Form H1817, SNAP Information Transmittal

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Documents

Effective Date: 8/2018

Instructions

Updated: 8/2018

Purpose

To provide a two-way communication form between eligibility staff and employment contractor staff administering Supplemental Nutrition Assistance Program (SNAP) employment services.

Procedure

When to Prepare

The employment contractor staff send HHSC Form H1817 to:

  • report that a client will/has been receiving unemployment benefits (TWC only);
  • report information such as employment or ask questions; and
  • refer a sanctioned client who wishes to participate in employment services. The worker must determine if the client has:
    • completed his penalty period; and
    • signed Form 1808.

Eligibility staff send the employment contractor Form H1817 to report information, ask questions or respond to a request for information.

Number of Copies

The originator completes an original and two copies of Form H1817.

Transmittal

The originator sends the original and first copy to the respondent and retains the second copy. If a response is needed, the respondent makes his response, returns the original to the originator and retains a copy (the respondent may initiate a new Form H1817 instead, if desired.)

Form Retention

Eligibility staff file Form H1817 under Work Registration and retain it according to instructions in the Texas Works Manager's Guide.

The employment contractor staff retain the form in the case record three years from date of case closure.

Detailed Instructions

To: (HHSC) — Enter respondent's name, address and mail code.

From: (Employment Contractor) — Enter originator's name, address and mail code.

Employment contractor enters the following:

Case name — Enter the name of the SNAP case in which the client is included.

Case No. — Enter the SNAP case number.

Client's Name — If the client name is the same as the case name, enter "same."

Client SSN — Self-explanatory.

Client No. — Self-explanatory.

Part I: Message from:

Employment Contractor to HHSC

The contractor staff check the appropriate box and use this section to report information to or request information from HHSC staff.

  • When reporting unemployment insurance benefits (UI), TWC staff must enter the check amount, the interval between checks and the date the check is mailed to client.
  • When requesting documentation that a client is certified to receive SNAP, contractor staff must check this box to request verification from eligibility staff.

Part II: Message from:

Eligibility Staff to Employment Contractor

Eligibility staff use this section to report information to the contractor.

Use the comments section to explain eligibility staff's decision when the contractor has requested reconsideration of a client's work registration status and HHSC disagrees (the client remains registered). Respond to these requests within 10 workdays.

Respondent — When the employment contractor requests documentation that the individual is certified to receive SNAP, enter the certification period for the client.

Enter comments, if any, in the lower comments section. Enter the response date and the respondent's signature.