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Effective Date: 
8/2016

Documents

Instructions

Updated: 1/2019

Purpose

  • Notifies renewing Medicaid households that our records show a certified child has a Texas Health Steps overdue date.
  • Notifies renewing Medicaid households that our records show noncompliance with Health Care Orientation.
  • Allows a household to self-declare compliance with Texas Health Steps or Health Care Orientation, intent to comply, good cause or confirmation of the noncompliance.

Procedure

When to Prepare

Complete Form H1024 as part of the renewal process when a certified child has a Texas Health Steps overdue date or the case is flagged for noncompliance with the Health Care Orientation and the overdue date or noncompliance cannot be cleared with a telephone call.

Number of Copies

Prepare one original for the Health Care Orientation and for each child with a Texas Health Steps overdue date.

Transmittal

Mail the original to the household with a return envelope.

Form Retention

See the Manager's Guide for Eligibility Programs.