Revision 18-1; Effective January 1, 2018

 

 

B—410 Students in Higher Education

Revision 13-4; Effective October 1, 2013
 

 

 

B—411 General Policy

Revision 15-4; Effective October 1, 2015

 

SNAP

A student in higher education is one who is enrolled at least half-time (as defined by the institution) in a college or university curriculum that offers degree programs, regardless of whether a high school diploma is required for admittance, or at a business, technical, trade or vocational school that normally requires a high school diploma or equivalent for admittance.

Student higher education policy does not apply to individuals:

  • under age 18 (students are 18 the month after the student's 18th birthday);
  • age 50 or older (students are 50 the month of the student's 50th birthday);
  • enrolled in curricula (such as beauty school or auto mechanics) that do not require a diploma or the equivalent for entrance; or
  • enrolled only in English as a second language curriculum.

Enrollment begins the first day of the first school term. For example, a high school senior might be accepted by a college and register for classes before graduation; however, the Texas Health and Human Services Commission (HHSC) does not consider the student enrolled until the first day of the college term.

Once enrolled, HHSC considers the student enrolled through vacation and recess, until the student graduates, is expelled, drops out, or does not intend to register for the next usual term, excluding summer school. A student remains enrolled between terms, breaks, and during summer vacations unless the student does not intend to return to school the next term.

 

B—412 Student Eligibility Requirements

Revision 15-4; Effective October 1, 2015

 

SNAP

A student qualifies for the Supplemental Nutrition Assistance Program (SNAP) if the student is:

  1. Unfit for employment. If not evident, proof is required from a certified doctor or psychologist, or receipt of permanent or temporary disability benefits issued by government or private sources must be verified.
  2. Employed for pay an average of 20 hours a week. If self-employed, the student must work an average of 20 hours a week and earn at least the federal minimum hourly wage.
  3. Participating during the regular school year in a state or federally-funded work study program. The student must be actually working at a job for pay or for dollar credits against tuition charges. This does not include students who must work for academic requirements, such as interns and student teachers.The student exemption begins the month the school term begins or the work study is approved to begin, whichever is later. The student exemption stops:
  • if the student quits working (unless it results solely from lack of work study funds), or
  • when there is a break between terms of a full calendar month or longer unless the student continues work study during the break.
  1. Enrolled in school through one of the following programs:
    • Workforce Innovation and Opportunity Act (WIOA),
    • Choices,
    • SNAP Employment and Training (E&T),
    • Trade Adjustment Assistance (a program administered by the Texas Workforce Commission), or
    • other state and local government training programs approved by state office as equivalent to E&T.
  2. Participating in an on-the-job training program (classroom study is not considered on-the-job-training for this purpose).
  3. Approved for Temporary Assistance for Needy Families (TANF).
  4. Responsible for the care of a dependent child who is a household member and the child is:
    • under age 6;
    • at least age 6 but under age 12, and the student states there is no available child care to enable the student to attend class and comply with work requirements in Item B or C above.

      Note: If both parents/caretakers are students, both cannot obtain student eligibility by caring for the same child.

  5. A single parent (natural, adoptive or stepparent in the home or other single adult with parental control) who is:
    • enrolled full-time (as determined by the school), and
    • responsible for the care of a child under age 12.

 

B—413 Ineligible Students

Revision 15-4; Effective October 1, 2015

 

SNAP

A student who does not meet the student eligibility requirements is not a member of the household. Do not count the student's income and resources for the remaining household members. If an ineligible student is also disqualified for another reason, the student is treated as a disqualified member.

If an ineligible student is also disqualified for another reason, the student is treated as a disqualified member. Advisors follow resource policy in A-1210, General Policy, and income policy in A-1362, Disqualified Members.

 

B—414 Work Registration

Revision 13-4; Effective October 1, 2013

 

SNAP

Eligible students are exempt from work registration during the regular school term. This exemption continues between terms, breaks and through scheduled school vacations for students who remain enrolled.

 

B—415 Verification Requirements

Revision 16-4; Effective October 1, 2016

 

SNAP

Staff must verify self-employment hours of students who work at least a weekly average of 20 hours and earn at least the federal minimum hourly wage. If the student does not provide verification by the due date, the student will be denied for failure to provide and is considered an ineligible student, unless they meet another student eligibility requirement as described in B-412, Student Eligibility Requirements.

 

B—416 Documentation Requirements

Revision 16-4; Effective October 1, 2016

 

SNAP

Advisors must document the student's eligibility, if questionable.

 

B—420 Other Special Situations

Revision 13-4; Effective October 1, 2013
 

 

B—421 Food Distribution Program on Indian Reservations (FDPIR)

Revision 13-4; Effective October 1, 2013

 

SNAP

FDPIR is a food distribution program that provides commodity foods to low-income households living on an Indian reservation, and to Native American families residing near reservations. The Indian tribe administers this program under approval from the Food and Nutrition Service (FNS). Households eligible for the FDPIR receive a monthly food package based on the number of household members. The only tribe approved in Texas is the Alabama-Coushatta Tribe of Texas in Polk County.

Individuals cannot participate simultaneously in SNAP and FDPIR. An Indian Tribal Household eligible for both programs may participate in only one of the programs of its choice for a given month. The household may switch from one program to the other, but benefits must be ended in one program before certifying the household for the other program. Benefits in the new program can be issued for the month after benefits end in the previous program.

 

B—421.1 Duplicate Participation

Revision 13-4; Effective October 1, 2013

 

HHSC staff must identify household members receiving duplicate benefits with SNAP and FDPIR. The household can be denied from either program. If duplicate participation occurs, a household overpayment occurs for the program that was certified for benefits last. HHSC staff must send an overpayment referral to the Office of Inspector General (OIG) if the overpayment occurred in SNAP.

The Livingston HHSC office receives a list of certified FDPIR households each month.

HHSC staff must:

  • perform inquiry to identify any household members receiving benefits in both FDPIR and SNAP;
  • notify FDPIR staff about any household member with duplicate participation;
  • notify the corresponding HHSC office in another county, if the duplicate participant household moved to that county; and
  • deny SNAP, if appropriate, and refer the household to OIG for a SNAP overpayment.

Related Policy
How to File an Overpayment Referral, B-730

 

B—421.2 Intentional Program Violation (IPV)

Revision 13-4; Effective October 1, 2013

 

Any member disqualified from SNAP for an IPV is also disqualified from participating in the FDPIR program. Likewise, any member disqualified from FDPIR for an IPV is also disqualified from participation in SNAP for the full length of the IPV disqualification period. Advisors follow policy in B-940, Texas Works (TW) Responsibilities.

 

B—421.3 Switching from FDPIR to SNAP

Revision 15-4; Effective October 1, 2015

 

SNAP

If an Indian Tribal Household chooses to receive SNAP, staff must contact the Alabama-Coushatta FDPIR staff to verify that the household does not receive FDPIR before determining SNAP eligibility.

Note: Alabama is the only other state that can be entered in the Out of State Benefit Logical Unit of Work in this situation, and advisors must document the facts in the Texas Integrated Eligibility Redesign System (TIERS) Case Comments.

 

B—421.4 Switching from SNAP to FDPIR

Revision 15-4; Effective October 1, 2015

 

SNAP

For Indian Tribal Households switching from SNAP to FDPIR, staff must:

  • process the switch as a verbal request for voluntary withdrawal from SNAP;
  • send Form TF0001, Notice of Case Action, allowing adequate notice;
  • terminate SNAP benefits for the household as soon as possible so the household may be certified for FDPIR; and
  • notify FDPIR staff of the SNAP denial effective date for the household.

Related Policy
Form TF0001 Required (Adequate Notice), A-2344.1

 

B—421.5 Verification Requirements

Revision 15-4; Effective October 1, 2015

 

SNAP

HHSC staff must contact Alabama-Coushatta FDPIR staff to verify that the household does not receive FDPIR and whether there is a current FDPIR IPV before determining SNAP eligibility for any Indian Tribal Household living in Polk County.

FDPIR staff must contact the Livingston HHSC office to verify the household does not receive SNAP and to verify any current SNAP IPV disqualification before certifying the household for FDPIR.

 

B—421.6 Documentation Requirements

Revision 15-4; Effective October 1, 2015

 

SNAP

Advisors must document the:

  • name and telephone number of the FDPIR staff who provides verification; and
  • name of the household member currently disqualified for an IPV in FDPIR.

Related Policy
Documentation, C-940

 

B—430 Households with Elderly Members or Members with a Disability

Revision 13-4; Effective October 1, 2013

 

B—431 Definition of Elderly

Revision 01-1; Effective January 1, 2001

 

SNAP

An elderly person is someone who is age 60 or older as of the last day of the month.

 

B—432 Definition of Disability

Revision 15-4; Effective October 1, 2015

 

SNAP

The following people are considered to have a disability:

  • People approved for Supplemental Security Income (SSI), Social Security disability or blindness payments, or SSI Medicaid only.
  • Veterans who receive Veterans Affairs (VA) benefits because they are rated a 100 percent service-connected disability or who, according to the VA, need regular aid and attendance or are permanently housebound.
  • Surviving spouses of deceased veterans who meet one of the following criteria according to the VA:
    • need regular aid and attendance,
    • are permanently housebound, or
    • are approved for benefits from the VA because of the veteran's death and could be considered to have a permanent disability for Social Security purposes. (See B-432.1, Social Security's Criteria for Disability.)
  • Surviving children (any age) of a deceased veteran who the VA:
    • determines are permanently incapable of self-support, or
    • approves for benefits because of the veteran's death and could be considered to have a permanent disability for Social Security purposes. (See B-432.1.)
  • People receiving disability retirement benefits from any government agency for a disability that could be considered permanent for Social Security purposes.
  • People receiving Railroad Retirement Disability who are also covered by Medicare.

 

B—432.1 Social Security's Criteria for Disability

Revision 15-4; Effective October 1, 2015

 

SNAP

The Social Security Administration (SSA) considers that any of the following 12 conditions result in permanent disability:

  • Permanent loss of use of both hands, both feet, or one hand and one foot.
  • Amputation of leg at hip.
  • Amputation of leg or foot because of diabetes mellitus or peripheral vascular diseases.
  • Total deafness, not correctable by surgery or hearing aid.
  • Statutory blindness, unless caused by cataracts or detached retina.
  • IQ of 59 or less, established after the person becomes age 16.
  • Spinal cord or nerve root lesions resulting in paraplegia or quadriplegia.
  • Multiple sclerosis in which there is damage to the nervous system caused by scattered areas of inflammation. The inflammation recurs and has progressed to varied interference with the function of the nervous system, including severe muscle weakness, paralysis, and vision and speech defects.
  • Muscular dystrophy with irreversible wasting of the muscles, impairing the ability to use the arms or legs.
  • Impaired renal function caused by chronic renal disease, resulting in severely reduced function which may require dialysis or kidney transplant.
  • Amputation of a limb of a person at least age 55.
  • AIDS progressed so that it results in extensive and/or recurring physical or mental impairment.

If the individual already receives SSI or Social Security blindness or disability payments, or the disability is obvious to the advisor (such as amputation of leg at hip), the advisor does not require additional verification. Other conditions may require the opinion of a physician. Advisors use Form H1836-A, Medical Release/Physician's Statement, in these instances.

 

B—433 Special Provisions for Households with Elderly Members or Members with a Disability

Revision 15-4; Effective October 1, 2015

 

SNAP

Households containing members who are elderly or who have a disability receive special treatment. The special provisions are:

  • Exemption from the gross income test;
  • Allowance of a deduction for medical expenses when the medical expenses exceed a total of $35 per month for all eligible members who are elderly or who have a disability; and
  • Allowance of an uncapped excess shelter deduction for the full monthly amount that exceeds 50 percent of the household's monthly income after the allowable deductions.

 

B—434 Verification Requirements

Revision 15-4; Effective October 1, 2015

 

SNAP

Advisors must verify that a household member:

  • is age 60 or older; and
  • meets the disability criteria in B-432, Definition of Disability.

Related Policy
Questionable Information, C-920
Providing Verification, C-930

 

B—435 Documentation Requirements

Revision 15-4; Effective October 1, 2015

 

SNAP

Advisors must document:

  • the reason the individual is considered to have a disability (see B-432, Definition of Disability);
  • how age was verified (see B-431, Definition of Elderly); and
  • how disability was verified (see B-432).

Related Policy
Documentation, C-940

 

B—440 Drug and Alcohol Treatment (D&A)/Group Living Arrangement (GLA) Facilities

Revision 05-1; Effective January 1, 2005

 

 

B—441 Residents of Drug and Alcohol Treatment (D&A) Facilities

Revision 16-3; Effective July 1, 2016

 

SNAP

Individuals receiving chemical dependency treatment and residing in a facility that conducts a chemical dependency program may be potentially eligible for SNAP, regardless of the number of meals the facility provides, if the treatment facility is an approved institution. A drug and alcohol treatment (D&A) facility is an approved institution if it is either:

  • certified as a retailer by Food and Nutrition Service (FNS) to accept SNAP benefits; or
  • a private, nonprofit organization or institution, or a publicly operated community mental health center. To qualify under this provision, the facility or organization must also meet one of the following two requirements:
  1. be licensed by the Texas Department of State Health Services (DSHS) to operate a chemical dependency treatment facility; or
  2. have written verification from DSHS that it is a registered faith-based exempt chemical dependency treatment program under Texas Health and Safety Code, Chapter 464, Subchapter C, and also is recognized by DSHS as operating a program that furthers the purposes of Part B of Title XIX of the Public Health Service Act, the rehabilitation of drug addicts and/or alcoholics. The facility does not have to actually receive funds from DSHS.

Individuals residing in D&A facilities that are not approved institutions are potentially eligible for SNAP only if the facility provides half of their meals or less as described in B-490, Determining Whether an Individual Who Resides in a Facility Is Institutionalized.

Note: See A-232.2, Disqualified Persons, for disqualification of individuals due to felony drug conviction.

Advisors must evaluate all other eligibility criteria to determine whether a resident of the treatment center is eligible for SNAP.

Advisors determine eligibility following the same income and resource policy as other households. Most time frames and procedures for certifying households apply to residents of treatment facilities. The exceptions are:

  • Household size — advisors must certify:
    • single residents of the treatment facility as separate one-person households; and
    • adult residents and their children as one household.
  • Authorized representative (AR) — The treatment facility must act as the AR for all residents of the facility.

Any facility that is disqualified by the U.S. Department of Agriculture (USDA) as a retailer or that loses its license from a state agency cannot serve as an AR. If this happens, the advisor must deny all existing SNAP Eligibility Determination Groups (EDGs) of residents in the facility. The facility may not debit residents' food accounts after the disqualification occurs.

  • Expedited service — The advisor must provide benefits so the resident has an opportunity to participate by the seventh calendar day after the application date. The application date is day zero.
  • Adverse action — When the facility loses its status as AR or loses its certification, the resident must be given adequate notice of adverse action.
  • Work registration — The resident is exempt from work registration.

Note: If a treatment center inquires about obtaining a SNAP retailer license from FNS, advisors should refer the center to the USDA FNS at 1-877-823-4369 or www.fns.usda.gov/snap/retailers/application-process.htm.

Related Policy
Nonmembers, A-232.1
Determining Whether an Individual Who Resides in a Facility Is Institutionalized, B-490

 

B—442 Residents of Group Living Arrangement (GLA) Facilities

Revision 16-3; Effective July 1, 2016

 

SNAP

A group living arrangement (GLA) is a public or private nonprofit residential facility that serves no more than 16 residents. Individuals residing in a GLA facility may be potentially eligible for SNAP, regardless of the number of meals the facility provides, if the GLA facility is an approved institution. A GLA is an approved institution if it is either:

  • a certified SNAP retailer; or
  • a nonprofit, certified by a state agency as required by Section 1616(e) of the Social Security Act.

Individuals residing in GLA facilities that are not approved institutions are potentially eligible for SNAP only if the facility provides half of their meals or less as described in B-490, Determining Whether an Individual Who Resides in a Facility Is Institutionalized.

Residents who meet the criteria in B-432, Definition of Disability, may be certified under group living arrangements. Eligibility is determined by the same income and resource standards as other households.

The residents of group living arrangements may apply:

  • for themselves,
  • through an AR of their choosing, or
  • through an AR employed by the facility.

If a member of the group wants to apply separately from other GLA residents, the facility makes the decision to let the resident apply separately based on the resident's physical and mental ability. Applications from any individual the facility allows to apply as a one-person household or for any group of residents applying as a household are accepted.

Most time frames and procedures for certifying households apply to group living arrangements. The exceptions are:

  • Household size — If the resident applies using the facility as AR, the resident is treated as a one-person household. If the residents apply without using the facility as AR, 16 is the largest allowable household size.
  • Expedited service — Benefits are provided so the resident has an opportunity to participate by the seventh calendar day after the application date. The application date is day zero.
  • Adverse action — When the facility loses its status as AR or loses its certification, the resident is given adequate notice of adverse action.
  • Work registration — Members must be registered unless exempt.

Related Policy
Nonmembers, A-232.1
Determining Whether an Individual Who Resides in a Facility Is Institutionalized, B-490

 

B—443 HHSC Responsibilities

Revision 13-4; Effective October 1, 2013

 

 

B—443.1 Advisor Responsibilities

Revision 15-4; Effective October 1, 2015

 

SNAP

For residents participating in D&A/GLA facilities, advisors must verify that the:

  • D&A facility meets the eligibility criteria in B-441, Residents of Drug and Alcohol Treatment (D&A) Facilities; and
  • GLA meets the eligibility criteria in B-442, Residents of Group Living Arrangement (GLA) Facilities.

Certification may be verified by contract documents or certificates of eligibility from the USDA, HHSC, DSHS, Texas Department of Aging and Disability Services (DADS), or Texas Department of Assistive and Rehabilitative Services (DARS). Verify nonprofit status by a current, valid Internal Revenue Service (IRS) exemption or a document from the Texas State Comptroller of Public Accounts. If the facility is a USDA-certified retailer, the facility's eligibility is verified.

  • Ensure the AR has a copy of Form H1851, Reference Guide for Drug and Alcohol Treatment (D&A)/Group Living Arrangement (GLA) Facilities. Have the AR acknowledge receipt of Form H1851 by signing Form H1846, Facility Authorized Representative Interview. Ensure the AR understands each of the facility's responsibilities.
  • Ensure the AR has a supply of Form H1852, List of Resident Participants in the Supplemental Nutrition Assistance Program (SNAP). The AR must return this form by the fifth of every month, or the following workday if the fifth is not a workday. Repeated failure to return this form is a program violation. Use Form H1852 to help monitor the facility's compliance with its responsibilities as AR. Complete and send Form H1847, Reminder to Submit Form H1852, when the facility report is three days past due.
  • Ensure the AR has a supply of Form H1019/H1019-S, Report of Change, and postage-paid envelopes.
  • Make on-site visits to the facility at least once every six months.

    During these visits, use Form H1845, Drug and Alcohol Treatment (D&A)/Group Living Arrangement (GLA) Facility Review, to document:
    • the date of the visit,
    • the number of residents, and
    • proof the facility continues to meet eligibility requirements.
  • Report suspected misuse of SNAP by the facility to the supervisor or program manager. Use Form H1845 or Form H1853, Documentation of Findings for Form H1852, if staff discover the suspected misuse during the monthly evaluation of Form H1852 that the facility returned.
  • Ensure the facility returns the correct amount of benefits to the individual's Electronic Benefit Transfer (EBT) card. If the facility is unable or unwilling to return the individual's benefits, send Form H1096, Notification Letter, to the facility advising them of the overpayment; email Form H1095, Treatment Facility Fraud Referral, to the OIG General Investigations Policy and Quality Control unit at oig_gi@hhsc.state.tx.us; and immediately restore improperly accessed benefits to the individual.

Note: If a Centralized Benefit Services (CBS) household moves into a D&A/GLA facility, the advisor must update the Living Arrangement record to convert the EDG back to SNAP and out of the CBS caseload.

Maintain a D&A/GLA facility case file in the local office for each facility. Keep copies of any forms, reports or supporting documentation in this file.

 

B—443.1.1 Monitoring Facilities

Revision 15-4; Effective October 1, 2015

 

SNAP

Advisors must monitor information provided each month by facilities on Form H1852, List of Resident Participants in the Supplemental Nutrition Assistance Program (SNAP), to ensure that certified residents receive the correct amount of SNAP benefits.

Facilities must return Form H1852 to the office by the fifth of every month, or the next workday if the fifth is not a workday. If the facility fails to provide the report, prompt the facility using Form H1847, Reminder to Submit Form H1852, when the report is three days past due.

Advisors must compare the information on the current month's Form H1852 to the information on the previous month's Form H1852 and clear any discrepancies. Consider the following questions in detail:

  • Are the same residents certified?
  • Did any of the residents move out during the month? If so:
    • Did the facility report the change and return the Lone Star Card and personal identification number (PIN) in the correct sleeve within three days?
    • Did the Lone Star account contain the correct amount of benefits?

If the facility fails to report residents who move out and/or fails to return the Lone Star Card and PIN, the advisor must take action to deny the EDGs following procedures in B-447, Resident Moves Out of a Drug and Alcohol Treatment (D&A)/Group Living Arrangement (GLA) Facility. Remind facilities of the responsibility as an AR to report moves and return the Lone Star Card and PIN within three days of the change. Complete Form H1853, Documentation of Findings for Form H1852, monthly to document findings. If no findings, document no findings. Provide a copy of negative findings to the program manager responsible for the facility case file, and file a copy in the facility case file.

 

B—443.2 Program Manager Responsibilities

Revision 17-3; Effective July 1, 2017

 

HHSC Benefit Office program managers report misuse of SNAP benefits in facilities certified as retailers by the USDA by sending Form H1853, Documentation of Findings for Form H1852, to:

Texas Health and Human Services Commission
Eligibility Operations - Field
Mail Code 992-6
909 W. 45th Street
Austin, TX 78751

State office makes referrals to the OIG and EBT. The USDA, if necessary, sends a copy to the program manager and subsequently, notification of any action taken.

Do not take any further adverse action on a facility certified by USDA before USDA's action. Compute overissuances for the individual residents as appropriate.

If the investigative unit confirms the report is valid, the investigative unit program manager refers the misuse to the USDA for its information and consideration for prosecution. The investigative unit sends a copy of the referral to the HHSC Benefit Office program manager responsible for the facility case file and notifies the program manager of any action taken by USDA.

 

B—444 Overview of Electronic Benefit Transfer (EBT) Processes for Residents of Drug and Alcohol Treatment/Group Living Arrangement (D&A/GLA) Facilities

Revision 15-4; Effective October 1, 2015

 

SNAP

Establish the AR as the primary cardholder (PCH) and issue a Lone Star Card to access a resident's benefits in the food account. Allow the AR to select a PIN through the Lone Star Help Desk Automated Voice Response (AVR) unit or receive a pre-assigned PIN.

Some D&A/GLA facilities are certified by the USDA as SNAP retailers and some are not. Either way, the facility serves as AR and is responsible for the use of SNAP benefits of all residents who participate in SNAP (except for some GLAs). Benefits issued via EBT for residents of these D&A/GLA facilities are handled according to one of the following three methods (1A, 1B, or 2):

  1. An EBT vendor contracts with D&A/GLA facilities certified by USDA as SNAP retailers to process EBT transactions in two ways:
    1. If the D&A/GLA facility processes a minimum monthly value of SNAP transactions, an EBT vendor installs Point of Sale (POS) equipment there. The facility, as AR/PCH, debits the residents' SNAP benefits by swiping each resident's Lone Star Card through their POS equipment and entering the associated PIN. An EBT vendor completes financial settlement to pay the retailer the day after SNAP transactions are completed.
    2. If the retailer processes less than the minimum monthly value of SNAP transactions to receive POS equipment, an EBT vendor contracts with the retailer to use a manual voucher system to process EBT SNAP transactions from each resident'saccount. An EBT vendor completes financial settlement to pay the retailer the day after SNAP transactions are completed.
  2. D&A/GLA facilities that are not USDA-certified retailers do not contract with an EBT vendor to accept SNAP benefits. However, as long as the facility meets the eligibility criteria specified in B-441, Residents of Drug and Alcohol Treatment (D&A) Facilities, or B-442, Residents of Group Living Arrangement (GLA) Facilities, for non-USDA certified retailers, residents of those facilities can still participate in the SNAP program with the facility AR responsible for the residents' SNAP benefits. In this situation, the facility AR is established as the PCH; a Lone Star Card is issued; and the AR is allowed to select a PIN through the Lone Star Help Desk AVR unit or receive a pre-assigned PIN. The facility AR may use the food account Lone Star Card and PIN to purchase food for the resident at a retail food store/market.

Note: GLAs do not always serve as AR for each resident. If the GLA employee is not listed as a GLA-AR on a resident's SNAP EDG:

    • advisors must follow normal EBT issuance procedures rather than procedures in this section for issuing cards and self-selecting/issuing PINs; and
    • the resident uses the card/PIN to purchase food from a regular retailer, or purchase prepared meals from the GLA if the GLA is certified as a retailer by USDA.

 

B—445 D&A/GLA Facility Responsibilities as Authorized Representatives

Revision 15-4; Effective October 1, 2015

 

SNAP

The facility acting as AR must:

  • apply for and provide accurate information on behalf of a resident;
  • use the Lone Star Card to debit the resident's food account;
  • buy and prepare food for eligible residents;
  • buy meals delivered to the individual residents;
  • report within 10 days to the SNAP office loss of USDA/DSHS certification or loss of nonprofit status;
  • report any changes, losses, misuse and overissuances of SNAP benefits;
  • give departing residents Form H1019/H1019-S, Report of Change, as appropriate, and advise the individual to report the new address within 10 days;
  • report and return to HHSC the Lone Star Card (in the proper sleeve) issued for that resident within three days after the resident moves out, whether announced or not;
  • ensure security of all Lone Star Cards and PINs issued to the facility AR;
  • ensure that the departing resident's Lone Star Card contains all the SNAP benefits that are unspent when the resident moves out; and
  • return Form H1852, List of Resident Participants in the Supplemental Nutrition Assistance Program (SNAP), by the fifth of every month, or the following workday if the fifth is not a workday.

The resident and AR both must sign the application form.

The facility, acting as an AR, is liable if it knowingly commits a program violation to obtain SNAP benefits for a resident.

B-445.1, Use of SNAP Benefits by Drug and Alcohol Treatment (D&A) /Group Living Arrangement (GLA) Facilities Which Serve as SNAP Authorized Representative (AR), explains facility responsibilities specific to EBT.

The facility must maintain a sufficient supply of required forms. Form H1852, Form H1019/H1019-S and HHSC return envelopes may be obtained from the local eligibility determination office and will be offered to the AR at each certification.

 

B—445.1 Use of SNAP Benefits by Drug and Alcohol Treatment (D&A)/Group Living Arrangement (GLA) Facilities Which Serve as SNAP Authorized Representative (AR)

Revision 15-4; Effective October 1, 2015

 

SNAP

HHSC restricts how the D&A/GLA facility may use the resident's benefits as explained in B-445.1.1, Account Access, through B-445.1.4, Residents Moving Out Before the 16th of a Month. The advisor must inform the facility AR of these rules during the interview and provide them with Form H1851, Reference Guide for Drug and Alcohol Treatment (D&A)/Group Living Arrangement (GLA) Facilities.

 

B—445.1.1 Account Access

Revision 15-4; Effective October 1, 2015

 

SNAP

HHSC issues a Lone Star Card to the facility AR and enables the AR to select a PIN through the Lone Star Help Desk AVR unit. HHSC allows the AR access only to benefits issued for a month the individual is a facility resident. The facility may have one person serve as AR to apply for the resident and another to serve as AR/PCH and use the Lone Star Card.

Note: When the D&A/GLA facility is the AR, it is responsible for all benefits in an account. Therefore, security of the card and PIN is as important to them as it is to an individual not in a facility.

A D&A/GLA facility AR may access benefits issued to a resident's food account only in the following situation. If HHSC is unable to issue benefits with the facility as AR for a month the resident is residing in the facility because that month's benefits were already issued to the resident's food account and the resident wants to allow the facility access to those previously issued benefits, the resident, not the facility AR, has the following options:

For facilities that are not USDA-certified retailers, the resident may:

  • use the card to purchase groceries to give to the facility; or
  • make the D&A/GLA facility AR a secondary cardholder on the existing account to access those benefits.

To establish the facility AR as secondary cardholder in this situation, the:

  • advisor must ensure that the individual made this choice and then approve it; and
  • local office EBT clerk must establish the secondary cardholder, issue the card, and enable PIN self-selection.

For facilities that are USDA-certified retailers, the resident can:

  • use one of the options listed above for facilities that are not USDA-certified; or
  • use the Lone Star Card and PIN to purchase meals via the facility POS device or via the EBT manual voucher process. The facility is not allowed possession of the card previously issued to the resident, nor knowledge of the resident's PIN. When using this option, the facility may only charge for prepared meals on a per day basis (not in advance).

 

B—445.1.2 Returning Lone Star Cards

Revision 13-4; Effective October 1, 201 3

 

SNAP

The D&A/GLA facility must return the facility AR's card for each resident who moves out within three days of the move.

 

B—445.1.3 Returning Unspent Benefits When a Resident Moves Out

Revision 15-4; Effective October 1, 2015

 

SNAP

When a resident moves out of the D&A/GLA facility, the facility must return all unspent benefits issued to the AR's account regardless of when the resident moves out, even if it means returning all of the resident's benefits. D&A/GLA facilities are not allowed to spend a resident's benefits after the resident moves out.

To return unspent benefits after a resident moves out, the facility returns the AR's card and ensures that the account contains all unspent benefits. For purposes of this policy, "spent" means the facility used the Lone Star Card to access the resident's benefits before the resident moved out.

If the facility accesses benefits that it is not allowed to use, the facility must return the benefits to the account. USDA-certified facilities can return benefits using the POS device to process a return on the account or via communication with an EBT vendor. Facilities not certified as retailers by USDA must return groceries to the store and get the store to process a return on the resident's account using the AR's card on the store's POS device.

If the retailer is unable to restore benefits to the EBT card, the advisor initiates a claim against the facility by sending Form H1096, Notification Letter, and sending Form H1095, Treatment Facility Fraud Referral, to the OIG General Investigations Policy and Quality Control Unit Outlook Mailbox. The advisor restores benefits to the individual as outlined in B-800, Restored Benefits.

 

B—445.1.4 Residents Moving Out Before the 16th of a Month

Revision 15-4; Effective October 1, 2015

 

SNAP

The D&A/GLA facility must return at least half of the monthly allotment for residents who move out before the 16th of a month. Therefore, even though the facility can access more than half of the monthly allotment before the 16th, it is not good practice to do so.

The D&A/GLA facility AR knows the full allotment amount from the individual notice. If the EDG has recoupment, the advisor must notify the facility AR so the AR can use the Lone Star Help Desk AVR system (1-800-777-7EBT) to verify monthly benefits.

When using a resident's benefits, D&A/GLA facilities without a POS device must be cautious to ensure they do not use more than half of a month's allotment before the 16th of the month, because they have no POS device to process a return if they spend more than half of a resident's allotment.

 

B—446 Application Processing for Drug and Alcohol Treatment (D&A)/Group Living Arrangement (GLA) Facilities

Revision 15-4; Effective October 1, 2015

 

SNAP

Advisors must process SNAP EDGs for residents in D&A/GLA facilities using one of the following three procedures, depending on the resident's situation at application.

 

B—446.1 New Resident (or Denied Resident with No Benefits in an Electronic Benefit Transfer [EBT] Account) Who Moves into a D&A/GLA Facility and Applies for SNAP

Revision 15-4; Effective October 1, 2015

 

SNAP

  1. The advisor:
  • interviews the AR;
  • advises the AR about the limitations noted on Form H1851, Reference Guide for Drug and Alcohol Treatment (D&A)/Group Living Arrangement (GLA) Facilities;
  • provides EBT training material if the AR has not already received it;
  • sends the PCH record for the facility AR to the EBT system by indicating in the TIERS issuance pages that there is an alternate payee and by filling out Part I of Form H1175, Authorization for Administrative Terminal Application Action, which is sent to EBT staff to data enter into the Administrative Terminal Application (ATA);

Note: Because the PCH must use biographical data to access PIN selection through the Lone Star Help Desk AVR system, the EBT clerk must enter additional data to the PCH record using the Form H1175/ATA process. TIERS does not collect this data on D&A/GLA facility ARs; therefore, TIERS cannot send the information to the EBT system.

At the time of disposition, advisors must ensure that TIERS has successfully included the PCH record for the facility AR by reviewing the Issuance – Details page and the Alternate Payee – Summary page.

  • disposes the SNAP EDG; and
  • completes and submits Form H1172, EBT Card, PIN and Data Entry Request, to the EBT clerk.
  1. The EBT clerk:
    • securely files the signed, original EBT forms;
    • issues a card to the AR and reports the personal account number (PAN);
    • prints the case/EDG name in the space under the signature field on the back of the Lone Star Card; and
    • enables the AR to select a PIN through the Lone Star Help Desk AVR system.
  2. The facility AR uses the card and PIN to access benefits in the food account. Note: If the resident also receives TANF, the cash account is not available to the D&A/GLA facility AR. The resident has a separate card and PIN for the cash account.

 

B—446.2 Resident Has an Active SNAP EDG (or a Denied-Ongoing SNAP EDG), No Benefits in the Food Account, and All SNAP Household Members Move into the D&A/GLA Facility

Revision 15-4; Effective October 1, 2015

 

SNAP

Advisors follow policy in B-446.1, New Resident (or Denied Resident with No Benefits in an Electronic Benefit Transfer [EBT] Account) Who Moves into a D&A/GLA Facility and Applies for SNAP, except the D&A/GLA facility representative is added as AR for the existing SNAP EDG and the SNAP EDG is certified if it is currently denied.

 

B—446.3 All Other Situations

Revision 15-4; Effective October 1, 2015

 

SNAP

Advisors assign the resident a new SNAP EDG number and certify the resident using the new EDG number to establish a separate EBT food account as a resident of a D&A/GLA facility with a facility AR.

  • If the resident is on an active SNAP EDG (and all members are not moving into the facility), the individual is removed from the existing EDG before being certified on a new case. This resident's application is processed using procedures in B-446.1, New Resident (or Denied Resident with No Benefits in an Electronic Benefit Transfer [EBT] Account) Who Moves into a D&A/GLA Facility and Applies for SNAP.
  • If the resident is currently certified as a single person household on a previous case (but has a remaining benefit balance), the resident is certified for SNAP with a certification period for the remaining months using a different case number. A new Form H1010, Texas Works Application for Assistance — Your Texas Benefits, is not required. The file date is the first day of the first month of the remaining certification period. The other case is cross referenced in the TIERS Case Comments section of each case.

Advisors enter the facility AR’s information in the Authorized Representative page and indicate in the Issuance – Details page that there is an alternate payee. Complete the subsequent Alternate Payee – Summary page.

Advisors complete and submit Form H1172, EBT Card, PIN and Data Entry Request, and Part I of Form H1175, Authorization for Administrative Terminal Application Action, to the EBT clerk. The EBT clerk enters additional data to the PCH record for the AR through the ATA for the new EDG number. Note: Because the PCH must use biographical data to access PIN selection through the Lone Star Help Desk AVR system, the EBT clerk must send the PCH record using the Form H1175/ATA process. TIERS does not collect this data on D&A/GLA facility ARs; therefore, TIERS cannot send the information to the EBT system.

At the time of disposition, advisors must ensure TIERS has successfully included the PCH record for the facility AR by reviewing the Issuance – Details page and the Alternate Payee – Summary page.

Advisors then follow policy in B-446.1, Numbers 2 and 3.

 

B—447 Resident Moves Out of a Drug and Alcohol Treatment (D&A)/Group Living Arrangement (GLA) Facility

Revision 15-4; Effective October 1, 2015

 

SNAP

Advisors follow these procedures when the resident moves out of the facility;

  1. The facility AR:
    • notifies the advisor of the move, and
    • returns the Lone Star Card (in person) for this account to the local office within three days of the move.
  2. The advisor checks the account balance to ensure the D&A/GLA facility returned the correct amount of benefits. The advisor must ensure that the facility returns to the resident's food account any amount of benefits spent after the resident moved out. Monthly benefits and account balance information are available on the ATA benefit history screen. The ATA transaction history screens provide information to verify the AR did not debit the account after the resident moved out. Transactions are listed by date and time.

Advisors must report violations as noted in B-443.1, Advisor Responsibilities.

  1. After ensuring benefits are properly returned, staff destroy the card according to procedures for returned cards in B-237, Returned Lone Star Cards and PIN Packets.
  2. The advisor follows procedure I or II below.
    1. The facility reports the move and the former resident has not contacted HHSC:
      • Send the EDG name to the EBT system as the new PCH. If necessary, complete Part I of Form H1175, Authorization for Administrative Terminal Application Action, and send to EBT staff, who will use the information to create the new PCH record through the ATA.
      • Immediately remove the AR entries in TIERS including any designations in the Issuance – Details and the Alternate Payee – Summary pages and update the address, if known.
      • Document in TIERS Case Comments the name of the facility and facility AR that are being removed and when. Do not issue a new card and PIN until the former resident requests it.
      • Follow normal adverse action procedures to deny the EDG.

Note: If the advisor fails to remove the AR before denying the EDG, establish a new PCH by updating the PCH record by completing Part III of Form H1175.

  1. Former resident reports the move:
    1. If the former resident moves to another D&A/GLA facility, the advisor must follow the procedure below:
      • Do not deny the existing active case.
      • Remove the former facility AR.
      • Document in TIERS Case Comments the name of the facility and facility AR that are being removed and the name of the new facility and facility AR that are being added and when.
      • Enter the new facility AR’s information in the Authorized Representative page and indicate in the Issuance – Details page that there is an alternate payee. Complete the subsequent Alternate Payee – Summary page.
      • Complete Form H1172, EBT Card, Pin and Data Entry Request, to issue a card and enable the new AR to select a PIN through the Lone Star Help Desk AVR system.
      • Complete Part I of Form H1175 and send to EBT staff, who will use the information to complete the new PCH record on the new AR via the ATA.

Note: Because the PCH must use biographical data to access PIN selection through the Lone Star Help Desk AVR system, the EBT clerk must enter additional data to the PCH record using the Form H1175/ATA process. TIERS does not collect this data on D&A/GLA facility ARs; therefore, TIERS cannot send the information to the EBT system.

At the time of disposition, advisors must ensure that TIERS has successfully included the PCH record for the new facility AR by reviewing the Issuance – Details page and the Alternate Payee – Summary page.

  • The EBT clerk securely files the signed, original EBT forms; issues a card to the AR; reports the PAN; prints the case/EDG name in the space under the signature field on the back of the Lone Star Card; and enables the AR to select a PIN through the Lone Star Help Desk AVR system.
  1. If the former resident moves in with another active SNAP household and the former resident will participate with that household, the advisor follows the procedure below:
    • Deny the active D&A/GLA case and send Form TF0001, Notice of Case Action, following regular adverse action procedures.
    • Send the case name to the EBT system to change the PCH on the case by removing all AR-related entries in TIERS including any designations in the Issuance – Details and the Alternate Payee – Summary pages.
    • Change the address to the resident's new address.
    • Document in TIERS Case Comments the name of the facility and facility AR that are being removed and when. Cross reference the other case in the TIERS Case Comments section of each case.
    • If there are still benefits in the account, process Form H1172 to give the former resident access to the account by issuing a card and enabling the individual to select a PIN through the Lone Star Help Desk AVR system.
    • If necessary, complete Part I of Form H1175 and send to EBT staff, who will use the information to create the new PCH record through the ATA.
    • Add the former resident to the other household's SNAP EDG effective for the month after any final benefits are received.
  2. If the former resident moves and no longer lives in a D&A/GLA facility or does not participate with another active SNAP household, use the following special procedure to move the former resident's remaining months of SNAP certification to a different case (and thus a new food account):
    • Send the case name to the EBT system to change the new PCH on the currently active case by removing all AR-related entries in TIERS including any designations in the Issuance – Details and the Alternate Payee – Summary pages.
    • Change the address to the resident's new address.
    • Document in TIERS Case Comments the name of the facility and facility AR that are being removed and when.
    • Deny the former resident's active SNAP EDG. Do not send notice of adverse action since benefits are not actually being denied.
    • Certify the former resident for SNAP with a certification period for the remaining months using a different case number. (Use a previous, denied-ongoing case number and associate the case number during Application Registration, if the former resident has one.) Do not require a new Form H1010, Texas Works Application for Assistance — Your Texas Benefits. The file date is the first day of the first month of the remaining certification period. Cross reference the other case in the TIERS Case Comments section of each case.
    • Process Form H1172 to give the former resident access to the account(s) by issuing a new card and enabling the individual to select a new PIN through the Lone Star Help Desk AVR system.
    • If necessary, complete Part I of Form H1175 and send to EBT staff, who will use the information to create the new PCH record through the ATA.

 

B—448 Drug and Alcohol Treatment (D&A)/Group Living Arrangement (GLA) Facility Replaces the Authorized Representative (AR)

Revision 15-4; Effective October 1, 2015

 

SNAP

To replace an AR, the D&A/GLA facility must provide the advisor a written request.

If a D&A/GLA facility replaces the AR, the local office may avoid replacing cards for all the residents' accounts. Advisors must:

  • change the name of the AR on all applicable TIERS cases by replacing the former facility AR with the new individual in the Authorized Representative page and the Alternate Payee Summary page. Advisors must document for each case the change and when the change occurred in TIERS Case Comments.
  • complete Part III of Form H1175, Authorization for Administrative Terminal Application Action, to update the existing PCH record to reflect the new AR name and biographical information. The advisor must not create a new PCH record.

Note: Because the PCH must use biographical data to access PIN selection through the AVR, the EBT clerk must send the PCH record using the Form H1175/ATA process. TIERS does not collect this data on D&A/GLA facility ARs; therefore, TIERS cannot send this information to the EBT system.

At the time of disposition, advisors must ensure that TIERS has successfully included the PCH record for the new facility AR by reviewing the Issuance – Details page and the Alternate Payee – Summary page.

EBT staff securely file the original, signed Form H1175 with the daily paperwork and the associated Form H1172, EBT Card, PIN and Data Entry Request. The office must ensure that the new AR gets a new PIN for each account.

Note: Advisors must complete a new Form H1846, Facility Authorized Representative Interview, at the first certification interview following replacement of the AR.

 

B—449 Verification Requirements

Revision 15-4; Effective October 1, 2015

 

SNAP

Advisors must verify that the GLA meets the eligibility criteria in B-442, Residents of Group Living Arrangement (GLA) Facilities.

Related Policy
Questionable Information, C-920
Providing Verification, C-930

 

B—450 Residents in Family Violence Shelters

Revision 13-4; Effective October 1, 2013
 

 

B—451 Eligibility Requirements

Revision 16-3; Effective July 1, 2016

 

SNAP

Individuals residing in a family violence shelter may be potentially eligible for SNAP, regardless of the number of meals the shelter provides, if the family violence shelter is an approved institution. A family violence shelter is an approved institution if it is either:

  • a certified SNAP retailer: or
  • a public or private nonprofit facility.

Individuals residing in family violence shelters that are not approved institutions are potentially eligible for SNAP only if the facility provides half of their meals or less as described in B-490, Determining Whether an Individual Who Resides in a Facility Is Institutionalized.

Residents in eligible family violence shelters may receive SNAP benefits as individual household units or as part of a group of individuals like any other household.

Residents in family violence shelters may apply for SNAP and use SNAP benefits on their own behalf. They may also appoint a shelter representative or another person to act as AR and/or secondary cardholder.

Resident households must meet the same income and resource standards as other households. Resources held jointly with the person who abused the individual are considered as inaccessible. Room payments to the shelter are considered as shelter expenses. These households have the same rights to notices of adverse action, fair hearing, and lost benefits as other households. Residents should be registered for work unless otherwise exempt.

The usual processing standards for initial and later eligibility decisions, handling reported changes and other actions, and usual verification and documentation requirements apply to residents in shelters for battered persons.

Related Policy
Nonmembers, A-232.1
Determining Whether an Individual Who Resides in a Facility Is Institutionalized, B-490

 

B—452 Approved Centers That Provide Meals

Revision 15-4; Effective October 1, 2015

 

SNAP

Family violence shelters that provide meals must be public or private nonprofit residential facilities that serve victims of family violence. If a facility serves other people, part of the facility must be set aside on a long-term basis to serve only family violence victims.

Advisors must verify the shelter's status as a nonprofit organization by seeing a current certificate from the IRS or a document from the Texas State Comptroller of Public Accounts. If the shelter is a USDA-certified retailer, the shelter's eligibility is verified.

 

B—452.1 Buying Meals

Revision 13-4; Effective October 1, 2013

 

SNAP

Individual households may use their SNAP benefits to buy meals prepared for them at a shelter that is a USDA-certified retailer.

 

B—453 Authorized Representatives

Revision 01-3; Effective April 1, 2001

 

SNAP

Employees of facilities that are USDA-certified retailers may not be authorized to serve as AR/secondary cardholders unless HHSC decides that there are no other representatives available.

If the shelter is not a USDA-certified retailer, the household may authorize a shelter representative as secondary cardholder.

 

B—454 Participation Twice in Same Month

Revision 10-4; Effective October 1, 2010

 

SNAP

A shelter resident can qualify for a duplicate SNAP benefit in a single month if:

  • the resident's former household already received benefits for the month; and
  • the resident's former household was based on a household size that included the resident, any children, and the person who abused or threatened to abuse them.

 

B—454.1 Duplicate Participation Procedures

Revision 15-4; Effective October 1, 2015

 

SNAP

Advisors must take action to remove the resident from the former household's case.

Special certification procedures based on entries made on the Living Arrangements screen allow duplicate participation until the resident is removed from the former household. The advisor must establish a new SNAP case and food account for the individual whether or not the individual is the case name or has a Lone Star Card on the previous case. The individual must complete a new Form H1010, Texas Works Application for Assistance — Your Texas Benefits.

If the individual has not been removed from the former case, the advisor must:

  • complete the certification process;
  • issue the individual a new Lone Star Card and PIN following procedures in B-233, Issuing a Lone Star Card;
  • enable the individual to select a PIN through the Lone Star Help Desk AVR unit following the procedures in B-234, Personal Identification Number (PIN) Selection and Issuance; and
  • issue benefits according to procedures in B-252, Benefit Issuance on Applications.

 

B—460 Prepared Meal Services

Revision 13-4; Effective October 1, 2013

 

 

B—461 Communal Dining or Meal Delivery Services

Revision 15-4; Effective October 1, 2015

 

SNAP

Eligible individuals and their spouses may use SNAP benefits to purchase prepared meals through communal dining or meal delivery services authorized by FNS.

To be eligible, a household member must:

  • be age 60 or older;
  • be housebound;
  • have a physical disability;
  • have a disability to the extent the member is unable to adequately prepare all meals; or
  • be receiving SSI.

 

B—462 Prepared Meals for Homeless

Revision 12-2; Effective April 1, 2012

 

SNAP

Homeless individuals may use SNAP benefits to purchase prepared meals from meal providers authorized by FNS.

 

B—463 Advisor Responsibilities

Revision 15-4; Effective October 1, 2015

 

SNAP

The Lone Star Card does not identify individuals qualifying for communal dining, meal delivery, or homeless individuals eligible for prepared meals. If the individual requests verification of his/her qualification for prepared meal services, the advisor must:

  • issue Form H1803, Food Stamp Identification Card; and
  • enter the appropriate code as follows:
    • C – Communal dining
    • M – Meal delivery
    • H – Homeless
    • E – Every service

When using Form H1175, Authorization for Administrative Terminal Application Action, to send the PCH record, the advisor must indicate in the endorsement box of Form H1175 either:

  • Communal dining
  • Meal delivery
  • Homeless
  • Every service

 

B—464 EBT Coordinator Responsibilities

Revision 15-4; Effective October 1, 2015

 

SNAP

If a meal-provider representative contacts HHSC about certification procedures, the advisor should refer the meal-provider representative to the EBT coordinator to approve these providers.

The EBT coordinator must ensure through discussion with the meal provider that the establishment:

  • provides meals to homeless people, and
  • is a public or private nonprofit organization as defined by IRS. HHSC may require the provider to present documentation from IRS to verify nonprofit status under §501(c)(3) of IRS regulations.

If the meal provider meets these requirements, the EBT coordinator will:

  • obtain the meal-provider representative's signature on Form H1832, Affidavit for Meal Providers to the Homeless; and
  • refer the provider to USDA, with the original, signed Form H1832, to apply for authorization as a retailer.

 

B—465 Matrix of Prepared Meals, Services, Households and Codes

Revision 15-4; Effective October 1, 2015

 

SNAP

Prepared Meals
SNAP Recipient Communal Dining (Public or Nonprofit Private) Meal Delivery Homeless Meal Provider (Public or Nonprofit Private)
Age 60 or older, not homeless XX XX  
SSI recipient who is under age 60, not homeless XX XX  
Under age 60, not an SSI recipient, housebound, a person with physical disabilities, or has disabilities to the extent they are unable to adequately prepare own meals   XX  
Homeless only     XX
Homeless age 60 or older XX XX XX
Homeless SSI recipient who is under age 60 XX XX XX
Endorsement status allowed to purchase from meal provider Codes C,E Codes C,M,E Codes H,E

Codes:

C – SSI/elderly member authorized to purchase prepared meals from communal dining facilities or meal delivery services.

E – Homeless and either elderly or SSI household authorized to purchase from every service (communal dining, meal delivery services or homeless meal providers).

H – Homeless household authorized to purchase from homeless meal provider.

M – Housebound or a member with a disability authorized to purchase from meal delivery service.

 

B—466 Loss of SNAP Identification (ID) Card (Form H1803)

Revision 15-4; Effective October 1, 2015

 

SNAP

When replacing a lost or damaged ID card, the advisor must:

  • verify the identity of the person requesting the replacement,
  • ensure the person is authorized to act for the household, and
  • issue a new SNAP ID card.

 

B—470 Categorically Eligible Households

Revision 05-5; Effective October 1, 2005

 

SNAP

Categorically eligible households are subject to fewer eligibility requirements than other SNAP households. HHSC uses special procedures to process applications from persons who potentially meet the categorical eligibility criteria. Categorical eligibility does not mean the applicants automatically receive SNAP.

 

B—471 Eligibility Criteria

Revision 15-4; Effective October 1, 2015

 

SNAP

SNAP households meet categorical eligibility criteria if:

  • all members are approved for TANF cash assistance or SSI; or
  • the household:
    • meets the resource criteria to be authorized to receive TANF Non-cash (TANF-NC) services (see A-1210, General Policy); and
    • has gross income less than or equal to 165 percent of the Federal Poverty Income Limit (FPIL) for its size.

This also includes households that have:

  • active EDGs but whose benefits are being recouped; or
  • a disqualified alien member or student who does not get TANF/SSI.

The household is not categorically eligible if:

  • one or more members are disqualified from TANF or SNAP for an IPV; or
  • the entire household is ineligible because the primary wage earner (PWE) failed to comply with E&T or voluntary quit requirements; or
  • if the household is otherwise ineligible due to one or more members' disqualification for any reason.

For TANF-NC, a household is not categorically eligible if one or more members has a current SNAP IPV disqualification. If the household meets the combined resource limit of $5,000 for liquid assets and excess vehicle value, the household is still authorized to receive TANF-NC, and their remaining resources are exempt. The household is not exempt from the gross/net income limits.

 

B—472 Special Treatment for Households Meeting Categorical Eligibility Criteria

Revision 15-4; Effective October 1, 2015

 

SNAP

Categorically Eligible TANF/SSI Households

Categorically eligible households are not subject to the resource or gross/net income limits. These households are exempt from verification requirements regarding:

  • Social Security numbers (SSNs),
  • resources,
  • residence, and
  • sponsored alien information.

Categorically Eligible TANF-NC Households

TANF-NC categorically eligible households are not subject to the gross/net income limits. Once the household passes the resource criteria for TANF-NC, the remaining non-liquid resources are exempt. TANF-NC categorically eligible households must comply with all other eligibility criteria.

Related Policy
General Policy, A-1210
Limits, A-1220
Prepaid Burial Insurance, A-1233.2
Vehicles, A-1238
How to Determine Fair Market Value of Vehicles, A-1238.5
General Policy, A-1310
Special Provisions for Households with Elderly Members or Members with a Disability, B-433

 

B—473 Application Processing

Revision 15-4; Effective October 1, 2015

 

SNAP

Advisors must follow these procedures when processing a joint application for TANF and/or SSI and SNAP:

If the TANF/SSI application is pending and the household... then ...
is eligible for SNAP without meeting categorical eligibility criteria, certify the SNAP application as soon as possible. Follow normal SNAP time frames.
will not be eligible for SNAP unless the TANF or SSI application is granted,

delay denial of the SNAP EDG. Pend the SNAP application for up to 30 days awaiting the TANF/SSI decision. If the TANF/SSI application is denied on or before the 30th day, deny the SNAP application immediately.

If the TANF/SSI application is granted by the 30th day, certify for SNAP as soon as possible. Prorate from the SNAP application date.

If the TANF/SSI application is still pending by the 30th day:

  • deny the SNAP application; and
  • notify the individual on the denial notice to contact the certification office if the TANF/SSI is later granted.

If the TANF/SSI application is granted after the 30th day:

  • copy Form H1010, Texas Works Application for Assistance — Your Texas Benefits, and return the original to the applicant (the applicant must initial any changes, re-sign Form H1010, and return it to the local eligibility determination office);
  • reopen the SNAP application when Form H1010 is returned;
  • verify and document any changes since the initial interview; and
  • prorate benefits from the original SNAP file date or the effective date of TANF/SSI benefits, whichever is later.*

* When prorating from the effective date of TANF/SSI benefits, use this date as the new SNAP file date. The effective date of benefits for TANF is the earlier of the certification date or 30 days after the file date. The effective date of benefits for SSI applicants is the:

  • SSI file date; or
  • date the individual met all eligibility criteria, if later than the file date.

Advisors must verify the SSI benefit effective date by viewing the award letter or by running Wire Third-Party Query (WTPY) or the State Online Query (SOLQ).

 

B—474 Centralized Benefit Services (CBS) Section

Revision 13-4; Effective October 1, 2013

 

SNAP and Medical Programs

CBS is a centralized section that processes certain types of cases statewide.

Related Policy
Specialized and Centralized Casework Units, C-1471

 

B—474.1 Programs Administered by CBS

Revision 13-4; Effective October 1, 2013

 

SNAP and Medical Programs

CBS administers SNAP and Medical Programs for several individual groups. For information concerning the SNAP Combined Application Project (SNAP-CAP), which is one of the programs that CBS administers, see B-475, Supplemental Nutrition Assistance Program Combined Application Project (SNAP-CAP).

 

B—474.1.1 SNAP Programs

Revision 18-1; Effective January 1, 2018

 

SNAP

CBS administers SNAP for:

  • pure categorically eligible SSI households:
    • either through the SNAP-SSI caseload; or
    • as part of SNAP-CAP.

 

B—474.1.1.1 SNAP-Supplemental Security Income (SSI) Caseload

Revision 15-4; Effective October 1, 2015

 

For the SNAP-SSI caseload, Texas is operating under a waiver that allows the state to process both timely and untimely redeterminations without an interview.

CBS staff may complete a redetermination for SNAP-SSI EDGs without an interview except in the following situations:

  • the household requests an interview,
  • the case contains earned income, or
  • it appears the household is going to be denied.

Advisors cannot deny redetermination households for a missed appointment, except for a case with earned income. For the other two situations, staff must schedule an appointment and attempt to conduct an interview but continue to process the redetermination application if the household misses the appointment. If the household is ineligible, the EDG must be denied for the appropriate reason rather than a missed appointment.

If the household submits a redetermination application by the last day of the last benefit month, no interview is required. If the file date falls after the last day of the last benefit month, an interview is required. These households may be denied for a missed appointment.

For untimely submitted redetermination applications, the initial application processing time frames are used, as stated in B-124, Processing Untimely Redeterminations.

 

B—474.1.1.2 Pending SNAP-SSI Redeterminations for Missing Information/Verification

Revision 15-4; Effective October 1, 2015

 

If more information is needed from the household to complete the redetermination, the advisor must attempt to contact the household immediately by telephone to obtain the information. If unable to reach the household by telephone, the advisor must mail Form H1830, Application/Review/Expiration/Appointment Notice, with the advisor’s telephone number, advising the household to call the advisor on a specific date and time, along with Form H1020, Request for Information or Action, clearly explaining the information/verification that is required.

Combining the pending information notice and the appointment notice in one envelope will help staff complete the redetermination timely, rather than waiting to schedule the appointment later if the household fails to provide requested information. The advisor should mail Form H1830-I, Interview Notice (Applications or Reviews), the same day the EDG is identified as one that must be scheduled for an interview, or no later than the next workday.

Households must be allowed the usual 10 days to provide the missing information/verification.

If the household member misses the scheduled appointment, a missed appointment notice is not required. The advisor should continue to attempt to process the EDG without an interview.

 

B—474.1.1.3 SNAP-SSI Redeterminations– Inconsistent or Discrepant Information

Revision 15-4; Effective October 1, 2015

 

While processing SNAP-SSI redeterminations, advisors may notice inconsistent or discrepant information (including management problems). If this occurs, the advisor must contact the household (and pend the EDG if necessary) to resolve the inconsistency. If unable to reach the household by telephone, the advisor must mail Form H1830, Application/Review/Expiration/Appointment Notice, with the advisor’s telephone number, advising the household to call the advisor on a specific date and time, along with Form H1020, Request for Information or Action, clearly explaining the information/verification that is required.

For the SNAP-SSI population, advisors should pay careful attention to shelter costs since this area historically is the most prone to quality control errors. Advisors should establish the actual costs the individual pays, review the current application's reported expenses compared to the previous entries, and resolve any inconsistencies or discrepant information.

 

B—474.1.1.4 SNAP-SSI Redetermination Denials

Revision 15-4; Effective October 1, 2015

 

With the exception of cases with earned income, the policy on scheduling an interview before denying a household's request to recertify SNAP benefits is a federal condition of HHSC's waiver approval. The policy is intended to ensure the household has an opportunity to explore continued eligibility before being denied. Additionally, advisors must review facts about the EDG, the household's income and all possible deductions for which the household may be eligible, especially ones that are not as commonly claimed, such as medical transportation costs or adult dependent care costs.

If the advisor determines the household appears ineligible while processing the SNAP-SSI redetermination, the advisor must attempt to conduct an interview before the EDG can be denied. The advisor must telephone the household to conduct the interview if a telephone number is available. If unable to reach the household by telephone, the advisor must mail Form H1830, Application/Review/Expiration/Appointment Notice, which contains the advisor's telephone number, notifying the household to call the advisor to complete the redetermination. Form H1830 must be mailed the same day, or no later than the next workday, when the EDG is identified as one that must be scheduled with an interview. Advisors should continue to attempt to process the redetermination, and deny if ineligible using normal processing time frames.

 

B—474.1.2 Medical Programs

Revision 17-2; Effective April 1, 2017

 

CBS administers medical programs for:

  • children placed in or released from a Texas Juvenile Justice Department (TJJD) or Juvenile Probation Department (JPD) facility;
  • former foster care children;
  • women diagnosed with breast or cervical cancer;
  • refugees; and
  • individuals incarcerated in the Texas Department of Criminal Justice (TDCJ) who receive inpatient services.

 

B—474.1.2.1 Child Placed in a Juvenile Facility

Revision 17-2; Effective April 1, 2017

 

The TJJD or JPD notifies HHSC within 30 days of a child's placement in a juvenile facility. Upon notification of the placement, TIERS automatically: 

  • suspends the child's Medicaid eligibility effective the day after HHSC receives the notification if the child is certified for TP 44;
  • terminates the child's Children's Health Insurance Program (CHIP) eligibility effective the day after HHSC receives the notification if the child is certified for CHIP;
  • terminates the child's Medicaid eligibility allowing adequate notice according to policy in A-2344.1, Form TF0001 Required, Adequate Notice, if the child is certified on a Medicaid type other than TP 44; and
  • removes the child from other Eligibility Determination Groups (EDGs) in which the child is included.

Exceptions:

  • Children certified on a Supplemental Security Income (SSI) or Department of Family and Protective Services (DFPS) type of Medicaid are not terminated by HHSC.
  • Children placed in a non-secure facility may receive TP 44 as an independent child. Therefore these EDGs are not suspended or denied when a notification of placement is received for one of these children.

When an exception to the automated process occurs, CBS must manually process the suspension, termination, or removal of the child from associated EDGs.    

Related Policy
Medicaid Suspension, A-825.2

 

B—474.1.2.1.1 Child Placed in a Non-Secure Facility

Revision 18-1; Effective January 1, 2018

 

Children placed in a non-secure juvenile facility with 16 or fewer beds are considered independent children and are potentially eligible for Medicaid. When reporting that a child has been placed in a juvenile facility, TJJD or JPD notifies HHSC if the facility is a secure or non-secure facility.

In general, children placed in a public, non-secure facility with more than 16 beds are not eligible for Medicaid, but children placed in a TJJD or JPD halfway house are not subject to this restriction. Children residing in a TJJD or JPD halfway house with more than 16 beds may be eligible for Medicaid if the halfway house meets the federally required criteria listed in A-241.3.1, Children’s Living Arrangements, and if the children meet all other eligibility criteria.

To determine the correct medical effective date (MED) for children in a non-secure facility, advisors may follow the chart below:

If the child is ...

then ...

not active on Medicaid/Children's Health Insurance Program (CHIP) and the file date is within the same month as the placement date of the child,

the MED is the placement date of the child.

not active on Medicaid/CHIP and the file date is not within the same month as the placement date of the child (that is, the application is filed the month after the placement date),

the MED is the first day of the application month. Note: For unpaid medical bills prior to the file date, follow policy in A-831.1, How to Apply for Three Months Prior Coverage.

active on CHIP,

test for Medicaid eligibility following procedures in A-126.3, Advisor Action for Determining Eligibility for Children.

Exception: If the child is receiving SSI or Foster Care Title IV-E, deny the application.

 

Related Policy
Children's Living Arrangement, A-241.3.1

 

B-474.1.2.2 Child Released from a Juvenile Facility

Revision 17-2; Effective April 1, 2017

 

Upon release from a juvenile facility, HHSC automatically reinstates the TP 44 eligibility for a child whose eligibility was suspended and there are months remaining on the child's original certification period. The effective date of the reinstatement is the date of the child's release from the juvenile facility. The child's eligibility is reinstated even if the case in which the child was originally certified is denied, or if the child is released to a different household than the one in which they were living at the time they were placed. 

If the child is not eligible for reinstatement, but is released to a home in which a sibling is receiving Medicaid or CHIP, the child is automatically added to the case. 

If the child is not eligible for reinstatement and cannot be added to an existing case, staff must send the household an application packet. 

Related Policy
Regular Medicaid Coverage, A-820
Medicaid Reinstatement, A-826
Additions to the Household, B-641

 

B-474.1.2.2.1 Notification of Anticipated Release

Revision 17-2; Effective April 1, 2017

 

Within 30 days prior to a child's release, TJJD or JPD notifies HHSC of the child's anticipated release date. Upon receipt of the information, HHSC determines if the child:

  • is eligible for reinstatement of TP 44 eligibility;
  • can be added to an existing case if not eligible for reinstatement; or
  • must reapply. 

If the child cannot be reinstated because their original certification period has ended or their TP 44 was not suspended or cannot be added to an existing case, CBS staff are notified in the HHSC Action Status field located under the TIERS TJJD/JPD Release page to send the household an application packet, which includes the following:

  • Form H1205, Texas Streamlined Application;
  • postage paid envelope addressed to CBS;
  • cover letter which provides information and instructions for submitting the application and information on how to obtain help in completing the application; and
  • list of Community Partners in the family's area that provide application assistance upon the household's request of assistance. 

Related Policy
Medicaid Reinstatement, A-826

 

B-474.1.2.2.2 Notification of Actual Release

Revision 17-2; Effective April 1, 2017

 

Upon notification from TJJD or JPD of the child's actual release, HHSC automatically reinstates the TP 44 eligibility for a child whose eligibility was suspended and there are months remaining on the child's original certification period. The child's TP 44 eligibility is effective the date of their release and they receive the remaining months of their original certification period.

Examples:

Child is certified for TP 44 from… HHSC receives notification from TJJD or JPD of the child's release from placement on… then the child's TP 44 is…

April 1, 2017 - March 31, 2018.

The TP 44 is suspended on June 3, 2017*

December 2, 2017, reinstated effective December 2, 2017 - March 31, 2018. The child's MED is 12/02/2017.

June 1, 2017 - May 31, 2018.

The TP 44 is suspended on August 19, 2017.*

March 31, 2018, reinstated effective March 31, 2018 - May 31, 2018.

The child's MED is 03/31/2018.

February 1, 2017 - January 31, 2018.

The TP 44 is suspended on July 17, 2017.*

December 19, 2017, reinstated effective December 19, 2017 - January 31, 2018. The child's MED is 12/19/2017.

December 1, 2016 - November 30, 2017.

The TP 44 is suspended on April 1, 2017.*

December 15, 2017, not reinstated, as the child does not have any months remaining on their original certification period. The child is added to an existing case or, if the child cannot be added to an existing case, the household is sent an application packet.

 

*The TP 44 suspension date is based on the date that TJJD or JPD notifies HHSC of the placement. See A-825.2, Medicaid Suspension. 

The child is automatically added to an existing case if the child is not eligible for reinstatement, but has a sibling receiving Medicaid or CHIP. The child is also added to any other EDGs on the case of which the child is required member. 

When an exception to the automated process occurs, CBS must manually process the reinstatement or add the child to an existing case. 

Within two business days of notification of the child's release, CBS staff must process and dispose any pending applications. 

CBS accepts applications up to and including the 14th calendar day after the confirmed date of release. Any applications received after the 14th day are routed to the local office for processing.

CBS reports to TJJD via the Juvenile Medicaid Tracker one of the following:

  • the child has Medicaid or CHIP;
  • the child was denied;
  • the CBS unit never received the application; or
  • the application was sent to the local office. 

If the child is eligible for Medicaid, the MED cannot be any earlier than the release date.

Related Policy
Adverse Actions Not Requiring Advance Notice, A-2344
Enrollment, D-1700
Regular Medicaid Coverage, A-820
Medicaid Reinstatement, A-826
Additions to Household, B-641

 

B-474.1.2.3   Medicaid for Transitioning Foster Care Youth

Revision 17-2; Effective April 1, 2017

 

Policy for TP 70 — Medicaid for Transitioning Foster Care Youth (MTFCY), is explained in Part M, Medicaid for Transitioning Foster Care Youth (MTFCY).

 

B-474.1.2.4 Former Foster Care in Higher Education

Revision 17-2; Effective April 1, 2017

 

Policy for type Assistance (TA) 77 — Former Foster Care in Higher Education (FFCHE), is explained in Part F, Former Foster Care in Higher Education (FFCHE).

 

B-474.1.2.5 Medicaid for Breast and Cervical Cancer

Revision 17-2; Effective April 1, 2017

 

Policy for TA 66 — Medicaid for Breast and Cervical Cancer (MBCC)-Presumptive, and TA 67 — MBCC, is explained in Part X, Medicaid for Breast and Cervical Cancer (MBCC).

 

B-474.1.2.6 Former Foster Care Children

Revision 18-1; Effective January 1, 2018

 

Policy for TA 82 — Medicaid for Former Foster Care Children (FFCC), is explained in Part E, Former Foster Care Children (FFCC).

 

B-474.1.2.7 Medicaid Coverage for Inmates of a Public Institution

Revision 18-1; Effective January 1, 2018

 

The policy and processes stated in this section only apply to inmates of the Texas Department of Criminal Justice (TDCJ) and do not apply to any other state, county, or city jails. Applications are submitted to HHSC only by The University of Texas Medicaid Branch at Galveston. 

An inmate of a public institution is eligible for Medicaid coverage if the following conditions are met:

  • The inmate meets Medicaid eligibility requirements. Inmates who are pregnant and children through age 18 could meet current Medicaid eligibility requirements. 
  • The inmate receives inpatient services.
  • The inpatient services are provided by a hospital that is not on the premises of a prison, jail, detention center, or other penal setting, including a facility run by a private health care entity.

The Medicaid coverage is limited to the specific days the inmate is admitted as a patient receiving inpatient services as verified by the medical provider using Form H1046, Inpatient Medical Services Certification. Inpatient services are those provided on the recommendation of a physician or dentist and received in a medical institution. The individual must receive or expect to receive room, board, and professional services in the institution for a 24-hour period or longer. 

If the inmate is ineligible due to U.S. citizenship or alien status, the medical provider must also complete Form H3038, Emergency Medical Services Certification. The ineligible inmate is eligible only for those dates verified as an emergency, even if the inpatient treatment continues after the verified emergency dates. 

The incarcerated individual is only eligible for prior coverage. 

The TDCJ or its designee submits the following documents to HHSC via fax:

  • Form H1205, Texas Streamlined Application, on behalf of the inmate the month following the month the eligible hospital bill was incurred;
  • Form H1046;
  • Form H3038, if applicable; and
  • all required verification, such as verification of citizenship, alien status, etc.

Note: If the required information or verification is not received, staff must call or send secure email to the designated TDCJ contact.

Upon disposition of the application, staff must send Form TF0001, Notice of Case Action, to the address of the representative provided on Form H1205. 

 

B—474.2 Conversion of EDGs

Revision 13-4; Effective October 1, 2013

 

SNAP

EDGs are converted to CBS when all members meet all SNAP eligibility requirements that pertain to categorically eligible households, receive SSI, and no individual is disqualified for:

  • able-bodied adults without dependents (ABAWD) time limits,
  • fleeing as a felon,
  • an IPV,
  • refusal to cooperate with a Quality Control review,
  • E&T noncooperation,
  • SSN noncooperation,
  • student status, or
  • felony drug conviction.

Note: Additionally, in order to be eligible for conversion to the SNAP-SSI caseload, no individual can reside in a group living arrangement, drug/alcohol treatment center or boarding house, or have earned income, including self-employment income.

After the local office completes an initial certification, an automated process converts EDGs that meet the criteria to CBS. The automated process occurs monthly at cutoff. The individual is mailed a notice to inform the individual:

  • that the EDG is handled by CBS, and
  • to report household changes by:
    • telephoning 2-1-1, or
    • entering the change in the Self-Service Portal, or
    • mail.

The notice includes contact information. Field staff continue to accept changes and complete case actions until the EDG converts to CBS.

 

B—474.3 Methods of Reporting Changes

Revision 15-4; Effective October 1, 2015

 

SNAP and Medical Programs

Local office staff may fax changes to CBS. The vendor will create a task for online or mailed changes.

Related Policy
Reporting Requirements, B-620

 

B—474.4 Reserved

Revision 15-4; Effective October 1, 2015

 

 

B—474.5 Replacement of Lone Star Cards/PINs/Medical Care IDs

Revision 15-4; Effective October 1, 2015

 

SNAP

See procedures in B-243, Centralized Benefit Services (CBS) Cases, for CBS individuals who request card or PIN replacements.

Medical Programs

Replacement or temporary medical care ID cards (Form H1027-A, Medicaid Eligibility Verification; Form H1027-B, Medicaid Eligibility Verification - MQMB; and Form H1027-C, Medicaid Eligibility Verification - QMB) must be issued by local eligibility determination offices. The individual can print an image of the medical care identification card and request a replacement online through YourTexasBenefits.com, or call 1-855-827-3748 to request a replacement.

 

B—474.6 Moving Cases Out of CBS

Revision 15-4; Effective October 1, 2015

 

SNAP

The CBS section:

  • moves cases out of the CBS caseload if:
    • the household no longer meets the criteria to be a CBS case (earnings, loss of SSI);
    • household composition changes; or
    • because regional staff request the transfer under special circumstances;
  • shortens the certification period as specified in B-474.6.1, Special Procedures for Shortening Certification Periods for Centralized Benefit Services (CBS) Eligibility Determination Groups (EDGs); and
  • documents in TIERS Case Comments the reason for return.

The CBS section also returns untimely redetermination EDGs received in the month after the last benefit month to the task queue and documents in TIERS Case Comments the reason for return.

Medical Programs

Children's MedicaiD – CBS moves completed Medicaid determinations, both active and denied, out of the CBS section.

 

B—474.6.1 Special Procedures for Shortening Certification Periods for Centralized Benefit Services (CBS) Eligibility Determination Groups (EDGs)

Revision 15-4; Effective October 1, 2015  

 

SNAP

If the household reports a change that results in the household no longer meeting CBS caseload criteria, such as the loss of SSI benefits, an addition to the household, or moving into a GLA, then CBS staff move the EDG out of the CBS caseload.

Before moving the EDG out of the CBS caseload, CBS must take appropriate action based on the following criteria:

If the household's certification period is in ... then ...
month 1-11, if benefits:
  • will increase or decrease, send the household Form TF0001, Notice of Case Action, informing the individual that the last benefit month is month 12; and
  • shorten the certification period to a 12-month total by processing a change action with the new benefit amount and change the last benefit month to month 12.
month 12-36, if benefits:
  • are being increased or decreased, send the household Form TF0001, Notice of Case Action, informing the household that the certification period is being shortened because it no longer meets the criteria specified in B-474, Centralized Benefit Services (CBS) Section; and
  • shorten the certification period to end on the last day of the month after the month Form TF0001 was sent.
Note: CBS staff also must include Form H1830, Application/Review/Expiration/Appointment Notice, and Form H1010, Texas Works Application for Assistance — Your Texas Benefits, advising the individual how to file future applications.

 

B—474.7 Denied EDGs

Revision 15-4; Effective October 1, 2015

 

SNAP

The local office must perform an inquiry on denied EDGs to ensure the CBS section is not in the process of certifying the EDG.

Note: Advisors must accept Form H1840, SNAP Food Benefits Renewal Form, if received at the local office and the CBS SNAP EDG certification period has expired.

Medical Programs

The local office must coordinate with CBS to determine the effective date of certification when a youth certified for TP 70, TA 82, or TP 44 (Medicaid coverage to eligible youths in the custody of or released from the Texas Juvenile Justice Department), or an adult certified for TA 67, applies for Medicaid.

 

B—474.8 Opportunity to Register to Vote

Revision 15-4; Effective October 1, 2015

 

All Programs

Advisors must mail Form H0025, HHSC Application for Voter Registration, to households who do not have a face-to-face interview, unless Form H0025 is requested through the Voter Registration Information Individual Demographic screen.

If the individual contacts the local office to decline the opportunity to register to vote after receipt of Form H0025, the advisor should mail Form H1350, Opportunity to Register to Vote, to the individual for a signature. The advisor sends the completed Form H1350 for imaging and retains the form for 22 months.

Related Policy
Registering to Vote, A-1521

 

B—475 Supplemental Nutrition Assistance Program Combined Application Project (SNAP-CAP)

Revision 13-4; Effective October 1, 2013

 

 

B—475.1 Overview

Revision 16-3; Effective July 1, 2016

 

SNAP-CAP

SNAP-CAP is a demonstration project to outreach older SSI recipients not currently certified for SNAP. Single SNAP-CAP households are certified for either a $65 or $95 standard SNAP-CAP allotment based on their reported monthly shelter expense.

If the household reports that the monthly shelter expense is less than $ 400 per month, the monthly SNAP-CAP allotment is $65. If the household reports that the monthly shelter expense is more than or equal to $ 400 per month, the monthly SNAP-CAP allotment is $95.

To be eligible for SNAP-CAP, an individual must:

  • be an SSI recipient,
  • be age 50 or older,
  • reside in Texas,
  • not reside in an institution that causes ineligibility, and
  • not receive regular SNAP benefits.

Additionally, an individual is not eligible to participate in SNAP-CAP if the person:

  • is a fleeing felon,
  • is disqualified for an IPV, or
  • is disqualified due to a felony drug conviction that occurred on or after September 1, 2015 as described in A-232.2, Disqualified Persons.

No other regular SNAP eligibility criteria apply to SNAP-CAP. Note: Individuals may switch from SNAP to SNAP-CAP as described in B-475.2.2, Switching from the Regular SNAP Program to SNAP-Combined Application Project (CAP).

 

B—475.2 Application Processing

Revision 15-4; Effective October 1, 2015

 

SNAP-CAP

State office identifies potential SNAP-CAP recipients via the Texas State Data Exchange (SDX) match process. State office automatically mails a form to individuals potentially eligible for SNAP-CAP. For individuals who previously received SNAP benefits in Texas, the mail out occurs two months after the last month individuals last received benefits in Texas. CBS certifies the SNAP-CAP EDG for 36 months, provides notice of eligibility, and authorizes an EBT account without a face-to-face or telephone interview.

If an individual receives a SNAP-CAP application and also applies for SNAP at the local office, advisors coordinate the application process with CBS staff before making an eligibility decision in the local office to ensure that the individual can make an informed choice about which program the individual prefers. The individual may voluntarily withdraw the other application.

If the spouse of an active SNAP-CAP participant submits an application at the local office, advisors certify the spouse separately from the active SNAP-CAP participant. If the spouse appears potentially eligible for SNAP-CAP, the advisor explains the program and requirements outlined in B-475, Supplemental Nutrition Assistance Program Combined Application Project (SNAP-CAP). The SNAP application may be withdrawn if the individual wants to participate in SNAP-CAP. Refer the individual to 2-1-1. Advisors must document that the individual was informed of the program, but that the individual withdrew the SNAP application.

A SNAP-CAP application returned to a local eligibility determination office must be faxed to the non-expedited fax line at 1-877-447-2839 the same day it is received.

Expedited processing and benefit proration do not apply to the SNAP-CAP program. A standard allotment is issued for the month the application is returned.

 

B—475.2.1 Identifying Intentional Program Violations (IPVs) and Felony Drug Convictions

Revision 15-4; Effective October 1, 2015

 

SNAP-CAP

The Data Broker vendor will receive the monthly SNAP-CAP application file and will notify state office Eligibility Operations of any clients with active out-of-state SNAP IPV disqualifications and felony drug convictions.

State office staff will forward any IPV matches to the Customer Care Center-Electronic Disqualified Recipient System (CCC-eDRS) staff using secure Voltage email at HHSC Office of Eligibility Services CCC Open Investigation (HHSC OES CCC IC) who will complete a secondary verification and then forward a completed Form H1856, SNAP Out-of-State Intentional Program Violations, to OIG at CDU@hhsc.state.tx.us, and document this action in TIERS Case Comments.

OIG Centralized Disqualification Unit (CDU) staff will enter the IPV disqualification data from Form H1856 into TIERS and create a reported change task to notify the advisor of the disqualification. The CBS advisor then takes appropriate action to deny the application/EDG. Note: If CBS staff has not yet processed the application, TIERS will ensure it is denied if the application is subsequently filed and/or processed.

State office also shares any felony drug conviction data matches with CBS. CBS staff must follow policy in A-232.2, Disqualified Persons, to take adverse action.

 

B—475.2.2 Switching from the Regular SNAP Program to SNAP-Combined Application Project (CAP)

Revision 15-4; Effective October 1, 2015

 

SNAP-CAP

If an SSI recipient receiving regular SNAP benefits wants to switch to SNAP-CAP, the individual must contact CBS staff and request to withdraw from the regular program and apply for SNAP-CAP.

Within 10 days of receipt of the request and determination that the individual meets SNAP-CAP eligibility requirements, CBS staff:

  • send the individual a notice of denial for the regular SNAP, using adequate notice procedures;
  • terminate the person's participation in the regular SNAP as soon as possible (that is, the end of the month the individual made the request if the 10th day falls before the monthly computer cutoff, and no later than the end of the next month); and
  • send the individual a SNAP-CAP application if the individual has not already filed one with CBS.

If HHSC fails to take action within 10 days to authorize denial of the regular SNAP EDG for the applicable month, HHSC restores any lost benefits as a result of untimely agency action.

HHSC does not provide a SNAP-CAP application to anyone who does not meet the SNAP-CAP eligibility criteria. CBS also certifies eligible individuals for SNAP-CAP if the individuals submit applications they obtained on their own. CBS will coordinate termination of the individual's participation in regular SNAP, if not already terminated. To avoid duplication of SNAP benefits when an eligible individual requests to switch from the regular SNAP to SNAP-CAP, CBS staff use a file date equal to the first day of the first month the individual qualifies for SNAP-CAP, if that date is later than the date the application form is actually received. CBS staff must document in TIERS Case Comments the reason for the modified file date as compared to the date on the application form.

Note: CBS staff may also cancel a month's regular SNAP issuance in order to expedite the recipient's switch to SNAP-CAP, if it is not too late to cancel that issuance. Refer to B-331, Cancelling Benefits in EBT Accounts.

 

B—475.3 Household Composition

Revision 15-4; Effective October 1, 2015

 

SNAP-CAP

A SNAP-CAP food unit consists of one person. Married individuals who are both receiving SSI are considered separate households and certified on individual SNAP-CAP EDGs. (See A-231, Who Is Included.)

A SNAP-CAP participant who resides in a household in which other members receive SNAP through the regular program is considered a separate household, regardless of how they purchase and prepare their meals. (See A-232.1, Nonmembers.)

Do not include a SNAP-CAP participant when determining regular SNAP eligibility for other household members. Follow policy in A-1326.1.1, Contributions from Noncertified Household Members.

A minor child residing with a SNAP-CAP participant may be certified as SNAP head of household. The SNAP-CAP participant must be listed as the AR on the minor child's EDG. (See A-231.)

 

B—475.4 Income

Revision 13-4; Effective October 1, 2013

 

SNAP-CAP

SSI eligibility is verified weekly via the SNAP-CAP participant's SDX record.

 

B—475.5 Shelter and Utility Expenses

Revision 15-4; Effective October 1, 2015

 

SNAP-CAP

Advisors follow policy in A-1429, Shelter Costs, for separate households sharing shelter expenses, including standard utility allowance (SUA)/basic utility allowance (BUA), if applicable.

 

B—475.6 Changes

Revision 15-4; Effective October 1, 2015

 

SNAP-CAP

SNAP-CAP participants are not required to report changes. CBS processes shelter and address changes reported by SNAP-CAP participants.

CBS will mail Form H0025, HHSC Application for Voter Registration, to the individual when the individual reports a change of address. If the individual contacts CBS to decline the opportunity to register to vote after receipt of Form H0025, CBS will mail Form H1350, Opportunity to Register to Vote, to the individual for a signature. After the household returns Form H1350, the advisor sends the form for imaging and retains the image for 22 months.

State office uses SDX records to automatically update individual information on a weekly basis. The weekly SDX update results in a SNAP-CAP EDG denial if the individual no longer receives SSI, dies or moves to a nursing home.

Related Policy
Registering to Vote, A-1521

 

B—475.7 Issuing Benefits

Revision 15-4; Effective October 1, 2015

 

SNAP-CAP

CBS authorizes a SNAP-CAP participant's EBT account. Replacement EBT cards may be obtained from local eligibility determination offices if the local office replacement criteria are met. Advisors follow policy in B-235.1, Lone Star Card Replacement Procedures, to determine whether the SNAP-CAP participant can get a replacement card locally or must obtain it from the Lone Star Help Desk.

Follow policy in B-362, Advisor Action on Dormant Accounts, when a SNAP-CAP EDG is dormant.

 

B—475.8 Fair Hearings

Revision 13-4; Effective October 1, 2013

 

SNAP-CAP

Follow policy in B-1000, Fair Hearings.

 

B—475.9 Claims

Revision 15-4; Effective October 1, 2015

 

SNAP-CAP

Advisors file an overpayment referral when a household receives benefits it is not entitled to receive. This may occur based on agency error, individual error/misunderstanding, or through fraud or an IPV. OIG receives the overpayment referral and establishes a claim if the referral is valid.

SNAP-CAP households are subject to overpayment referrals and claims. Households may repay benefits through recoupment or through restitution. Recoupment is a method of recovering an overpayment claim by withholding a portion of the household's benefits. Restitution is a method of recovering an overpayment claim by the receipt of payments from the household paid to HHSC.

For additional information, follow policy in B-700, Claims.

 

B—475.10 Redeterminations

Revision 15-4; Effective October 1, 2015

 

SNAP-CAP

State office automatically mails Form H1842, SNAP-CAP Renewal Application, two months before the last benefit month. To reapply in a timely manner, the individual must submit the completed Form H1842 by the 15th day of the last benefit month.

CBS staff must process timely redeterminations by the last workday of the certification period. CBS staff certify the SNAP-CAP EDG for 36 months and provide a notice of eligibility without a face-to-face or telephone interview. Advisors must ensure that the individual's normal issuance cycle is not interrupted.

If CBS receives Form H1842 after the 15th day of the last benefit month, advisors certify or deny the application by the 30th day after the file date. Expedited processing and benefit proration do not apply to SNAP-CAP.

A Form H1842 returned to a local eligibility determination office must be faxed to CBS the same day it is received. The fax number is 1-877-447-2839.

 

B—475.10.1 Opting Out of SNAP-CAP

Revision 15-4; Effective October 1, 2015

 

SNAP-CAP

Individuals currently receiving SNAP-CAP may choose to apply for traditional SNAP because they may be eligible for a higher allotment. If an individual returns Form H1010, Texas Works Application for Assistance — Your Texas Benefits, and chooses to opt out of SNAP-CAP, the local office must:

  • contact and confirm the applicant wants to apply for benefits under regular SNAP;
  • schedule an appointment for an interview;
  • perform Application Registration using a different SNAP EDG number than the SNAP-CAP EDG number;
  • determine if the individual would receive a higher allotment under regular SNAP;
  • notify the individual of the allotment amount under regular SNAP and confirm if the individual wishes to withdraw from SNAP-CAP;
  • contact 2-1-1 to request EDG closure because the individual wishes to withdraw from SNAP-CAP;
  • confirm the SNAP-CAP EDG has been denied; and
  • certify the individual for regular SNAP effective the first month the individual qualifies for benefits without duplicating benefits.

 

B—476 Joint Supplemental Security Income (SSI)-SNAP Applications

Revision 15-4; Effective October 1, 2015

 

 

B—476.1 Applications Filed in the Social Security Office

Revision 15-4; Effective October 1, 2015

 

SNAP

Households whose members are all applying for or receiving SSI may apply for SNAP at the SSA office unless the households already have a SNAP application pending. These individuals are not required to come to the SNAP office to complete the application or redetermination process. If more information is needed from the household, the advisor must contact the household by home visit, telephone, or mail.

SSA:

  • accepts and completes the SNAP application during the SSI interview; and
  • forwards the following items to the Document Processing Center within one workday after receiving the application:
    • the application;
    • Form SSA-4233, Social Security Administration Transmittal for Food Stamp Applications; and
    • any verification SSA has received.

The file date for the application is the date SSA receives the application. SSA notes this date on Form SSA-4233. When SSA receives additional verification after forwarding the application to the Document Processing Center, SSA sends the additional verification with Form SSA-4233.

 

B—476.1.1 Expedited Service

Revision 15-4; Effective October 1, 2015

 

SNAP

Advisors determine expedited services eligibility for SSI households the same as other households, except expedited time limits begin with the date the correct SNAP office receives the application.

SSA staff:

  • screen the application for expedited services on the day they receive it;
  • note "Expedited Processing" on the first page of Form H1010, Texas Works Application for Assistance — Your Texas Benefits, if the household appears to be eligible; and
  • fax the application within one workday to the Document Processing Center's expedited fax number.

The individual may also take the application to the SNAP office.

 

B—476.1.2 Work Registration

Revision 16-2; Effective April 1, 2016

 

SNAP

SSI household members who apply for SSI and SNAP at the Social Security office are exempt from work registration until the SSA determines their eligibility for SSI.

Related Policy
E&T Exemptions, A-1822.1

 

B—476.1.3 Special Review

Revision 15-4; Effective October 1, 2015

 

SNAP

For households applying at SSA, advisors process a special review during the third month of the certification period to determine whether the individual received a decision on the SSI claim.

 

B—476.1.4 Notice of Expiration

Revision 13-4; Effective October 1, 2013

 

SNAP

TIERS sends Form H1830-R, Texas Works Renewal Notice, to the SSI household:

  • no earlier than the month before the last month of the certification period, and
  • no later than the first day of the last month of the certification period.

The notice of expiration informs the individual:

  • what programs are due for redetermination,
  • verifications needed for the redetermination,
  • when the redetermination application and verifications are due, and
  • the individual's rights and responsibilities.

 

B—476.1.5 Reporting Changes

Revision 15-4; Effective October 1, 2015

 

SNAP

These households are subject to the same change reporting requirements as other SNAP households.

HHSC receives information on whether the SSI was granted or denied through an interface with SSA. Advisors must take action on information from this or any other source.

Related Policy
Reporting Requirements, B-620

 

B—476.1.6 Redetermination

Revision 13-4; Effective October 1, 2013

 

SNAP

Households in which all members are applying for or receiving SSI may file a redetermination for SNAP at the SSA.

The SSA office sends:

  • the application,
  • transmittal sheet (Form SSA-4233), and
  • any available verification to the Document Processing Center.

 

B—476.2 Applications Filed in Public Institutions

Revision 15-1; Effective January 1, 2015

 

SNAP

A resident of a public institution may jointly apply for SSI and SNAP while in the institution if scheduled for release within 30 days.

SSA:

  • within one business day, sends non-expedited applications to:
    • HHSC
      P.O. Box 149024
      Austin, TX 78714-9024

      or
    • faxes them to 1-877-447-2839;
  • within one business day, faxes expedited applications to 1-866-559-9628;
  • notes "PRERELEASE" in red ink across the top of Form H1010, Texas Works Application for Assistance — Your Texas Benefits;
  • sends Form SSA-4233 to HHSC; and
  • gives HHSC the name, address and telephone number of a staff contact at the institution.

When the individual does not have a post-release address, SSA holds the application for 30 days and documents its actions. SSA sends these applications and Form SSA-4233 to HHSC within one business day when:

  • SSA receives a post-release residence address;
  • release has occurred, but SSA has not received a post-release address;
  • SSA denies SSI prior to release; or
  • release from the institution is canceled.

HHSC staff:

  • register the application, and
  • pend the application until SSA notifies HHSC that the applicant has been released.

If the applicant is:

  • not released, HHSC denies the application.
  • released, HHSC determines eligibility for benefits, including expedited services. HHSC offers benefits to allow the individual a chance to participate per the time frames in A-100, Application Processing.

Note: The file date is the date the applicant is released from the institution. The file date is day zero.

Certification Period/Special Review — The advisor must process a special review during the third month of the certification period to determine whether the individual receives SSI.

 

B—480 A Household with Members on TANF, TANF-State Program (SP), TP 07, TP 08 and TP 20

Revision 15-4; Effective October 1, 2015

 

TANF

When household members on a TANF EDG that includes other-related children become ineligible, and the other-related children remain eligible for TANF, advisors must ensure the other-related children continue to receive TANF.

Advisors must:

  • deny the TANF or TANF-SP EDG; and
  • continue the TANF for the other-related children.

TP 08

If a caretaker relative who receives TP 08 based on caring for (an) other-related child(ren) receiving Medicaid becomes ineligible for TP 08 due to new or increased earnings or spousal support and begins receiving TP 07 or TP 20, the other-related child(ren) will also transition from their TP 43, TP 44, or TP 48 EDG to a TP 07 or TP 20 EDG.

 

B—481 EDGs That Include an Other-Related Child

Revision 15-4; Effective October 1, 2015

 

 

B—481.1 At Initial Certification

Revision 15-4; Effective October 1, 2015

 

TANF or TANF-SP

When a TANF EDG includes an other-related child, advisors must:

  • explain to the household that the other-related child, if eligible alone, can continue receiving TANF even if the TANF for the other members of the household is denied. Denials include, but are not limited to, those because of:
    • resources,
    • earnings, or
    • child support.
  • advise households that have an other-related child included in the TANF EDG to contact HHSC immediately if they receive a notice in the mail stating that their TANF or TANF-SP will be denied because they are no longer eligible for the 90 percent earned income deduction.
  • set a special review to contact the household and continue TANF for an eligible other-related child when the EDG is expected to be denied because the 90 percent earned income deduction will be removed.

 

B—481.2 Before a TANF or TANF-SP EDG Is Denied

Revision 15-4; Effective October 1, 2015

 

TANF

Advisors determine whether an other-related child is eligible for TANF on a separate EDG before the household's TANF is denied. Advisors must contact the household to ensure that the household wants the child's TANF to continue.

Advisors provide TANF to the other-related child without a break in benefits, if the other-related child is eligible alone and the household:

  • wants the other-related child's TANF to continue, or
  • cannot be contacted.

If more than one other-related child is in the household, other-related children who are not siblings are certified on separate EDGs. Exception: The individual may choose to combine EDGs if one EDG is ineligible separately but would be eligible if the members were combined.

The other-related child is kept in the original household group if the:

  • child is not eligible alone, or
  • the household does not want the child to receive TANF.

 

B—482 Separating Household Members

Revision 15-4; Effective October 1, 2015

 

TANF

The eligibility system creates an EDG for the other-related child's TANF. Advisors must verify that each certified group contains the correct members. Advisors also must ensure that a new Lone Star Card is issued for the other-related child's new EDG. A new application is not required.

Note: These procedures ensure that TANF-SP EDG numbers follow the SP members.

 

B—490 Determining Whether an Individual Who Resides in a Facility  Is Institutionalized

Revision 16-3; Effective July 1, 2016

 

SNAP

Individuals residing in institutions that are not approved may be potentially eligible for SNAP only if the individual is not considered institutionalized. Approved institutions are defined in A-116.2, Applications from Residents of a Homeless Shelter; B-440, Drug and Alcohol Treatment (D&A)/Group Living Arrangement (GLA) Facilities; and B-450, Residents in Family Violence Shelters.

Additionally, individuals who reside together and receive residential services from nonprofit organizations or for-profit providers who contract with DADS or HHSC to provide residential services may participate in SNAP only if the individual is not considered institutionalized.

Provider staff may:

  • manage an individual's personal funds at the request of the individual; or
  • be the payee on the resident's SSI benefit check.

If the individual requests the provider staff to manage the individual's personal account, the staff must maintain a financial account for the individual and a separate detailed record of all deposits and expenditures for each individual.

Provider staff may not commingle the individual's personal funds with the provider's funds.

For individuals residing in a facility or receiving residential services, staff must determine whether an individual is institutionalized for SNAP eligibility following the steps below:

Step Yes No
  1. Does the individual do their own shopping and meal preparation for more than 50 percent of their meals, or do the facility staff manage the individual's personal account (which can include SNAP benefits) and use those funds to purchase a majority of the individual's meals and prepare them for the individual?
The individual is not considered institutionalized.  The individual is eligible for SNAP if all other SNAP eligibility requirements are met. Go to Step 3. Go to Step 2.
  1. Does the facility :
  • contract with DADS or HHSC to furnish a majority of the individual's meals along with other services;
  • provide a majority of the individual's meals from food purchased with money other than the individual's funds; or
  • charge the individual a standard fee for a majority of the individual's meals?
The individual is considered "institutionalized" for purposes of SNAP eligibility since the contractor is providing a majority of meals for the individual. The individual can only qualify if the individual meets the requirements for a resident of a nonprofit GLA in B-442, Residents of Group Living Arrangement (GLA) Facilities. The individual is not considered institutionalized. The individual is eligible for SNAP if all other SNAP eligibility requirements are met. Go to Step 3.
  1. Does the individual purchase and prepare their meals separately from others (including situations in which an attendant purchases food for the individual with the individual's money and prepares the individual's meals separately from other individuals), or does the individual intend to purchase and prepare separately after certification for SNAP?
The individual can apply as a one-person household following regular policy. Individuals who purchase or prepare their food together must be included together on the SNAP application. HHSC determines eligibility for all those purchasing or preparing together following policy in A-210, General Policy. Example: The facility uses each individual's personal funds to purchase groceries and then prepare meals for all individuals together. In this example, those individuals must be included together for SNAP.

 

Verify and document the answers to the questions in the chart. If the individual designates provider staff as the AR and the AR states the attendant purchases meals/food using the individual's funds, the AR must provide a copy of the detailed record of deposits and expenditures for those individuals.

 

B—491 Documentation Requirements

Revision 15-4; Effective October 1, 2015

 

SNAP

For households receiving residential assistance, responses to the questions in B-490, Determining Whether an Individual Who Receives Residential Assistance Is Institutionalized, must be documented.