Healthy Texas Women Cost Reimbursement Manual
1000, Contact Information and Purpose
Body
1100 Contact Information
Revision 25-2; Effective Sept. 1, 2025
Mailing Address
HHSC Healthy Texas Women Cost Reimbursement
North Austin Complex, Mail Code 0224
4601 W. Guadalupe St.
Austin, TX 78751-2920
Helpline
8 a.m. to 5 p.m. Central Time
Monday through Friday
Austin Phone No. 512-776-7796
Program Administrator and Contractor Portal
Family Clinical Services Contractor Portal, Sharepoint.com
1200 Purpose
Revision 23-1; Effective Sept. 27, 2023
This policy manual has been structured to provide contractor staff with information needed to comply with cost reimbursement requirements. The manual applies only to Healthy Texas Women cost reimbursement (HTW CR) and not to the HTW fee-for-service (FFS) component.
Federal and state laws related to reporting abuse, operation of health facilities, professional practice, coverage and similar topics also impact women’s health and family planning services. Grantees are required to be aware of and comply with current laws, as well as the policies put forth in the Texas Medicaid Provider Procedures Manual (TMPPM).
2000, Authorization, Services and Definitions
Body
Revision 21-0; Effective September 1, 2021
2100 HTW Cost Reimbursement
Revision 25-1; Effective Jan. 28, 2025
The Texas Health and Human Services Commission (HHSC) provides a continuum of care through an array of women’s health and family planning-related services, including Healthy Texas Women (HTW). Through HTW cost reimbursement, HHSC provides reimbursement for support services important to maintaining the HTW program and enhancing HTW direct care services.
2200 HTW Fee-for-Service (FFS)
Revision 23-1; Effective Sept. 27, 2023
Claims for direct clinical care services provided to clients are reimbursed using the fee-for-service (FFS) reimbursement method.
FFS claims are not funded under HTW CR. The HTW FFS component is managed through the HHSC Medicaid and CHIP Services Division (MCS). Information on this process, as well as general program policies and procedures, are located in the Healthy Texas Women (HTW) Handbook, which is included in the Texas Medicaid Provider Procedures Manual (TMPPM). Grantees should refer to the TMPPM for more information on the HTW FFS program and provider requirements including, but not limited to, the following areas:
- Client Rights and Access
- Client Eligibility
- Covered FFS Procedures and Codes
- FFS Billing Requirements
- Consent Requirements
- Abuse and Neglect Reporting
- Provider Certification and Requirements
2300 Guidance on Services for Minors
Revision 21-0; Effective September 1, 2021
Provider responsibilities and guidance concerning the treatment of minors under HTW, including requirements for confidentiality and consent, is available on the HHS website.
2400 Authorization
Revision 21-0; Effective September 1, 2021
State rules for HTW services can be found in the Texas Administrative Code (TAC), Title 1, Part 15, Chapter 382, Subchapter A. The current TAC does not reflect recent changes to the HTW program, as covered in the Texas Medicaid Providers Procedures Manual (TMPPM), and is in the process of being updated.
2500 Definitions
Revision 25-2; Effective Sept. 1, 2025
The following words and terms, when used in this manual, have the following meanings, which are exclusive to HTW CR:
Anticipated Eligibility – When a client’s HTW application has not yet been processed and approved by HHSC, HTW CR grantees may provide services of up to 90 days to clients who have been screened using the Prescreening Tool on YourTexasBenefits.com, or the Am I Eligible? tool on the Healthy Texas Women website, and who are anticipated to be eligible based on that screening. HTW CR grantees may use a portion of their cost reimbursement funds to provide services for a limited time to a person who is anticipated to be eligible for HTW if the application for HTW is ultimately denied. If a client’s HTW application is ultimately approved, cost reimbursement funds may not be used to support services for that client as those costs must be billed to the HTW program through Texas Medicaid & Healthcare Partnership (TMPPM). Specific billing requirements are outlined in 3000, Cost Reimbursement Administrative Policies. Services for anticipated eligible clients must follow the TMPPM guidelines. Anticipated eligibility, as used in this manual, is distinct from Medicaid presumptive eligibility. Note: Before federal approval of the 1115 Medicaid waiver, HTW cost reimbursement contracts and policy guidance historically referred to allowability and reimbursement for presumptive eligibility in HTW.
Class D (Clinic) Pharmacy License – A license issued to a pharmacy to dispense limited types of drugs or devices under a prescription drug order. Instructions for Filing a Class D Pharmacy Application (PDF) is on the Texas State Board of Pharmacy’s website.
Client – A person who has been screened and determined to be eligible for the program.
Contraceptive Methods – A broad range of birth control options approved by the U.S. Food and Drug Administration, except for emergency contraception.
Cost Reimbursement – The basis for reasonable, allowable and allocable Grant Project direct costs.
Family Planning Services – Educational or comprehensive medical activities that enable clients to freely determine the number and spacing of their children and select the means by which this may be achieved.
Fee-for-Service (FFS) – The payment mechanism for services that are reimbursed on a set rate per unit of service, also known as unit rate.
Fiscal Year (FY) – State fiscal year, Sept. 1 – Aug. 31.
Grantee – A non-state entity that receives an award directly from the state awarding agency to carry out an activity under a state program. The term grantee does not include subgrantees.
Health and Human Services Commission (HHSC) –The Texas administrative agency established under Chapter 531, Texas Government Code, or its designee. HHSC manages programs that help families with food, health care, safety and disaster services.
Healthy Texas Women (HTW) – A program administered by HHSC to provide uninsured women with health and family planning services, such as women’s health exams, health screenings and birth control. HTW providers must deliver client services on an FFS basis. Providers may also, but are not required to, contract with HHSC to provide support services that enhance the HTW FFS client delivery on a cost reimbursement basis.
HTW Cost Reimbursement – The funding mechanism for qualified agencies that supports the overall outcomes of client services provided through the HTW FFS program. These funds may be used for support services that enhance HTW FFS client service delivery.
HTW FFS – Women’s health and family planning client services provided through the HTW program on an FFS basis through the Texas Medicaid & Healthcare Partnership system. General program policies and procedures are included in the Healthy Texas Women (HTW) Handbook, which is included in the Texas Medicaid Provider Procedures Manual (TMPPM).
HTW Provider – A Medicaid-enrolled health care provider that performs covered HTW services. An HTW provider’s agency may be contracted with HHSC to receive more funding through a cost reimbursement contract to support the HTW FFS program.
Indirect Costs – Costs incurred for a common or joint purpose that benefits more than one project or cost objective of a grantee's organization and not readily identified with a project or cost objective. Refer to the Indirect Cost Rates webpage for more information.
Long-Acting Reversible Contraceptives (LARCs) – Methods of birth control that provide highly effective contraception for an extended period without requiring user action. LARCs include intrauterine devices (IUDs) and subdermal contraceptive implants.
Medicaid – The Texas Medical Assistance Program, a joint federal and state program provided in Texas Human Resources Code Chapter 32, and subject to Title XIX of the Social Security Act, 42 USC Section 1396 et seq.
Minor – Per the Texas Family Code, a person younger than 18 years who is not and has not been married or who has not had the disabilities of minority removed for general purposes such as emancipated.
Outreach – Activities that are conducted to inform and educate the community about HTW services and reach eligible clients.
Patient Navigator – Someone who provides personalized assistance to clients to eliminate barriers to timely care across all segments of the health care continuum. This includes application assistance for HTW FFS, Family Planning Program (FPP), and Breast and Cervical Cancer Services (BCCS) programs.
Program Income – Money collected directly by the grantee, subrecipient or provider for services provided under the grant award such as third-party reimbursements, Title XIX, private insurance and client copay fees. Program income also includes client donations.
Service – Any client encounter at a facility that results in the client having a medical or health-related need met.
Subgrantee – A non-state entity that receives a subaward from a pass-through entity to carry out part of a state program but does not include a person who is a beneficiary of such a program. A subgrantee may also be a grantee of other state awards directly from a state awarding agency. A subgrantee may also be referred to as a subrecipient. Refer to Texas Grant Management Standards (PDF), Appendix 2, p.57.
Texas Medicaid & Healthcare Partnership (TMHP) – The Texas Medicaid Claims administrator. HHSC contracts with TMHP to process claims for providers.
3000, Cost Reimbursement Administrative Policies
Body
Revision 21-0; Effective September 1, 2021
3100 HTW CR Services
Revision 21-0; Effective September 1, 2021
Healthy Texas Women Cost Reimbursement (HTW CR) provides funds to agencies that support the overall outcomes of clients served through HTW fee-for-service (FFS). These funds may be used for support services that enhance HTW FFS client service delivery. Cost reimbursement awards may be used to fund personnel, fringe benefits, staff travel, contractual services, equipment, supplies, other direct costs, and indirect costs per state and federal requirements and must be reasonable, allowable and already allocated. Additional information on what is reimbursable under HTW CR is found in 4130, HTW CR Reimbursement.
3110 HTW CR Patient Navigation Services
Revision 25-2; Effective Sept. 1, 2025
If a grantee is awarded funding for a dedicated HTW CR patient navigator, a policy must be in place to make sure the following services and activities are provided.
- Application assistance to clients who screen eligible for preventive and primary health programs, including:
- HTW
- Family Planning Program (FPP)
- Breast and Cervical Cancer Services (BCCS)
- Primary Health Care (PHC)
- Nonmedical service needs assessment provided by HHSC that identifies barriers to transportation, childcare, housing, food and employment. Grantee may use a comparable, alternative tool with prior HHSC written approval. Grantee must administer these assessments during initial contact and annually thereafter.
- Education, appropriate referrals and follow-ups to show any resolution of barriers.
- Grantee must document these activities and support services in the client record including:
- Information about covered program benefits.
- Attempt at resolution of client barriers such application assistance for Supplemental Nutrition Assistance Program (SNAP) benefits, referrals to local resources and client travel.
- Document informed refusal from the person if the person fails to keep appointments, completed the Nonmedical Service needs assessment or refuses recommended procedures. If the person cannot, or will not, sign an informed refusal, the grantee must document verbal refusal.
- Grantee must document these activities and support services in the client record including:
- Document person’s refusal, lost to follow-up and good faith effort, as appropriate.
- Good faith effort is defined as at least three documented attempts to assist with applications or to navigate people to services via phone, email, text or other preferred method of communicating with the person.
- Personal contact attempts can be made by office visit, phone, home visit, mail or a combination of these methods. Attempts to contact the person must be written or presented verbally in the client’s primary language if the client has limited English proficiency. Policy must include appropriate provisions for the visually and hearing impaired.
- Before closing the person’s record as a refusal, a thorough review of the person’s plan, recommendations and the following navigator's actions must be conducted to ensure proper closure.
3200 HTW CR Anticipated Eligibility
Revision 25-2; Effective Sept. 1, 2025
HTW emphasizes the importance of proper family planning and women’s health preventive care. HTW’s goal is to provide women access to women’s health services and not rely on episodic, acute care. To ensure prompt access to such care, HTW CR grantees can receive reimbursement for services provided to clients awaiting approval of an HTW application if said application is ultimately denied.
HTW CR grantees may use a portion of their cost reimbursement funds for this purpose. If a client’s HTW application is ultimately approved, cost reimbursement funds may not be used to support services for that client. Those costs must be billed to the HTW program through Texas Medicaid & Healthcare Partnership (TMHP).
Grantees must screen all HTW applicants for eligibility in the following programs that provide family planning services in this order:
- Medicaid;
- HTW;
- FPP;
- BCCS;
- PHC; and
- Any other system agency-funded health program for which the Grantee holds a grant agreement.
If a grantee believes an applicant should be enrolled in multiple HHSC-funded programs, alert applicable HHSC program mailboxes for further guidance.
HTW CR grantees are expected to have policies in place to verify if a client has been approved for HTW. HTW CR grantees are expected to screen clients using the Prescreening Tool on YourTexasBenefits.com, or the Am I Eligible? tool on the Healthy Texas Women website. Both tools are acceptable methods for screening for HTW eligibility. If a client is anticipated to be eligible for HTW based on that screening, the grantees may request reimbursement from HHSC from their HTW CR contract for services provided within 90 days from the date the client is first seen by the medical provider. The request for reimbursement cannot be submitted until 45 days after the HTW application was submitted to ensure adequate time for HTW application processing and eligibility determination. HTW CR grantees cannot bill for a client’s services based on anticipated eligibility status more than once in a 12-month period. All services provided must follow the HTW guidelines in the TMPPM.
Clients seen on an anticipated eligibility basis should be recorded for reporting purposes on the monthly HTW CR voucher. For more information on vouchers and required reports, refer to 4200, Data Collection and Reporting.
Note: Anticipated eligibility, as used in this manual, is distinct from Medicaid presumptive eligibility. Before federal approval of the 1115 Medicaid waiver, HTW cost reimbursement contracts and policy guidance historically referred to allowability and reimbursement for presumptive eligibility in HTW.
4000, Reimbursement, Data Collection and Reporting
Body
Revision 23-1; Effective Sept. 27, 2023
4100 HTW CR Reimbursement Guidance
Revision 23-1; Effective Sept. 27, 2023
4110 HTW CR Provider Reimbursement Criteria
Revision 23-1; Effective Sept. 27, 2023
To be reimbursed for HTW CR activities, the organization must meet all requirements as an HTW fee-for-service provider. This includes being a Medicaid (Title XIX) provider in accordance with 1 Texas Administrative Code Chapter 352 Subchapter A and meeting all other eligibility requirements outlined in the TMPPM. Failure to comply with these requirements will result in grant termination.
4120 Texas Medicaid Provider Procedures Manual (TMPPM) and the Healthy Texas Women Program Handbook
Revision 23-1; Effective Sept. 27, 2023
The TMPPM and the Healthy Texas Women Program Handbook within the TMPPM include information related to the HHSC HTW fee-for-service program claims submission process.
Volume 1 of the TMPPM also includes information on claims filing and submissions for Medicaid providers.
Medicaid bulletins and Remittance and Status (R&S) banner messages provide up-to-date claims filing and payment information. The R&S banner messages and the TMPPM are all available on the TMHP website, along with billable service codes.
4130 HTW CR Provider Reimbursement
Revision 23-1; Effective Sept. 27, 2023
HTW grantees may seek reimbursement for program costs by submitting monthly vouchers for expenses outlined in a cost reimbursement budget approved by HHSC, as required for the cost reimbursement program. Supporting documentation must be submitted with each voucher.
HHSC HTW CR funding is used for support services that enhance services provided by the grantee to a client under the HTW fee-for-service (FFS) program. Support services include, but are not limited to:
- assisting eligible women with enrollment into the HTW program;
- direct clinical care for women anticipated to be eligible for HTW FFS, who are awaiting approval for an HHSC-approved HTW application and whose application is ultimately denied;
- staff development and training related to HTW program service delivery; and
- client and community-based educational activities related to the HTW program.
Costs may be assessed against any of the following categories the grantee identifies during their budget development process:
- personnel;
- fringe benefits;
- travel;
- equipment and supplies;
- contractual;
- other; and
- indirect costs.
Long-Acting Reversible Contraception (LARC)
LARC devices, such as IUDs and contraceptive implants, may be purchased in bulk using cost reimbursement dollars and should be accounted for in the “equipment and supplies” section of a grantee's budget. The grantee will bill Texas Medicaid & Healthcare Partnership (TMHP) for the insertion of the LARC device only when issued to a client. LARC bulk supply purchases must be listed in the approved cost reimbursement budget.
Providers may obtain LARC products through the existing buy and bill process, which requires providers to purchase LARCs from wholesalers or other sources before obtaining reimbursement upon insertion of the device and opting to receive reimbursement for LARC products as a clinician-administered drug. They can also order a device from a specialty pharmacy for the client to pick up and bring in for insertion.
Claims for Services Provided Under Anticipated Eligibility
Grantee will bill their approved cost reimbursement budget categories based on the cost incurred by personnel to perform services for clients under anticipated eligibility.
To seek reimbursement for these costs, grantee must hold claims at least 45 calendar days from the date of the client’s HTW application submission. Grantees must have documented procedures in place for how they will monitor the eligibility status of “anticipated eligible” clients, and how they will assist clients who are deemed ineligible for HTW.
The purpose of these procedures is to ensure grantees receive proper reimbursement and clients deemed ineligible for HTW are referred to other services for which they may be eligible within a timely manner.
Cost Reimbursement Payment Requirements
The cost reimbursement payment method is based on an approved budget and the submission of expense reimbursement requests. Grantees are required to finance upfront operational costs and request reimbursement for costs incurred. Payments are made by HHSC to reimburse the grantees for actual cash disbursements in accordance with supporting documentation.
As per the HHSC HTW CR grant, the reimbursement amount requested may not exceed 25 percent of the grantee's expected HTW FFS payments for the funding period. Grantee compliance will be assessed by HHSC quarterly. Upon review at each quarter, grantees that have exceeded the 25 percent will be notified and provided technical assistance, followed by appropriate actions as needed to resolve any issues. Annual award determination and reallocation of funds will be based in part on those grantees that leverage a higher percentage for direct services.
Additionally, as per the HHSC HTW CR grant, no more than five percent of the payments received under an HTW CR grant may be used for expenses related to performing administrative functions derived from terms of the grant for subgrantees. Grantee compliance will be assessed by HHSC quarterly. Upon review at each quarter, grantees that have exceeded the five percent will be asked to remit payment to HHSC for the amount exceeded.
Administrative functions include, but are not limited to, the grantee’s personnel costs for provision of oversight and technical assistance with a subgrantee, monitoring subgrantee performance, and all other related general and administrative expenses for administration of the subgrant, such as related fringe, rent and office supplies.
HTW CR Budget Revisions
HHSC, at its sole discretion, may approve fund transfers between categories upon a grantee’s written request. That request must include a detailed explanation that supports the need for the fund transfer. The grantee must seek HHSC’s written approval prior to making any fund transfers.
The approved budget for the state award summarizes the financial aspects of the program as approved during the state award process. It may include either the state and non-state share or only the state share, depending upon the state awarding agency’s requirements. It must be related to performance for program evaluation purposes, whenever appropriate. The local government is required to report deviations from budget or project scope or objective and request prior approval from the state awarding agency for budget and program plan revisions. For more information, visit the Texas Grant Management Guide.
4140 HTW CR Prohibitions
Revision 23-1; Effective Sept. 27, 2023
Prohibitions apply to awarded funds. HTW CR funds may not be used to support the following services, activities and costs:
- inherently religious activities, such as prayer, worship, religious instruction or proselytization;
- lobbying;
- any portion of the salary of, or any other compensation for, an elected or appointed government official;
- vehicles or equipment for government agencies that are for general agency use and do not have a clear nexus to terrorism prevention, interdiction and disruption (such as mobile data terminals, body cameras, in-car video systems or radar units for officers assigned to routine patrol);
- weapons, ammunition, tracked armored vehicles, weaponized vehicles or explosives (exceptions may be granted when explosives are used for bomb squad training);
- admission fees or tickets to any amusement park, recreational activity or sporting event;
- food, meals, beverages or other refreshments, except for eligible per diem associated with grant-related travel or where pre-approved for working events;
- membership dues for individuals;
- any expense or service that is readily available at no cost to the grantee;
- to replace (i.e., supplant) funds that have been budgeted for the same purpose through non-grant sources;
- fundraising;
- statewide projects;
- the acquisition or construction of facilities; or
- any other prohibition imposed by federal, state or local law.
4200 Data Collection and Reporting
Revision 25-2; Effective Sept. 1, 2025
4210 Required Reporting and Frequency
Revision 25-2; Effective Sept. 1, 2025
Grantees must submit these reports in an accurate and timely manner throughout the grant term, regardless of status, to report on progress and implementation.
| Report | Frequency |
|---|---|
| Monthly Voucher Packet and Supporting Documentation Financial Status Report (FSR) | Last business day of the month following the month in which expenses were incurred or services provided. Final voucher is due 45 days after the end of the grant term. Within 30 calendar days after the end of each quarter. Final FSR is due 45 calendar days after the end of the grant term. |
Quarters for HTW Cost Reimbursement:
- Quarter 1: September – November
- Quarter 2: December – February
- Quarter 3: March – May
- Quarter 4: June – August
Required Form or Report 1: Monthly Voucher Packet
- Description: Monthly report that includes all expenditures, program income and non-HHSC funding for the defined reporting period with amounts received for Fee for Service (FFS).
- Supporting documents including a detailed general ledger that supports the expenditures on the reimbursement request.
- Submission Date: By the last business day of the month following the month when expenses were incurred or services provided. Final voucher due within 45 calendar days after end of the grant term.
- Accepted Method of Submission: Email
- Submit Copy to: fcs_finance@hhs.texas.gov
- Original Signature Required: No
- Number of Copies: One
- Instructions: Enter Cost Reimbursement monthly expenses per budget category, co-pays or donations, which is program income, non-HHSC funding and data collection.
- Note: The Monthly Voucher Packet templates are sent to grantees by their contract manager. Vouchers must be submitted each month even if there are no expenditures. Vouchers must still be submitted each month for actual program expenditures even if the grant limit has been reached.
Required Form or Report 2: Financial Status Report (FSR) Form 269A
- Description: Quarterly report that includes all expenditures, program income and non-HHSC funding for the defining three months with amounts received from HHSC.
- Submission Date: By the last business day of the month following the end of each quarter. Final voucher due within 45 calendar days after end of the grant term.
- Accepted Method of Submission: Email
- Submit Copy to: fcs_finance@hhs.texas.gov
- Original Signature Required: No
- Number of Copies: One
Required Form or Report 3: Quarterly Patient Navigator Report, if applicable
- Description: Grantees with HTW CR -funded Patient Navigator(s) will be expected to submit the Patient Navigator Quarterly Performance Report with the following measures:
- Total number of active funded Patient Navigator(s);
- Total number of unduplicated people screened for any program offered at the clinic location by any staff person. This is not limited to HHSC programs;
- Total number of unduplicated people screened and served by the funded Patient Navigator(s);
- Total number of unduplicated people screened and served by the funded Patient Navigator(s) lost to follow-up or refusal of services;
- Total number of unduplicated people served by the funded Patient Navigator(s) who are successfully navigated to Medicaid, HTW, Family Planning Program (FPP), Primary Health Care (PHC), and Breast and Cervical Cancer Services (BCCS); and
- Total number of Nonmedical Service Needs identified by Patient Navigator(s).
- Submission Date: By the last business day of the month following the end of each quarter
- Accepted Method of Submission: Email
- Standard Naming Convention: FYXX.QX.HTW.PN.AgencyName.xlsx
- Submit Copy to: famplan@hhs.texas.gov
- Original Signature Required: No
- Number of Copies: Not applicable
- Instructions: Submit completed reports quarterly by due date outlined above.
Required Form or Report 4: Promotion and Outreach Annual Plan
- Description: This plan should outline the grantee’s goals to inform the public of the program’s:
- purpose and available services,
- enhance community understanding of its objectives,
- disseminate basic family planning and women’s health care knowledge,
- enlist community support, and
- recruit potential clients for FPP.
- Submission Date: The contractor completes the report within 45 calendar days of the start of the grant period and keeps it on file for monitoring purposes.
- Accepted Method of Submission: Plans must be kept on file for monitoring requirements, but do not need to be submitted to HHSC.
- Submit Copy to: Not applicable
- Original Signature Required: No
- Number of copies: Not applicable
- Instructions: Complete plan annually by due date outlined above.
Required Survey 5: Promotion and Outreach Biannual Survey
- Description: This survey will be sent via email to designated HTW signature authorities biannually.
- Submission Date: The report is due within 30 days of receipt.
- Accepted Method of Submission: Submission method will be emailed to the grantee via famplan@hhsc.texas.gov
- Original Signature Required: No
- Number of Copies: Not applicable
- Instructions: Submit completed surveys biannually by the due date outlined above.
Required Survey 6: Clinic Locator Survey
- Description: This survey will be sent via email to designated HTW CR signature authorities annually. Grantees are required to complete the survey within 10 days. This survey will assess the grantee’s patient navigation activities and services to determine if they continue to be effective throughout the year.
- Submission Date: The report is due within 10 days of request.
- Original Signature Required: No
- Number of Copies: Not applicable
- Instructions: Submit completed reports annually.
4220 Voucher and Support Submission
Revision 25-2; Effective Sept. 1, 2025
HTW CR grantees will receive a personalized voucher packet at the beginning of each grant year for monthly reimbursement and reporting.
The HTW Monthly Voucher Packet and Quarterly FSR must be submitted to the designated email address on the HTW Monthly Voucher Packet.
4230 Program Promotion, Outreach and In-reach
Revision 25-2; Effective Sept. 1, 2025
Grantees must develop and implement an annual plan for promotion and outreach within 45 calendar days from the start of each fiscal year. Grantees are expected to follow the plan and make the plan available for monitoring purposes. This plan must outline the grantee’s goals to:
- inform the public of the purpose of the program and available services;
- enhance community understanding of its objectives;
- disseminate basic family planning and women’s health care knowledge;
- enlist community support; and
- recruit potential clients for HTW.
The plan should be based on an assessment of the needs of the geographic community and contain an evaluation strategy. Grantees must consider a variety of program promotion and client in-reach and outreach strategies per:
- organizational capacity;
- availability of existing resources and materials; and
- the needs of the local community.
To gauge the efficacy of program promotion and client outreach activities, grantees must complete the biannual survey of promotion and outreach activities. This survey is delivered twice a year and is due within 30 days of receipt.
| Survey Sent | Reporting Period | Survey Due Date |
|---|---|---|
| Mid-month February | Sept. 1 – Feb. 28, Q1 and Q2 | Mid-month March |
| Mid-month August | March 1 – Aug. 31, Q3 and Q4 | Mid-month September |
Submit questions about the surveys to FamPlan@hhs.texas.gov.
Guidance for Promotion and Outreach Plans
The plan should include the determination of the priority population, a recruitment work plan and in-reach and outreach methods.
Grantees should have many materials and resources to promote community awareness. Grantees must develop and maintain relationships with local partners and collaborators who can help recruit the priority populations.
Grantees must include in their outreach plan how they plan to implement strategies to enroll clients in HTW and raise community awareness of HTW services. The outreach plan must describe how the grantee plans to:
- identify priority populations in the community;
- identify the populations at highest risk for unintended pregnancies and STIs;
- provide health education and social support;
- help reduce participants’ barriers to accessing clinical services;
- establish relationships with internal and external partners to reach eligible clients in the priority populations;
- establish relationships with clinic sites that offer other HHSC programs such as the Family Planning Program, Breast and Cervical Cancer Services Program and the Primary Healthcare Program to increase cross-program referrals, coordination and service provision;
- link and connect participants to partner clinics for HTW services;
- educate clients diagnosed with breast or cervical cancer about Medicaid for Breast and Cervical Cancer eligibility requirements and how to apply for services;
- provide information to each eligible client in their primary language; and
- provide access to information that is linguistically appropriate and available to the visually and hearing impaired.
5000, Personnel Policy and Procedures
Body
Revision 25-2; Effective Sept. 1, 2025
Grantees must develop and maintain personnel policies and procedures to make sure all staff are hired, trained and evaluated appropriately for their job position. Personnel policies and procedures must include:
- job descriptions;
- a written orientation plan for new staff members that includes a statement of skills, competencies appropriate for the position or both; and
- a performance-evaluation process for all staff members.
Job descriptions, including those for contracted personnel, must specify required qualifications and licensure.
Grantees must show evidence employees meet all required qualifications and receive annual training. Job evaluations should include observation of staff-client interactions during clinical, counseling and educational services.
Grantees must establish safeguards to prohibit employees from using their positions for a purpose that constitutes or presents the appearance of personal or organizational conflict of interest or personal gain. All employees and board members must complete a conflict-of-interest statement during orientation. All medical care must be provided under the supervision, direction and responsibility of a qualified medical director. The designated medical director for a grantee must be a licensed Texas physician.
Grantees must establish, annually review and train staff on HTW CR program requirements and policies, including any updates to the program policy manual and required forms that occur during the Grant Term.
Grantees must have a documented plan for organized staff development. There must be an assessment of:
- training needs;
- quality assurance indicators; and
- changing regulations and requirements.
Staff development must include orientation and in-service training for all personnel and volunteers. Nonprofit entities must provide orientation for board members and government entities must provide orientation for their advisory committees. Employee orientation and continuing education must be documented in agency personnel files.
Grantees must notify and provide in writing within 30 calendar days of change, if funded under this contract or not, updated contact information to HHSC of changes in:
- Any grant-funded positions;
- Chief executive officer (CEO), chief financial officer (CFO), program director or program manager
Grantees must make sure at least one representative with capabilities to disseminate information to program administrative and clinic staff:
- has access to the HHSC’s web-based applications on the SharePoint site. The grantee must sign and submit a Family Clinical Services Extranet and Data Upload Security Agreement form for each grantee staff person accessing HHSC’s web-based applications on the SharePoint site. Grantees must make sure staff members who use HHSC’s web-based applications have an Outlook or Microsoft Office 365 account, and
- participates in all trainings required by HHSC, including Monthly Patient Navigation Meetings, if applicable.
6000, Additional Resources
Body
Revision 25-2; Effective Sept. 1, 2025
HTWCR Forms
HTWCR Revisions
25-2, Miscellaneous Revisions
Body
Revision 25-2; Effective Sept. 1, 2025
| Section | Title | Change |
|---|---|---|
| 1100 | Contact Information | Updates contact information. |
| 2500 | Definitions | Updates text. |
| 3110 | HTW CR Patient Navigation Services | Adds section. |
| 3200 | HTW CR Anticipated Eligibility | Updates text. |
| 4210 | Required Reporting and Frequency | Updates text. |
| 4220 | Voucher and Support Submission | Updates text. |
| 4230 | Program Promotion, Outreach and In-reach | Updates text. |
| 5000 | Additional Resources | Changes title to Personnel Policy and Procedures and updates text. Moves to 6000, Additional Resources. |
| 6000 | Additional Resources | Adds section. |
25-1, Miscellaneous Revisions
23-1, Miscellaneous Revisions
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Revision 23-1; Effective Sept. 27, 2023
| Revised | Title | Change |
|---|---|---|
| 1100 | Contact Information | Updates email addresses and contractor portal link. |
| 1200 | Purpose | Updates language. |
| 2200 | HTW Fee-for-Service | Updates language and TMPPM link. |
| 2500 | Definitions | Updates language and definitions throughout. |
| 3200 | HTW CR Anticipated Eligibility | Updates language. |
| 4110 | HTW CR Provider Reimbursement Criteria | Updates language. |
| 4120 | Texas Medicaid Provider Procedures Manual (TMPPM) and the Healthy Texas Women Program Handbook | Updates text. |
| 4130 | HTW CR Provider Reimbursement | Updates language. |
| 4140 | HTW CR Prohibitions | Updates language. |
| 4210 | Required reporting and Frequency | Updates language and revises reporting requirements. |
| 4220 | Voucher and Support Submission | Updates language. |
| 4230 | Program Promotion and Outreach | Changes title to Program Promotion, Outreach and Inreach. Updates language. Revises promotion and outreach requirements. |
| 5000 | Additional Resources | Removes forms. |
21-0, New Manual
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Effective September 1, 2021
The Healthy Texas Women Cost Reimbursement Manual replaces the Healthy Texas Women Policy and Procedure Manual as a guide for cost reimbursement contractors who deliver women’s health and family planning services in Texas through the Healthy Texas Women (HTW) Program. The manual applies only to HTW cost reimbursement and not the HTW fee-for-service component.
HTWCR Contact Us
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For questions about the Healthy Texas Women Cost Reimbursement Manual, email HTWContracts@hhs.texas.gov.
For technical or accessibility issues with this handbook, email: form.handbook.request@hhs.texas.gov.