4200, Client Eligibility Screening Process

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Revision 25-3; Effective Nov. 14, 2025

For a person to receive PHC services, three criteria must be met:

  • gross family income at or below 200% of the Federal Poverty Level (FPL);
  • Texas resident; and
  • not eligible for other programs or benefits providing the same services.

Residency is self-declared. Grantees must require residency verification, but such verification should not jeopardize delivery of services. Grantees must require income verification for countable income, except in cases when submitting the income verification jeopardizes the client's right to confidentiality or imposes a barrier to receive services. In these special cases, the grantee must waive the requirement for income verification. Note the reasons for waiving verification of income in the client’s record.

Eligibility determinations for PHC can be made by conducting interviews over the phone or in person for new applicants and re-certify current clients. Phone interviews for eligibility determinations must comply with all eligibility guidelines outlined in program policy.

Instead of a client’s signature on the application in the Acknowledgment section of Form 3029, Application for Program Benefits, the eligibility staff person may read the statements to the applicant and document that the applicant affirms the statements. The documentation must include the date and time of the applicant’s affirmation and the eligibility staff person’s signature. The client must sign the document at the time of their next visit to the clinic.