Control (QC) review. You will incur this penalty through February 2, yyyy, or until you decide to cooperate with the QC review process, whichever occurs first." Include HHSC's Spanish translation: "Sus beneficios de SNAP o TANF se negaron porque usted se negó a cooperar con la revisión de Control de Calidad (QC). Esta sanción se le aplicará hasta el 2 de febrero de [YEAR] o hasta que decida cooperar con el proceso de revisión de la QC, lo que ocurra primero."
4. Q: Is the advisor required to send Form TF0001 with the appropriate penalty wording for individuals who are no longer receiving benefits by the time Form H1025, Report of Quality Control Assessment Findings, is received? Example: QC reviews and the EDG is denied in October. The advisor receives Form H1025 information December 2011. The individual is not receiving benefits when Form H1025 is received. The penalty period expires February 2, 2013.
- A: Yes. The individual must be notified of the penalty period. Form TF0001 must advise the individual that the individual cannot receive benefits through February 2, 2013, or until the individual cooperates with the QC analyst, whichever is earlier as noted in #3 above.
5. Q: Does the penalty period ever change? If so, how does it change?
- A: The penalty period is always 125 days after the reporting period ends. The reporting period ends each federal fiscal year on September 30. One hundred twenty-five days from September 30 is February 2. These are for the prior federal fiscal year.
6. Q: Do we deny the entire EDG or just the individual listed on Form H1025?
- A: Deny the entire EDG reviewed by QC. Note: When denying a TANF EDG for refusal to cooperate, the associated SNAP benefits should not be increased (the TANF grant should not be removed from the budget) as the individual failed to cooperate with a QC review (see A-1324.18, Temporary Assistance for Needy Families [TANF]).
7. Q: Can the individual appeal the denial of the EDG when it has been denied for refusal to cooperate?
- A: Yes, the decision may be appealed. Refer to B-1000, Fair Hearings.

TANF

1. Q: Is the individual entitled to restored benefits when QC discovers an underpayment?
- A: When the household is currently eligible for and receiving TANF, then the answer is yes. See B-810, Entitlement to Restored Benefits.
2. Q: What happens when we restore benefits and the individual has an overpayment claim filed?
- A: The restored benefits must be used to offset the claim first. See B-810.

SNAP

1. Q: Is the individual entitled to restored benefits when QC discovers an underissuance?
- A: When the QC error was caused by the agency, then the answer is yes. When the QC error was caused by the individual due to unreported changes or other individual error, then the answer is no. See B-840, Notice to the Household.
2. Q: What happens when we restore benefits and the individual has an overissuance claim filed?
- A: The restored benefits must be used to offset the claim first. See B-810.

 

C—1460 Helpful Toll-Free Numbers

Revision 19-2; Effective April 1, 2019

 

All Programs

Use the following list of toll-free phone numbers for reference purposes, or print the list and provide it to applicants or recipients.

Question or Concern Organization Telephone Number

Questions about social services or community resources in Texas, including the location and phone number of local agency offices.

2-1-1 Texas Information and Referral Network

2-1-1 or
877-541-7905 (after selecting a language, press 1)

Provides households with information about EDG status such as active, on hold or denied; benefit amounts; and availability dates of current benefits.

Automated Voice Response (AVR) system hotline

2-1-1 or
877-541-7905 (after selecting a language, press 2)

Assists the public with issues or complaints about health and human services programs that have not been resolved under the agency's normal complaint process.

Texas Health and Human Services Office of the Ombudsman

877-787-8999

To report suspicions of the abuse or neglect of children, or the abuse, neglect or exploitation of people age 65 or older or adults with disabilities.

Texas Department of Family and Protective Services

800-252-5400

Questions about Social Security Administration benefits or the maintenance of an individual's record.

Social Security Administration

800-772-1213
TTY number
800-325-0778

For claims of discrimination experienced by either individuals or applicants.

HHSC Civil Rights Office

888-388-6332

Concerns about fraud, waste or abuse of SNAP, Medicaid, TANF or Children's Health Insurance Program (CHIP) services or benefits.

Office of Inspector General

800-436-6184

The Children with Special Health Care Needs Services Program, within the Division for Family and Community Health Services, which provides services to children with extraordinary medical needs, disabilities and chronic health conditions.

Texas Department of State Health Services

800-252-8023

For child support services including the collection of court-ordered child support, information about the Crime Victims Compensation Fund and enforcement of the state's consumer protection laws.

Office of Attorney General

800-252-8011

For information on early intervention services for children with disabilities and developmental delays, services for people who are deaf or hard of hearing or children who are blind or visually impaired.

Texas Health and Human Services

Main number:
512-424-6500

TTY number:
512-424-6597

For information on vocational rehabilitation for persons with disabilities, and services for adults who are blind or visually impaired. Texas Workforce Commission 800-628-5115
For information on disability determination services. Social Security Administration

800-772-1213

TTY number:
800-325-0778

Information and assistance concerning family violence.

National Domestic Violence 24-hour hot line

800-799-SAFE (7233)

TTY number
800-787-3224

Medicaid

Question or Concern Organization Telephone Number

Help finding or questions about a doctor, dentist or case manager for a person age 20 or younger.

Texas Health Steps

877-847-8377

For transportation assistance to a doctor's appointment.

Medical Transportation (HHSC)

877-633-8747

Helps people enrolled in STAR, STAR+PLUS, STAR Health or STAR Kids with Medicaid managed care issues.

HHSC Medicaid Managed Care Helpline

866-566-8989

Questions about services covered by Medicaid, or help when a bill is received from a Medicaid provider, or questions about Medically Needy with Spend Down cases.

Statewide Medicaid help line

800-335-8957

Questions about enrolling in the STAR Managed Care Program or help changing a health plan.

State of Texas Access Reform (STAR)

800-964-2777

 

C—1470 Eligibility Environments

Revision 15-4; Effective October 1, 2015

 

All Programs

Texas Works serves applicants and recipients in Texas through a variety of eligibility environments. The following is a brief summary of each type.

Local eligibility offices: HHSC staff conduct business in a face-to-face environment with people seeking information or applying for health and human services programs. Interviewing tasks are performed at the local eligibility office either in person or by telephone.

The eligibility staff in local offices provide information and application assistance, receive applications, perform Data Broker and other third-party inquiries, collect data, assess missing information, determine eligibility, issue benefits, and perform other tasks associated with eligibility services operations. Work is processed by eligibility staff in local offices in TIERS. Individuals are assigned to specific offices and a single eligibility worker processes an EDG until it is disposed as approved or denied.

Eligibility staff in a local office process multiple types of assistance: SNAP, Medicaid, CHIP, and TANF. Eligibility staff in the offices work all types of EDGs/cases; however, some offices may have specialized staff based on workload. Clerical staff handle front desk and lobby-area tasks, telephones, mail, faxes, scheduling and other support duties.

Vendor staff creates and routes tasks for applications received via mail or fax to staff in the local eligibility offices or changes received via telephone, mail or fax to staff in the Customer Care Centers (CCCs). The vendor may register a new application or reschedule an appointment, then route the interviewing tasks to local eligibility offices. Applications, redeterminations and changes submitted online through YourTexasBenefits.com are routed to the appropriate areas by the State Portal.

Centralized units: These units are able to specialize in certain programs or tasks and conduct eligibility work through the mail and by telephone without face-to-face contact. The centralized units help balance the workload of local eligibility offices. In a centralized unit, tasks are assigned based on due dates. Centralized functions have centralized mail, centralized telephone systems and do not require lobby space as eligibility offices do. Centers also have staff to answer telephones and provide status information, in addition to the staff working the cases.

 

C—1471 Specialized and Centralized Casework Units

Revision 18-1; Effective January 1, 2018

 

The following chart details various specialized and centralized casework units.

Centralized Units That Serve Both Texas Works (TW) Programs and Medicaid for the Elderly and People with Disabilities (MEPD) Programs

Unit Name Description
Centralized Representation Unit (CRU) The CRU files appeal requests and assembles EDG information in preparation for hearings for TIERS cases. The CRU represents the agency at fair hearings and implements all decisions for EDGs statewide. Members of this unit are housed across the state in local eligibility offices. HHSC created the unit in September 2007, and the unit initially processed EDG actions resulting from TIERS fair hearings for both Texas Works and MEPD. More details are available in the Eligibility Services State Processes document. Staff must file all appeal requests using the Hearings and Appeal — Create Appeal functionality in TIERS, accessed through the left navigation menu. Form H4800, Fair Hearing Request Summary, which is sent directly to the hearings division, will be returned to staff with instructions to enter the information in TIERS.
Customer Care Centers (CCCs) The CCCs are located in Athens, Austin, El Paso, Houston and San Antonio. State staff, along with vendor staff, conduct business using the 2-1-1 Texas telephone system. CCC staff handle inquiries and concerns that vendor staff cannot resolve. The vendor creates tasks and routes non-interview changes received via telephone, mail, fax or the Self-Service Portal to state staff in the CCCs. The CCCs are supported by TIERS and by Eligibility Supporting Technologies, such as the Task List Manager and the State Portal. CCC state staff perform Data Broker and other third-party inquiries, collect data, assess missing information, determine eligibility, issue benefits, process individual- and agency-generated changes, perform other non-interview tasks, and process six-month income check task. CCC performs these functions, as applicable, for TW and MEPD.

The CCC operates Monday to Friday from 8 a.m. to 6 p.m. Central time (excluding state holidays).

Below are some helpful toll-free numbers:
  • 800-645-7164 — CHIP provider toll-free telephone line
  • 877-543-7669 (877-KIDS-NOW) — CHIP and Children’s Medicaid toll-free telephone line
  • 800-735-2988 or 7-1-1 — TDD/TTY users (Relay Texas)

Effective Jan. 15, 2013, HHSC centralized the clearance of Income Eligibility and Verification System (IEVS) Internal Revenue Service (IRS) data matches for TW and MEPD. Data matches that OIG identifies for each program are processed by CCC staff.

HHSC set up CCCs with the Integrated Eligibility and Enrollment pilot rollout in January 2006.

Assistance Response Team (ART) ART staff housed throughout the state serve as on-site support to regional staff. These state staff offer TIERS technical support for Texas Works and MEPD on-the-job trainings (OJT), conduct clerical OJTs, offer TIERS technical support to eligibility staff (offer pre-ticket support to all regions to mitigate unneeded tickets), process Texas Works cases based on MEPD email box referrals and Health Insurance Portability and Accountability Act of 1996 (HIPAA) referrals for all regions, and assist State Office Data Integrity with merging assignments. HHSC set up ART with the Integrated Eligibility and Enrollment pilot rollout in January 2006.

 

Centralized Units That Serve Only MEPD Programs

Unit Name Description

MEPD

HHSC created a special statewide eligibility unit in January 2007 to process eligibility for MEPD programs. Statewide staff specialize in MEPD eligibility programs to help make sure MEPD casework is evenly distributed. Members of this unit are housed across the state in local eligibility offices.

 

Centralized Units That Serve Only Texas Works Programs

Unit Name Description
Centralized Benefit Services (CBS) Staff in this centralized Austin location process SNAP EDGs for households in which all members get Supplemental Security Income (SSI), using specialized automation that supports the modified eligibility requirements for these households. In addition, the unit also processes applications and redeterminations for:
  • SNAP Combined Application Project (SNAP-CAP) EDGs;
  • Medicaid for Breast and Cervical Cancer (MBCC);
  • Medicaid for children under the jurisdiction of the juvenile court and for youth under age 19 in non-secure facilities;
  • Medicaid for Transitioning Foster Care Youth (MTFCY);
  • Former Foster Care Children (FFCC); and
  • Medicaid for inmates of a public institution;
and applications for:
  • Former Foster Care in Higher Education (FFCHE) health care benefits program.
Appointed staff process Medicaid requests for babies who are born to mothers incarcerated in Texas. Most babies receive ongoing Medicaid, but factors such as with whom the baby will reside or if the baby will remain in Texas may affect eligibility.

When the baby cannot be certified for ongoing newborn Medicaid, the EDG is referred to Data Integrity to add coverage for the birth of the baby under a state-paid medical program.
Children's Medicaid Center (CMC) Centralized CMCs process applications and/or renewals for Children's Medicaid and CHIP, but do not process other associated-program case actions, to ensure a streamlined, timely approach. The CMCs are located in regions across the state:
  • Region 3 (Dallas Metroplex)
  • Region 6 (Houston)
  • Region 8 (San Antonio)
  • Region 11 (Rio Grande Valley)
Currently, Regions 3, 6 and 8 have CMCs to process applications and renewals for Children's Medicaid and CHIP for their respective regions.
Region 8 Central Processing Unit Staff in this centralized Region 8 location process applications and redeterminations for all SNAP-interviewed applications from the Community Partners Interviewer (CPI) Project. This single regional structure simplifies reporting and data gathering; centralizes EBT activities under one EBT coordinator, which streamlines record keeping and adds integrity to the EBT accounting and audit functions; adds efficiency to training activities since there is one location for staff; and enhances accountability as all regional activities will be under one management structure.

The five CPI project food banks as of June 2011 were:
  • Houston Food Bank
  • North Texas Food Bank
  • San Antonio Food Bank
  • Tarrant Area Food Bank
  • South Plains Food Bank (limited to six counties in Region 1 — Bailey, Crosby, Floyd, Hockley, Lamb and Lubbock)
Healthy Texas Women (HTW) This center, located in San Antonio, processes statewide HTW applications, changes and renewals. The HTW center also process Form H3038-P, CHIP Perinatal – Emergency Medical Services Certification, for CHIP perinatal mothers.