Revision 15-2; Effective November 20, 2015

 

 

 

4100 Introduction and Legal Basis — 1 Texas Administrative Code (TAC) §357.521

Revision 15-2; Effective November 20, 2015

 

A respondent becomes ineligible to take part in the Supplemental Nutrition Assistance Program (SNAP) and/or Temporary Assistance for Needy Families (TANF) program if a state or federal court or administrative agency finds he has committed an intentional program violation.

The Food Stamp Act of 1977, as amended in Section 6(b) by the Omnibus Budget Reconciliation Act of 1981, and Sections 403, 416 and 1102 of the Social Security Act provide for this action.

 

4110 Requirement for Administrative Disqualification Hearing (ADH)

Revision 15-2; Effective November 20, 2015

 

Federal regulations implementing the provisions of the Food Stamp Act and Social Security Act require the Texas Health and Human Services Commission (HHSC) to establish procedures for holding administrative disqualification hearings.

According to TAC, Title 1, Part 15, Chapter 357, §357.521, HHSC may initiate an administrative disqualification hearing in SNAP and TANF cases. To initiate this hearing, HHSC must have documented evidence to prove that a respondent has intentionally committed one or more of the acts described in Section 4111, Definition of Intentional Program Violation.

HHSC will combine the proceedings against a person taking part in both the SNAP and TANF programs if the factual issue arises from the same or similar circumstances.

 

4111 Definition of Intentional Program Violation

Revision 15-2; Effective November 20, 2015

 

The Code of Federal Regulations (CFR), Title 7, Subtitle B, Chapter II, Part 273, Subpart F, §273.16(c) states that a SNAP intentional program violation is one or more of the following intentional actions:

  • Making a false or misleading statement, or misrepresenting, concealing or withholding facts.
  • Committing any act that constitutes a violation of the Food Stamp Act; SNAP regulations; or any state statute relating to the use, presentation, transfer, acquisition, receipt, possession or trafficking* of SNAP coupons or authorization cards, or reusable documents used as part of an automated benefit delivery system (access device).

* Trafficking means:

  • the buying, selling, stealing or otherwise effecting an exchange of SNAP benefits issued and accessed via Electronic Benefit Transfer (EBT) cards, card numbers and personal identification numbers (PINs), or by manual voucher and signature, for cash or consideration other than eligible food, either directly, indirectly, in complicity or collusion with others, or acting alone;
  • attempting to buy, sell, steal or otherwise effect an exchange of SNAP benefits issued and accessed via EBT cards, card numbers and PINs, or by manual voucher and signature, for cash or consideration other than eligible food, either directly, indirectly, in complicity or collusion with others, or acting alone;
  • the exchange of firearms, ammunition, explosives or controlled substances, as defined in Section 802 of Title 21, United States Code, for SNAP benefits;
  • purchasing a product with SNAP benefits that has a container requiring a return deposit with the intent of obtaining cash by discarding the product and returning the container for the deposit amount, intentionally discarding the product, and intentionally returning the container for the deposit amount;
  • purchasing a product with SNAP benefits with the intent of obtaining cash or consideration other than eligible food by reselling the product, and subsequently intentionally reselling the product purchased with SNAP benefits in exchange for cash or consideration other than eligible food; or
  • intentionally purchasing products originally purchased with SNAP benefits in exchange for cash or consideration other than eligible food.

Title 45 CFR, Subtitle B, Chapter II, Part 235, §235.110(b) states that a TANF intentional program violation is determined in accordance with state law. A TANF violation occurs when a person’s action results in:

  • a false or misleading statement, or misrepresentation, concealment or withholding of facts; or
  • any act intended to mislead, misrepresent, conceal or withhold facts or to represent a falsehood as a fact.

HHSC may charge a respondent with an intentional program violation even if he has not actually received benefits to which he is not entitled.

 

4112 Initiating the Administrative Disqualification Process

Revision 15-2; Effective November 20, 2015

 

Office of Inspector General (OIG) investigators are responsible for starting the process to inform certain individuals accused of an intentional program violation about their right to waive an administrative disqualification hearing. If the respondent signs the waiver, see Section 4131, Waivers. When the respondent does not sign the waiver, OIG investigators send the case to a hearings officer to schedule an administrative disqualification hearing. The hearings officer decides whether or not the respondent is guilty of committing an intentional program violation.

 

4120 Administrative Disqualification Hearings Officer

Revision 15-2; Effective November 20, 2015

 

 

 

4121 Designation of Hearings Officer — 1 TAC §357.522

Revision 15-2; Effective November 20, 2015

 

HHSC employs impartial officials to preside over fair and fraud hearings and to issue decisions on actions taken by HHSC and its designees, per state and federal law. A person authorized to conduct fair hearings under Section 1000, Fair Hearings, may also conduct administrative disqualification hearings.

 

4122 Disqualification of Hearings Officer — 1 TAC §357.523

Revision 15-2; Effective November 20, 2015

 

HHSC disqualifies a hearings officer if he takes part in the decision to:

  • refer the case to the investigation unit, or
  • recommend disqualification for intentional program violation.

HHSC may disqualify a hearings officer for any of the following reasons:

  • The hearings officer took part in a case conference with the worker, investigator or the supervisor to make a referral for an intentional program violation decision. The hearings officer may not have discussed or evaluated a case or any major points at issue.
  • The hearings officer reviewed the entire record or a comprehensive summary of the record to make a referral for disqualification.
  • The hearings officer has a personal interest in the outcome of the hearing decision or has some other conflict of interest.
  • A respondent asks that a certain hearings officer not hold the hearing or makes allegations against the fairness of the hearings officer.
  • The hearings officer has supervised the worker or investigator within the past two years, although the hearings officer may not have been involved in the decision.

HHSC does not disqualify a hearings officer for answering a question about HHSC policy concerning the case if the question and answer are stated in broad terms.

 

4123 Alternate Hearings Officer

Revision 15-2; Effective November 20, 2015

 

If the hearings officer questions his qualifications, he informs the hearings manager or hearings administrator about his concerns. The hearings manager or administrator may assign the hearing to another hearings officer.

If an alternate hearings officer cannot be chosen from within the same area, the hearings administrator appoints an alternate hearings officer from another area.

When the hearings manager or administrator appoints an alternate hearings officer, the first hearings officer immediately sends all documents concerning the hearing to the alternate hearings officer.

 

4124 Hearings Officer's Powers and Duties — 1 TAC §357.524

Revision 15-2; Effective November 20, 2015

 

The hearings officer:

  • administers oaths or affirmations;
  • makes sure all relevant issues are considered;
  • requests, receives and includes in the record all evidence determined necessary to make a decision;
  • ensures an orderly hearing by regulating the conduct and course of the hearing;
  • makes an administrative decision concerning the hearing in the name of HHSC; and
  • requires the attendance of an HHSC representative to explain and defend HHSC’s allegation. The hearings officer may request the presence of another HHSC representative, but does not have the authority to subpoena witnesses.

 

4130 Referral Process

Revision 15-2; Effective November 20, 2015

 

The OIG investigator sends the hearings officer a referral for an administrative disqualification concerning the alleged intentional program violation. The referral must include, but is not limited to:

  • a recommendation of TANF or SNAP disqualification,
  • a brief statement of allegations,
  • a summary of the evidence,
  • the respondent's most current address and telephone number available to any division within HHSC.

Before the hearing, the OIG investigator sends the hearings officer and the respondent an evidence packet which must include, but is not limited to:

  • the referral summary,
  • the notice and final notice to the respondent, and
  • copies of all documents necessary to support the disqualification recommendation.

The OIG investigator should send the evidence packet to the hearings officer and the respondent at least 20 calendar days before the hearing to allow sufficient time for review.

The hearings officer sets the date for the hearing and sends Form H4851-F, Notice of Administrative Disqualification Hearing, to the respondent and OIG investigator.

If two or more members of the same household are charged, the hearings officer handles each as a separate case. However, at the request of both parties, HHSC may hold a joint hearing. Even if HHSC holds a joint hearing, the hearings officer issues separate decisions and must send a separate notice to each person.

 

4131 Waivers

Revision 15-2; Effective November 20, 2015

 

OIG investigators are responsible for starting the process to inform certain individuals accused of an intentional program violation about their right to waive an administrative disqualification hearing. The respondent may waive his right to a hearing when the respondent signs and returns the waiver. If the respondent waives the administrative disqualification hearing, he will sign a Waiver of Disqualification Hearing form and a Repayment Agreement form.

The OIG investigator sends a copy of the signed waiver to the Appeals Division and to the OIG Disqualification Unit, State Office, which initiates the disqualification penalty. The Appeals Division will make sure appropriate hearings staff are informed.

 

4132 Definition of a Valid Waiver

Revision 15-2; Effective November 20, 2015

 

7 CFR §273.16(f) refers to waivers. Please see the full section for more information.

7 CFR §273.16(f) defines a valid waiver as:

"(ii) The written notification provided to the household member which informs him/her of the possibility of waiving the administrative disqualification hearing shall include, at a minimum:

(A) The date that the signed waiver must be received by the State agency to avoid the holding of a hearing and a signature block for the accused individual, along with a statement that the head of household must also sign the waiver if the accused individual is not the head of household, with an appropriately designated signature block."

 

4133 Processing ADH Waivers or Withdrawals

Revision 15-2; Effective November 20, 2015

 

Upon receipt of a valid waiver from a respondent or a request from OIG to withdraw the ADH referral, the hearings officer takes action based on the circumstances described below. A case folder will be created for each waiver/withdrawal and filed according to local office procedures.

Scenario 1: After hearings staff mail the appointment notice, the hearings officer receives a waiver, or OIG asks to withdraw the ADH request.

OIG sends an ADH case report to hearings staff asking for an ADH. Hearings staff schedule the ADH and mail the appointment letter to the respondent. After the mailing of the appointment notice, but before the hearing, OIG gives the hearings officer a valid waiver. The hearings officer sends the respondent a letter stating the hearing will not be held because the respondent waived his right to a hearing. Hearings staff generate all waiver and withdrawal notices via the Texas Integrated Eligibility Redesign System (TIERS) Hearings and Appeals Correspondence.

Scenario 2: Before hearings staff mail the appointment notice, the hearings officer receives a waiver, or OIG asks to withdraw the ADH request.

OIG sends an ADH summary to hearings staff asking for an ADH. Before hearings staff mail the appointment letter, OIG receives a valid waiver from the respondent and sends it to the hearings officer, or OIG decides it should not have asked for an ADH and sends a withdrawal to the hearings officer. If the ADH has not been assigned to a hearings officer, the waiver/withdrawal is sent to the manager for assignment. The hearings officer generates a letter to the respondent via TIERS Hearings and Appeals Correspondence.

Scenario 3: During or after the hearing, OIG asks to withdraw the ADH request, or the hearings officer receives a waiver.

OIG sends an ADH summary to hearings staff asking for an ADH. Hearings staff schedule the ADH and mail the appointment letter to the respondent. During or after the hearing, OIG decides to withdraw its request or submits a waiver. The hearings officer will issue a decision. The decision will be “did not commit” if OIG requests to withdraw the ADH request. If the hearings officer receives a waiver during or after the hearing, he will decide the case based on the evidence.

 

4134 Scheduling the Hearing — 1 TAC §357.525

Revision 15-2; Effective November 20, 2015

 

Form H4851-F, Notice of Administrative Disqualification Hearing, must be sent to the respondent within 20 calendar days from the date OIG asks for the hearing. The hearings officer must hold the hearing and issue a written decision no later than 90 calendar days from the date hearings staff mail the hearing notice to the respondent. The hearings officer schedules the hearing at a reasonable time and place. Hearings are normally held using a scan call conferencing system. A respondent may ask for a face-to-face hearing, but must show good cause for a face-to-face hearing before the hearings officer grants the request. The hearings officer decides whether good cause exists for a face-to-face hearing.

 

4135 Advance Notice of Hearing — 1 TAC §357.526

Revision 15-2; Effective November 20, 2015

 

The hearings officer sends the respondent advance notice of the hearing in sufficient time to allow receipt at least 30 calendar days before the scheduled hearing date. The notice is sent first class and certified mail, return receipt requested, to the most current mailing address available to any division within HHSC, and it is marked "return service requested." Delivery is not restricted to the addressee. The notice specifies the charges against the respondent and a summary of the evidence (including how and where it may be examined). If the notice is returned showing a new address, the hearings officer will re-send it and reapply advance notice requirements.

Form H4851-F, Notice of Administrative Disqualification Hearing, serves as a notice of the hearing for the respondent. Hearings staff generate all hearing notices via TIERS Hearings and Appeals Correspondence.

The hearings officer sends a full hearing packet to the respondent and the respondent’s representative, which includes a copy of Form H4800-ADH, Request for Administrative Disqualification Hearing; Form H4851-F; Form H4855, Statement of Household Member's Rights in Administrative Disqualification Hearing; Form H4856, Request for Another Appointment for Administrative Disqualification Hearing; Form H4861, Receipt of Notice; and an envelope addressed to the hearings officer.

The hearings officer sends a partial hearing packet to the witnesses, which includes Form H4851-F only.

TIERS generates an alert to the agency representative when the Managed Office Resource (MOR) search function is used to create the appeal. If MOR is not used, a packet containing Form H4851-F is generated.

Because the respondent must receive the notice at least 30 days before the hearing, TIERS will not allow hearings staff to enter the notice less than 40 days before the hearing if advance notice requirements apply. (See Section 4220, Time Frames, Postponements, Recesses and Delays — 1 TAC §357.533 and §357.534, for information on when advance notice requirements do not apply. If advance notice requirements do not apply, TIERS will not allow hearings staff to enter the notice less than 14 days before the hearing.)

Advance notice requirements are met when the hearings officer mails the notice to the most current mailing address available to any division within HHSC. Regardless of whether the certified or first class mail is returned, if the hearings officer mailed it per advance notice requirements, the hearing will be held.

  • If the returned notice shows a new address, another notice is mailed following the procedures in the first paragraph of this section, and the 90-day time requirement for issuing a decision begins again with the date that the second notice is mailed.
  • If the respondent claims non-receipt of notice of the hearing, he has one year after the date of the hearing decision to claim good cause for not appearing at the hearing. In all other instances, the respondent has 10 calendar days from the date of the hearing to claim good cause for not appearing. If the respondent is found to have committed an intentional program violation, but a hearings officer later finds that good cause existed for the respondent's failure to appear, then the previous decision shall no longer be valid, a new hearing will be held, and a new decision will be issued.

 

4136 Participation While Hearing Is Pending — 1 TAC §357.527

Revision 15-2; Effective November 20, 2015

 

HHSC may not disqualify a respondent for an intentional program violation until the hearings officer finds that the person committed an intentional program violation. A pending hearing does not affect the respondent's or the household's right to be certified and participate in the program.

HHSC reduces or terminates benefits if:

  • HHSC has documentation substantiating the household is either ineligible or eligible for fewer benefits (even if these facts suggest an intentional program violation and lead to an administrative disqualification hearing), or
  • the household fails to ask for a fair hearing and for continued benefits pending the hearing.

HHSC may adjust benefits if it has facts substantiating the household's failure to report a change in its circumstances. HHSC does not have to show that the failure to report was an intentional program violation before making the adjustment.

Pending the hearing, HHSC determines the eligibility and benefit level of the household per usual procedures. If the suspected action does not affect the household's current circumstance, the household:

  • continues to get its allotment based on the latest certification action, or
  • is recertified based on a new application and current circumstances.

HHSC terminates benefits if:

  • the certification period has expired, and
  • the household fails to reapply after receiving an expiration notice.

 

4200 Hearing Procedure

Revision 10-1; Effective January 15, 2010

 

 

4210 Conduct of Hearing — 1 TAC §357.528

Revision 15-2; Effective November 20, 2015

 

The hearings officer conducts the administrative disqualification hearing as an informal proceeding, not as a formal court hearing. The participants are placed under oath, but the formal rules of evidence are not followed.

At the hearing, the hearings officer must advise the respondent or his representative that he may refuse to testify or answer questions during the hearing.

The hearing is recorded.

 

4211 Presentation of HHSC's Case — 1 TAC §357.540

Revision 15-2; Effective November 20, 2015

 

OIG is responsible for presenting HHSC'S case in the administrative disqualification hearing.

 

4212 Respondent's Rights During Hearing — 1 TAC §357.530

Revision 15-2; Effective November 20, 2015

 

The hearings officer must give the respondent or his representative an adequate chance to do the following:

  • Examine all relevant documents and records at a reasonable time before and during the hearing. The case record is available to the respondent or his representative, including the application form and the verification documents used to find out the household's ineligibility or eligibility and allotment amount. All open records requests should be sent to the hearings administrator. If the respondent or his representative asks for a copy of the case record, HHSC provides a free copy of the portions that are relevant to the hearing. HHSC protects confidential information from release. Confidential information may include the names of people who have disclosed information about the household without its knowledge, or information that shows the nature or status of pending criminal prosecutions. Confidential information and other documents or records that the household may not otherwise have a chance to contest or challenge are not introduced at the hearing. They do not affect the hearings officer's decision.
  • Present the case or have it presented by a legal counsel or another person.
  • Present witnesses.
  • Present or refuse to present arguments without undue interference.
  • Question or refute any testimony or evidence, including a chance to confront and cross-examine adverse witnesses.
  • Submit evidence to show all pertinent facts and circumstances in the case.
  • Refuse to answer any question whether it is asked by the hearings officer or the agency representative.

 

4213 Attendance at Hearing — 1 TAC §357.529

Revision 15-2; Effective November 20, 2015

 

A representative from OIG must attend the hearing to explain and defend HHSC's case.

The respondent may attend the hearing, offer evidence, present testimony, ask questions and answer questions; however, he is not required to do so. If the respondent does not attend the hearing or chooses not to testify or answer questions, the hearings officer will consider only HHSC's evidence and testimony in making a decision.

The hearing is not open to the public; however, at the respondent's request, friends and relatives may attend. If space is limited, the hearings officer may limit the number of people attending the hearing.

 

4213.1 Failure of OIG to Appear

Revision 15-2; Effective November 20, 2015

 

If the OIG representative does not appear to explain or defend HHSC’s case, the hearings officer opens the record and states that the agency representative did not appear. The hearings officer will take no testimony. The hearings officer closes the record and issues a decision finding the respondent did not commit an intentional program violation, regardless of whether the respondent appears for the hearing.

 

4213.2 Failure of Respondent to Appear – Notice Requirement Met — 1 TAC §357.532

Revision 15-2; Effective November 20, 2015

 

If advance notice requirements (as outlined in Section 4135, Advance Notice of Hearing — 1 TAC §357.526) are met and the respondent or his representative fails to attend a hearing without good cause, the hearings officer holds the hearing without the respondent. The respondent has 10 calendar days from the date of the hearing to show good cause for failing to appear.

If the hearings officer finds the respondent committed an intentional program violation, but later finds that the respondent or his representative did not receive notice of the hearing or had good cause for not appearing, a new hearing is held. The previous decision is no longer valid, and a new decision is issued. The respondent has one year from the date of the hearing decision to show good cause for failure to appear because he did not receive notice of the hearing.

 

4213.3 Failure of Respondent to Appear – Notice Requirement Not Met — 1 TAC §357.532(c)

Revision 15-2; Effective November 20, 2015

 

If advance notice requirements are not met, the hearings officer reschedules the hearing to ensure advance notice requirements are met.

 

4220 Time Frames, Postponements, Recesses and Delays — 1 TAC §357.533 and §357.534

Revision 15-2; Effective November 20, 2015

 

The hearings officer must hold the hearing and issue a written decision no later than 90 calendar days from the date that hearings staff mail Form H4851-F, Notice of Administrative Disqualification Hearing, to the respondent. 

If the initial notice is returned due to a bad address and hearings staff re-send it to a more current address, the hearings officer must issue the written decision no later than 90 calendar days from the date that hearings staff mail the second Form H4851-F. Advance notice is still required if the hearings officer reschedules a hearing for this reason. When entering the new notice in TIERS, use the delay reason "Bad Address/Unable to Locate."

Exceptions: Issuing some decisions may be delayed beyond the time periods described above. In the instances below, hearings staff may enter a delay in TIERS, and the due date will be extended by the number of delay days entered. Hearings staff should enter a delay for the number of days between the first and second hearing date or for the number of days needed to get additional information. The maximum allowable delay is 30 days.

The respondent or his representative may ask for one postponement of up to 30 calendar days. Additional postponements may be requested and approved if the respondent has good cause for asking for the postponement. Advance notice is not required for hearings rescheduled at the respondent’s request. The hearings officer must allow a minimum notice of 14 days for these hearings. When rescheduling the hearing in TIERS, enter a delay using "Rescheduled at Client's Request."  

Hearings may also be postponed at the request of OIG for business reasons if OIG makes the request no later than five calendar days after the date on Form H4851-F. Business reasons include conflicts in scheduling due to training, meetings or multiple hearings scheduled at the same time. Business reasons do not include conflicts in scheduling due to leave or flex time. If the hearings officer postpones a hearing at the request of OIG, the hearings officer must give advance notice of the postponed hearing to the respondent. When entering the new notice in TIERS, use the delay reason "Request by Agency."

Hearings may be postponed due to factors beyond the control of the hearings officer, such as inclement weather or power outages. If factors beyond the control of the hearings officer cause a postponement, the hearings officer must give advance notice of the postponed hearing to the respondent. When rescheduling the hearing in TIERS, enter a delay using "Delay Beyond Agency Control."

If the respondent asks for additional information or wants additional information considered, the hearings officer may recess the hearing to allow time to receive this information. The respondent may question or refute any additional testimony or evidence after a recess.

The hearings officer may order a recess to ask for and receive additional testimony or evidence. The hearings officer tells the respondent or his representative the reason for the recess and the nature of the requested information. The respondent may question or refute any additional testimony or evidence after a recess.

The hearings officer reconvenes the hearing after the witness, document or other evidence is available. Once the hearings officer reconvenes the hearing, it is held as any other hearing.

Advance notice of 30 days is not required for hearings held open for additional evidence. The hearings officer should allow notice of 14 days for these hearings unless all parties agree in advance upon a date and time to reconvene. When scheduling the reconvened hearing in TIERS, enter a delay using "Record Held Open for Additional Evidence."

Use the chart below to determine due dates, notice requirements, delay reasons and maximum delays allowed.

Situation Notice Requirement Delay Reason Maximum Delay Days New Due Date
Form H4851-F returned, or more current address discovered Advance notice (40 days, to allow receipt 30 days before hearing) Bad Address/Unable to Locate N/A Form H4851-F date plus 90 calendar days
Respondent asks to reschedule 14 days Rescheduled at Client's Request 30 Initial due date plus number of delay days
OIG asks to reschedule for business reasons Advance notice Request by Agency 30 Initial due date plus number of delay days
Inclement weather
Power outage
Advance notice Delay Beyond Agency Control 30 Initial due date plus number of delay days
Respondent asks for time to send new information
Reconvene
14 days unless shorter time frame agreed upon by all parties Record Held Open for Additional Evidence 30 Initial due date plus number of delay days

 

4230 Consideration of the Case and Findings by the Hearings Officer — 1 TAC §357.531 and §357.535

Revision 15-2; Effective November 20, 2015

 

The hearings officer must base his decision on clear and convincing evidence that the respondent committed an intentional program violation, as defined in Section 4111, Definition of Intentional Program Violation.

Clear and convincing evidence means the trier of fact must be persuaded by the evidence that it is highly probable the claim is true. The clear and convincing evidence standard is greater than the preponderance of the evidence standard but less than beyond a reasonable doubt.

The hearings officer must substantiate his decision by identifying supporting evidence and applicable regulations. He must also respond to reasonable arguments made by the respondent or the respondent's representative.

The hearings officer makes a decision about the allegation that the respondent committed an intentional program violation. The hearings officer issues a written decision within the time frames specified in Section 4220, Time Frames, Postponements, Recesses and Delays — 1 TAC §357.533 and §357.534. The decision of the hearings officer must comply with HHSC policy and federal law and regulations, and it must be based exclusively on the hearing record.

The hearings officer may not find that the respondent committed an intentional program violation unless there is clear and convincing evidence in the record to support a decision that the respondent knowingly, willfully and with deceitful intent committed an act described in Section 4111, Definition of Intentional Program Violation.

 

4240 The Hearing Record and Decision — 1 TAC §357.536

Revision 15-2; Effective November 20, 2015

 

Respondents or their representatives may inspect the hearing record during work hours. They may also ask for a copy of the hearing record.

The hearings officer sends written notice of the decision to the respondent or to the appropriate HHSC staff per Section 4243, Notice of Hearing Decision and the Effect on Remaining Household Members — 1 TAC §357.538. The hearings officer's decision:

  • specifies the reasons for the decision,
  • identifies the supporting evidence and regulations, and
  • responds to reasonable arguments of the respondent or his representative.

The hearing record includes all exhibits admitted to the hearing record, all correspondence concerning the hearing and the audio recording of the hearing.

HHSC keeps hearing records for both SNAP and TANF administrative disqualification hearings for audit and review purposes per the records retention schedule, which is currently six years from the decision date.

 

4241 Effect of an Administrative Determination of Intentional Program Violation — 1 TAC §357.537

Revision 15-2; Effective November 20, 2015

  • If a hearings officer finds a respondent committed an intentional program violation, the respondent is disqualified from SNAP and/or TANF for the following periods:
    • TANF. If the intentional program violation occurred on or after Sept. 1, 2003, the person is disqualified:
      • 12 months for the first intentional program violation determination, and
      • permanently for the second intentional program violation determination.
    • SNAP. The person is disqualified:
      • for a period of one year upon the first occasion of any such determination;
      • for a period of two years upon:
        • the second occasion of any such determination; or
        • the first occasion of a finding by a federal, state or local court of the trading of a controlled substance (as defined in Title 21, United States Code [USC], §802) for coupons;
      • permanently upon:
        • the third occasion of any such determination;
        • the second occasion of a finding by a federal, state or local court of the trading of a controlled substance (as defined in Title 21, USC, §802) for coupons;
        • the first occasion of a finding by a federal, state or local court of the trading of firearms, ammunition or explosives for coupons; or
        • conviction of the offense of knowingly receiving, transferring, acquiring, altering or possessing coupons, authorization cards or access devices in any manner contrary to the Food Stamp Act of 1977 involving an aggregate amount of $500 or more; or
      • for a period of 10 years if a person is convicted in a state or federal court or is found by a state administrative hearing to have made a fraudulent statement or representation with respect to the identification or place of residence of the individual in order to receive multiple benefits simultaneously under SNAP.
  • The disqualification period does not depend on the amount of benefits involved. The disqualification period set at the time of the hearing is applicable regardless of current eligibility.
  • If one hearing is held for several offenses, HHSC may impose only one disqualification period.
  • If the hearings officer imposes a one-year disqualification for an initial violation, no further disqualifications may be imposed for violations occurring before the hearing decision that are later discovered. Although the hearings officer makes a decision about the intentional program violation, the respondent may appeal the amount of overpayment. The administrative disqualification hearing must be held and a decision issued before the fair hearing on the overpayment, unless the hearings officer holds both the administrative disqualification hearing and the fair hearing at the same time.

 

4241.1 Procedures for SNAP and TANF Administrative and Judicial Reviews

Revision 15-2; Effective November 20, 2015

 

If HHSC disagrees with the hearings officer’s decision, HHSC may ask for a review via the exception process.

If the respondent disagrees with the hearings officer’s decision, the respondent may ask for an administrative review.

An administrative review is when HHSC Regional Legal Services reviews a hearings officer’s decision on an administrative disqualification hearing. The assigned attorney reviews the hearing record and issues a new decision.

An administrative review must be requested within 30 calendar days of the date on the decision. The request for a review is sent to the hearings administrator at:

Hearings Administrator
Mail Code W-613
P.O. Box 149030
Austin, TX 78714

Exception: The 30 days does not start until the hearings officer issues a new decision if the respondent or respondent’s representative is working with the hearings officer to reopen or reschedule the hearing.

Upon receipt of an administrative or judicial review request or an exception request, follow procedures in Section 2100, Administrative Review — 1 TAC §§357.701-703, through Section 2450, Hearing Manager’s Responsibility in the Exception Process. The administrative disqualification procedures for administrative and judicial reviews and for exceptions are the same as those used for fair hearings.

 

4242 Effect of Nondetermination of Intentional Program Violation — 1 TAC §357.541

Revision 15-2; Effective November 20, 2015

 

If a hearings officer finds that the respondent did not commit an intentional program violation, the respondent will not be disqualified.

Although the hearings officer makes a decision about the intentional program violation, the respondent may appeal the amount of overpayment. The administrative disqualification hearing must be held and a decision issued before the fair hearing on the overpayment, unless the hearings officer holds both the administrative disqualification hearing and the fair hearing at the same time.

 

4243 Notice of Hearing Decision and the Effect on Remaining Household Members — 1 TAC §357.538

Revision 15-2; Effective November 20, 2015

 

The hearings officer informs the respondent of the decision in writing.

Within 15 calendar days of a hearings officer's written decision to disqualify the respondent, the HHSC Central Disqualification Unit informs the respondent of the effect of the hearings officer's decision. In dismissed cases or cases in which the hearings officer finds that the respondent did not commit an intentional program violation, the hearing decision is the final notice sent to the respondent. Except for dismissed, withdrawn and waived cases, the hearings officer informs the respondent of the decision on Form H4857, Notice of Decision, Administrative Disqualification Hearing. The hearings officer sends one copy each to the investigator and the respondent's representative. In addition, the hearings officer sends all “did commit” and “did not commit” ADH decisions (Form H4857 and order) electronically to the Central Disqualification Unit.

 

4244 Court Actions in Relation to Administrative Disqualification — 1 TAC §357.539

Revision 15-2; Effective November 20, 2015

 

A hearings officer does not have jurisdiction to hear or make a decision on a case that a court has already heard.

TANF and SNAP federal regulations allow a court of appropriate jurisdiction to order that a person be disqualified from participating in the program for the time periods described in 1 TAC §357.537, Effect of an Administrative Determination of Intentional Program Violation.

The state, a political subdivision of the state, or the United States may serve as prosecutor or plaintiff.

If the court fails to impose a disqualification period on a respondent who committed an intentional program violation, HHSC imposes one of the penalties described in 1 TAC §357.537. HHSC imposes the appropriate penalty unless the court order prohibits the penalty.

 

4245 Imposing a Disqualification

Revision 15-2; Effective November 20, 2015

 

HHSC must enforce administrative SNAP and TANF program disqualifications the first month after the month the household receives Form H4857, Notice of Decision, Administrative Disqualification Hearing. HHSC must enforce court-ordered SNAP disqualifications within 45 days of the date of the court decision.

If HHSC imposes the SNAP disqualification period after these limits, it is reduced by one month for each month or part of a month that the imposition is delinquent. Thus, a one-year disqualification period that was imposed two months late is reduced to 10 months. (However, the remaining two months are treated as overpayments due to HHSC error.)

When a SNAP and TANF respondent waives the hearing, HHSC must enforce the disqualification no later than the second month after the date the notice of disqualification was sent to the respondent.

 

4246 Consolidation of Administrative Disqualification Hearings and Fair Hearings — 1 TAC §357.542

Revision 15-2; Effective November 20, 2015

 

The hearings officer may combine a fair hearing and an administrative disqualification hearing to settle the amount of the claim at the same time as deciding whether or not an intentional program violation has occurred. To do this, the following conditions must exist:

  • The factual issues arise out of the same or related circumstances, and the respondent receives advance notice that the hearings will be combined.
  • Disqualification hearing procedures are adhered to.

At the respondent's request, the hearings officer must allow the respondent to waive the 30-day advance notice period that is required when a disqualification hearing and fair hearing are combined. If the respondent does not receive advance notice that the hearings will be combined, but decides to waive the advance notice requirement, the hearings officer obtains the respondent's signature on a waiver of notice. The hearings officer then proceeds with a fair hearing on the claim.

When a disqualification hearing and fair hearing are combined and the respondent does not waive the advance notice requirement, the hearings officer follows the time frames for holding disqualification hearings.

When the hearings are combined to settle the amount of the claim while deciding whether or not an intentional program violation has occurred, the respondent loses the right to a subsequent fair hearing on the amount of the claim.

When a respondent chooses to waive the advance notice requirement, the hearings officer documents in the decision (under procedural history) that the respondent waived the Notice of Administrative Disqualification Hearing.