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Effective Date: 




Updated: 1/2011



TANF, SNAP and Medical Programs

  • To notify households when their certification period expires.
  • To tell households the date by which the Health and Human Services Commission (HHSC) must receive Form H1010-R for it to be timely.
  • To explain to clients their responsibilities for completing and submitting the renewal form.
  • To tell clients to bring items needed for the interview and inform them of their rights and responsibilities, in addition to HHSC's responsibilities.
  • To explain to the household how to renew their benefits.
  • To advise clients who receive Supplemental Security Income (SSI) that they:
    • may apply for recertification at the HHSC benefit office or at a Social Security office.
    • are entitled to a home or telephone interview if they are unable to appoint an authorized representative.



When to Prepare

SNAP, TANF and Medicaid

  • The Texas Integrated Eligibility Redesign System (TIERS) generates Form H1830-R to send with the renewal packet.
  • TIERS pre-populates the following basic client information:
    • name,
    • address,
    • program to be renewed,
    • Eligibility Determination Group (EDG) number, and
    • the date when the certification is expiring.


Form H1830-R is sent with Form H1010-R during the month before the last month of certification. The notice tells the household the date HHSC must receive the application to be timely.

TANF and TANF Level Families Medicaid

Form H1830-R is sent with Form H1010-R during the two months before the review date.

Children's Medicaid

Form H1830-R is sent with Form H1010-R when the household has another Texas Works program up for renewal or recertification and it is during the fourth month of six-month certification or the 10th month of 12-month certification of a Children's Medicaid EDG.



  • The form is only generated by TIERS and is mailed to the clients with Form H1010-R.
  • Staff may reprint the form if a household requests a copy from TIERS History Correspondence.
  • TIERS will not allow staff to generate the form in Manual Correspondence.


Form Retention

TIERS maintains a copy of the form in History Correspondence.