Revision 18-3; Effective July 1, 2018

 

 

B—610 General Policy

Revision 15-4; Effective October 1, 2015

 

All Programs

Changes are situations that occur in a household that may affect eligibility or the amount of benefits. The advisor must take action on reported changes to ensure that:

  • individual benefits are issued timely and accurately;
  • the Texas Health and Human Services Commission (HHSC) is not sanctioned for failure to provide correct benefits for the correct month; and
  • Quality Control (QC) initiatives are met.

 

B—620 Reporting Requirements

Revision 05-4; Effective August 1, 2005

 

 

B—621 What to Report

Revision 17-3; Effective July 1, 2017

 

All Programs

The advisor must inform all households of their responsibility to report changes in residence.

TANF and SNAP except SNAP Streamlined Reporting (SR) Households

The advisor must inform all households of their responsibility to report the following changes:

  • source of income;*
  • household composition;
  • ownership of a licensed vehicle; and
  • wage rate or status (full-time to part-time or vice versa as defined by the employer) for employed household members.*

* SR households must report any change that causes the ongoing income to exceed the 130 percent federal poverty income limit (FPIL) including a new household member.

TANF

The advisor must inform all households of their responsibility to report the following changes:

  • the amount of non-exempt unearned income of any household member;
  • circumstances other than employment that affect an individual's amount of benefits or employment services exemption status;
  • address, job, or other information related to the absent parent; and
  • available cash, stocks, bonds, or money in a bank or savings account if the total is over $1,000.

SNAP

Streamlined Reporting 1 households meet the SR criteria described in A-2350, Streamlined Reporting Households, and have income below 130 percent FPIL. These households are required to report:

  • residence and associated changes in shelter cost such as rent/mortgage and utilities; and
  • when the ongoing gross monthly income exceeds 130 percent FPIL for the household's size. Consider the income ongoing if it exceeds 130 percent FPIL for two consecutive months. Example: A new household member who is required to be included in the SNAP Eligibility Determination Group (EDG) moves into an SR household and the new member has income that causes the household's income to exceed the current 130 percent FPIL. The household must report the change. The advisor must issue a new Form TF0001, Notice of Case Action, notifying the household of the requirement to report changes in residence and associated changes in shelter costs.

Streamlined Reporting 2 households meet the SR criteria described in A-2350 and have income above 130 percent FPIL. These households are required to report changes in residence and associated changes in shelter costs such as rent/mortgage and utilities only.

Streamlined Reporting 3 households do not meet the SR criteria in A-2350. These households are required to report:

  • gross monthly household unearned income if the amount changes by more than $50 during the certification period;
  • residence and associated changes in shelter costs such as rent/mortgage and utilities;
  • legal obligation of child support paid to or for nonmembers; and
  • available cash, stocks, bonds or money in a bank or savings account if the combined resources total is $5,000 or more.

When an SR 1 household reports a change that occurs after certification and the change causes their ongoing income to exceed their gross monthly income limit (130 percent FPIL) for two consecutive months, the household has met the SR reporting requirement. If the household remains eligible for an allotment, the household is not required to report additional income changes during the certification period, and is only required to report changes in residence. However, if the advisor later processes a reported change and income is again below 130 percent FPIL (due to decreased income or fewer household members), Form TF0001 should be issued advising the household they are again responsible for reporting if their income exceeds 130 percent FPIL.

SR 1 and SR 2 households:

  • must respond as directed to all notices and letters from the employment program;
  • are not required to report any other changes. If the household reports a change, the advisor takes the appropriate action and continues to act on all agency-generated changes; and
  • are not required to report when a child turns age 18 during the certification period. If an SR household contains a child who will turn age 18 during the certification period, time limits do not apply to anyone until the next redetermination.

Advisors must inform SR 1 and SR 2 households with associated TANF or Medical Program (MP) EDGs of the TANF/MP reporting requirements. A status of SR 1 or SR 2 on a SNAP EDG does not alter the change reporting requirements for associated TANF or MP EDGs.

If the SR 1 or SR 2 household reports that a minor child is no longer in the home and the only person age 18 up to age 50 is now an Able Bodied Adult without Dependents (ABAWD) who:

  • does not meet the SNAP ABAWD work requirement, the advisor processes the household composition change and registers the individual for SNAP Employment and Training (E&T). The advisor must send the ABAWD a new notice informing the individual of the time limit and set a special review for the month before the end of the ABAWD's time limit to disqualify the ABAWD or deny the EDG.
  • meets the SNAP ABAWD work requirement, the ABAWD's months do not count and a special review is not required.

Medical Programs except TP 45

Advisors must inform all households of their responsibility to report the following changes:

  • address;
  • intent to reside in Texas;
  • the individuals living in the home;
  • income, including sources of income, regular hours worked and pay rate;
  • Modified Adjusted Gross Income (MAGI) expenses;
  • a child being institutionalized or dying; and
  • medical insurance coverage.

TP 08 and TA 31

Advisors must inform all households of their responsibility to report changes in the address, job, or other information related to the absent parent.

TP 40

Households must report the termination of a pregnancy.

TP 45

Households must report if the child no longer resides in Texas.

Related Policy
General Reminders, A-1510
Monitoring Questionable Management, A-1731
Length of Certification, A-2324
Streamlined Reporting Households, A-2350

 

B—622 When to Report

Revision 05-4; Effective August 1, 2005

 

All Programs

During the interview or application processing, households must report changes that occurred since the application was filed. See B-116, Information Reported During Application Processing.

After the interview, the household must report changes listed in B-621, What to Report, within 10 days after the household knows about the change.

For special reviews, see the requirements in B-125, Processing Special Reviews.

 

B—623 How to Report

Revision 15-4; Effective October 1, 2015

 

All Programs

Household members or someone acting on the household's behalf may report changes:

  • online through YourTexasBenefits.com;
  • in person;
  • by telephone;
  • by fax;
  • by mail; or
  • on Form H1019, Report of Change, submitted in person, by fax or by mail.

Notes:

  • When a change is reported by telephone, the advisor must verify that the person speaking has the authority to report a change.
  • When a signed Form H1019 is not on file, the individual's signature on Form H1028, Employment Verification, is acceptable as a written, signed report of income change for adequate notice purposes.
  • When a change is reported on an application form, staff do not have to act on the change within 10 days. The file date is considered the report date for purposes of determining the effective date of the change. The date the advisor begins working the EDG and becomes aware of the change is day zero for purposes of taking action on the change for the associated EDGs. The individual must provide any requested verification by the Form H1020, Request for Information or Action, due date to be considered timely verification.
  • If the household reports a change of address in person, the advisor must provide the individual with the opportunity to complete Form H0025, HHSC Application for Voter Registration, to register to vote based on their new address. If the individual declines to register to vote, the advisor should ask the individual to sign Form H1350, Opportunity to Register to Vote. The advisor must send Form H1350 for imaging when the individual returns the form and retain the form for 22 months.
  • If the household reports a change of address online through YourTexasBenfits.com, or via mail, fax, telephone, or through an authorized representative, the advisor must mail the individual Form H0025 to register to vote based on the new address. If the individual contacts the local office to decline the opportunity to register to vote after receipt of Form H0025, the advisor must mail Form H1350 to the individual for a signature. The advisor must send Form H1350 for imaging when the individual returns the form and retain the form for 22 months.
  • When a household requests to make a new person or organization their authorized representative, the advisor must verify the change using the client’s signature or documentation explained in A-170, Authorized Representatives (AR).

Related Policy
Form TF0001 Required (Adequate Notice), A-2344.1
Receipt of Duplicate Application, A-121.2
Receipt of Identical Application, A-121.3
Registering to Vote, A-1521

 

B—623.1 Determining Whether New Income Information Is a Reported Change

Revision 15-4; Effective October 1, 2015

 

TANF, TP 08 and SNAP

When an advisor works a Children's Medicaid application/redetermination during a TANF/Medicaid/SNAP certification period, and a household member's source of income currently budgeted on the other active EDG has not changed, the advisor must determine whether the member is reporting a change in income. To do this, the advisor must determine whether the income verification the household provided with the Children's Medicaid application/redetermination is:

  • a more recent payment than previously verified; and
  • within the range of payments previously verified that are currently used in the budget for the associated active EDG(s), whether the individual provides only one or more than one. "Range of payment" is the highest to the lowest representative pay amounts used to determine the current ongoing budget.

Advisors may follow the guidelines below:

If ... then ...
any of the payment amounts provided as verification for the Children's Medicaid application/redetermination are:
  • more recent; and
  • at least $25 outside the range of payment currently used as "representative income" in the budget for the active EDG,
treat this as a reported change for the active EDG and take action following B-631, Actions on Changes (including additional verification of income, if necessary). If the individual fails to provide timely verification, follow policy in B-642, Changes Increasing Benefits (Other than Additions to the Household), and B-643, Changes Decreasing Benefits.
all of the payment amounts provided as verification for the Children's Medicaid application/redetermination are:
  • older than those currently used, or
  • less than $25 outside the range of payment currently used as "representative income" in the budget for the active EDG,
do not treat this as a reported change for the active EDG (unless the individual reports that the source of income or amount of income has changed).

 

Example: The lowest representative check used for the current certification period is $175 and the highest representative check used is $200. The individual provides a check stub for the Children's Medicaid EDG in the amount of $210. This check is less than $25 outside the range of payments and is not considered a change.

If a change is reported during the Children's Medicaid application/redetermination, the advisor processing the Medicaid EDG must either take action on the associated TANF/Medicaid/SNAP EDG or notify the local office of the reported change. The file date is considered the report date for purposes of determining the effective date of the change. The date the advisor works the Children's Medicaid EDG and becomes aware of the change is day zero for purposes of taking action on the change for the associated EDG. The individual must provide any requested verification by the due date on Form H1020, Request for Information or Action, to be considered timely verification.

 

B—624 Receipts for Reported Changes

Revision 15-4; Effective October 1, 2015

 

All Programs

Households may request a receipt to acknowledge the change report. The receipt includes the type of change(s) and the date reported. If an individual requests a receipt, the advisor must issue:

  • a copy of the individual's completed Form H1019, Report of Change; or
  • Form H1800, Receipt for Application/Medicaid Report/Verification/Report of Change.

 

B—630 Processing Requirements

Revision 05-5; Effective October 1, 2005

 

 

B—631 Actions on Changes

Revision 17-2; Effective April 1, 2017

 

All Programs

Customer Care Center (CCC) staff is responsible for processing most client-reported changes.

Upon receipt of a change report in the local office, staff must:

  • Accept the change.
  • Date stamp the written change report.
  • Enter the change into the State Portal — Report a TIERS Change portlet if the change is received without verification and verification is required.
  • Complete an MI/Change Routing Cover Sheet and fax the change to the vendor at 1-877-236-4123 if the change is received with verification. The advisor must not enter the information in the State Portal — Report a TIERS Change portlet.

Note: Advisors provide Form H1800, Receipt for Application/Medicaid Report/Verification/Report of Change, upon request.

  • To reduce the potential for quality control (QC) errors when the household reports a change in person or by phone, staff taking the change report must attempt to collect enough information to determine whether the change will decrease benefits. For new or increased income, this includes the following information:
    • date of the change;
    • date of the first payment;
    • source of the income;
    • expected pay amounts (or weekly hours and rate of pay for earnings); and
    • pay frequency.

Note: Advisors do not verify income if the amount reported makes the household ineligible.

  • Advisors provide the household with Form H1020, Request for Information or Action, and Form H1020-A, Sources of Proof, on the day of the report (no later than the next workday) if more information or verification is required to complete the change action. The household is allowed 10 full days to provide the requested information or verification.

Note: When a SNAP household reports a change during the last certification month, staff are not required to give the household Form H1020/Form H1020-A, if the effective date of the change is after the certification period expires. Staff may send the change for imaging and address it with the individual at the redetermination interview.

Advisors must:

  • Document the:
    • reported change;
    • date the change occurred; and
    • date the change was reported.
  • Calculate the budget (if applicable).

Exception: Advisors must take the following steps when an individual reports a change in annual or seasonal self-employment income or expenses during their certification period:

Step Yes No
  1. Does the current budget already include fluctuations as significant as the change reported?
Stop — the change is part of the normal fluctuation of the business; do not rebudget. Re-evaluate, go to Step 2.
  1. Does the re-evaluation result in a change of more than $25 to the average monthly net self-employment income?
Rebudget the EDG(s) using new average monthly net self-employment income. Stop — do not rebudget.

 

  • Send the individual Form TF0001, Notice of Case Action:
    • Following policy in B-642, Changes Increasing Benefits (Other than Additions to the Household); B-642.1, Verification Provided Timely; and B-642.2, Verification Not Provided Timely, if benefits increase or remain the same.
    • Following policy in B-643, Changes Decreasing Benefits, if benefits decrease. See A-2343.1, How to Take Adverse Action if Advance Notice Is Required.
  • Provide the household with a new Form H1019, Report of Change, and a prepaid envelope to report future changes.

Related Policy
The Texas Department of Family and Protective Services (DFPS) notifies HHSC via an interface when a child receiving TANF, Medicaid or SNAP has been placed in foster care. Mass Update is triggered, and the child is automatically removed from the EDG(s). If Mass Update fails because the case is not in ongoing mode, HHSC staff must take action to remove the child from the EDG(s).

For this type of change, advance notice of adverse action is required for SNAP, but not for TANF or Medicaid.

The Texas Juvenile Justice Department (TJJD) or Juvenile Probation Department (JPD) notifies HHSC via the TJJD/JPD Placement Logical Unit of Work in the Texas Integrated Eligibility Redesign System (TIERS) when a child certified for Medicaid has been placed in a juvenile facility and when a child has been released. Please see policy in A-825, Medicaid Suspension, and in A-826, Medicaid Reinstatement regarding action taken on a case containing a child placed in or released from a juvenile facility.  

Related Policy
Change in Medical Expenses During Certification, A-1428.4
Adverse Actions Not Requiring Advance Notice, A-2344
Form TF0001 Required (Adequate Notice), A-2344.1
Information Received During Expedited Application Processing, B-116.1

 

SNAP

When SR and non-SR households report a change in residence address, staff must request information on the associated changes in shelter costs. The advisor contacts the household by phone or using Form H1020, Request for Information or Action, to request the amount of the new shelter cost and utilities at the new residence. If the household fails to provide this information, the advisor must rebudget eligibility without the shelter expense and notify the household.

 

Medical Programs

Advisors are required to update the case information for all reported changes regardless of whether the recipient is in a continuous or non-continuous eligibility period.

During a non-continuous eligibility period, when a client reports any financial or non-financial change, advisors must attempt to verify client-reported income and expenses by determining if the reported income is reasonably compatible with electronic data sources, as explained in A-1370, Verification Requirements, Medical Programs.

If the applicant’s or client’s statement of income is not determined to be reasonably compatible with electronic data, income must be verified using other acceptable income verification sources, explained in A-1371, Verification Sources.

When processing a change during a non-continuous eligibility period, the system automatically sends individuals determined ineligible for Medicaid and the Children’s Health Insurance Program (CHIP) to the Marketplace for an eligibility determination for federal health care coverage programs.

To qualify for the federal health care coverage programs, all individuals must first be determined ineligible for Medicaid and CHIP. Advisors must test whether an individual is eligible for all Medical Programs. The Texas Works Medical Programs Hierarchy, explained in A-132.1, Medical Programs Hierarchy, does this automatically for most programs.

Related Policy
Verification Requirements, A-1370

For non-financial changes reported during a period of continuous eligibility, advisors must set a special review in the first week of the sixth month before cutoff. Advisors must process the change following the process explained in B-125, Processing Special Reviews, before cutoff, as long as nothing else is needed to process the change. This will ensure that the change is effective in the seventh month, which is when the non-continuous eligibility period begins. A special review is not needed for financial changes, as these will be processed during a periodic income check (PIC), as explained in B-637, Periodic Income Checks.

 

TP 40, TP 43, TP 44, TP 48

When processing a change, a household may be eligible for expedited CHIP enrollment if the household:

  • is determined ineligible for Medicaid during the eligibility period but before the end of the certification period;
  • is determined eligible for Children's Health Insurance Program (CHIP); and
  • owes a CHIP enrollment fee.

As explained in D-1711, Expedited CHIP Enrollment, an appeal and reactivation due to a change or PIC is an eligible case action for expedited CHIP enrollment.

Related Policy
Medicaid Termination, A-825
Expedited CHIP Enrollment, D-1711

 

B—631.1 Multiple Changes

Revision 15-4; Effective October 1, 2015

 

All Programs

Multiple changes reported on the same day must be processed as one occurrence. If required, the advisor must send Form H1020, Request for Information or Action, with the corresponding pending period and list the verifications needed for all changes.

Multiple changes reported on different days must be processed as separate occurrences. If required, the advisor sends Form H1020 for each reported change with the corresponding pending period and lists only the verification needed for that change.

Each change could affect the benefits for different months. Advisors refer to B-640, Changes Affecting Benefits, to determine the correct month for each change.

Exception: All changes associated with an individual at the time the individual joins a household affects the benefits for the same month, even if the report of change is on a different day.

Example A – A household consists of a mother and son who receive SNAP, TANF and Medicaid (TP 08 for the mother and Children's Medicaid for the son). On January 10, the mother reports the birth of her daughter on January 4 and that she and the newborn went home from the hospital on January 6. The EDGs are pended for more information with a due date of January 20. The mother provides the requested information on January 20, reports she has gone to work, and provides verification of her new employer. She reports her first day of work was January 16 and that she is paid semimonthly. She will receive her first check January 30, and it is not a partial payment. The advisor must:

  • Add the newborn to the SNAP and TANF certified group effective February and request supplements for both programs;
  • Adjust the TANF benefit amount, counting the income effective for March benefits, since adverse action must first expire — apply the 90 percent earned income deduction if the mother is eligible; and
  • Adjust the SNAP budget to include the new TANF grant amount and the new earned income effective for March, since adverse action must first expire.

Example B – A household consists of a father, mother, and three children who receive SNAP and Children's Medicaid. The father is employed, and the mother receives Unemployment Insurance Benefits (UIB). On January 5, the mother reports that the father left the household on October 31 and that she received her last UIB check November 16. She also reports she started working December 3 and provides verification.

  • Remove the father from the household and terminate his income effective for February SNAP benefits.
  • Terminate the mother's UIB using either the Texas Workforce Commission inquiry system or the verification provided, effective for February SNAP benefits.
  • Add the mother's new income effective for February.
  • Children's Medicaid is continuously eligible for the first six months. The income change will be processed during a PIC, as explained in B-637, Periodic Income Checks.
  • There is no overissuance because this is a streamlined reporting household.

Example C – On March 7, the household in Example B reports that the mother's sister has moved in, and the sister wants to be added to the SNAP EDG. The EDG is pended for the sister's Social Security number (SSN) with a due date of March 17. The sister provides a current pay stub from her employer that includes her SSN on March 17. On the same day, the SNAP EDG is pended again for verification of income that was not previously reported, with a new due date of March 27. On March 25, the sister provides Form H1028, Employment Verification, that states she has worked for her employer for one year and includes all other needed information.

  • The sister is not added to the certified group for April SNAP benefits. Advance notice of adverse action for the addition of the sister's income will not expire in March.
  • The sister is added to the certified group and her income counts, effective for May benefits.

 

B—631.2 Actions on Office of Inspector General (OIG) Match Action Alert Changes

Revision 18-3; Effective July 1, 2018

 

All Programs

OIG staff assist help with clearing computer matches for the following reports:

  • Public Assistance Reporting Information System (PARIS) Interstate Matches
  • Texas Department of Criminal Justice (TDCJ);
  • Social Security Administration Prisoner Verification System (PVS);
  • Income and Eligibility Verification Systems (IEVS);
  • Bureau of Vital Statistics Deceased Individual Report; and
  • Social Security Administration Deceased Individual Report

PARIS Interstate Matches 

When OIG staff receive an Interstate Match through PARIS that shows a person on an active TIERS EDG is receiving benefits in another state, OIG informs HHSC staff by creating a task within the Task List Manager (TLM). Staff must take the appropriate action to process the task based on the information provided by OIG.

TDCJ and PVS Matches

When OIG staff finds a match through TDCJ or PVS that shows a person on an active TIERS EDG is incarcerated, OIG informs HHSC staff by creating a task within TLM. Staff must take the appropriate action to process the task based on the information provided by OIG.

When staff request Data Broker, the Texas Department of Criminal Justice (TDCJ) information is displayed on the combined report for an incarcerated person. See C-825.17, Inmate/Parolee Match, for staff instructions for processing Prisoner Matches viewed in Data Broker.

Note: When clearing Form H1186 for a Children's Medicaid household, follow policy in B-631, Actions on Changes.

Income and Eligibility Verification Systems (IEVS)

Go to C-1000, Procedures for Clearance of Income and Eligibility (IEVS) Reports and Internal Revenue (IRS) Federal Tax Information (FTI) to find the procedures for clearing IEVS reports.

Deceased Individual Matches

HHSC matches recipients on active TIERS EDGs with records from the Social Security Administration and Texas Bureau of Vital Statistics to find deceased individuals and remove them from active EDGs, or tasks eligibility staff to perform additional research to determine the validity of the computer match. TIERS updates the date of death information for all active and inactive individuals and either:

  • denies single household member cases if all data elements match; or
  • creates and routes a Date of Death Action Alert Task List Manager (TLM) task with one of the following alerts:
    • Alert 810 — Process a Date of Death with a Perfect Match (created when the record exactly matches a TIERS individual and the case is in a mode other than Ongoing, or the deceased individual is the head of household);
    • Alert 811 — Process a Date of Death with a Non-Perfect Match (created when the record closely matches a TIERS individual, but is not an exact match); or
    • Alert 812 — Verify Discrepancy in Date of Death for Individual (created when the record exactly matches a TIERS individual, but the date of death does not match the date of death already in TIERS).

For detailed processing instructions, advisors may review the Eligibility Services State Processes document and the Change and Alert Guide.

Related Policy
Inmate/Parolee Match, C-825.17

Procedures for Clearance of Income & Eligibility IEVS, Reports & Internal Revenue IRS, Federal Tax Information FTI, C-1000

B—632 Mass Changes

Revision 15-4; Effective October 1, 2015

 

All Programs

The state or federal government initiates changes that can affect all individuals or large numbers of individuals. Individuals are not required to report mass changes. These changes occur in the:

  • income eligibility standards;
  • shelter and dependent care maximum deductions;
  • Thrifty Food Plan and standard deductions;
  • utility standard;
  • cost-of-living adjustments for Social Security, Supplemental Security Income (SSI) and other federal benefits;
  • TANF grants; and
  • other eligibility criteria based on legislative or regulatory actions.

When these changes occur, HHSC automatically adjusts eligibility or benefits for most individuals and notifies the households via Form TF0001, Notice of Case Action. The adjustments are effective the date of the change. Advisors do not send Form TF0001.

HHSC generates an exception report for EDGs that are not adjusted during the state office conversion. Advisors must review the EDGs, adjust benefits if necessary, and send the individual Form TF0001, allowing advance notice of adverse action if required.

 

B—633 Changes in Eligibility Test

Revision 15-4; Effective October 1, 2015

 

All Programs except TP 45

If a household's circumstances change and the household is subject to a new income/resource test, the advisor must determine eligibility by applying the new test when the change is reported.

 

B—634 Changes in SNAP EDGs Jointly Processed with Supplemental Security Income (SSI)

Revision 15-4; Effective October 1, 2015

 

SNAP

Individuals whose SNAP and SSI applications have been jointly processed must report changes like other SNAP individuals.

 

B—635 Shortening Certification Periods as a Result of a Change

Revision 15-4; Effective October 1, 2015

 

SNAP

In the following situations, the advisor may shorten a non-public assistance (NPA) SNAP certification period:

  • A change occurs that makes the case circumstances unstable, and the advisor cannot readily determine the effect of the change on the household's eligibility or benefits. This includes:
    • receipt of the discrepancy report Alert 254, Employer New Hire Data;
    • new listings of information on Data Broker that are inconsistent with information previously reported by the household; and
    • situations in which a public assistance household's TANF is denied for some administrative reason, such as missed appointment, voluntary withdrawal, or failure to provide information requested to redetermine TANF eligibility, and the individual's SNAP EDG becomes questionable.
  • The household's eligibility becomes questionable as described in special reviews for known changes. See B-125.1, Due Dates.

Exception: Do not shorten the certification period if the household is designated SR. The advisor must send Form H1020, Request for Information or Action, requesting specific verification. If the SR household does not provide the verification, the EDG is denied and the advisor sends Form TF0001, Notice of Case Action. See A-2330, Setting Special Reviews, to determine when to set a special review on SR EDGs.

Centralized Benefit Services (CBS) staff shorten certification periods when a household reports a change that results in the household being transferred out of CBS. See B-474.6.1, Special Procedures for Shortening Certification Periods for Centralized Benefit Services (CBS) Eligibility Determination Groups (EDGs).

In all of the situations where advisors may shorten an NPA SNAP certification period, the advisor must use the following procedures before shortening the certification period:

  • Send the household Form H1020 and list the specific verification needed to process the case. If the household responds, take appropriate action.
  • If the household fails to provide verification, deny the EDG using denial reason failure to provide information and send Form TF0001.
  • Send Form H1830, Application/Review/Expiration/Appointment Notice, and Form H1010, Texas Works Application for Assistance – Your Texas Benefits, to the household along with Form TF0001. Mark the first box on Form H1830 that begins, "Attached is an application for ..." and mark "SNAP." When the individual returns Form H1010, follow normal application time frames.

Related Policy
Data Broker, C-820
Questionable Information, C-920

 

B—636 Change in Head of Household

Revision 15-4; Effective October 1, 2015

 

All Programs

When the current head of household dies or leaves the home, the advisor must change the head of household to another responsible household member without requiring the remaining household members to reapply for benefits.

If the head of household who left the home was the Electronic Benefit Transfer (EBT) primary cardholder, the advisor must update the primary cardholder information to allow the household access to SNAP and TANF benefits and issue the individual a new Lone Star Card if one is needed.

Related Policy
When to Send a PCH Record, B-231.1
Issuing a Lone Star Card, B-233

 

B—637 Periodic Income Checks

Revision 17-2; Effective April 1, 2017

 

TP 08, TP 43, TP 44 and TP 48

Initiating a PIC requires no advisor action and uses the automated income check process to determine whether there has been a change in the client’s income that makes the client potentially ineligible for Medical Programs.

As part of the automated income check process, the client’s income information in the eligibility system is compared with income data available through electronic data sources to determine whether it is reasonably compatible, as explained in A-1370, Verification Requirements, Medical Programs.

Electronic income data is requested one month before it is used by the eligibility system. If the client’s income is not determined to be reasonably compatible with electronic data, the client must provide other acceptable verifications explained in A-1371, Verification Sources. When there are no earned income electronic data sources (TWC or TALX) available for the client, the eligibility system checks to see whether there is a New Hire Report. When a New Hire Report exists with an employer's name and hire date that is not currently included in the client’s income, the client must provide verification of the information on the New Hire Report.

Advisors must process verifications returned as the result of a PIC following the process explained in B-631, Actions on Changes. If the client does not provide the requested verification by the 10th day, the eligibility system will automatically deny the individual on the 11th day.

The eligibility system may be able to complete the entire PIC process without any advisor action or correspondence sent to the client if the PIC does not find an indication that there has been a change in the client’s income that makes them potentially ineligible for Medical Programs. If the result of the reasonable compatibility calculation is “Process Failure,” the PIC is attempted again at the next scheduled PIC.

Note: Verification is required for SNAP and TANF during the automated income check process when:

  • The reasonable compatibility calculation result is “Need Info because ELDS above limit” or the client is required to provide verification of information found on a New Hire Report for a Medical Program.
  • An individual in the MAGI household is included in a SNAP or TANF budget group.

The client has 10 days to provide the verification for SNAP and TANF. If the client does not provide verification by the 10th day, the eligibility system will automatically take the following action on the 11th day based on the income type and electronic data source used during the automated income verification process:

  • Deny SNAP and TANF benefits for the following data sources:
    • quarterly wage data from the Texas Workforce Commission (TWC); or
    • new Hire Report data from the Office of the Attorney General (OAG).
  • Notify the advisor to adjust SNAP and TANF benefits for the following data sources:
    • earned income data from TALX;
    • unearned Retirement, Survivors, and Disability Insurance (RSDI) income data from the Social Security Administration (SSA); or
    • unearned unemployment data from TWC.

Note: Earned income data from TALX, unearned RSDI data from SSA, or unearned unemployment data from TWC are valid forms of verifications for SNAP and TANF. Since quarterly wage data from TWC and New Hire Report data from OAG are not valid forms of verifications for SNAP and TANF, the client must provide verification of the income.

 

TP 08

A PIC is initiated in months three through eight of the certification period when the following conditions are met:

  • Any of the following is true for at least one individual in the MAGI household for at least one countable income or expense source:
    • an income or expense is not verified;
    • one of the following income types uses “Verified by Reasonable Compatibility” as the verification source:
      • employment income;
      • unemployment compensation income; or
      • RSDI income; or
    • The verification source is anything other than “Verified by Reasonable Compatibility” and the verification received date is more than 60 days old.
  • The case is in Approved Ongoing mode.
  • There are no pending TLM tasks for the case.

 

TP 43, TP 44 and TP 48

A PIC is initiated in months five through eight of the certification period when the following conditions are met:

  • The individual will not age out before or during the PIC review month;
  • Any of the following is true for at least one individual in the MAGI household for at least one countable income or expense source:
    • an income or expense is not verified;
    • one of the following income types uses “ Verified by Reasonable Compatibility” as the verification source:
      • employment income;
      • unemployment compensation income; or
      • RSDI Income; or
    • The verification source is anything other than “Verified by Reasonable Compatibility” and the verification received date is over 60 days old.
  • The case is in Approved Ongoing mode.
  • There are no pending TLM tasks for the case.

The first time the result of a PIC could impact eligibility is the seventh month of the 12-month certification period because the first six months are continuous.

Exception: A PIC is not initiated when a TP 44 child released from placement in a juvenile facility is reinstated to a different household than the one in which they were residing at the time of their placement, or is reinstated as an independent child.

When taking action on the result of a PIC due to excess income, a household may be eligible for expedited CHIP enrollment if the household:

  • is determined to be ineligible for Medicaid during the eligibility period but before the end of their certification period;
  • is determined eligible for Children's Health Insurance Program (CHIP); and
  • owes a CHIP enrollment fee.

An appeal and reactivation due to a change or PIC is an eligible case action for expedited CHIP enrollment.

Related Policy
Medicaid Termination, A-825
Expedited CHIP Enrollment, D-1711

 

B—638 Returned Mail

Revision 16-4; Effective October 1, 2016

 

All Programs

Advisors must take the following action when returned mail is received:

If the case includes an active SNAP EDG:

  1. Review the address indicated on the returned mail, the case record, and the State Portal to determine whether the household has reported a new address.  If a new address was reported, process the address change and any related changes in shelter expenses.  Otherwise, go to Step 2.
  2. If the new address was not reported and a forwarding address was not provided, make one attempt to contact the household via telephone to confirm the address and document the attempt. If able to contact the household and the household provides a new address, process the change and any related changes in shelter expenses. Otherwise, go to Step 3.
  3. If the returned mail is a SNAP redetermination packet and there are no other active EDGs, document these facts in Texas Integrated Eligibility Redesign System (TIERS) Case Comments and take no further action. Otherwise, go to Step 4.
  4. For households with:
    • no individuals receiving Retirement, Survivors, and Disability Insurance (RSDI) or Supplemental Security Insurance (SSI), go to Step 5; or
    • individuals receiving RSDI or SSI, use the State Online Query (SOLQ) to verify the household's address. If the address in SOLQ:
      • is different from the address in the TIERS case record, use the information in SOLQ to update the address and explore shelter expenses as necessary; and
      • matches the address in the TIERS record, document in TIERS Case Comments that the SOLQ inquiry address matches the TIERS address and take no further action. Otherwise, go to Step 5.
  5. If unable to contact the household via telephone to obtain an update on their address and no household member receives RSDI or SSI, send Form H1020, Request for Information or Action, to the TIERS address to request verification of address and any change in shelter expenses. To pend for address information:
    • in Change Action mode, go to "Individual Demographics";
    • edit the head of household's record;
    • change the effective begin date appropriately;
    • on the "Residency" page, select "not verified" from the residency verification drop down menu;
    • complete the Logical Unit of Work (LUW);
    • document all attempts to contact the household by telephone; and
    • run eligibility.
  6. If the household fails to provide information as requested on Form H1020, deny the household for failure to provide information.  Send Form TF0001, Notice of Case Action, to deny the case using the denial reason "Failed to Provide Information."  
  7. If the household is denied for failure to provide information and provides a correct address within the advance notice of adverse action period, reopen the EDG using the original certification period and process any related changes in shelter expenses. Please refer to the TIERS Advance Notice of Adverse Action Reference Guide in the ASK iT Knowledge Base for instructions.

If the case does not include an active SNAP EDG:

  1. Review the address on the returned mail, the case record, and the State Portal to determine whether the household has reported a new address.  If a new address has been reported, process the address change.  Otherwise, go to Step 2.
  2. If a new address has not been reported and a forwarding address was not provided, make one attempt to contact the household via telephone to obtain an update on their address and document the attempt. If the household provides a new address, process the change.   Otherwise, go to Step 3.
  3. For households with individuals receiving RSDI or SSI, use SOLQ to verify the household's address. If the address in SOLQ is different from the address on file, use the address in SOLQ to update the address. If the address in SOLQ matches the address in the TIERS record, document in TIERS Case Comments that the SOLQ inquiry address matches the TIERS address and take no further action. Otherwise, go to Step 4. 
  4. If unable to contact the household by telephone to obtain an updated address and no household member receives RSDI or SSI, use the following steps to deny the EDG using the denial reason “Unable to Locate” as stated in TWH A-2344.1, Form TF0001 Required (Adequate Notice):
    • in Change Action Mode, go to "Household Information" and select "Yes" for the question "Is the worker unable to locate the household?";
    • document all attempts to contact the household by telephone; and
    • run eligibility.

Related Policy
Actions on Changes, B-631
Returned Mail, E-2221
Returned Mail, M-2221

 

B—640 Changes Affecting Benefits

Revision 09-3; Effective July 1, 2009

 

 

B—641 Additions to the Household

Revision 17-2; Effective April 1, 2017

 

TANF and SNAP

Advisors determine household eligibility when a member must be added. If the addition to the household causes benefits to increase or remain the same, the advisor must send Form TF0001, Notice of Case Action, by the 10th day after the change is reported. If additional information or verification is required, the advisor sends Form TF0001 the next workday, but no later than the workday after the Form H1020, Request for Information or Action, due date. The advisor must request supplemental benefits, if required, no later than the last day of the month in which the verification is received.

If the household addition is a member of another active EDG, the individual is removed from the other EDG before the individual is added to the new EDG. Benefits are restored if the addition of the individual increases benefits and HHSC failed to remove the individual from the active EDG in a timely manner. The advisor should take overpayment action on the old EDG.

 

Medical Programs except TP 45

Under MAGI household composition rules, explained in A-240, Medical Programs, an individual joining or leaving the home may or may not affect eligibility depending on that person’s tax status, tax relationships, and family relationships.

 

TP 08

If the household requests Medicaid for an additional legal parent or caretaker relative, the new individual is given a separate EDG and the system aligns the certification period of the newly created EDG with the existing TP 08 certification period.

Exception: Advisors assign a Medicaid eligibility date as early as three months before the month the individual reports the change for applicants who have unpaid medical bills and meet the criteria described in A-830, Medicaid Coverage for the Months Prior to the Month of Application. When applying the criteria in A-830, the application month is the month the individual reports the change.

 

TP 43, TP 44 and TP 48

If the household requests Medicaid for a new child who is the sibling of a child receiving TP 43, TP 44 or TP 48, a separate application is not needed. If the new child is not a sibling, a new application is required. The new child is given a separate EDG and the system aligns the certification period of the newly created EDG with the existing child’s Medicaid certification period.

Exception: Staff must not add additional children/siblings to a case where a denied EDG was reinstated due to the release from a juvenile facility. The household must submit an application for the additional children/siblings.

If there is not an existing TP 43, TP 44, TP 48 or CHIP EDG, a separate application is required to initiate benefits for a new child being added to the case, as explained in A-121, Receipt of Application. 

Related Policy
Regular Medicaid Coverage, A-820

 

B—641.1 Adding Newborns to the Case

Revision 15-4; Effective October 1, 2015

 

TANF and Medical Programs

Before adding a newborn child, advisors use inquiry to determine whether a TP 45 EDG has been opened. This helps prevent the assignment of duplicate coverage and individual numbers.

To locate the TP 45 EDG, the advisor must perform inquiry using the newborn's mother's individual number or demographic information.

Newborns are added to the household even if they are still hospitalized as long as the parent(s) exercises care and control and intends to bring the newborn home.

SNAP

The TP 45 certification date is considered the change report date for the birth of the child. This is considered a reported change whether the case is SR or non-SR, and the agency is required to take action on this reported change.

Before adding the newborn to the EDG, the agency must confirm that the child was released from the hospital to the individual's home. The advisor must attempt to contact the household by phone to confirm whether the newborn child has moved into the home (and the date that occurred) and to obtain any information not already available on the TP 45 EDG that is needed to add the child. If the advisor is not able to reach the individual by phone, the advisor must send Form H1020, Request for Information or Action, requesting the necessary information. The advisor must not pend for verification of an SSN application at change action to add a child age six months or younger. Advisors follow policy in B-641.2, Steps for Adding New Members, to determine the effective date of the change. If the individual does not respond by the Form H1020 due date:

  • the child is not added to the SNAP EDG; and
  • the advisor must document that the individual failed to provide required information to add the child.

If the household later provides information and verification related to the newborn, the child is added, effective the month after verification is received.

Related Policy
General Policy, A-410

 

B—641.2 Steps for Adding New Members

Revision 15-4; Effective October 1, 2015

 

All Programs

When the household reports a new member, the advisor sends Form H1020, Request for Information or Action, and Form H1020-A, Sources of Proof, the day of the report or no later than the next workday to request any necessary additional information or verification.

If the change is:

  • Timely reported and verified, the advisor adds the new member to the case the month after the change occurred, unless benefits decrease. If benefits decrease, the advisor sends Form TF0001, Notice of Case Action, and decreases or denies benefits effective the month after notice of adverse action expires, as explained in B-643, Changes Decreasing Benefits.
  • Untimely reported with timely verification, the advisor adds the new member effective the month after the change is reported. If the change decreases benefits, the advisor sends Form TF0001 and decreases or denies benefits effective the month after notice of adverse action expires, as explained in B-643.
  • Timely or untimely reported with a delay in verification of eligibility points that results in individual disqualification (for example, SSN or alien status) and verification is not provided by the Form H1020 due date, advisors must take the following actions:
    • For TANF, if the new member is a required member of the certified group, disqualify the new member following applicable policy. Notify the household on Form TF0001 as appropriate. Exception: See TANF policy for household members who are not required members of the certified group.
    • For SNAP, disqualify the new member following applicable policy. Notify the household of the disqualification on Form TF0001 as appropriate.
    • For Medical Programs, see reasonable opportunity policy explained in A-351.1, Reasonable Opportunity.
  • Timely or untimely reported with enough information to determine benefits will decrease, but verification is delayed, the advisor sends Form TF0001 and decreases or denies benefits based on the individual's unverified statement effective the month after notice of adverse action expires, as explained in B-643.
  • Timely or untimely reported lacking enough information regarding income, resources, or other factors necessary to determine eligibility and/or benefits, the advisor sends Form H1020 and Form H1020-A to request verification the same day the change was reported or no later than the next workday and attempts to contact the household by phone within 10 days after the change is reported to obtain enough information to determine the effect of the change.
    • If information is obtained, policies for changes apply as described in this section.
    • If information is not obtained, the impacted EDGs are kept pending until the Form H1020 due date.
    • If verification is not received by the Form H1020 due date, the advisor sends Form TF0001 the next workday to deny the EDG for failure to furnish information.

Notes:

  • There may be situations in which verification is provided to establish eligibility for one program and not the other.
  • When the household reports a new member using an application or redetermination form, the file date is considered the report of change date. The individual must provide the verification by the Form H1020 due date to be considered timely verification.

TANF

Delays in verification of other legal requirements for required members: If the new member is a required member of the certified group and the household does not provide proof of age, relationship, or domicile by the Form H1020 due date:

  • because it is not available, the advisor sends Form TF0001 to notify the household that the person cannot be added without required verification.
  • but it is available, the advisor sends Form TF0001 to deny the EDG for failure to furnish information.

Delays in verification for persons who are not required members of the certified group: If the new member is not a required member of the certified group and the individual fails to provide requested proof by the Form H1020 due date, the advisor sends Form TF0001 to notify the household that the new person cannot be added without required verification. If the household later provides verification, the member is added the month after the verification is received.

SNAP

Request a combined Data Broker report for a new adult member.

 

B—641.3 Adding Disqualified Members

Revision 15-4; Effective October 1, 2015

 

TANF and SNAP

If the member being added was disqualified, the new member is added effective the month after the disqualification ends. See A-1800, Employment Services, for adding household members disqualified for noncompliance with employment services requirements.

SNAP

See A-1362, Disqualified Members, for special budgeting of TANF benefits.

 

B—642 Changes Increasing Benefits (Other than Additions to the Household)

Revision 15-4; Effective October 1, 2015

 

All Programs

Advisors determine the effective dates of a change based on the date the change is reported and the date the verification is provided, as explained in B-642.1, Verification Provided Timely, and B-642.2, Verification Not Provided Timely. If supplemental benefits are necessary, the advisor must request the issuance no later than the last day of the month in which the verification is received.

Note: If verification is not required, the change is treated the same as if verification was received timely (see B-642.1).

 

B—642.1 Verification Provided Timely

Revision 15-4; Effective October 1, 2015

 

All Programs

If the household provides verification of a reported change by the Form H1020, Request for Information or Action, due date, benefits are increased, effective the month after the change is reported, regardless of whether the change was reported timely. The advisor sends Form TF0001, Notice of Case Action, the next workday, but no later than the workday after the Form H1020 due date.

If the household reports a change on an application form, the file date is considered the report of change date. The individual must provide the verification by the Form H1020 due date to be considered timely verification.

 

B—642.2 Verification Not Provided Timely

Revision 15-4; Effective October 1, 2015

 

All Programs

If the household fails to provide timely verification, benefits are not increased until verification is received. The advisor sends Form TF0001, Notice of Case Action, by the next workday after the Form H1020, Request for Information or Action, due date to explain that benefits remain the same. If the household later provides verification untimely, benefits are increased, effective the month after verification is received.

If the household fails to provide verification before the next SNAP, TANF, or TP 08 redetermination, request it again during the interview process and deny the EDG if verification is not received.

SNAP

If decreased or denied TANF or Refugee Cash Assistance (RCA) benefits result in an increase in SNAP benefits, benefits are increased the same month the TANF or RCA is decreased, with some exceptions (see A-1324.18, Temporary Assistance for Needy Families [TANF]).

If the household appeals the TANF or RCA decision and receives continued TANF or RCA benefits, the advisor continues to budget the TANF or RCA grant in the SNAP EDG.

 

B—643 Changes Decreasing Benefits

Revision 16-; Effective October 1, 2016

 

TANF and SNAP

Advisors must act on changes as indicated below. Benefits are decreased or denied, effective the month after the notice of adverse action expires. If applicable, an overpayment claim is processed as specified in B-700, Claims. To determine the first month of an overpayment, advisors may refer to C-1140, TANF and SNAP Overpayment Determination Chart.

If a household reports a change ... then ...
and provides all verification, send Form TF0001, Notice of Case Action, by the 10th day after the change was reported* to decrease or deny benefits.
with enough information to determine eligibility/benefits but does not provide verification, send Form H1020, Request for Information or Action, and Form H1020-A, Sources of Proof, the same day the change was reported or no later than the next workday to request verification.**

Send Form TF0001 to decrease or deny benefits based on the individual's unverified statement at the time the change was reported:

  • by the 10th day after the change was reported;* or
  • with Forms H1020 and H1020-A if the change was reported untimely.

Require verification of the change at the next TANF or SNAP redetermination.

Note: Do not verify income if the amount reported makes the household ineligible.
without enough information to determine eligibility/benefits, send Form H1020 and Form H1020-A the same day the change was reported or no later than the next workday to request verification.**

Attempt to contact the household by phone to obtain enough information to send Form TF0001 by the 10th day after the change was reported.*

Note: The regional director may opt out of the requirement to make a phone contact.

If information is not obtained to redetermine eligibility, keep the EDG pending until the Form H1020 due date. If verification is not received by the Form H1020 due date, send Form TF0001 the next workday to deny the EDG for failure to furnish information. Exception: If the household fails to provide verification of a deductible expense that requires verification, do not deny the EDG; instead, disallow the deduction. Follow policy in A-1440, Verification Requirements, to determine if any deduction is allowable for the expense.

* If the due date for sending Form TF0001 falls on a non-workday, send it the preceding workday to meet the 10-day requirement.

** Allow the individual 10 days to provide the verification requested on Form H1020. If the 10th day falls on a non-workday, use the following workday as the due date.

Note: See B-631, Actions on Changes, for situations where the Texas Department of Family and Protective Services (DFPS) places a TANF or Medicaid child in foster care.

TP 08

If an individual reports or electronic data sources indicate new or increased earned income or alimony/spousal support that makes the individual ineligible for TP 08, the advisor must request verification of the income. If the individual fails to provide verification of the earned income or alimony/spousal support, the advisor must deny the TP 08 EDG and open the appropriate Transitional Medicaid EDG if:

  • the information is not questionable; and
  • they meet the eligibility requirements for the applicable Transitional Medicaid program as explained in A-842, TP 07 Transitional Medicaid and A-850, TP 20 Alimony/Spousal Support Transitional Medicaid Coverage.

In addition, the advisor must deny the Medicaid EDG and open the appropriate Transitional Medicaid EDG for each associated parent or caretaker and dependent child.

If the EDG is denied for failure to provide verification that does not cause Medicaid ineligibility, the advisor must determine the household's eligibility for other medical programs. See A-2342, Denial at Redetermination.

Related Policy
General Eligibility Information, A-841
General Eligibility Information, A-851

 

B—650 Correcting Incorrect Information

Revision 15-4; Effective October 1, 2015

 

All Programs

Individuals have a right to correct any information that HHSC has about the individual and any other individual on the individual's case.

Advisors follow policies in A-2300, Case Disposition; B-100, Processes and Processing Time Frames; and B-600, Changes, for the time frames and procedures to correct or update information when processing:

  • applications,
  • redeterminations, and
  • other actions on active cases.

 

B—651 Correction Request

Revision 15-4; Effective October 1, 2015

 

All Programs

A request for correction must be in writing and:

  • identify the individual asking for the correction;
  • identify the disputed information about the individual;
  • state why the information is wrong;
  • include any proof that shows the information is wrong;
  • state what correction is requested; and
  • include a return address, telephone number, or email address at which HHSC can contact the individual.

During application, redetermination, and other actions on active EDGs, individuals are not required to request correction of incorrect information in writing. (Refer to B-116, Information Reported During Application Processing; B-124, Processing Untimely Redeterminations; and B-623, How to Report.)

 

B—652 Action on Denied EDGs or During the Last Month of Certification and the Client Has Not Reapplied

Revision 15-4; Effective October 1, 2015

 

All Programs

Advisors must respond according to the following chart:

When an individual requests that the agency correct their information ... then ...
at application, redetermination, or anytime when an EDG is active, follow policies in A-2300, Case Disposition; B-100, Processes and Processing Time Frames; and B-600, Changes.
on a denied EDG or during the last month of certification, and the individual has not reapplied,
  • review the request,
  • contact third parties if necessary, and
  • send the correct information for imaging.

 

The advisor notifies the individual in writing within 60 days (using current HHSC letterhead without the board members' names) that the information is corrected or will not be corrected and the reason. The advisor informs the individual if HHSC needs to extend the 60-day period by an additional 30 days to complete the correction process or obtain additional information.

If HHSC makes a correction to individually identifiable health information, the advisor must ask the individual for permission before sharing with third parties. HHSC will make a reasonable effort to share the correct information with persons who received the incorrect information from HHSC if they may have relied or could rely on it to the disadvantage of the individual. Advisors follow regional procedures to contact the HHSC privacy officer for a record of disclosures.

Note: Advisors follow procedures to establish a claim or restore benefits if an overissuance or underissuance occurred. Advisors make a referral to the Office of Inspector General for intentional program violation occurrences.

 

B—653 Different Review Process

Revision 15-4; Effective October 1, 2015

 

All Programs

Advisors must not follow procedures in B-600, Changes, when the accuracy of information provided by an individual is determined by another review process such as a:

  • fair hearing,
  • civil rights hearing, or
  • other appeal process.

The decision in that review process is the decision on the request to correct information.

 

B—660 Documentation Requirements

Revision 15-4; Effective October 1, 2015

 

All Programs

According to B-631, Actions on Changes, advisors must document the:

  • reported change,
  • date the change occurred,
  • date the change was reported, and
  • date the verification is provided.

For new income changes, advisors document the date of the first payment.

For address changes, advisors document the actions taken to provide the individual with Form H0025, HHSC Application for Voter Registration, and Form H1350, Opportunity to Register to Vote.

Refer to A-1380, Documentation Requirements, for further requirements related to income.

SNAP

Advisors must document:

  • the reason for shortening certification as a result of a change. See B-635, Shortening Certification Periods as a Result of a Change.
  • that the individual failed to provide required information to add a newborn when based on the TP 45 certification according to B-641.1, Adding Newborns to the Case.

Medical Programs

Clients are not required to report a change in tax status or tax relationship during the certification period because tax status and tax relationships are self-declared based on what the client expects to happen on their federal income taxes. If a change is reported, advisors should document the change in case comments and it will be addressed at the time of redetermination.

However, if multiple individuals self-declare to claiming the same person as a tax dependent, the advisor must clear the discrepancy with all individuals attempting to claim the same person as a tax dependent and update the tax statuses as a change in the eligibility system if necessary. For example, a change is reported that a child certified on Children’s Medicaid will no longer be claimed as a tax dependent. This change will be addressed at redetermination.

TP 08

Advisors must document the reason for denying a TP 08 EDG and opening a TP 07 EDG when new or increased income makes the household ineligible.

Related Policy
Documentation Requirements, A-1380
Documentation, C-940
Registering to Vote, A-1521
The Texas Works Documentation Guide