Revision 15-4; Effective October 1, 2015

Advisors must make an eligibility determination by the 45th day from the file date.

Reopen an application denied for failing to furnish information/verification if the missing information is provided by the 60th day from the file date. Use the date the missing information/verification was provided as the new file date.

Use the original application or renewal form until it is 60 days old. If the information on the form has changed or is more than 45 days old, the individual and advisor must update the form.

Revision 10-2; Effective April 1, 2010

Provide Form TF0001-F, Notice of Case Action, the same day eligibility is determined for an application but no later than 45 days from the file date.

Revision 10-2; Effective April 1, 2010

No interview is required to process an application or renewal unless requested by the applicant or recipient. If requested, provide the individual with a telephone interview. If the individual fails to keep the interview, do not deny the application or renewal but continue to process the request for assistance.

Revision 10-2; Effective April 1, 2010

Advisors must request documents that are readily available to the household and consider it sufficient verification. Use the verification sources listed in the various eligibility elements of Part A, Determining Eligibility, as potential and acceptable sources of verification. C-900, Verification and Documentation, gives information on verification procedures.

In determining eligibility, staff must consider any information the individual reports between the application date and the decision date. Include any information the individual reports during the application decision process.

Revision 15-4; Effective October 1, 2015

The Texas Integrated Eligibility Redesign System (TIERS) sends a renewal packet containing Form H1869, Renewal for Health Care Services; Form H1870, School Enrollment Verification Form; and a business reply envelope in the 11th month of the 12-month certification period.

F—2161 How to Process a Renewal

Revision 15-4; Effective October 1, 2015

Former Foster Care in Higher Education (FFCHE) recipients receive a passive renewal. Individuals are only required to return a renewal packet if information they provided during the application process has changed. If the individual does not return a renewal packet by the first calendar day of the last month of the certification period, TIERS automatically re-certifies the FFCHE Eligibility Determination Group (EDG) for another 12-month period, or through the month of the individual’s 23rd birthday, whichever is earlier. This will not require the Centralized Benefit Services (CBS) advisor to run eligibility or dispose the case.

Exception: School enrollment must be verified at application or renewal for FFCHE. If an FFCHE individual does not return the renewal packet, TIERS will process the passive renewal and will pend the EDG for school enrollment verification. If verification is not provided, the advisor will be required to run eligibility and dispose the case to sustain or deny benefits.

There is no interview requirement for an FFCHE renewal. The file date is the day any local Texas Health and Human Services Commission (HHSC) eligibility determination office receives the FFCHE application.

Verification from an associated EDG can be used if provided within 90 days of the FFCHE file date.

Follow the policy below when Form H1869/Form H1869-S, Renewal for Health Care Benefits, is returned for a renewal.

If the individual provides Form H1869/Form H1869-S indicating no change and has an associated EDG, review the associated EDG to determine if there is any conflicting data and if there is any documentation to clear the conflicting information. If not, request new verification via Form H1020, Request for Information or Action.

If the individual returns Form H1869/Form H1869-S reporting changes, provides verification and there are no associated EDGs, process the renewal using the new verification.

If the individual returns Form H1869/Form H1869-S reporting changes, provides verification and there are associated EDGs, review the associated EDGs and use the most recent information provided.

If the associated EDGs have other information the family did not report for the FFCHE EDG that would impact FFCHE eligibility, contact the individual (by telephone or Form H1020 with due date) to determine if the information in the associated EDGs is correct before denying or taking adverse action on the EDG.

If the individual returns Form H1869/Form H1869-S reporting changes without verification and has associated EDGs, request new verification via Form H1020.

If the individual returns Form H1869/Form H1869-S indicating changes, does not provide verification and does not have associated EDGs, request information needed to determine eligibility. If the individual does not provide the information, do not renew eligibility.

Revision 10-2; Effective April 1, 2010

If the individual returns a renewal packet, advisors must make an eligibility determination by the 30th day from the file date.

Note: A renewal application is considered a renewal if it is received by the last day of the 12-month certification period.

Reopen a renewal application denied for failing to furnish information or verification if the missing information/verification is provided by the 60th day from the file date. Use the date the missing information/verification was provided as the new file date.

Use the original Form H1869/Form H1869-S, Renewal for Health Care Benefits, until it is 60 days old. If the information on Form H1869/Form H1869-S has changed or is more than 45 days old, the individual and advisor must update the form.

Reminder: Consider a renewal application received after the last day of the 12-month certification period as an application using application processing time frames.

Revision 15-4; Effective October 1, 2015

Allow the household at least 10 days to provide missing information/verification. The due date must be a workday. Advisors must request documents that are readily available to the household if the documents are anticipated to be sufficient verification. If the applicant has any active or inactive EDGs, check to see if any verification previously provided for another EDG can be used to determine eligibility for FFCHE.

Use verifications accepted for Temporary Assistance for Needy Families (TANF), Medical Programs or the Supplemental Nutrition Assistance Program (SNAP).

For example, if you accept wage verification for a SNAP case, that same verification is acceptable for TANF, Medical Programs or FFCHE.

Exception: Verification of U.S. citizenship for applicants must be from a Medicaid-acceptable source. Staff cannot access the State Online Query/Wire Third-Party Query (SOLQ/WTPY) inquiry to verify citizenship or Retirement, Survivors and Disability Insurance (RSDI) for FFCHE processing. Advisors must request other types of verification, such as copies of birth certificates for citizenship and award letters for RSDI benefits.

Note: Do not use verification that is over 90 days old from the FFCHE file date.

 

F—2181 Summary of Due Dates for Form H1020, Request for Information or Action

Revision 15-4; Effective October 1, 2015

Case Action	Due Date	Final Due Date
Application	10 days	30th day, or 10th day if the household's Form H1020 due date extends beyond the 30th day
Renewal	10 days	30th day, or by the 10th day if the household's Form H1020 due date extends beyond the last day of the last benefit month
Incomplete review	10 days	10th day

Note: Staff have until the 45th day from the file date to determine eligibility for applications.