ORDER NO. 31127
KERR COUNTY INDIGENT HEALTH POLICY
Came to be heard this the 8th day of December, 2008, with a motion made by
Commissioner Baldwin, seconded by Commissioner Oehler, the Court unanimously
approved by a vote of 4-0-0 to:
Approve of the proposed Kerr County Indigent Health Policy as presented.
311a~
\ ` ~ ") COMMISSIONERS' COURT AGENDA REQUEST
PLEASE FURNISH ONE ORIGINAL AND NINE COPIES OF THIS
REQUEST AND DOCUMENTS TO BE REVIEWED BY THE COURT.
MADE BY: Rosa Lavender
MEETING DATE: Dec 8, 2008
OFFICE: Indigent Health
TIlVIE PREFERRED: Last on agenda
SUBJECT: Consider, Discuss and Approve the proposed Kerr County Indigent Health
Policy
EXECUTIVE SESSION REQUESTED: (PLEASE STATE REASON)
NAME OF PERSON ADDRESSING THE COURT: Rosa Lavender, Rex Emerson,
Dawn Lantz
ESTIMATED LENGTH OF PRESENTATION: 15 to 20 minutes
IF PERSONNEL MATTER -NAME OF EMPLOYEE:
Time for submitting this request for Court to assure that the matter is posted in accordance
with Title 5, Chapter 551 and 552, Government Code, is as follows:
Meeting scheduled for Mondays:
THIS REQUEST RECEIVED BY:
THIS REQUEST RECEIVED ON:
5:00 P.M. previous Tuesday.

All Agenda Requests will be screened by the County Judge's Office to determine if adequate
information has been prepared for the Court's formal consideration and action at time of Court
Meetings. Your cooperation will be appreciated and contribute towards you request being
addressed at the earliest opportunity. See Agenda Request Rules Adopted by Commissioners'
Court.
2008-2009
KERB COUNTY INDIGENT HEALTH CARE POLICY
(This policy, adopted by Kerr County Commissioners' Court at the regular meeting in
December, 2008, shall become effective .~anuary 31, 2009, and remain in effect until
August 31, 2009)
The Kerr County Indigent Health Program is established with an application,
documentation, and verification process based on Texas Department of State Health
Services (TDSHS) guidelines established Chapter 61 of the Health and Safety Code.
Chapter 61, the Indigent Health Care and Treatment Act was passed in 1986 by the 69~'
Texas Legislature.
The Kerr County Indigent Health Program will be referred to as KCII~P in the remainder
of this policy document.
KCII~P is a county-based program providing basic services according to the TDSHS
guidelines and does not offer any optional services.
KCII-IP has a maximum county liability per client for each state fiscal year (September 1
to August 31) for health services provided by all assistance providers, including hospital
and skilled nursing facility.
Eligibility must (by law) be determined within 14 days of application completion date.
KCII~P will consider four eligibility criteria for determination of eligibility:
Residence, Household, Income and Resources.
KCIHP Residency Requirements (may include but are not limited to):
• Mail addressed and delivered to the applicant's physical address. No post office
box addresses are acceptable.
• Texas driver's license or other official identification showing current Kerr
County address.
• Rent or mortgage payment showing applicant's name and address of property and
date signed.
• Kerr County property tax receipt for the most recent tax year
• Kerr County voter registration card showing current address
• School enrollment records
KCIHP Household Requirements (may include but are not limited to):
• A KCH' household may be a person living alone or two or more persons living
together where legal responsibility for support exists, excluding disqualified
persons. Verification of household is required.
• Legal responsibility for support exists between persons who are legally married,
a legal parent and a minor child, or a managing conservator and a minor child.
KCIHP Income Requirements
• A household must pursue and accept all income to which the household is legally
entitled.
• The income of all household members is considered in determining eligibility.
• Monthly Income Standards will be based on the annual Federal Poverty
Guidelines
• Verification of income may include but is not limited to requests for paycheck
stubs, statements from employers, W-2 forms, verification of cash contributions,
business records, award letters, court orders or public decrees, sales records,
income tax returns or statements completed, signed and dated by the self-
employed person.
KCIHP Resources Requirements
• A household must pursue all resources to which the household is legally entitled
unless it is unreasonable to pursue the resource. Indigent health care should be
considered the source of last resort.
• The resources of all household members are considered. Proof of resources may
be required.
KCIHP Policies
• All applicants for KCII3P will be required to visit the county's indigent health
office in the basement of the Kerr County Courthouse annex for an interview. If
the applicant misses the interview appointment the application will be denied and
applicant will have to reapply. If approved, a photo identification card will be
generated for the applicant.
• Persons already on the program will be photographed and an identification card
generated when they are reviewed. Reviews must be done every 6 months but
can be required at any interval of time less than the 6 months, as determined by
KCH'.
• Beginning Feb. 1, 2009, persons covered under the Kerr County Indigent Health
Program will be asked to share in the costs of their health care. $50 co-pay per
hospital services, $25 co-pay per doctor visit and $5 co-pay per prescription will
be requested. Program participants will be encouraged to seek information on
other low-cost prescription plans that aze available through their providers.
• Persons on KCIHP or new applicants will have 14 days to report changes in
address, in income or resources, people living in the household, or any
application for or receipt of Medicaid, TANF, or SSI to our office. Failure to do
so will jeopardize eligibility and could lead to criminal charges.
Applicants will be required to sign an affidavit swearing to the accuracy of
information provided in the application process and the affidavit will be notarized
at no cost to the applicant. A person who provides false information will be
banned from re-applying for indigent health care in Kerr County for a period of
two years. Giving false information on an application could lead to criminal
charges.
• Applicants will be subject to background checks to include screening under
wwti~.yourtexasbenefits.com and http.fibest.ssa.800
• The filing of an application for Kerr County II~P or the receipt of services
constitutes an assignment of the applicant's or recipient's right of recovery from
personal insurance, other sources, or another person for personal injury caused by
another person's negligence or wrong doing. An applicant or recipient shall
inform the county at the time of application or any time during eligibility, of any
unsettled tort claim that may affect medical needs and of any private accident or
sickness insurance coverage that is or may become available. Notice must be
given to KCII3P within 10 days of the date the person learns of the insurance
coverage, tort claim or potential cause of action.
• If an applicant is denied coverage, the person will have 14 days to file a written
appeal with KCIHP. A form will be provided. An appeals committee will review
the application and written appeal and set up a hearing with the applicant. The
review committee will be made up of the IHC Coordinator and two unbiased
members.
• Kerr County may, by state law, designate providers for indigent health care
recipients. Out-of-county care will require prior approval and a referral in writing
from a Ken County physician or meet one of three criteria (an emergency
situation, when medical care is not available in Kerr County, or when care in
Kerr County would be medically inappropriate).
• KCII3P requires dispensing of generic prescriptions, if there is a generic
available. A physician can request the name-brand as part of the prescription but
the IHC recipient cannot make the choice. Medications that are available in an
over-the-counter form will not be covered. Prescriptions are limited to a total of
three per month for each IHC recipient. If a physician writes the prescription for
a 90 day supply then the prescription will count as one of the three for each of the
three months. Dosage verification will be required for all prescriptions.
• Persons on KCII~P may be required to register with the Workforce Solutions
Alamo for job eligibility or training. They may also be advised to seek services
from the Texas Rehabilitation Commission or ask Social Security to determine
whether they are eligible for Social Security Disability Insurance/Medicare.
• For claim payments to be considered, a claim must be received in the KCII-IP
office no later than 95 days from (1) the date of service, for services provided
after the date of approval, or (2) the date of approval, for services provided
before the household was approved.
2008
~R~, CO`U~IrY
I7V~DIy'F,9V77f~AG47f CA2~`E
~G~
SUGGESTIONS FOR PROGRAM
• Designate a pharmacy (3 prescriptions per recipient per month) 14.201
• Designate anon-emergency health care provider ("mandated provider") 61.030* and
61.029
• Establish an appeal process -Texas Administration Code 25, Chapter 14(a) - 14.2
• Establish procedures to get asset information on applicants-shall adopt 61.024
• Establish background check procedures to include screening under:
www. yourtexasbenefits. com
http://best.ssa.800
• Change eligibility from 21% Federal Poverty Guideline
to 50% Federal Poverty Guideline 61-006(b~61.00221(b)
• County shall review at least once every six (6) months the eligibility of those who have
been granted assistance and received assistance
~ Request application to Texas Workforce Commission 61.042
Cannot take into account for 3 months
• Request nominal contribution amount toward assistance from recipients 61.005
• Must establish standards per state year effectiveness 61.023(d)
• Can request provider to obtain approval prior to non-emergency services 61.031
• Establish subrogation procedures 61.044
INDIGENT HEALTH CARE ACT -SUMMARY
Health and Safety Code Subtitle C Chapter 61
ELIGIBLE COUNTY RESIDENT 61.002 (2)
1) Eligible Resident
Meets income and resource requirements established by chapter or
government entity of jurisdiction of residence.
2) Does not reside in service area of public hospital or hospital district.
EMERGENCY SERVICES 61.002 (4)
Health and Safety Code, Chapter 773
MANDATED PROVIDER 61.0002 (8)
Person who provides health care is selected by the County and agrees to provide services.
RESIDENCE
61.003
Presumed to be where a person's home or fixed place of habitation is located, to which
person intends to return after a temporary absence.
Intent to reside may be evidenced by any relevant information including;
1) Mail addressed to person, or
to person's spouse or children if they live with person
2) Voting records
3) Auto registration
4) Texas Driver's License or other official identification
5) Children's school enrollment
6) Property tax receipt
Person is not considered a resident if person attempted to establish residence solely to obtain
health care assistance. 61.003 (d)
The burden of proving intent to reside is on the person requesting assistance. 61.003 (e)
RESIDENCE DISPUTE 61.004
a) If provider and government cannot agree on residence or whether person is eligible for
assistance, provider or government entity may submit it to the Texas Department of
Health.
b) Shall submit under 61.006 procedures.
c) If provider or government entity does not agree with Department's decision, provider
must file an appeal not later than 30 days after receiving notice of decision.
d) Final order of Department may be appealed per Government Code Chapter 2001
e) Service may not be denied, pending administrative or judicial review of residence, (not
eligibility).
INFORMATION NECESSARY TO DETERMINE ELIGIBILITY 61.0045
a) Any provider that delivers health care services who provider suspects is not a resident
of the County, may request patient to:
1) Provide a_y information necessary to establish eligible residency, and
2) Authorize release of a~ information relating to patient, including medical
information and residency information, to permit provider to submit claim to
County.
b) The County that receives information under (a) shall use information to determine
whether patient is an eligible resident, and if so, shall pay claim in accordance with the
statute.
c) Application, documentation and verification procedures established by Texas Dept. of
Health for counties may include standard format for obtaining information to facilitate
eligibility and residence.
NOMINAL REIMBURSMENT 61.005
a) County may request an eligible resident receiving health care assistance to contribute a
nominal amount toward cost of assistance.
b) County cannot deny or reduce assistance to eligible resident who cannot or refuses to
contribute.
STANDARDS AND PROCEDURES 61.006
a) Texas Dept of Health's minimum eligibility standards and application, documentation
and verification procedures will be used for the County to determine eligibility.
b) Minimum eligibility must incorporate net income eligibility level, equal to 21 % of
Federal Poverty Level, based on Federal Office of Management and Budget Poverty
Index.
c) Department shall establish services and payment standards in 61.028 (a) and
61.0285.
INFORMATION PROVIDED BY APPLICANT
At least:
1) Name and address
2) Social Security Number, if available
3) Number of persons in household, excluding those receiving:
temporary assistance for needy families,
SSI
and Medicaid
4) County of residence
5) Existence of insurance coverage:
hospital or health benefits for which applicant is eligible.
6) Any transfer of real property title applicant made in preceding 24 months.
7) Applicants annual household income,
excluding assistance from # 3.
2
ELIGIBILITY 61.008
1) County may not consider value of applicant's homestead.
2) County must consider equity value of car that is in excess of amount exempted under
department guidelines as resource.
3) County must subtract work related and child care expense allowed.
4) ,County must consider as a resource: real property other than homestead.
5) If applicant transferred property for less than market value to be eligible, the County
may not credit toward eligibility as an expenditure for that applicant.
6) Real property can be disregarded, if applicant agrees to enforceable obligation to
reimburse County for all or part of benefits received.
SUBCHAPTER B:
COUNTY RESPONSIBILITY 61.022
a) County shall provide health care assistance;
as prescribed
to each eligible County resident
b) County is payor of last resort and;
shall provide assistance
only if other adequate public or private sources are not available.
ELIGIBILITY 61.023
a) Eligible if:
1) Applicant does not reside in service area of public hospital or hospital
district.
2) Applicant meets basic income requirement and resources requirement under
61.006 and 61.008.
3) No other adequate source of payment exists.
b) County may use a less restrictive standard of eligibility for residents than in (a):
May credit toward eligibility for state assistance the services provided for
each person who is an eligible resident under a standard that incorporates a
net income eligibility level that is less than 50% of Federal Poverty Income.
c) County may contract with the Department to perform eligibility determination services:
1) Not later than beginning of State fiscal year:
2) County shall adopt eligibility standards it will use.
3) County shall make reasonable efforts to notify the public.
4) Standards may not be more restrictive than 61.006.
COUNTY APPLICATION PROCEDURE 61.024
a) Shall adopt application procedure.
b) May use application, documentation and verification procedures under 61.006 and
61.007 or less restrictive.
c) Not later than State fiscal year
1) County shall specify procedure to be used in that fiscal year to verify eligibility
and documentation required to support a request for assistance,
2) and shall make reasonable efforts to notify public.
d) County shall furnish applicant with written forms.
e) On request of applicant, County shall assist applicant in filling out forms and
completing application process. County shall inform applicant of availability of
assistance.
fj County shall require an applicant to sign a written affidavit as to truth of information.
g) County shall explain to applicant:
if approved, applicant must report any change of income or
resources that might affect eligibility not later than 14 days after
change, and County shall explain possible penalties.
h) County shall review each application and shall accept or deny not later than the 14~'
day after the application is received.
i) County shall provide procedure to review applications and procedure for appeal
of denial of assistance.
j) County shall provide written notification of County's decision, and if denied, the
reason for denial, and explanation of appeal process.
k) Records retention - 3 years
1) If denied, Applicant can resubmit if circumstances justify redetermination.
REVIEW OF ELIGIBILITY 61.026
County shall review at least once every 6 months the eligibility of a resident who has been
approved and received assistance.
CHANGE IN ELIGIBLITY STATUS 61.027
a) Shall report within 14 days.
b) For failure to report, resident is liable for any benefits received while ineligible. This
status does not affect criminal liability.
BASIC HEALTH CARE SERVICES 61.028
Listed in detail.
PROVISION OF HEALTH CARE SERVICES 61.029
a) County may arrange to provide through private provider.
b) County may affiliate with other governmental entities to provide regional administration
and delivery of health care services.
MANDATED PROVIDER 61.030
a) County may select one or more providers of health care services.
4
b) County may require eligible County residents to obtain care from mandated provider.
Except:
1) In an emergency
2) When medically inappropriate
3) When care is not available
NOTICE OF PROVISION OF NON-EMERGENCY SERVICES 61.031
a) County may require any provider, including mandated providers, to obtain
approval from the County before providing non-emergency health care services to
and eligible County patient's County of residence, that health care services have been or
will be provided.
b) Notice from provider to County shall be made:
1) by telephone not later than 72 hours after determination of County of
residence; and
2) by mail, postmarked not later than the 5~` day.
c) If County selects mandated provider and County requests that patient be transferred,
provider shall transfer patient unless medically inappropriate.
d) County must determine eligibility within 14 days or patient is considered eligible.
e) If provider delivers non-emergency services to patient who is eligible and fails to
comply with notice and transfer per 61.031, provider is not eligible for payment.
PROVISION OF EMERGENCY -NOTIFICATION 61.032
If anon-mandated provider delivers emergency services to patient the provider suspects might
be eligible for assistance, provider shall notify County. See Statute for details.
PAYMENT STANDARDS 61.034
a) County may contract with provider to provide health care services at rate below payment
standard set by the department.
MAXIMUM LIABILITY 61.035
To each eligible County resident:
1) $30,000, or
2) Payment of 30 days of treatment in skilled nursing or a hospital, or both,
or $30,000, whichever occurs first.
COUNTY REPORTING 61.041
Monthly reporting required to the State.
EMPLOYMENT SERVICES PROGRAM 61.042
County may establish procedures consistent with those used by Texas Dept. of State Health
Services under Chapter 31, Human Resources Code, for administering an employment services
program and requiring an applicant to register for work with Texas Employment Commission.
PREVENTION AND DETECTION OF FRAUD 61.043
Reasonable Procedures for minimizing opportunity for fraud and associated
administrative procedures.
SUBROGATION 61.044
a) Filing of application for or receipt of services constitutes an assignment right of
recovery from:
1) Personal insurance
2) Other sources, or
3) Another person for personal injury caused by other person
b) Applicant shall inform County, at time of application or anytime during eligibility, of
any unsettled tort claim that may affect medical needs of any private accident or illness
insurance. Applicant shall inform County of any injury or illness that is caused by
failure to act by another person. Applicant shall inform the County within 10 days.
c) Claim for personal injury on damages does not constitute grounds for denying.
d) Separate and distinct cause of action in favor of the County is created, and the County,
without written consent, can take civil action.
e) Right of recovery of the County is limited to amount of the cost of services paid by the
County.
6

2008-2009
KERR COUNTY INDIGENT HEALTH CARE POLICY
(This policy, adopted by Kerr County Commissioners' Court at the regular meeting in
December, 2008, shall become effective January 31, 2009, and remain in effect until
August 31, 2009)
The Kerr County Indigent Health Program is established with an application,
documentation, and verification process based on Texas Department of State Health
Services (TDSHS) guidelines established Chapter 61 of the Health and Safety Code.
Chapter 61, the Indigent Health Care and Treatment Act was passed in 1986 by the 69'i'
Texas Legislature.
The Kerr County Indigent Health Program will be referred to as KCII-IP in the remainder
of this policy document.
KCII~' is a county-based program providing basic services according to the TDSHS
guidelines and does not offer any optional services.
KCII~P has a maximum county liability per client for each state fiscal year (September 1
to August 31) for health services provided by all assistance providers, including hospital
and skilled nursing facility.
Eligibility must (by law) be determined within 14 days of application completion date.
KCII~' will consider four eligibility criteria for determination of eligibility:
Residence, Household, Income and Resources.
KCIHP Residency Requirements (may include but are not limited to):
• Mail addressed and delivered to the applicant's physical address. No post office
box addresses are acceptable.
• Texas driver's license or other official identification showing current Kerr
County address.
• Rent or mortgage payment showing applicant's name and address of property and
date signed.
• Kerr County property tax receipt for the most recent tax year
• Kerr County voter registration card showing current address
• School enrollment records

KCIHP Household Requirements (may include but are not limited to):
• A KC1I~ household may be a person living alone or two or more persons living
together where legal responsibility for support exists, excluding disqualified
persons. Verification of household is required.
• Legal responsibility for support exists between persons who are legally married,
a legal parent and a minor child, or a managing conservator and a minor child.
KCIHP Income Requirements
• A household must pursue and accept all income to which the household is legally
entitled.
• The income of all household members is considered in determining eligibility.
• Monthly Income Standards will be based on the annual Federal Poverty
Guidelines
• Verification of income may include but is not limited to requests for paycheck
stubs, statements from employers, W-2 forms, verification of cash contributions,
business records, award letters, court orders or public decrees, sales records,
income tax returns or statements completed, signed and dated by the self-
employed person.
KCIHP Resources Requirements
• A household must pursue all resources to which the household is legally entitled
unless it is unreasonable to pursue the resource. Indigent health care should be
considered the source of last resort.
• The resources of all household members are considered. Proof of resources may
be required.
KCIHP Policies
• All applicants for KCII3P will be required to visit the county's indigent health
office in the basement of the Kerr County Courthouse annex for an interview. If
the applicant misses the interview appointment the application will be denied and
applicant will have to reapply. If approved, a photo identification card will be
generated for the applicant.
• Persons already on the program will be photographed and an identification card
generated when they are reviewed. Reviews must be done every 6 months but
can be required at any interval of time less than the 6 months, as determined by
KCIHP.
• Beginning Feb. 1, 2009, persons covered under the Kerr County Indigent Health
Program will be asked to share in the costs of their health care. $50 co-pay per
hospital services, $25 co-pay per doctor visit and $5 co-pay per prescription will
be requested. Program participants will be encouraged to seek information on
'~ other low-cost prescription plans that are available through their providers.
;~, • Persons on KCII~iP or new applicants will have 14 days to report changes in
address, in income or resources, people living in the household, or any
application for or receipt of Medicaid, TANF, or SSI to our office. Failure to do
so will jeopardize eligibility and could lead to criminal charges.
• Applicants will be required to sign an affidavit swearing to the accuracy of
information provided in the application process and the afIdavit will be notarized
at no cost to the applicant. A person who provides false information will be
banned from re-applying for indigent health care in Kerr County for a period of
two years. Giving false information on an application could lead to criminal
charges.
• Applicants will be subject to background checks to include screening under
~~~~1~_yourte;xasbenetits.ccam and httpa/best.ssa.800
• The filing of an application for Kerr County II3P or the receipt of services
constitutes an assignment of the applicant's or recipient's right of recovery from
personal insurance, other sources, or another person for personal injury caused by
another person's negligence or wrong doing. An applicant or recipient shall
inform the county at the time of application or any time during eligibility, of any
unsettled tort claim that may affect medical needs and of any private accident or
sickness insurance coverage that is or may become available. Notice must be
given to KCII~P within 10 days of the date the person learns of the insurance
coverage, tort claim or potential cause of action.
• If an applicant is denied coverage, the person will have 14 days to file a written
appeal with KCII~P. A form will be provided. An appeals committee will review
the application and written appeal and set up a hearing with the applicant. The
review committee will be made up of the IHC Coordinator and two unbiased
members.
• Kerr County may, by state law, designate providers for indigent health care
recipients. Out-of-county care will require prior approval and a referral in writing
from a Kerr County physician or meet one of three criteria (an emergency
situation, when medical care is not available in Kerr County, or when care in
Kerr County would be medically inappropriate).
KCIITP requires dispensing of generic prescriptions, ifthere is a generic
available. A physician can request the name-brand as part of the prescription but
the IHC recipient cannot make the choice. Medications that are available in an
over-the-counter form will not be covered. Prescriptions are limited to a total of
three per month for each IHC recipient. If a physician writes the prescription for
a 90 day supply then the prescription will count as one of the three for each of the
three months. Dosage verification will be required for all prescriptions.
• Persons on KCIHP may be required to register with the Workforce Solutions
Alamo for job eligibility or training. They may also be advised to seek services
from the Texas Rehabilitation Commission or ask Social Security to determine
whether they are eligible for Social Security Disability Insurance/Medicare.
• For claim payments to be considered, a claim must be received in the KCII-IP
office no later than 95 days from (1) the date of service, for services provided
after the date of approval, or (2) the date of approval, for services provided
before the household was approved.
err
i a~
«Prev_Rule Texas Administrative Code Next Rule»
TITLE 25 HEALTH SERVICES
PART 1 DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 14 COUNTY INDIGENT HEALTH CARE PROGRAM
SUBCHAPTER A PROGRAM ADMINISTRATION
RULE §14.1 State Assistance Fund
(a) The Department of State Health Services (department) is responsible for distributing state assistance
to eligible counties to the extent appropriated state funds are available.
(b) The department establishes the eligibility requirements and internal procedures for a county
applying for state assistance.
(c) The department determines a county's eligibility for state assistance.
(d) The department distributes funds to eligible counties based on a maximum annual allocation.
(1) The maximum annual allocation will be based on such factors as spending history, population, and
the number of residents living below the Federal Poverty Guideline.
(2) The department-established allocation of the state assistance funds will distinguish the amount of
funds allocated between the counties that actually were eligible and received state assistance funds the
prior state fiscal year and other potentially eligible counties.
(3) Up to the legislatively-mandated or department-established appropriated state assistance funds for
each county, the department may reallocate the unspent funds to eligible counties.
(4) No county can be approved for more than the legislatively-mandated or department-established
percent of the appropriated state assistance fund within a state fiscal year.
Source Note: The provisions of this §14.1 adopted to be effective April 1, 2004, 29 TexReg 3177;
amended to be effective February 28, 2008, 33 TexReg 1549
r<tix~. pa•,e Previous Pa,~
~- List of Titles Back to List
II~J~E ~ TC~,~SS 1~~~}TE4'i ~ ~~~~ ~i~s~~fi~~x~~l~~j~ ~~v~~ ~ ~F~~~~ ~1~E~~~i~~ ~ ~~~~
http://info. sos. state.tx.us/pls/pub/readtac$ext. TacPage?s1=R&app=9&p_dir=&p_rloc=&p_... 10/3/2008
rage i of i
«Prev Rule Texas Administrative Code Next Rule»
TITLE 25 HEALTH SERVICES
PART 1 DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 14 COUNTY INDIGENT HEALTH CARE PROGRAM
SUBCHAPTER A PROGRAM ADMINISTRATION
RULE §14.2 Eligibility Dispute
(a) If a provider of assistance and a governmental entity or hospital district cannot agree on a
household's eligibility for assistance, the provider or the governmental entity or hospital district may
submit the matter to the department not later than the 90th day after the eligibility determination was
issued.
(b) The provider of assistance and the governmental entity or hospital shall submit all relevant
information to the department in accordance with the internal procedures established by the department.
(c) From the information submitted, the department shall determine the household's eligibility for
assistance.
(d) Not later than the 45th day after the receipt of the matter, the department shall notify each
governmental entity or hospital district and the provider of assistance of the decision and the reasons
for the decision.
Source Note: The provisions of this § 14.2 adopted to be effective April 1, 2004, 29 TexReg 3177;
amended to be effective February 28, 2008, 33 TexReg 1549
P~ext Page Previous Page
List of Titles Back to List
http://info.sos.state.tx.us/pls/pub/readtac$ext.TacPage?s1=R&app=9&p_dir=&p rloc=&p_... 10/3/2008
1 GXQJ tiU1111111JL1QUVG I.VUC
t"~I~C 1 UL G
«Prev Rule Texas Administrative Code Next Rule»
TITLE 2S HEALTH SERVICES
PART 1 DEPARTMENT OF STATE HEALTH SERVICES
CHAPT>CR 1.4 COUNTY INDIGENT HEALTH CARE PROGRAM
SUBCHAPTER B DETERMINING ELIGIBILITY
RULE §14.101 Application Processing
(a) An identifiable application is an application that minimally contains the applicant's name, address,
signature, and the date signed.
(b) The application file date is the date the county first receives an identifiable application.
(c) A complete application is an application with at least the following information provided by the
applicant:
(1) the applicant's full name and address;
(2) the applicant's social security number, if available;
(3) the names of all other household members and their relationship to the applicant;
(4) the applicant's county of residence;
(S) information about any medical insurance and hospital or health care benefits for which the
household members are eligible;
(6) any transfer of title of a countable resource, including real property, that the applicant has made
within three months before application or any time after certification;
(7) the gross monthly income of each household member, excluding the income of any household
member receiving Temporary Assistance for Needy Families (TANF), Supplemental Security Income
(SSI), or Medicaid benefits;
(8) the amount of liquid assets, the fair market value of vehicles, and the equity value of real property
that the household members own;
(9) the applicant's signature and the date the form is filled out; and
(10) all needed verifications.
(d) The application completion date is the date the county receives a complete Application for
Assistance Form.
(e) Day is defined as a calendar day, unless otherwise clearly defined.
Source Note: The provisions of this §14.101 adopted to be effective April 1, 2004, 29 TexReg 3177;
http://info. sos. state.tx. us/pls/pub/readtac$ext. TacPage?s1=R&app=9&p_dir=&p_rloc=&p_... 1013 /2008
i"Q~C G VL G
amended to be effective February 28, 2008, 33 TexReg 1549

List of Titles Back to List
1{i~~iE I TE~~~ }'~E~{~TEEd I lE~~ ~~3~Ih[~T,~TI~~E ~~CE I E~Etd ~lEEll{1C~ I {1EE€~ i
http://info.sos. state.tx.us/pls/pub/readtac$ext.TacPage?s1=R&app=9&p_dir=&p_rloc=&p_... 10/3/2008
1GXtlJ t~U1111111J1IQl1VG I.UUe
rake
«Prev Rule Texas Administrative Code Next Rule»
TITLE 25 HEALTH SERVICES
PART i DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 14 COUNTY INDIGENT HEALTH CARE PROGRAM
SUBCHAPTER B DETERMINING ELIGIBILITY
RULE §14.102 Residence
(a) A person must live in the Texas county to which he applies for assistance.
(b) No time limit is placed on a person's absence from the county. If a person proves county residency
at application, the person remains a county resident until factual evidence proves otherwise.
(c) There are no durational requirements for residency.
(d) Even if a minor student lives in the county, the minor student primarily supported by his parents,
whose home residence is in another county or state, is not considered a county resident.
(e) A person cannot qualify for county health care assistance from more than one county
simultaneously.
(f) A person is not required to have a permanent dwelling or a fixed residence.
Source Note: The provisions of this § 14.102 adopted to be effective April 1, 2004, 29 TexReg 3177;
amended to be effective February 28, 2008, 33 TexReg 1549
Next = •~~~~ Pros-~.cus ~'ag~
List of Titles Back to List
http://info.sos.state.tx.us/pls/pub/readtac$ext.TacPage?s1=R&app=9&p_dii=&p_rloc=&p_... 10/3/2008
rage
«Pre_v_Rule Next Rule»
Texas Administrative Code
TITLE 25 HEALTH SERVICES
PART 1 DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER l.4 COUNTY INDIGENT HEALTH CARE PROGRAM
SUBCHAPTER B DETERMINING ELIGIBILITY
RULE §14.103 Household
~,
(a) A county health care assistance household is a person living alone, or two or more persons living
together, who are legally responsible for the support of the other person(s). Disqualified persons are not
household members regardless of their legal responsibility for support.
(b) An inmate in a county jail qualifies as a household if the inmate meets all other eligibility criteria.
(c) A non-TANF foster care child qualifies as a household if the child meets all other eligibility criteria.
A foster child in the managing conservatorship of a licensed, privately-funded 24-hour child care
facility does not qualify for county health care assistance.
(d) A person appealing a social security disability denial qualifies as a household if the person meets all
other eligibility criteria.
(e) Legal responsibility for support exists between persons who are legally married, a legal parent and a
minor child, or a managing conservator and a minor child.
(f) Non-household members are defined as individuals who cohabitate without legal responsibility.
(g) A minor child is a person under 18 years of age who is not, or has not been, married and has not had
the disabilities of minority removed for general purposes.
(h) An adult is a person at least. l 8 years of age, or a younger person, who is or has been married or had
the disabilities of minority removed for general purposes.
(i) The following persons are disqualified from inclusion in the household:
(1) a person who receives or is categorically eligible to receive Medicaid;
(2) a person who receives TANF or SSI benefits; and
(3) a Medicaid recipient who has exhausted a part or all of that recipient's Medicaid benefit.
(j) The following persons are considered aone-person household:
(1) an adult living alone;
(2) an adult living with others who are not legally responsible for supporting each other;
(3) a minor child living alone or with others who are not legally responsible for his support; or
http://info.sos.state.tx.us/pls/pub/readtac$ext.TacPage?s1=R&app=9&p dir=&p_rloc=&p_... 10/3/2008
ra~,C~~i~
(4) aMedicaid-ineligible parent whose spouse and/or minor children are Medicaid-eligible.
(k) The following persons living together are considered a household group:
(1) two persons legally married to each other;
(2) one or both legal parents and their legal minor children;
(3) a managing conservator and a minor child and the conservator's spouse and other legal minor
children, if any;
(4) minor children who are siblings; or
(5) both Medicaid-ineligible parents of Medicaid-eligible children.
(1) When one household lives with another household, eligibility for each household must be
determined independently.
Source Note: The provisions of this § 14.103 adopted to be effective April 1, 2004, 29 TexReg 3177;
amended to be effective February 28, 2008, 33 TexReg 1549
i~~ex: Fagg Frey_~us ~a~
List of Titles Back to List
http://info.sos. state.tx.us/pls/pub/readtac$ext.TacPage?s1=R&app=9&p_dir=&p_rloc=&p_... 10/3/2008
rake
«Prev Rule Texas Administrative Code Next Rule»
TITLE 25 HEALTH SERVICES
PART 1 DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 1.4 COUNTY INDIGENT HEALTH CARE PROGRAM
SUBCHAPTERS DETERMINING ELIGIBILITY
RULE §14.104 Income
(a) Definitions. The following words and terms when used within this chapter shall have the following
meanings, unless the context clearly indicates otherwise.
(1)Income--Any type of payment that is of gain or benefit to the household. As established by the
department, income is either countable or exempt under the department-established budgeting process.
(2) Earned income--Income related to employment and entitles the household to deductions not
allowed for unearned income.
(3) Unearned income--Payments received without performing work-related activities. It includes
benefits from other programs.
(b) A county must subtract the work-related and childcare expense deductions allowed under
department guidelines.
(c) A household must pursue and accept all income to which the household is legally entitled.
~,,,- Reasonable time (at least three months) rfiust be allowed for the household to pursue the income. The
income is not considered available during this time.
(d) Income from non-household members and/or disqualified household members is excluded.
Source Note: The provisions of this § 14.104 adopted to be effective April 1, 2004, 29 TexReg 3177;
amended to be effective February 28, 2008, 33 TexReg 1549
.Next Page Pre;ri.ous :Wage
List of Titles Back to List

http://info.sos.state.tx.us/pls/pub/readtac$ext.TacPage?s1=R&app=9&p_dir=&p_rloc=&p_... 10/3/2008
1 G1iQJ tiU1111111J11dUVC I.UUC
ra~c
«Prev Rule Texas Administrative Code Next Rule»
TITLE 25 HEALTH SERVICES
PART 1 DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER l.4 COUNTY INDIGENT HEALTH CARE PROGRAM
SUBCHAPTER B DETERMINING ELIGIBILITY
RULE §14.105 Resources
(a) Definitions. The following words and terms when used within this chapter shall have the following
meanings, unless the context clearly indicates otherwise.
(1)Assets--All items of monetary value owned by an individual, excluding personal possessions.
(2) Resources--Both liquid and non-liquid assets a person can convert to meet his immediate needs.
As established by the department, resources are either countable or exempt.
(A) Liquid resources are resources that are readily negotiable, such as cash, checking or savings
accounts, savings certificates, stocks, or bonds.
(B) Non-liquid resources include vehicles, buildings, land, or certain other property.
(3) Accessible resource--A resource that is legally available to the household.
(4) Inaccessible resource--A resource that is not legally available to the household.
(5) Personal possessions--Furniture, appliances, jewelry, clothing, livestock, farm equipment, and
other items if the household uses them to meet personal needs essential for daily living.
(6) Real property--Land and any improvements on it.
(7) Fair market value--The amount of money an item would bring if sold in the current local market.
(8) Equity--The fair market value of an item minus all money owed on it and the cost associated with
its sale or transfer.
(b) Resource Limit. The total value ofnon-exempt resources available to the household cannot exceed:
(1) $3,000 for households which include the applicant or a relative living in the home who is aged or
disabled; or
(2) $2,000 for all other households.
(c) The following criteria will be used to determine the household's resource limit category.
(1) A related person is a person who meets the TANF relationship criteria, either biologically or by
adoption.
(2) An aged person is a person age 60 or older as of the last day of the month for which benefits are
http://info.sos. state.tx.us/pls/pub/readtac$ext.TacPage?s1=R&app=9&p_dir=&p_rloc=&p_... 10/3/2008
rage ~ or ~
being requested.
(3) A disabled person is a person who meets the TANF disability criteria.
(d) In determining eligibility:
(1) a county must not consider the value of the applicant's homestead;
(2) a county must consider as a resource the value of a vehicle under department-established
guidelines;
(3) if, within three months before application or any time after certification, the household transfers
title of a countable resource for less than its fair market value to qualify for assistance, the county must
consider the household ineligible for the department-established length of time. This penalty applies if
the total of the transferred resource added to other resources affects eligibility for assistance;
(4) a county must consider as a resource real property other than a homestead and must count that
property in determining eligibility; and
(5) a county may disregard the applicant's real property if the applicant agrees to an enforceable
obligation to reimburse the county for all or part of the benefits received under the County Indigent
Health Care Program. The county and the applicant may negotiate the terms of the obligation.
Source Note: The provisions of this § 14.105 adopted to be effective April 1, 2004, 29 TexReg 3177;
amended to be effective February 28, 2008, 33 TexReg 1549

List of Titles Back to List
11~#~E I TE~~,~ 1;~~iTI~~ l lE~~~ ~;a~It~li1~~T1';E C~"fPE 113F'EI'~ C~E~IIf~C~ I fall? I
http://info. sos. state.tx.us/pls/pub/readtac$ext. TacPage?s1=R&app=9&p_dir=&p_rloc=&p_... 10/3 /2008
i exas tiumims~ra~ive ~oae
rage i or 4
«Prev Rule Next Rule»
Texas AdmmistratiVe Code
TITLE 25 HEALTH SERVICES
PART 1 DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 14 COUNTY INDIGENT HEALTH CARE PROGRAM
SUBCHAPTER C PROVIDING SERVICES
RULE §14.201 Basic and Optional Services
(a) Except as specified in the department-established service exclusions and limitations, counties are
required to provide the following basic health care services to eligible households by reimbursing
providers of services who meet the requirements of this chapter and the responsible county.
(1) Inpatient hospital services. Services must be medically necessary and:
(A) provided in an acute care hospital;
(B) provided to hospital inpatients;
(C) provided by or under the direction of a physician; and
(D) provided for the care and treatment of patients.
(2) Outpatient hospital services. Services must be medically necessary and:
(A) provided in an acute care hospital or hospital-based ambulatory surgical center;
(B) provided to hospital outpatients;
(C) provided by or under the direction of a physician; and
(D) are diagnostic, therapeutic, or rehabilitative.
(3) Physician services. Services must be medically necessary and provided by a physician in the
doctor's office, a hospital, a skilled nursing facility, or elsewhere.
(4) Up to three prescriptions for drugs per recipient per month. New and refilled prescriptions count
equally toward this total prescription limit. Drugs must be prescribed by a physician or other
practitioner within the scope of practice under law. The quantity of drugs prescribed depends on the
prescribing practice of the physician and the needs of the patient.
(5) Skilled nursing facility services (SNF). Services must be medically necessary, ordered by a
physician, and provided in a skilled nursing facility that provides daily services on an inpatient basis.
(6) Rural health clinic services. Rural health clinic services must be provided in a rural health clinic by
a physician, a physician's assistant, a nurse practitioner, a nurse midwife, or other specialized nurse
practitioner.
(7) Family planning services. These are preventive health and medical services that assist an
http://info. sos.state.tx.us/pls/pub/readtac$ext.TacPage?s1=R&app=9&p_dir=&p_rloc=&p_... 10/3/2008
individual in controlling fertility and achieving optimal reproductive and general health.
(8) Laboratory and x-ray services. These are technical laboratory and radiological services ordered
"`ri.~ and provided by, or under the direction of, a physician in an office or a similar facility other than a
hospital outpatient department or clinic.
(9) Immunizations. These are given when appropriate.
(10) Medical screening services. These medical services include blood pressure, blood sugar, and
cholesterol screening.
(11) Annual physical examinations. These are examinations provided once per calendar year by a
physician or a physician's assistant (PA). Associated testing, such as mammograms, can be covered
with a physician's referral. These services may also be provided by an Advanced Practice Nurse (APN)
if they are within the scope of practice of the APN in accordance with the standards established by the
Board of Nurse Examiners and published in 22 Texas Administrative Code, §221.13.
(b) The following services are optional health care services.
~-----
(1) Ambulatory surgical center (ASC) services. These services must be provided in a freestanding
ASC, and are limited to items and services provided in reference to an ambulatory surgical procedure,
including those services on the Center for Medicare and Medicaid Services (CMS)-approved list and
selected Medicaid-only procedures.
(2) Federally Qualified Health Center (FQHC) services. These services must be provided in an FQHC
by a physician, a physician's assistant, a nurse practitioner, a clinical psychologist, or a clinical social
worker.
(3) Physician assistant (PA) services. These services must be medically necessary and provided by a
PA under the direction of a physician and may be billed by and paid to the supervising physician.
(4) Advanced practice nurse (APN) services. An APN must be licensed as a registered nurse (RN)
within the categories of practice, specifically, a nurse practitioner, a clinical nurse specialist, a certified
nurse midwife (CNM), and a certified registered nurse anesthetist (CRNA), as determined by the Board
of Ntlrse Examiners. APN services must be medically necessary, provided within the scope of practice
of an APN, and covered in the Texas Medicaid Program.
(5) Counseling services. Psychotherapy services must be medically necessary based on a physician
referral, and provided by a licensed professional counselor (LPC), a licensed master social worker-
advanced clinical practitioner (LMSW-ACP), a licensed marriage family therapist (LMFT), or a Ph.D.
psychologist. These services may also be provided based on an APN referral if the referral is within the
scope of their practice in accordance with the standards established by the Board of Nurse Examiners
and published in 22 Texas Administrative Code, §221.13.
(6) Diabetic medical supplies and equipment. These supplies and equipment must be medically
necessary and prescribed by a physician. The county may require the supplier to receive prior
authorization. Items covered are lancets, alcohol prep pads, syringes, test strips, humulin pens and
glucometers. These supplies and equipment may also be prescribed by an APN if this is within the
~,.r scope of their practice in accordance with the standards established by the Board of Nurse Examiners
and published in 22 Texas Administrative Code, §221.13.
http://info.sos. state.tx.us/pls/pub/readtac$ext.TacPage?s1=R&app=9&p_dir=&p_rloc=&p_... 10/3/2008
(7) Colostomy medical supplies and equipment. These supplies and equipment must be medically
necessary and prescribed by a physician. The county may require the supplier to receive prior
authorization. Items covered are colostomy bags/pouches; cleansing irrigation kits, paste, or powder;
and skin barriers with flange (wafers). These supplies and equipment may also be prescribed by an
APN if this is within the scope of their practice in accordance with the standards established by the
Board of Nurse Examiners and published in 22 Texas Administrative Code, §221.13.
(8) Durable medical equipment. This equipment must be medically necessary; meet the
Medicare/Medicaid requirements; and provided under a written, signed, and dated physician's
prescription. The county may require the supplier to receive prior authorization. Items can be rented or
purchased, whichever is the least costly. Items covered are crutches, canes, walkers, standard wheel
chairs, hospital beds, home oxygen equipment (including masks, oxygen hose, and nebulizers), and
reasonable and appropriate appliances for measuring blood pressure. These supplies and equipment
may also be prescribed by an APN if this is within the scope of their practice in accordance with the
standards established by the Board of Nurse Examiners and published in 22 Texas Administrative
Code, §221.13.
(9) Home and community health care services. These services must be medically necessary; meet the
Medicare/Medicaid requirements; and provided by a certified home health agency. A plan of care must
be recommended, signed, and dated by the recipient's attending physician prior to care being given. The
county may require prior authorization. Items covered are Registered Nurse (RN) visits for skilled
nursing observation, assessment, evaluation, and treatment provided a physician specifically requests
the RN visit for this purpose. A home health aide to assist with administering medication is also
covered. Visits made for performing housekeeping services are not covered.
(10) Dental care. These services must be medically necessary and provided by a DDS, a DMD, or a
DDM. The county may require prior authorization. Items covered are an annual routine dental exam
and the least costly service for emergency dental conditions for the removal or filling of a tooth due to
abscess, infection, or extreme pain.
(11) Vision care, including eyeglasses. The county may require prior authorization. Items covered are
one examination of the eyes by refraction and one pair of prescribed glasses every 24 months.
(12) Emergency medical services. These services are ground ambulance transport services. When the
client's condition is life-threatening and requires the use of special equipment, life support systems, and
close monitoring by trained attendants while en route to the nearest appropriate facility, ground
ambulance transport is an emergency service.
(13) Other medically necessary services or supplies that the local governmental municipality/entity
determines to be cost effective.
Source Note: The provisions of this § 14.201 adopted to be effective April 1, 2004, 29 TexReg 3177;
amended to be effective February 28, 2008, 33 TexReg 1549
Nex~ Fa~~e Previous Face

http://info.sos.state.tx.us/pls/pub/readtac$ext.TacPage?s1=R&app=9&p_dir=&p rloc=&p_... 10/3/2008
List of Titles Back to List
tI01~E I Tf~~~~ F~~I~T~I'6I iE~ IflfEf~T.~TI~L I~I~CE I ~F'CI~ 1~1EI:111~~~ I III:1~ I

http://info.sos. state.tx.us/pls/pub/readtac$ext. TacPage?s1=R&app=9&p_dir=&p_rloc=&p_... 10/3/2008
TEXAS DEPARTMENT OF STATE HEALTH SERVICES (TDSHS)
~r-
COUNTY INDIGENT HEALTH CARE PROGRAM HANDBOOK
TABLE OF CONTENTS
CHAPTER 61, HEALTH AND SAFETY CODE may be accessed at
httg://www.capitol.state.tx. us/statutes/hs.toc.htm
TABLE OF CONTENTS ....................................................................................................
TECHNICAL ASSISTANCE ......................................................•--......................................
SECTION ONE. PROGRAM ADMINISTRATION
Page
....... i
..... iii
Introduction .................................................................................................................................1
Work Registration .......................................................................................................................3
Definitions ...................................................................................................................................4
SECTION TWO. ELIGIBILITY CRITERIA
Residence ...................................................................................................................................1
Household ...................................................................................................................................2
Resources ................................................................................................................................... 5
Income ......................................................................................................................................15
Budgeting Income ................................................................................................................25
SECTION THREE. CASE PROCESSING
General Principles .......................................................................................................................1
Processing an Application ...........................................................................................................3
Denial Decision Disputes ............................................................................................................5
Case Record Maintenance ..........................................................................................................6
CIHCP 08-1
April 2008
Table of Contents /Page 2
SECTION FOUR. SERVICE DELIVERY
General Principles .......................................................................................................................1
Basic Health Care Services (Physician Services, Annual Physical Examinations, Immunizations, Medical
Screening Services, Laboratory and X-ray Services, Family Planning Services, Skilled Nursing Facility Services,
Prescription Drugs, Rural Health Clinic Services) .....................................................................................5
Rural Health Clinic Rates ....................................................................................................13
Hospital Rates -Inpatient Rate, Outpatient Rate, and Hospital SDA ..................................41
Optional Health Care Services (APN Services, Freestanding ASC Services, Colostomy Medical Supplies
and Equipment, Counseling Services, Dental Care, Diabetic Medical Supplies and Equipment, DME, Emergency
Medical Services, Home and Community Health Care Services, PA Services, Vision Care, FQHC Services) ........65
FQHC Rates .......................................................................................................................77
User's Guide to Fee Schedules .....................................................................................•---........84
SECTION FIVE. STATE ASSISTANCE FUNDS
General Principles .......................................................................................................................1
Steps for Applying .......................................................................................................................2
SECTION SIX. FORMS (in numerical order)
Form 100	Application for Health Care Assistance
Form 101	Worksheet
Form 101-A	Report of Changes
Form 102	Appointment Notice
Form 103	Request for Information
Form 104	Health Care Services Record
Form 105	CIHCP Monthly Financial/Activity Record
Form 106	Eligibility Dispute Resolution Request (EDRR)
Form 108	Case Record Information Release
Form 109	Notice of Eligibility
Form 110	Claim Processing Notification
Form 111	Facility and Prescription Drug Payment Rate Request
Form 117	Notice of Ineligibility
Form 120	Optional Health Care Services Notification
Form 128	Employment Verification
Form 149	Statement of Self-Employment Income
Form 222	Monthly Gross Income Screening Table
Form 500	Request for State Assistance Funds
CIHCP 08-1
April 2008
~"~ ~ Form 101/ Page 1 of 4
County Indigent Health Care Program (CIHCP)
WORKSHEET
Date Identifiable Form 1lx) Is Received in Office	Case Record Number	Type of Determination
		^ Application ^ Review
Case Record Name (Last, Rrst, Middle)	Case Record Action	Eligibility Effective Date (MM-DD-YYYY)
	^ Approved ^ Continued ^ Denied	
	Prior Eligibility Effective Dates (MM-DD-YYYY)
Date Signature -Eligibility Determiner

ELIGIBILITY ITEMS
2. H
C.
D.
E.
DOCUMENTATION
Form 100	
~. Is the Form 100 appropriately signed and dated by the	
applicant? ........................................................... ^Yes ^ No	
3. Is the Form 100 appropriately signed and dated by the	
spouse, if the applicant is married and the spouse lives in the	

house? ...................................................^Yes ^ No ^ N/A	- -
;. Is information complete and consistent?............ ^Yes ^No	
lousehold	
Who is applying for CIHCP?	
	
. Does legal responsibility for support exist between the	
applicant(s) listed in 2A and any other person living in the	
house? ............................................................... ^Yes ^ No	
If Yes, between whom?	
	
	
Does any individual listed in 2A or 26 receive Medicaid? ........	
^Yes ^ No If Yes, who?	
Disqualify the Medicaid recipient(s) listed in 2C and use	
Step 2 of the Budget Calculation on Page 3, if applicable.	
Is any individual listed in 2A or 26 potentially eligible to	
receive Medicaid? .............................................. ^Yes ^ No	
If yes, who?	
Use the Medicaid screening tool: www.vourtexasbenefits.com	
and refer to the CIHCP Handbook for application processing.	
Who are the members of the CIHCP household?	
	
eri household if uestionable.	
In the following questions 3 - 10, "CIHCP household member"	
refers to each individual listed in 2E above.	
CIHCP 08-1 /April 2008
~`~ ~~~~ °° Form 101/ Page 2 of 4
3. Residence
ELIGIBILITY ITEMS
DOCUMENTATION
A. Is each CIHCP household member a county resident? .............
............................................................................ ^ Yes ^ No
B. Does each CIHCP household member plan to remain in the
county? ............................................................... ^ Yes ^ No
(Verify residence if questionable.]
4. Resources [Exempt al! resources of the Medicaid recipients Listed in 2C.]
A. Does any CIHCP household member own the following?
Resource	Yes	No	Countable
Value
1. Cash on Hand			
2. Certificates of De osit			
3. Checkin Accounts			
4. Insurance Settlements			
5. Lawsuit Settlements			
6. Livestock			
7. Lum Sum Pa ments			
8. Notes Bonds, Stocks			
9. Pre aid Burial Insurance			
10. Real Estate ~exd~a~~ nomescead~			
11. Retirement (~nduaing iRns~			
12. Savin s Accounts			
13. Vehicles			
14. Other Resources			
15. TOTAL COUNTABLE RESOURCES
(This amount is not rounded.]	$
B. Has any CIHCP household member transferred a countable
resource within 3 months before application? .... ^ Yes ^ No
(Document regarding countable resources for the application month
and the 3 months prior. Verify resources if questionable or if the
countable value is close to the resource limit.)
5. Income [Exempt all income of the Medicaid recipients listed in 2C.j
A. Does any CIHCP household member have terminated income
in the application month or the 3 months prior? . ^ Yes ^ No
B. Does any CIHCP household member have any other countable
income in the application month or the 3 months prior?...........
............................................................................ ^ Yes ^ No
[Document and verify all countable income, including terminated
income, for the application month and the 3 months prior.]
CIHCP 08-1 /April 2008
is 71~ ~ ~ `..'.
' Form 101/ Page 3 of 4
6. Budget Calculation
ITEMS
DOCUMENTATION
A. Determine the household's monthly total countable income.
		Name of Member with Income	
-
Type of Income			
amed Income #1 throw h 7			
1. Month) Gross Earned Income			
2. Standard Work-Related Ex nse	-	-	
3. Subtotal Line 1 minus Line 2			
4. 113 of Line 3	-	-	
5. Subtotal Line 3 minus Line 4			
6. Child /Inca acitated Adult Care	-	-	
7. Countable Earned Income			
neamed In me #8 throw h #17			
8. Alien S onsor's Income			
9. Cash Gifts, Contributions Prizes			
10. Child Su rt Pa ments			
11. Interest and Dividend Pa ents			
12. Retirement Benefit Pa ments			
13. Social Securi Benefit Pa ments			
14. Unem to ment Benefit Pa ents			
15. V. A. Benefit Pa ments			
16. Worker's Com ensation Pa ments			
17. Other Unearned Income			
(Add Line 7 plus Lines 8 through 17.)				
18. TOTAL COUNTABLE INCOME	+		_ ~	
B. Complete 6B if any of the CIHCP applicants is a spouse, a legal parent, or a stepparent not receiving Medicaid.
If the household contains no Medicaid recipients, go to 6C.
1. Total countable Income from 6A, Line 18	$
2. Deduction for the su ort of the Medicaid reci Tents listed in 2C (see Handbook, Section 2, Page 29.)	- $
3. Deduction for legally obligated child support payments made by members of the household	$
4. Net Countable Income Line 1 minus line 2	$
C. Compare the CIHCP Household's Net Countable Income to the CIHCP Monthly Income Standard.
1. NET COUNTABLE INCOME from sa, une to or from se, une 3 with cents rounded down $
2. CIHCP Month) Income Standard for the CIHCP household See Handbook, section z, Page 30.) $
If the Line 1 amount is equal to or less than the Line 2 amount, the CIHCP household is income eligible.
If the Line 1 amount is greater than the Line 2 amount, the CIHCP household is not income eligible.
CIHCP 08-1 /April 2008
V ~ 1 i^,4 ,
Form 1011 Page 4 of 4
7.
ELIGIBILITY ITEMS
DOCUMENTATION
[If 1
8.
t
I
c
r
F
9. 5
P
B
10. C
Eligibility
A. Is the household eligible for CIHCP? ................. ^Yes ^ No	
B. [Question 78 is for applications. Mark N/A if Phis is a review. j
Is any CIHCP household member eligible in any of the three
month(s) before the month in which the identifiable application
was filed? ............................................... ^Yes ^ No ^ N/A
If Yes, list the name(s) and the eligible prior month(s).	
___ _______________________________________ __ __
	
	
	
~e househo/d is eligible for CIHCP, complete Items 8, 9, and 10.j	____

)they Sources of Health Care Coverage	_______ __________
___
___ ____

)oes any CIHCP household member have private health
isurance, Veterans' Administration (V. A.) health care coverage,
Yorker's Compensation health care coverage, Texas
iehabilitation Commission (TRC) health care coverage, or any
ther source of health care coverage? ...................^Yes ^No	_____________ _________
__

__ _________________ ______ ________
Yes, document regarding other source(s).	_
receipt of any other source ofnon-Medicaid health care coverage does	__
of deny an applicant or recipient from CIHCP. It may indicate another	__
ayment source.]	
SI Status	
. Has any CIHCP household member applied for SSI or RSDI	
with the Social Security Administration? ...................................	
^Yes ^ No ^ N/A If yes, who?	
	
Is any CIHCP household member an SSI or RSDI appellant	
with the Social Security Administration? ...................................	
^Yes ^ No ^ N/A If yes, who?	
	
The Benefit Eligibility Screening Tool (BEST) screens for	
potential eligibility for benefits from any of the programs that	
Social Security administers. BEST may be accessed at	
http//best.ssa.gov	
use Review	
This case is due for its next 6-month review in ........................	
MM•YYYY		
CIHCP OS-1 /April 2008
ra~C
NEW! Trainino in San Patricio County in October, Jasper County in November 2008
NEW! CIHCP Handbook Revision 08-2 Effective August 1, 2008
NEW! CIHCP Training dates, October 2008 & January 2009
NEW! FY07 CIHCP Spending Data
What is the County Indigent Health Care Program?
The County Indigent Heath Care Program provides health care services to eligible residents through the
counties, hospital districts and public hospitals in Texas. Click here for more information about the
program.
Click here for information on the Indigent Heath Care Advisory Committee
Who is eligible for assistance?
~ Persons who meet the eligibility criteria may have services rendered by or paid for through the program.
What services are available?
Counties are required to provide Basic Health Care Services to eligible residents and may elect to provide a
number of DSHS-established Optional Health Care Services. Click here to find your local CIHCP Office.
Texas Department of State Health Services
Preventive and Primary Care Unit, MC 2831
1100 W. 49th Street
PO Box 149347
Austin, TX 78714-9347
Phone: (512) 458-7706
Fax: (512) 458-7713
Email: County Indigent Feedback
TECHNICAL ASSISTANCE
The County Indigent Health Care Group may be contacted at:
Texas Department of State Health Services
Community Health Services
County Indigent Health Care Group Y-990
1100 West 49th Street
Austin, Texas 78756-3168
Fax: (512) 458-7713
www.dsh s.state.tx. us/cihcp
E-mail policy questions to: IHCNETCa~dshs.state.tx.us

Individual staff members can be contacted at (512) 458-7706.
Ms. Jan Maberry, Group Manager
(All Aspects of the Program)
Ext. 7728
E-mail: jan.maberryC«?dshs.state.tx.us
Mr. Chris Nicholas, Administrative Technician
(General Information)
(512) 458-7706
E-mail: chris.nicholasC«?dshs.state.tx.us
Ms. Stephanie Atkins, Program Specialist Ms. Rene' Kennedy, Program Specialist
(CIHCP Lead Policy, Procedures, Special Projects) (Medicaid Reimbursements, TMHP Liaison)
Ext. 3529 Ext. 2105
E-mail: stephanie.atkinsC«~dshs.state.tx.us E-mail: rene.kennedyC«~dshs.state.tx.us
Ms. Karen Gray, Program Specialist
(Policy, Procedures, Training)
Ext. 2752
E-mail: karen.arayCc~dshs.state.tx.us
Ms. Elizabeth Alvarado
(Medicaid Reimbursements)
Ext. 3036
E-mail: elizabeth.alvaradoC«~dshs.state.tx.us
Ms. Tiffany Ford, Program Specialist
(Policy, Data, State Assistance Fund)
Ext. 6631
E-mail: tiffany.fordC«~dshs.state.tx.us
Ms. Gina Baber, Program Specialist
(Primary Health Care Lead Policy, Procedures)
Ext. 2023
E-mail: gina.baberCa~dshs.state.tx.us
Ms. Eva Cruz, Program Specialist
Community Liaison
Ext. 6728
E-mail: eva.cruzCa~dshs.state.tx.us
CIHCP 08-2
August 2008
~,: .
~-Re~ide~"aa N s°
SECTION TWO
ELIGIBILITY CRITERIA
Page 1
General A person must live in the Texas county in which he applies. There is no
Principles durational requirement for residency.
• A person lives in the county if the person's home or fixed place of
habitation is located in the county and he intends to return to the county
after any temporary absences.
• A person with no fixed residence or a new resident in the county who
declares intent to remain in the county is also considered a county
resident.
• A person does not lose his residency status because of a temporary
absence from the county. No time limits are placed on a person's
absence from the county.
• A person cannot qualify for CIHCP from more than one county
simultaneously.
• Persons Not Considered Residents:
o An inmate or resident of a state school or institution operated by
any state agency,
o An inmate, patient, or resident of a school or institution operated by
a federal agency,
o A minor student primarily supported by his parents whose home
residence is in another county or state,
o A person living in an area served by a public facility, and
o A person who moved into the county solely for the purpose of
obtaining health care assistance.
Verifying if questionable.
Residence
Proof may include but is not limited to:
• Mail addressed to the applicant, his spouse, or children,
• Texas driver's license or other official identification,
• Rent, mortgage payment, or utility receipt,
• Property tax receipt,
• Voting record,
• School enrollment records, and
• Statement from a landlord, a neighbor, or other reliable source.
Documenting On Form 101, Worksheet, document why information regarding residence
Residence is questionable and how questionable residence is verified.
CIHCP 04-3
July 2004
SECTION TWO
ELIGIBILITY CRITERIA
Page 2
Household
General • A CIHCP household is a person living alone or two or more persons
Principles living together where legal respor~ ik~ifity for support.~~~~sts, excluding
disqualified persons.
• Legal responsibility for support exists between:
o Persons who are legally married,
o A legal parent and a minor child, or
o A managing conservator and a minor child.
s a :,. .
• ,., the only program that disqualifies a person from the County
Indigent Health Care Program.
Definitions Adult - a person at least age 18 or a younger person who is or has been
married or had the disabilities of minority removed for general purposes.
Common Law Marriage -relationship in which the parties age 18 or older
are free to marry, live together, and hold out to the public that they are
husband and wife.
A minor child in Texas is not legally allowed to enter a common law
marriage unless the claim of common law marriage began before
September 1, 1997.
Emancipated Minor - a person under age 18 who has been married. The
marriage must not have been annulled.
Managing Conservator - a person designated by a court to have daily
responsibility for a child.
Married Minor - an individual, age 14-17, who is married. These
individuals must have parental consent or court permission. An individual
under age 18 may not be a party to an informal (common law) marriage.
Minor Child - a person under age 18 who is not or has not been married
and has not had the disabilities of minority removed for general purposes.
CIHCP 04-4
November 2004
SECTION TWO
ELIGIBILITY CRITERIA
Page 3
Household (continued)
CIHCP The CIHCP household is a person living alone or two or more persons
Household living together where legal responsibility for support exists, excluding
disqualified persons.
Disqualified Persons
• A person who receives or is categorically eligible to receive Medicaid,
• A person who receives TANF benefits,
• A person who receives SSI benefits,
• A person who receives Qualified Medicare Beneficiary (QMB),
Medicaid Qualified Medicare Beneficiary (MQMB), Specified
• Low-Income Medicare Beneficiary (SLMB), Qualified Individual-1
• (QI-1); or Qualified Disabled and Working Individuals (QDWI), and
• A Medicaid recipient who partially exhausts some component of his
Medicaid benefits.
A disqualified person is not a CIHCP household member regardless of his
legal responsibility for support.
CIHCP One-Person Household
• A person living alone,
~,, An adult living with others who are not legally responsible for the adult's
support,
• A minor child living alone or with others who are not legally responsible
for the child's support,
• AMedicaid-ineligible spouse,
• AMedicaid-ineligible parent whose spouse and/or minor children are
• Medicaid-eligible,
• AMedicaid-ineligible foster child, and
• An inmate in a county jail.
CIHCP Group Households -two or more persons who are living together
and meet one of the following descriptions:
• Two persons legally married to each other,
• One or both legal parents and their legal minor children,
• A managing conservator and a minor child and the conservator's
spouse and other legal minor children, if any,
• Minor children, including unborn children, who are siblings, and
• Both Medicaid-ineligible parents of Medicaid-eligible children.
GIHCP 04-4
July 2004
SECTION TWO
ELIGIBILITY CRITERIA
Page 4
Household (continued)
Screening Your Texas Benefits screens for potential eligibility for Medicaid and
Tools other programs provided by Texas state agencies. Your Texas
Benefits may be accessed at:
www.yourtexasbenetf its.com
• The Benefit Eligibility Screening Tool (BEST) screens for potential
eligibility for benefits from any of the programs that Social Security
administers. BEST may be accessed at:
httg://best.ssa.aov
Verifying Verify household, if questionable.
Household
Proof may include but is not limited to:
• Lease agreement or
• Statement from a landlord, a neighbor, or other reliable source.
Documenting On Form 101, Worksheet, document why information regarding household
Household is questionable and how questionable household is verified.
CIHCP 06-2
June 2006
SECTION TWO
ELIGIBILITY CRITERIA
Page 5
Resources
General ~~ousehoid t?~usi ,ptar~~;e.~ a1J ~ r~est~urces •:10 > wY~ich ~~h~,:t~iu~et~old is,
Principles ~ec~~l~y~ ;entitle~i;-urtleSS it~° ~s° a~r~r.2"asb'na'ble `to `{~ursue'hye r~~oUrce:
Reasonable time (at least tJtree months). must be allowed for the
household to pursue the resource, which is n~..considered accessible
during this time. -
• The resources of all':~IHCP household members are considered.
• Resources are either countable or exempt.
• All resources of a disqualified person are exempt.
• A household is not eligible if the~~t~IRcountable household resources
exceed
o $3,000.00 when a person who is aged or disabled and who meets
relationship requirements lives in the home or
~; $2,000.00 for all other households.
• A household is not eligible if their total countable resources exceed the
limit on or after
o the first interview date or
o the date Form 101 is completed for cases processed without an
interview.
• In determining eligibility for a prior month, the household is not eligible if
their total countable resources exceed the limit anytime during the prior
month.
Definitions Accessible resources -resources legally available to the household.
Aged person -someone age 60 or older as of the last day of the month
for which benefits are being requested.
Assets -all items of monetary value owned by an individual.
Disabled person -someone who is physically or mentally unfit for
employment.
CIHCP 07-3
January 2008
SECTION TWO
ELIGIBILITY CRITERIA
Page 6
Resources (continued)
Definitions Equity -the amount of money that would be available to the owner after
(continued) the sale of a resource. Determine this amount by subtracting from the fair
market value any money owed on the item and the costs normally
associated with the sale and transfer of the item.
Fair market value -the amount a resource would bring if sold on the
current local market.
ces~t resources - resources not legally available to the
household. Examples include but are not limited to: irrevocable trust
funds, property in probate, security deposits on rental property and utilities.
Personal possessions -appliances, clothing, farm equipment, furniture,
jewelry, livestock, and other items if the household uses them to meet
personal needs essential for daily living.
Real property- land and any improvements on it.
Reimbursement -repayment for a specific item or service.
Relative - a person who has one of the following relationships biologically
or by adoption:
• Mother or father,
• Child, grandchild, stepchild,
• Grandmother or grandfather,
• Sister or brother,
• Aunt or uncle,
• Niece or nephew,
• First cousin,
• First cousin once removed, and
• Stepmother or stepfather.
Relationship also extends to:
• The spouse of the relatives listed above, even after the marriage is
terminated by death or divorce,
• The degree of great-great aunt/uncle and niece/nephew, and
• The degree ofgreat-great-great grandmother/grandfather.
- both liquid and non-liquid assets a person can convert to
meet his needs. Examples include but are not limited to: bank accounts,
boats, bonds, campers., cash, certificates of deposit, gas rights, livestock
(unless the livestock is used to meet personal needs essential for daily
living), mineral rights, notes, oil rights, real estate (including buildings and
land, other than a homestead), stocks, and vehicles.
CIHCP 04-0
November 2004
SECTION TWO
ELIGIBILITY CRITERIA
Page 7
Resources (continued)
Alien Count the resources of an alien sponsor and sponsor's spouse for three
Sponsor's years after the alien's entry date if the sponsor and spouse are living
Resources together.
Determine the sponsor's countable resources as follows:
1) Apply the policies contained in this section.
2) Subtract $1,500.
3) Consider the remainder as resources available to the household.
Bank Count the cash value of checking and savings accounts unless exempt for
Accounts another reason.
Burial Exempt up to $7,500 cash value of a prepaid burial insurance policy,
Insurance funeral plan, or funeral agreement for each certified household member.
(Prepaid)
Count the cash value exceeding $7,500 as a liquid resource.
Burial Plots Exempt all burial plots.
Crime Victim's Exempt.
Compensation
Payments
Energy Exempt payments or allowances made under any federal law for the
Assistance purpose of energy assistance.
Payments
Exemption: If a payment or benefit counts as income for a particular month, do not
Resources / count it as a resource in the same month. If you prorate a payment as
Income income over several months, do not count any portion of the payment as a
Payments resource during that time.
Example: Income of students orself-employed persons that is prorated
over several months.
tf the client combines this money with countable funds, such as a bank
account, exempt the prorated amounts for the time you prorate it.
CIHCP 06-3
December- 2006
Resources (continued)
SECTION TWO
ELIGIBILITY CRITERIA
Page 8
Homestead Exempt the household's usual residence and surrounding property not
separated by property owned by others. The exemption remains in effect if
public rights of way, such as roads, separate the surrounding property from
the home. The homestead exemption applies to any structure the person
uses as a primary residence, including additional buildings on contiguous
land, a houseboat, or a motor home, as long as the household lives in it. If
the household does not live in the structure, count it as a resource.
Houseboats and Motor Homes. Count houseboats and motor homes
according to vehicle policy, if not considered the household's primary
residence or otherwise exempt.
Own or Purchasing a Lot. For households that currently do not own a
home, but own or are purchasing a lot on which they intend to build,
exempt the lot and partially-completed home.
Real Property Outside of Texas. Households cannot claim real property
outside of Texas as a homestead, except for migrant and itinerant workers
who meet the residence requirements.
Homestead Temporarily Unoccupied Exempt a homestead temporarily
unoccupied because of employment, training for future employment, illness
~, (including health care treatment), casualty (fire, flood, state of disrepair,
etc.), or natural disaster, if the household intends to return.
Sale of a Homestead. Count money remaining from the sale of a
homestead as a resource.
Income- Exempt property that:
Producing
Property Is essential to a household member's employment or self-employment
(examples: tools of a trade, farm machinery, stock and inventory).
Continue to exempt this property during temporary periods of
unemployment if the household member expects to return to work;
• Annually produces income consistent with its fair market value, even if
used only on a seasonal basis; or
Is necessary for the maintenance or use of a vehicle that is exempt as
income-producing or as necessary for transporting a physically disabled
household member. Exempt the portion of the property used for this
purpose.
For farmers or fishermen, continue to exempt the value of the land or
equipment for one year from the date that the self-employment ceases.
CIHCP 04-3
July 2004
SECTION TWO
ELIGIBILITY CRITERIA
Page 9
Resources (continued)
Insurance Count, minus any amount spent or intended to be spent for the household's
Settlement bills for burial, health care, or damaged/lost possessions.
Lawsuit Count, minus any amount spent or intended to be spent for the household's
Settlement bills for burial, legal expenses, health care expenses, or damaged/lost
possessions.
Life Insurance Exempt the cash value of life insurance policies.
Liquid Count, if readily negotiable. Examples include but are not limited to: cash,
Resources checking accounts, savings accounts, certificates of deposit (CDs), notes,
bonds, and stocks.
Loans Exempt these loans from resources.
(Non-
Educational) Consider financial assistance as a loan if there is an understanding that the
loan will be repaid and the person can reasonably explain how he will
repay it.
Count assistance not considered a loan as unearned income (contribution).
Lump-Sum Count lump-sum payments received once a year or less frequently as
Payments resources in the month received, unless specifically exempt.
Countable lump-sum payments include but are not limited to: income tax
refunds, lump-sum insurance settlements, lump-sum payments on child
support, public assistance, refunds of security deposits on rental property
or utilities, retirement benefits, and retroactive lump-sum RSDI.
Count lump-sum payments received or anticipated to be received more
often than once a year as unearned income in the month received.
Exception: Count contributions, gifts, and prizes as unearned income in
the month received, regardless of the frequency of receipt.
Personal Exempt.
Possessions
CIHCP 04-4
November 2004
SECTION TWO
ELIGIBILITY CRITERIA
Page 10
Resources (continued)
Real Property Count the equity value of real property unless it is otherwise exempt.
Exempt any portion of real property directly related to the maintenance or
use of a vehicle necessary for employment or to transport a physically
disabled household member. Count the equity value of any remaining
portion unless it is otherwise exempt.
Good Faith Effort to Sell. Exempt real property if the household is making
a good effort to sell it.
Jointly-Owned Property. Exempt property jointly owned by the household
and other individuals not applying for or receiving benefits if the household
provides proof that he cannot sell or divide the property without consent of
the other owners and the other owners will not sell or divide the property.
Reimbursement Count as a resource in the month after receipt.
Exempt a reimbursement earmarked and used for replacing and repairing
an exempt resource. Exempt the reimbursement indefinitely.
Retirement A retirement account is one in which an employee and/or his employer
Accounts contribute money for retirement. There are several types of retirement
plans.
The term 401 K refers to the section of the Internal Revenue Services
Code. A 401 K plan allows an employee to postpone receiving a portion of
current income until retirement.
An individual retirement account (IRA) is an account in which an individual
contributes an amount of money to supplement his retirement income
(regardless of his participation in a group retirement plan).
A Keogh plan is an IRA for aself-employed individual.
A Simplified Employee Pension (SEP) plan is an IRA owned by an
employee to which an employer makes contributions or an IRA owned by a
self-employed individual who makes contributions for himself.
A vested retirement account is an account to which an employee makes
contributions for a specified period of time as defined by the employer. The
employer does not match the money contributed by the employee until the
defined period of time ends.
(Retirement Accounts continued on next page)
CIHCP 04-3
July 2004
SECTION TWO
ELIGIBILITY CRITERIA
Page 11
Resources (continued)
Retirement IRA, SEP, or Keogh Plan. If the retirement account is an IRA, SEP, or
Accounts Keogh plan, count as a resource, even if there is a penalty for early
(continued) withdrawal. Deduct the early withdrawal penalty and count the remainder
as a resource.
401 K or Other. If the retirement account is a 401 K or other account,
exempt the amount even if the retirement account is accessible with
penalty. The money remains exempt until the person withdraws it. If the
person elects to withdraw the total amount as a lump sum, count the
money as a resource beginning with the month it is received. If the person
elects to receive a monthly retirement check, count it as unearned income
in the month received.
Trust Fund Exempt a trust fund if all of the following conditions are met:
• The trust arrangement is unlikely to end during the certification period;
and
• No household member can revoke the trust agreement or change the
name of the beneficiary during the certification period; and
• The trustee of the fund is either a
o Court, institution, corporation, or organization not under the
direction or ownership of a household member; or
o Court-appointed individual who has court-imposed limitations
placed on the use of the funds; and
The trust investments do not directly involve or help any business or
corporation under the control, direction, or influence of a household
member. Exempt trust funds established from the household's own
funds if the trustee uses the funds
o Only to make investments on behalf of the trust or
o To pay the education or health care expenses of the beneficiary.
Vehicles Exempt a vehicle necessary to transport physically disabled household
members, even if disqualified and regardless of the purpose of the trip.
Exempt no more than one vehicle for each disabled member. There is no
requirement that the vehicle be used primarily for the disabled person.
CIHCP 07-2
September 2007
SECTION TWO
ELIGIBILITY CRITERIA
Page 12
Resources (continued)
Vehicles Exempt vehicles if the equity value is less than $4,650, regardless of the
(continued) number of vehicles owned by the household. Count the value in excess of
$4,650 toward the household's resource limit. Examples listed below:
$15,000 (FMV)
- 12.450 (Amount still owed)
$ 2,550 (Equity Value)
- 4.650
$ 0 (Countable resource)
$ 9,000 (FMV)
- 0 (Amount still owed)
$ 9,000 (Equity Value)
- 4,650
$ 4,350 (Countable resource)
Income-producing Vehicles. Exempt the total value of all licensed vehicles
used for income-producing purposes. This exemption remains in effect
when the vehicle is temporarily not in use. A vehicle is considered income-
producing if it:
• Is used as a taxi, a farm truck, or fishing boat,
• Is used to make deliveries as part of the person's employment,
• Is used to make calls on clients or customers,
• Is required by the terms of employment, or
• Produces income consistent with its fair market value.
Solely-Owned Vehicles. A vehicle, whose title is solely in one person's
name, is considered an accessible resource for that person. This includes
the following situations:
Consider vehicles involved in community property issues to belong to
the person whose name is on the title.
If a vehicle is solely in the household member's name and the
household member claims he purchased it for someone else, the
vehicle is considered as accessible to the household member.
Exceptions: The vehicle is inaccessible if the title holder verifies:
• That he sold the vehicle but has not transferred the title. In this
situation, the vehicle belongs to the buyer. Note: Count any payments
made by the buyer to the household member or the household
member's creditors (directly) as self-employment income.
• That he sold the vehicle but the buyer has not transferred the title into
the buyer's name.
• That the vehicle was repossessed.
• That the vehicle was stolen.
• That he filed for bankruptcy (Title 7, 11, or 13) and that the household
member is not claiming the vehicle as exempt from the bankruptcy.
Note: In most bankruptcy petitions, the court will allow each adult
individual to keep one vehicle as exempt for the bankruptcy estate.
This vehicle is a countable resource.
CIHCP 07-2
September 2007
SECTION TWO
ELIGIBILITY CRITERIA
Page 13
Resources (continued)
Vehicles A vehicle is accessible to a household member even though the title is not
(continued) in the household member's name if the household member purchases or is
purchasing the vehicle from the person who is the title holder or if the
household member is legally entitled to the vehicle through an inheritance
or divorce settlement.
Jointly-Owned Vehicles. Consider vehicles jointly-owned with another
person not applying for or receiving benefits as inaccessible if the other
owner is not willing to sell the vehicle.
Leased Vehicles. When a person leases a vehicle, they are not generally
considered the owner of the vehicle because the
• Vehicle does not have any equity value,
• Person cannot sell the vehicle, and
• Title remains in the leasing company's name.
Exempt a leased vehicle until the person exercises his option to purchase
the vehicle. Once the person becomes the owner of the vehicle, count it as
a resource. The person is the owner of the vehicle if the title is in their
name, even if the person and the dealer refer to the vehicle as leased.
Count the vehicle as a resource.
How To Determine Fair Market Value of Vehicles.
'fir • Determine the fair market value of licensed vehicles using the average
trade-in or wholesale value listed in the current (i. e., within the last six
months) National Automobile Dealer's Association (NADA) Used Car
Guide. Note: If the household claims that the listed value does not
apply because the vehicle is in less-than-average condition, allow the
household to provide proof of the true value from a reliable source,
such as a bank loan officer or a local licensed car dealer.
Do not increase the basic value because of low mileage, optional
equipment, or special equipment for the handicapped.
• Accept the household's estimate of the value of a vehicle no longer
listed in the NADA guide unless it is questionable and would affect the
household's eligibility. In this case, the household must provide an
appraisal from a licensed car dealer or other evidence of the vehicle's
value, such as a tax assessment or a newspaper advertisement
indicating the sale value of similar vehicles.
• Determine the value of new vehicles not listed in the NADA guide by
asking the household to provide an estimate of the average trade-in or
wholesale value from a new car dealer or a bank loan officer. If this
cannot be done, accept the household's estimate unless it is
questionable and would affect eligibility. Use loan value only if other
sources are unavailable. Request proof of the value of licensed
antique, custom made, or classic vehicles from the household.
CIHCP 07-2
September 2007
SECTION TWO
ELIGIBILITY CRITERIA
Page 14
Resources (continued)
Penalty for A household is ineligible if, within three months before application or any
Transferring time after certification, they transfer a countable resource for less than its
Resources fair market value to qualify for county health care assistance.
This penalty applies if the total of the transferred resource added to other
resources affects eligibility.
Base the length of denial on the amount by which the transferred resource
exceeds the resource maximum when added to other countable resources.
Use the chart below to determine the length of denial.
Amount in Excess of Resource Limit	Denial Period
$ .01	to	$ 249.99	1	month
$ 250.00	to	$ 999.99	3	months
$1,000.00	to	$2,999.99	6	months
$3,000.00	to	$4,999.99	9	months
$5,000.00	to	$5,000.00 and more	12	months
If spouses separate and one spouse transfers his property, it does not
affect the eligibility of the other spouse.
Verifying Verify countable resources, if questionable or close to the limit.
Resources
Proof may include but is not limited to:
Bank account statements and
• Award letters.
Documenting On Form 101, Worksheet, document whether a resource is countable or
Resources exempt and why resources are verified.
CIHCP 04-4
November 2004
SECTION TWO
ELIGIBILITY CRITERIA
Page 15
Income
General • A household must pursue and accept all income to which the
Principles household is legally entitled. Reasonable time (at least three months)
must be allowed for the household to pursue the income, which is not
considered accessible during this time.
• The income of all CIHCP household members is considered.
• Income is either countable or exempt.
• If attempts to verify income are unsuccessful because the payer fails or
refuses to provide information and other proof is not available, the
household's statement is used as best available information.
• All income of a disqualified person is exempt.
Definitions Alien Sponsor - a person who signed an affidavit of support (namely, INS
Form I-864 or I-864-A) on or after December 19, 1997, agreeing to support
an alien as a condition of the alien's entry into the United States.
Not all aliens must obtain a sponsor before being admitted into the U. S.
Budgeting -the method used to determine eligibility by calculating income
and deductions using the best estimate of the household's current and
future circumstances and income.
Earned income - income a person receives for a certain degree of activity
or work. Earned income is related to employment and, therefore, entitles
the person to work-related deductions not allowed for unearned income.
Gross income -income before deductions.
Income -any type of payment that is of gain or benefit to a household.
Net income -gross income minus allowable deductions.
Real Property -land and any improvements on it.
Tip Income -income earned in addition to wages that is paid by patrons to
people employed in service-related occupations, such as beauticians,
waiters, valets, pizza delivery staff, etc.
Unearned income -payments received without performing work-related
activities.
CIHCP 04-4
November 2004
SECTION TWO
ELIGIBILITY CRITERIA
Page 16
Income (continued)
Adoption Exempt.
Payments
Alien If the legal alien is required to have a sponsor, count the income of an alien
Sponsor's sponsor as unearned income for three years after the alien's entry date. To
Income budget the sponsor's income:
1) Consider all of the sponsor's and sponsor's spouse's gross countable
income.
2) From that income, subtract the following deductions:
o The lesser of 20% of the total monthly gross earned income
(including net self-employment earned income), or $175;
o An amount equal to the income limit for the sponsor's family size as
it corresponds to 100% of the Federal Poverty Guideline listed on
Form 222. Include all members of the household the sponsor
claims or could claim as tax dependents;
o The total amount the sponsor pays to claimed tax dependents living
outside the home; and
o The total alimony or child support the sponsor pays to persons
living outside the home.
3) Count the remaining amount as unearned income for the alien.
Cash Gifts and Count as unearned income unless they are made by a private, nonprofit
Contributions organization on the basis of need; and total $300 or less per household in a
federal fiscal quarter. The federal fiscal quarters are January -March,
April -June, July - September, and October-December. If these
contributions exceed $300 in a quarter, count the excess amount as
income in the month received.
Exempt any cash contribution for common household expenses, such as
food, rent, utilities, and items for home maintenance, if it is received from a
non-certified household member who:
• Lives in the home with the certified household member,
• Shares household expenses with the certified household member, and
• No landlord/tenant relationship exists.
CIHCP 04-3
Jufy 2004
SECTION TWO
ELIGIBILITY CRITERIA
Page 17
Income (continued)
Child's Earned Exempt a child's earned income if the child, who is under age 18 and not
Income an emancipated minor, is a full-time student (including a home schooled
child) or a part-time student employed less than 30 hours a week.
Child Support Count as unearned income after deducting $50 from the total monthly child
Payments support payments the household receives.
Count payments as child support if a court ordered the support, or the
child's caretaker or the person making the payment states the purpose of
the payment is to support the child.
Count ongoing child support income as income to the child even if
someone else living in the home receives it.
Count child support arrears as income to the caretaker.
Exempt child support payments as income if the child support is intended
for a child who receives Medicaid, even though the parent actually receives
the child support.
Child Support Received for aNon-Member. If a caretaker receives
ongoing child support for anon-member (or a member who is no longer in
the home) but uses the money for personal or household needs, count it as
unearned income. Do not count the amount actually used for or provided
to the non-member for whom it is intended to cover.
Lump-Sum Child Support Pavments. Count lump-sum child support
payments (on child support arrears or on current child support) received, or
anticipated to be received more often than once a year, as unearned
income in the month received. Consider lump-sum child support payments
received once a year or less frequently as a resource in the month
received.
Returning Parent. If an absent parent is making child support payments
but moves back into the home of the caretaker and child, process the
household change.
Crime Victim's Exempt.
Compensation
Payments These are payments from the funds authorized by state legislation to assist
a person who has been a victim of a violent crime; was the spouse, parent,
sibling, or adult child of a victim who died as a result of a violent crime; or is
the guardian of a victim of a violent crime. The payments are distributed by
the Office of the Attorney General in monthly payments or in a lump sum.
CIHCP 04-3
July 2004
SECTION TWO
ELIGIBILITY CRITERIA
Page 18
Income (continued)
Disability Count as unearned income.
Insurance
Payments
Dividends Count dividends as unearned income. Exception: Exempt dividends from
and Royalties insurance policies as income.
Count royalties as unearned income, minus any amount deducted for
production expenses and severance taxes.
Educational Exempt educational assistance, including educational loans, regardless of
Assistance source. Educational assistance also includes college work study.
Energy Exempt the following types of energy assistance payments:
Assistance
• Assistance from federally-funded, state or locally-administered
programs, including HEAP, weatherization, Energy Crisis, and one-time
emergency repairs of a heating or cooling device (down payment and
final payment);
• Energy assistance received through HUD, USDA's Rural Housing
Service (RHS), or Farmer's Administration (FmHA);
• Assistance from private, non-profit, or governmental agencies based on
need.
If an energy assistance payment is combined with other payments of
assistance, exempt only the energy assistance portion from income (if
applicable).
Foster Care Exempt.
Payments
Government Exempt federal disaster payments and comparable disaster assistance
Disaster provided by states, local governments and disaster assistance
Payments organizations if the household is subject to legal penalties when the funds
are not used as intended.
Examples: Payments by the Individual and Family Grant Program, Small
Business Administration, and/or FEMA.
CIHCP 08-2
August 2008
SECTION TWO
ELIGIBILITY CRITERIA
Page 19
Income (continued)
In-Kind Exempt. An in-kind contribution is any gain or benefit to a person that is
Income not in the form of money/check payable directly to the household, such as
clothing, public housing, or food.
Interest Count as unearned income.
Job Training Exempt payments made under the Workforce Investment Act (WIA).
On The Job (OJT) payments funded under the W IA of 1998 are earned
income and counted for adults.
OJT payments received by a child who is under age 19 and under parental
control of another household member are exempt.
Loans Count as unearned income unless there is an understanding that the
(Non- money will be repaid and the person can reasonably explain how he will
educational) repay it.
Lump-Sum Count as income in the month received if the person receives it or expects
Payments to receive it more often than once a year.
Exception: If a person is scheduled to receive retroactive SSI benefits in
installment payments (up to three, paid every six months), count the
payments as a resource in the month received.
Exempt lump sums received once a year or less, unless specifically listed
as income. Count them as a resource in the month received.
If a lump sum reimburses a household for burial, legal, or health care bills,
or damaged/lost possessions, reduce the countable amount of the lump
sum by the amount earmarked for these items.
Military Pay Count military pay and allowances for housing, food, base pay, and flight
pay as earned income, minus pay withheld to fund education under the
G.I. Bill.
Mineral Rights Count payments for mineral rights as unearned income.
CIHCP 04-4
November 2004
SECTION TWO
ELIGIBILITY CRITERIA
Page 20
Income (continued)
Pensions Count as unearned income. A pension is any benefit derived from former
employment, such as retirement benefits or disability pensions.
Reimbursement Count as unearned income, minus the actual expenses. Exempt a
reimbursement for future expenses only if the household plans to use it as
intended.
RSDI Count as unearned income the Retirement, Survivors, and Disability
Payments Insurance (RSDI) benefit amount including the deduction for the Medicare
premium, minus any amount that is being recouped for a prior RSDI
overpayment.
If a person receives an RSDI check and an SSI check, exempt both checks
since the person is a disqualified household member.
If an adult receives a Social Security survivor's benefit check for a child,
this check is considered the child's income.
Self- Count as earned income, minus the allowable costs of producing the
Employment self-employment income.
Income
Seff-employment income is earned or unearned income available from
one's own business, trade, or profession rather than from an employer.
However, some individuals may have an employer and receive a regular
salary. If an employer does not withhold FICA or income taxes, even if
required to do so by law, the person is considered self-employed.
Types of self-employment include:
• Odd jobs, such as mowing lawns, babysitting, and cleaning houses;
• Owning a private business, such as a beauty salon or auto mechanic
shop;
• Farm income; and
• Income from property, which may be from renting, leasing, or selling
property on an installment plan. Property includes equipment, vehicles,
and real property.
If the person sells the property on an installment plan, count the
payments as income. Exempt the balance of the note as an
inaccessible resource.
CIHCP 04-3
July 2004
SECTION TWO
ELIGIBILITY CRITERIA
Page 21
Income (continued)
SSI Payments Exempt Supplemental Security Income (SSI) benefits.
A person receiving any amount of SSI benefits also receives Medicaid and
is, therefore, a disqualified household member.
TANF Exempt Temporary Assistance to Needy Families (TANF) benefits.
A person receiving TANF benefits also receives Medicaid and is, therefore,
a disqualified household member.
Terminated Count terminated income in the month received. Use actual income and
Income do not use conversion factors if terminated income is less than a full
month's income.
Income is terminated if it will not be received in the next usual payment
cycle.
Income is not terminated if:
• Someone changes jobs while working for the same employer,
• An employee of a temporary agency is temporarily not assigned,
~` Aself-employed person changes contracts or has different customers
without having a break in normal income cycle, or
• Someone received regular contributions, but the contributions are from
different sources.
Third-Party Exempt the money received that is intended and used for the maintenance
Payments of a person who is not a member of the household.
If a single payment is received for more than one beneficiary, exclude the
amount actually used for the non-member up to the non-member's
identifiable portion or prorated portion, if the portion is not identifiable.
Tip Income Count the actual (not taxable) gross amount of tips as earned income. Add
tip income to wages before applying conversion factors.
Tip income is income earned in addition to wages that is paid by patrons to
people employed in service-related occupations, such as beauticians,
waiters, valets, pizza delivery staff, etc.
Do not consider tips as self-employment income unless related to a
self-employment enterprise.
CIHCP 04-3
July 2004
SECTION TWO
ELIGIBILITY CRITERIA
Page 22
Income (continued)
Trust Fund Count as unearned income trust fund withdrawals or dividends that the
household can receive from a trust fund that is exempt from resources.
Unemployment Count as unearned income the gross benefit less any amount being
Compensation recouped for a UIB overpayment.
Payments
Count the cash value of UIB in a UI debit account, less amounts deposited
in the current month, as a resource. Account inquiry is accessible to a UIB
recipient online at www.myaccount.chase.com or at any Chase Bank
automated teller machine free of charge.
Exception: Count the gross amount if the household agreed to repay a
food stamp overpayment through voluntary garnishment.
VA Payments Count the gross Veterans Administration (VA) payment as unearned
income, minus any amount being recouped for a VA overpayment. Exempt
VA special needs payments, such as annual clothing allowances or
monthly payments for an attendant for disabled veterans.
Vendor Exempt vendor payments if made by a person or organization outside the
Payments household directly to the household's creditor or person providing the
service.
Exception: Count as income money that is legally obligated to the
household, but which the payer makes to a third party for a household
expense.
Wages, Count the actual (not taxable) gross amount as earned income.
Salaries,
Commissions If a person asks his employer to hold his wages or the person's wages are
garnished, count this money as income in the month the person would
otherwise have been paid. If, however, an employer holds his employees'
wages as a general practice, count this money as income in the month it is
paid. Count an advance in the month the person receives it.
Workers' Count the gross payment as unearned income, minus any amount being
Compensation recouped for a prior worker's compensation overpayment or paid for
Payments attorney's fees. NOTE: The Texas Workers' Compensation Commission
(TWCC) or a court sets the amount of the attorney's fee to be paid.
Do not allow a deduction from the gross benefit for court-ordered child
support payments.
CIHCP 08-1
Apri12008


Income (continued)
SECTION TWO
ELIGIBILITY CRITERIA
Page 23
	Exception: Exclude worker's compensation benefits paid to the household
	for out-of-pocket health care expenses. Consider these payments as
	reimbursements.
Other Types of	Exempt benefits and payments from the following programs:
Benefits and	
Payments	Americorp,
	• Child Nutrition Act of 1966
	,
• Food Stamp Program
	,
• Foster Grandparents
	,
• Funds distributed or held in trust by the Indian Claims Commission f
	or
Indian tribe members under Public Laws 92-254 or 93-135,
	• Learn and Serve,
	• National School Lunch Act
	,
• National Senior Service Corps (Senior Corps)
	,
• Nutrition Program for the Elderly (Title III, Older American Act of 1965),
	• Retired and Senior Volunteer Program (RSVP)
	,
• Senior Companion Program
	,
• Tax-exempt portions of payments made under the Alaska Native
	Claims Settlement Act,
	• Uniform Relocation Assistance and Real Property Acquisitions Act
	(Title II),
	• Volunteers in Service to America (VISTA), and
	• Women, Infants, and Children (WIC) Program.
Verifying	Verify countable income, including recently terminated income, at initial
Income	application and when changes are reported. Verify countable income at
	review, if questionable.
Proof may include but is not limited to:
• Pay stubs,
• Statements from employers,
• W-2 forms,
• Notes for cash contributions,
• Business records,
• Award letters,
• Court orders or public decrees (support documents),
• Sales records,
• Income tax returns, and
• Statements completed, signed, and dated by the self-employed person
CIHCP 04-3
July 2004
SECTION TWO
ELIGIBILITY CRITERIA
Page 24
'~.. Income (continued)
Documenting On Form 101, Worksheet, document the following items.
Income
• Exempt income and the reason it is exempt
• Unearned income, including the following items:
o Date income is verified,
o Type of income,
o Check or document seen,
o Amount recorded on check or document,
o Frequency of receipt, and
o Calculations used.

• Self-employment income, including the following items:
o The allowable costs for producing the self-employment income,
o Other factors used to determine the income amount.
• Earned income, including the following items:
o Payer's name and address,
o Dates of each wage statement or pay stub used,
o Date paycheck is received,
o Gross income amount,
o Frequency of receipt, and
o Calculations used.
• Allowable deductions.
CIHCP 04-3
July 2004
SECTION TWO
ELIGIBILITY CRITERIA
Page 25
Budgeting Income
General Count income already received and any income the household expects
Principles to receive. If the household is not sure about the amount expected or
when the income will be received, use the best estimate.
• Income, whether earned or unearned, is counted in the month that it is
received.
Count terminated income in the month received. Use actual income
and do not use conversion factors if terminated income is less than a
full month's income.
• Use at least four consecutive, current pay periods to calculate
fluctuating income.
• The self-employment income projection, usually 12 months, is the
period of time that the household expects the income to support the
family.
• There are deductions for earned income that are not allowed for
unearned income.
• The earned income deductions are not allowed if the income is gained
from illegal activities, such as prostitution and selling illegal drugs.
CIHCP 04-3
July 2004
SECTION TWO
ELIGIBILITY CRITERIA
Page 26
Budgeting Income (continued)
Steps for Budaetina Income
• Determine countable income.
• Determine how often countable income is received.
• Convert countable income to monthly amounts.
• Convert self-employment allowable costs to monthly amounts.
• Determine if countable income is earned or unearned.
• Subtract converted monthly self-employment allowable costs, if any, from
converted monthly self-employment income.
• Subtract earned income deductions, if any.
• Subtract the deduction for Medicaid individuals, if applicable.
• Compare the monthly net income to the CIHCP monthly income standard.
Step 1 Determine countable income, using CIHCP guidelines.
Evaluate the household's current and future circumstances and income.
Decide if changes are likely during the current or future months.
If changes are likely, then determine how the change will affect eligibility.
Step 2 Determine how often countable income is received, such as yearly,
monthly, twice a month, every other week, weekly.
All income excluding self-emoloyment Based on verifications or the
person's statement as best available information, determine how often
income is received. If the income is based hourly or for piecework,
determine the amount of income expected for one week of work.
Self-employment Income.
• Compute self-employment income, using one of these three methods:
o Annual. Use this method if the person has been self-employed for
at least the past 12 months.
o Monthly. Use this method if the person has at least one full
representative calendar month of self-employment income.
o Daily. Use this method when there is less than one full
representative calendar month of self-employment income, and the
source or frequency of the income is unknown or inconsistent.
CIHCP 04-4
November 2004
Budgeting Income (continued)
Step 2
(continued)
Self-Emplovment Income (continued)
SECTION TWO
ELIGIBILITY CRITERIA
Page 27
• Determine if the self-employment income is annual or seasonal, since
that will determine the length of the projection period.
o The projection period is annual if the self-employment is intended to
support the household for at least the next 12 months. The
projection period is 12 months whether the income is received
monthly or less often.
o The projection period is seasonal if the self-employment income is
intended to support the household for less than 12 months since it
available only during certain months of the year. The projection
period is the number of months the self-employment is intended to
provide support.
• Determine the allowable costs of producing self-employment income,
which include:
o Capital asset improvements,
o Capital asset purchases, such as
real property, equipment,
machinery and other durable
goods, i. e., items expected to
last at least 12 months,
o Fuel,
o Identifiable costs of seed and
fertilizer,
o Insurance premiums,
o Interest from business loans on
income-producing property,
o Labor,
o Linen service,
o Payments of the principal of
loans for income-producing
property,
o Property tax,
o Raw materials,
o Rent,
o Repairs that maintain
income-producing property,
o Sales tax,
o Stock,
o Supplies,
o Transportation costs. The
person may choose to use
58.5 cents per mile instead of
keeping track of individual
transportation expenses. Do
not allow travel to and from
the place of business.
o Utilities.
NOTE: If the applicant conducts aself-employment business in his home,
consider the cost of the home (rent, mortgage, utilities) as shelter costs, not
business expenses, unless these costs can be identified as necessary for
the business separately.
CIHCP 08-2
August 2008
Budgeting Income (continued)
SECTION TWO
ELIGIBILITY CRITERIA
Page 28
Step 2 Self-Employment Income. (continued)
(continued)
The following are not allowable costs of producing self-employment
income:
• Costs not related to self-employment,
• Costs related to producing income gained from illegal activities, such as
prostitution and the sale of illegal drugs,
• Depreciation,
• Net loss which occurred in a previous period, and
• Work-related expenses, such as federal, state and local income taxes,
and retirement contributions.
Step 3 Convert countable income to monthly amounts, if income is not
received monthly.
When converting countable income to monthly amounts, use the following
conversion factors:
• Multiply weekly amounts by 4.33.
• Multiply amounts received every other week by 2.17.
• Add amounts received twice a month (semi-monthly).
• Divide yearly amounts by 12.
Step 4 Convert self-employment allowable costs to monthly amounts.
When converting the allowable costs for producing self-employment to
monthly amounts, use the conversion factors in Step 3 above.
Step 5 Determine if countable income is earned or unearned. For earned
income, proceed with Step 6. For unearned income, skip to Step 8.
Step 6 Subtract converted monthly self-employment allowable costs, if any,
from converted monthly self-employment income.
CIHCP 06-2
June 2006
SECTION TWO
ELIGIBILITY CRITERIA
Page 29
Budgeting Income (continued)
Step 7 Subtract earned income deductions, if any. Subtract-these deductions, if
applicable, from the household's monthly gross income, including monthly
self-employment income after allowable costs are subtracted:
• Deduct $120.00 per employed household member for
work-related expenses.
Deduct 1/3 of remaining earned income per employed household
member.
Deduct the actual cost up to $200.00 per month per dependent for
dependent childcare or incapacitated adult care, if necessary for
employment.
Exception: For self-employment income from property, when a person
spends an average of less than 20 hours per week in management or
maintenance activities, count the income as unearned and only allow
deductions for allowable costs of producing self-employment income.
Step 8 Subtract the deduction for Medicaid individuals, if applicable. This
deduction applies when the household has a member who receives
Medicaid and, therefore, is disqualified from the CIHCP household. Using
the Deduction chart below, deduct an amount for the support of the
Medicaid member(s) as follows: Subtract an amount equal to the deduction
for the number (#) of Medicaid-eligible individuals.
Deduction for Medicaid-Eligible Individuals

# of Medicaid-Eligible Individuals	Single Adult
or
Adult with
Children	
Minor Children
Only
1	$ 78	$ 64
2	$163	$ 92
3	$188	$130
4	$226	$154
5	$251	$198
6	$288	$214
7	$313	$267
8	$356	$293
Step 9 Subtract the deduction for legally obligated child support payments made by
a member of the household group. (Conversion Factors -Page 28)
CIHCP 08-1
April 2008
SECTION TWO
ELIGIBILITY CRITERIA
Page 30
Budgeting Income (continued)
Consider the remainder as the monthly net income for the CIHCP
household.
Step 10 Compare the household's monthly net income to the 21% FPG
Minimum Income Standard, using the CIHCP Monthly Income Standards
chart below.
CIHCP Monthly Income Standards
Based on the 2008 Federal Poverty Guideline (FPG)
# of Individuals
in the
CIHCP Household	21 %FPG
Minimum
Income Standard	50% FPG
Maximum
Income Standard
1	$ 182	$ 434
2	$ 245	$ 584
3	$ 308	$ 734
4	$ 371	$ 884
5	$ 434	$1,034
6	$ 497	$1,184
7	$ 560	$1,334
8	$ 623	$1,484
9	$ 686	$1,634
10	$ 749	$1,784
11	$ 812	$1,934
12	$ 875	$2,084
A household is eligible if its monthly net income, after rounding down cents,
does not exceed the monthly income standard for the~CIHCP household's
size.
CIHCP 08-1
April 2008

b		N
N		
Z	
~										
_	
O
L	
Y O	
O
~i		~	Q.	U	11		C~ ~	d" ~ ct	d'	d'	~	~	d'	.
..
~	~	N
H		tL	
V	
N	u		~ M	! O) 1n` r	hr	CO	~	: to	r O
(D	~
cd	~ .-
f0	~
				
V	~		y3 N	N	M	~1'	'ch	t[)	to	CD	h	~
O	U	~
.yt	i	.			N											;6	~ L	3
~ ,																V ctf	cG v	Q
	L=			=						'								
N

`~	-
r-- ° '		
U	

~	LL		O 0

~°
`T	~

~	0

N	ct

N	0

~	~

rn	0

~	~'

o	rn
in
in
°
'	"O N	O O
~
n	N
o
			~		o		_
y
N	r
N	
M	a
O
c~	r
i
d~	
~	
u7	
O	r
n
_
cD ~	~ cu
y	cu
~ r	a
U
~	~
~C			~	~		q							C		U
C	b9	=
a	~
~															~~	~~	~
					c~	_~												
N ~			V		rai	a3i	p o
~n	0
o	0
in	0
o	0
i
n	o
o	O
rn	o
o	o
~n o	~ °-
~ m	~	

'.O
U			
=
Q		
c
a	
r	
~ h	
N	
O	

'	.
'tn	
O	
'. V	
~	
C') LA
~	
O~
=	p
O	
			.		r
n	Q	Ef3	N	N	C
7	M	V	V	~	tf~	~	V O)
O	
~ to					'-	Z										C O	~ i	
d ~
a l ~					
~	
a					
C				
O	~ N
~	N U
~	

~					V
~		r O
n	T-
N	CD
~	
h	D
0	
~	t0
~	
l	C
~	++
~
N	3
~ "O	
			_
Q,		~
~
.N	?
~	~
~	r	r	C
D_	0
0	N	N	r
N	N	=
~ O~	V L	
>., ~	W ~		U		~
o Ea											3a a	a~i-C	

~			
V		N	~				
M	
~	
~	
~	
~	
~	C ~ O
~	•p U	
5~
~	m ~
.				to ~ ~	~	M ~	~	~	
O		c
rJ
C`7	-0
0
V	(
')
(D	0 O
a
h	y C	N ~	
~	~
~				~ 0	Z	~ ~	h	M						r	fl. ~ O
-	~ O
O	
'~ N
ri ~	N
(~ O															m
O
C A N	C N	

td O	~
Z															O ~
O	= b9	

U	
~				
E	~
~	c+')
rn -00D0	
N	
~	
~	
o	
o	to
p	~
~	~
N	C
O Y o	O O	
~:~ ~	w~°		ra		~~~	3	~ ~	a
O
~	~	h	c
o
~	c
o
~				mom-	N~	
~	O		V		LL
- 'gy											~
~ ~	fd _O i	
.~"-~	W
a~		_		'
p
~ E c											.
~ ~ t~	~
~	
	
L
L
O		

V		
o ~ ~	
~										
y ~ C1.	~
.N. O_	
0 N~	'
1
U				N .~	~	~ ~			~				O	~ M	C
C	C= O	
tf~i •ri
~	~ C				~		.
N
d	O
t+')	h
C7	tt	O
d	(D
l!')	N
(D	a
0
(D	h CD	S
p ^. ~	p ~ O	
,
U	
W					Z	g									~ ~ ~	~ ~ O	
~~b	~															Q Qcri	Q c~~	
	c
O				
~											
~	
a	
•ri tS1. in	O					~	r` h	h	h	h	!~	h	r`	h	h			
-1 t0 N	~
U					O	O LO	M	00	00	M	M	OO	CO	CO		
-	
!~~A 41 U	O

? Q-				« n-

u'	~	

,-
~	

r	

r	N	N	N	C7	Ch	M	
C
c~	O L
=
~ (~
c
f	
.~..~ ~ U					so
o											E	t
ttf
a~
~	
crro ro	n				c
'												~	
~ :~ r-! in Q1	~ c
•				8 r	-~	~p Co	cD	cD	co	cD	c0	cfl	co	co
O		U Q "'	
'i f ~ • .A	~
O					O	O	~	h	o	c7	tD	rn	N	r.c~
Ch	~ ~	O y ~
"	
- 'r `	N				V	Z	~			N	N	N	N	(`7	M	fC ~	O •- r`	
IV	U																	
l r1 ' ~
~
"
-	~
~ O				~	~	n N	r	O	O	~	[\	CD
'	r1~	~	Q O.	~ w C	
_
~
-' ~ Vl	
~..I y				~
~ (~	O
?	h
N cD	rr
O	h
d'	CD
N	CD
N	tD
c0	(O
O	(D
~	(D
a0	
L~
~	C (lS
U N O	
aj .~	= N				r laL	~	EA
~	N	N	CV	C7	Q~	~	~t	V	..
.
ti-. ~	~ ~ ~?	
,	~																~ Q	
W
a	~
Z "				~ u
a		
M									N~
-	N	
~	
O				•• M
r	~	N
~	r	O	O	M;
d'	n	(L3	lf)	d' O	y ~	a-~ «s	
~i ~	F
~		Q		t	O	lf?	O	C")	h		t!')	O	M	h O	~_` ~	~~ N	
O W	v		V		U	Z	~ r	r	N	N	M	M	C`7	~	~ M	~ N	O ~	
W
N			_

~													„LS ~	C N 3
r	
~, ro			
w		~ H	~	~									a~ •a	~ ~ -v	

~
~ ~~			~		r ~
i	~
o	n O
iti	d'
M .	O
ao	"~
v	6>
rn	~
r
n	6~
o	V
co	67	Y N
>	~ .
(~ L	
.ter
s
~~	
a				m~ (~
C	~
~	N
N	M	M
''	rn
•'	~	.
O	c~		h	C '~	m C U
~	
~ ,A ~	
tL				d ~
LL		~	N	(
)	C
J	V	to	u7	cD	cD	C ~	Y
CJ	
{
~ ~
5					~											L	w..	
~.S
~
,,<..
~	C
m				L C D
'a
r	O
~	O O
~n	'~
,-	O
co	V
N	61
r-	d'
ch	~
oo	V'
v	67
rn ~	~ Q)
L	C C O	
r~,
K ~	'p				~		~ r								
~	.n	O lS3	
~ l . ri	C7				V d	Z	d9 N	N	c~	c~	d	~	~	cD	cf7	i ~	N ~ O	
P~',a4-I	~'															° ~	°' cv ~ -	
. _z Ul

-	
Q~
G				

'a	N

~	

~									~

O f~	N p O

p C +•~
~	
, ~ -	4.					~	Cp
M	l1y	00
~	t~	N	O	Lr~	N
e	h		O	

.					Z		~	M		^7	tf)	In	rfi	c
p	cD	t ~	C ~ ~ O
~	
~	~
~				~.
R											y O
~°-	~ 3~
a~~cum	
	~				V	O	~ CD	In	00	r-	N	O	rf)	N	t`	O N	~ ~ ~ c6	
	~				~	Z	~ N	N	«~	c~7	cOi	~	V	~	ran ~	U O y O
O C	
	N															.
~
C O O _O	
	
a		
NNW										
~~;;	O
f~
rn~	O
op.c~p	

O	N
R		
V-Q~~J~		r N M V'	+l'1 (D t~ 00	O	O m° a v
T o$~~	O U S O N O-
d~ Q~~~	
	m														LL &	
N		
~~
4* ~ y<																		
Lii~iviii~y ..ii~cita
Eligibility Criteria
rage i or i
Residence. The applicant must live in the county in which s/he applies and must intend to remain
there.
• Household. A CIHCP household is a person living alone or two or more persons living together where
legal responsibility for support exists, excluding disqualified persons. A disqualified person is one who
receives or is categorically eligible to receive Medicaid.
• Resources. A household is eligible if the total countable household resources do not exceed:
o $3,000.00 when a person who is aged or disabled and who meets relationship requirements fives in
the home or
o $2,000.00 for all other households.
• Income. A household is eligible if its monthly net income does not exceed 21% of the Federal Poverty
Guideline (FPG).~;C~a~a-r ~, t, ~.-xM~:l~ ~ndarsi xo a„~rnax~ ~~,~ aft-
~ < t~.. s~ 1~~'~'s~~~p ~fate_ ass~stavr~ce- , ~ ..~
CIHCP Monthly
Income Standards
April 1, 2007
Family Size	21% of FPG
1	$182
2	$245
~- 3	~ $308
4	$371
5	$434
Your Texas Benefits is an eligibility screening tool that can help you determine if you may be potentially
eligible for a variety of assistance programs, including the County Indigent Health Care Program.
Last Updated January 26, 2005
http://www. dshs. state.tx. us/cihcp/eligibility. shtm
10/1/2008
vaaavl /aabavuaL' vaaL~.l1(A
Eligibility Criteria
1 GLb'G 1 Vl 1
• Residence. The applicant must live in the county in which s/he applies and must intend to remain
there.
• Household. A CIHCP household is a person living alone or two or more persons living together where
legal responsibility for support exists, excluding disqualified persons. A disqualified person is one who
receives or is categorically eligible to receive Medicaid.
• Resources. A household is eligible if the total countable household resources do not exceed:
o $3,000.00 when a person who is aged or disabled and who meets relationship requirements lives in
the home or
o $2,000.00 for all other households.
• Income. A household is eligible if its monthly net income does not exceed 21% of the Federal Poverty
Guideline (FPG). Counties may choose to increase the monthly income standard to a maximum of
50% FPG, and still qualify to apply for state assistance funds.
CIHCP Monthly
Income Standards
April 1, 2007
Family Size 21% of FPG
1 -~~-$182
2 $245
~- 3 ~	$308
4	$371
5 -~	~ $434
Your Texas Benefits is an eligibility screening tool that can help you determine if you may be potentially
eligible for a variety of assistance programs, including the County Indigent Health Care Program.
Last Updated January 26, 2005
http://www.dshs. state.tx.us/cihcp/eligibility. shtm
10/1/2008
" STATEMENT OF APPLICANT'S RIGHTS AND RESPONSIBILITIES FORM 101
~* '` rEx~s
~- =~_•~ DECLARACIbN DE LOS DERECHOS Y DEBERES DEL SOLICITANTE



	By signing this application for assistance, 1 affirm the following:	AI firmar esta solicitud para recibir asistencia, yo afirmo to siguiente:
	The information on the application and its attachments is true	La informacibn escrita en la solicitud y en sus anexos es verdadera y
	and correct. This application is a legal document. Deliberately	corrects. Esta solicitud es un documento legal. EI deliberadamente omitir
	omitting information or giving false information may cause the	informacibn o el proporcionar informacibn falsa podrfa dar lugar a que el
	Provider to terminate services to a member of my	Proveedor cancele los servicios a uno de los miembros de mi hogar, de mi
r	
household/family or me.	
familia o los mfos propios.
	If I omit information, fail or refuse to give information, or give	Si yo omito informacibn, dejo de proporcionar o me niego a proporcionar
	false or misleading infonmation about these matters, I may be	informacibn o; proporciono informacibn falsa o engariosa acerca de estos
	required to reimburse the State for the services rendered if I am	asuntos, podrfa requerirseme que reembolse al Estado el costo de los
	found to be ineligible for services. I will report changes in my	servicios recibidos, si acaso se determina que no califico para los seroicios.
	household/family situation that affect eligibility during the	Yo reportare los cambios en la situacibn de mi hogar, de mi familia, que
	certification period (changes in income, household/family	afecten la elegibilidad durante el perfodo de certificacibn (cambios en el
	members, and residency).	ingreso, en los miembros del hogar, en la familia y, cambios de residencia.)
	I authorize release of all information, including but not limited to,	Yo autorizo la divulgacibn de toda la informacibn, incluyendo pero no
	income and medical information, by and to the Tezas Department	limitada a, el ingreso y a la informacibn medics, de pane de y para, el
	of State Health Services (DSHS) and Provider in order to	Texas Department of State Health Services (DSHS) (Departamento Estatal
	determine eligibility, to bill, or to render services to my	de Servicios de Salud de Texas] y, al Proveedor para poder detem,inar la
	household/family or me.	elegibilidad, para poder cobrar o, proporcionar seroicios en mi hogar, a mi
		familia o, a mf personalmente.
	I understand I may be asked by Provider to provide proof of any	Entiendo y acepto que podrfa pedirme et Proveedor que proporcione
	of the information provided in this application.	comprobantes de cualquiera de la informacibn proporcionada en esta
		solicitud.
Health insurance coverage, including but not limited to individual	La cobertura de seguro de salud, incluyendo pero no limitada a seguro
or group health insurance, health maintenance organization	para un individuo o seguro de salud para un grupo de personas; los de
membership, Medicaid, Medicare, Veterans Administration	membresfa proporcionados por organizaciones para el mantenimiento de la
benefits, Civilian Health and Medical Program of the Uniformed	salud [como HMO), Medicaid, Medicare; beneficios de la Veterans
Services (GRAMPUS), and Worker's Compensation benefits,	Administration; de la GRAMPUS y Worker's Compensation [beneficios de
must be reported to Provider. Benefits from health insurance may	Compensacibn Laboral], deben ser reportados al Proveedor. Los
be considered the primary source of payment for health care	beneficios provenientes de esos seguros de salud pudieran ser
received. I hereby assign to Provider any such benefits. I also	considerados como la fuente principal de pago de la atencibn de salud
assign payment for benefits and services received from and	recibida. Por este medio yo, asigno al Proveedor cualquiera de dichos
through Provider directly to the service providers.	beneficios. Tambien asigno el pago de los beneficios y servicios recibidos
	de parte de y, a traves del Proveedor, directamente a los proveedores de
	servicios.
1 understand that, to maintain program eligibility, I will be	Yo entiendo y acepto que, para mantener la elegibilidad para el programs,
~-' required to reapply for assistance at least every twelve months.	se me va a requerir que vuelva a solicitar para recibir asistencia, por to
	menos cads doce meses.
I am a bona fide resident of Texas or a dependent. I physically	Soy residente legitimo de Texas o bien, dependiente del territorio. Yo vivo
live in Texas, maintain living quarters in Texas, and do not claim	ffsicamente en Texas, mantengo residencia en Texas y, no afirmo ser
to be a resident of another state or country, or am a dependent of	residente de otro estado o pats o bien, soy un dependiente de un residente
a bona fide Texas resident.	legftimo de Texas.
Some programs provide care through program-approved	Algunos programas proporcionan atencibn a traves de proveedores
providers. I understand that, to receive benefits from such	aprobados por los programas. Yo entiendo y acepto que, para recibir
programs, treatment must be received through those program-	beneficios de dichos programas, el tratamiento debe ser recibido a traves
approved providers.	de esos proveedores aprobados por el programs.
1 understand that criteria for participation in the program are the	Yo entiendo y acepto que el criterio para la participacibn en el programs es
same for everyone regardless of sex, age, disability, race, or	el mismo para todos sin importar sexo, edad, discapacidad, raza o bien,
national origin.	origen de nacionalidad.
I understand I have the right to file a complaint regarding the	Yo entiendo y acepto que tengo el derecho de registrar una queja con
handling of my application or any action taken by the program	relacibn al manejo de mi solicitud o con relacibn a cualquier accibn tomada
with the HHSC Civil Rights Office at 1-888-388-6332.	por el programs con HHSC Civil Rights Office de 1-888-388-6332.
I understand that 1 will receive written documentation concerning	Yo entiendo y acepto que recibire documentacibn por escrito concerniente
the services forwhich my householdtfamily or I is eligible or	a los servicios para los cuales mi hogar, mi familia o yo calificamos o,
potentially eligible.	potencialmente Ileguemos a cal~car.
With few exceptions, you have the right to request and be	Tan solo por unas cuantas excepciones, usted tiene el derecho de solicitar
informed about information that the State of Texas collects about	y de ser informado sobre la informacibn que el Estado de Texas reune
you. You are entitled to receive and review the information upon	sobre usted. A usted se le debe conceder el derecho de recibir y revisar la
request. You also have the right to ask the state agency to	informacibn al requerirla. Usted tambien tiene el derecho de pedir que la
correct any information that Is determined to be incorrect. See	agencia estatal corrija cualquier informacibn que se ha determinado sea
htto://www.dshs.state.tx.us for more information on Privacy	incorrecta. Dirijase a httn://www.dshs.state.tx.us para mfis informacibn
Notification. (Reference: Govemment Code, Section 552.021,	sobre la Not~cacibn sobre privacidad. (Referencia: Govemment Code,
522.023 and 559.004)	seccibn 552.021, 522.023 y 559.004)
I understand and agree that the program does not provide	Entiendo y acepto que el programs no proporciona pago por la atencibn de
payment for inpatient care. l understand that I must make my own	pacientes internos. Entiendo y acepto que yo debo hacer mis propios
arrangement for hospital care and that I am responsible for the	arreglos de atencibn en el hospital y que yo soy responsable por el costo
cost of the care.	de la atencibn.
~Salipf nte'~;''' _r rk" 'pate(~echa .~£:.	' fo ~ i ture ~ `='_
_1]~
	_,
PHC 08-1
September 2008
~ ~ °~.
* TEAS
Deparkment of
State 1 iealth Sen,~ices
Summary of Revisions to the
FY 09 Primary Health Care Policy and
Procedures Manual
September 1, 2008
The following is a summary of the changes to the FY09 Primary Health Care Policy and
Procedures Manual. Revisions not detailed in the summary include modifications to the
text to achieve greater clarity and consistency and updates to names, dates and web links
referenced throughout the document.
Each page, per section is individually numbered, except in the Forms and Appendices
sections. The numbering system starts over in each section. The new footer displays the
year and the revision number (i.e. - 08-1/means year 2008 ls` revision).
HEADING	SUMMARY OF CHANGE
	All DSHS PHC central office staff and regional contract
	coordinators are included and moved to the front of the policy
	manual.
~ ~	
	• Chan ed from Introduction to Section One
~ ~	
	• Program Administration changed from Section I in the
	FY '08 Policy Manual to Section Two in the FY '09
	Policy Manual
1	
	Client Services and Community Activities changed from
	Section II in the FY '08 Policy Manual to Section Three
	in the FY '09 Policy Manual
	• Income -(Pages 7 - 12) defines countable and exempt
	income (i.e. -Educational Assistance -Exempt)
	• Cost Sharing/Fees (Page 17) -Revised
	• Continuation of Services (Pa a 18) -Revised
'	
	Clinical Informed Consent and Clinical Guidelines
	changed from Section II in the FY '08 Policy Manual to
	Section Four -Clinical Information in the FY '09 Policy
	Manual
	• Clinical Informed Consent (Pages 1- 2) -Revised
	• Clinical Guidelines -Revised
	
	• Reimbursement, Data Collection and Reporting changed
	from Section III in the FY '08 Policy Manual to Section
	Five in the FY '09 Polic Manual

	
	
	• All forms are now in Forms Section and the instruction
	pages are followed by each individual form
	• Screening and Eligibility Determination Form for
	Medical Services Assistance changed from Appendix A
	in the FY'08 Policy Manual to Form 100 in the FY '09
	Policy Manual and the Instructions is Form 100A
	• Statement of Applicant's Rights & Responsibilities
	changed from Appendix B in the FY '08 Policy Manual
	to Form 101 in the FY '09 Policy Manual
	• Presumptive Eligibility Form changed from Appendix C
	in the FY '08 Policy Manual to Form 102 in the FY '09
	Policy Manual and the Instructions is Form 102A
	• Notice of Eligibility Form changed from Appendix D in
	the FY '08 Policy Manual to Form 103 in the FY '09
	Policy Manual and the Instructions is Form 103A
	• Monthly Reimbursement Request for PHC changed
	from Appendix E in the FY '08 Policy Manual to Form
	200 in the FY' 09 Policy Manual and the Instructions is
	Form 200A
	• PHC -Monthly Reporting Form changed from Form
	200 in the FY '08 Policy Manual to Form 300 in the FY
	'09 Policy Manual and the Instructions is Form 300A
	• Primary Care Annual Report changed from Appendix G
	/ Form 300 in the FY '08 Policy Manual to Form 400 in
	the FY '09 Policy Manual and the Instructions is Form
	400A
	• Appendix A - DSHS Division for Family and
	Community Health -Community Health Services has
	changed the phone numbers and extensions changed
	from PMU, QMB, CDSB and added Contract
	Management Branch
	• Resources changed from Appendix J in the FY '08
	Policy Manual to Appendix B in the FY'09 Policy
	Manual
	• Appendix K in the FY '08 Policy Manual changed to
	Appendix C in the FY '09 Policy Manual.
	• There are now 10 BCCS Algorithms in the FY '09
	Polic Manual -Revised
m
x
v
H
A
N
b
.y
O
~I
a
~ o
rd " U
.~
~ ~
a~ a~
~ .~
O k
ua Q1
b N
.U o'.
.,~
'~
~'
~ ~ ..
O dJ +~
w •.~ ro
U
~ ~ '~
~ ~
,~~ ru ~
•~ v
A .ai U
~ro ro
r-l ~ ~
N ,S~
m ro
•d ~,
r~ rn
v +~
~ '~
O W
1_a ~
~~.o
j 4-I
~ ~~~yy
1V
'A W W
d1 H
V1 ~ ~
N ~
•~
4^-i1
W
?`.'~
~~:t
~'.
:- fn
i ~~ ~
:' z~..~?
v;.
x
F~-
W
J O
m
H ~
~.
m
_Z ~
Z
W -a,
W '~,
(%j o
c
W >;
0 ~
U °'
Z Q.
Q
_~
c
U
O
~' O
J _,_~
N
Z ~
N
N		
Z ~														
O
O O
~
~
~												
M			O	.. .
...
.
= 'O "O
li	=	_ ~	^		M	~	~	~	N	M	6	i	LM	~	O	'O 't3 ~ •+
	(.~	N o	~		N	N	C'1	~	'~	~	t.f	)	(D	~	CO	C (~ RS U ~
v		0
V N														O .d .p t 7
}																a
v
a a
																c
v
~
		°8 U														N N ~ N
~
-	V	= LL	O	-	O	d'	O	~'	O	~	C	~	~	M
'		_
~ p O O oD
		V
c	
~	I	n	r
~	L.O
N	N
M	f`
M'	M
O	O
~	O	~
O	CA
t!)	In
~	L i O
~ N tC ~ p
		~
c ~
G	~	N		N	M	M	~	d'	t	o	(D	CD	~	V U -UO r U
=
																~~ c ~f3
c
																i~ U
d c'
c
																	i
a
																	
	U LaL	m		O	tOf	) O	L~	O	tOf	?	O	L~	O		lOf)	
o	
n. m
~~ N O
-
	
0	
~N		
C	
h ~	
N	
CO'	
r	
[(	
)	
O	
~	
D	
)	
C`7	
~
~	c
~
O O O)
	a r	Q		~		N	N	M	~		~	~	~		~		o~ ~~
																	Q .~ L
"O N
N
															N
c r ~
				^			im								~
`~
	_ c ~

Q
a~ N	~

~		
h
~	rn

CT	N	V	, ~	~

+-	r

N	~

N	i1

N	~

N		"~
n3 O
C~
H O C
L
	,
U ti a~ ~														Y
O '= m c
															'
	o o d?

V ~ ~		
~	

P	

~t	

~'	

d-	

~	

~	

~	

~	

M	

H		c a 47
o U
c~ t~
~ ~ N
N
	~		~	'J	~	~	~	O		('
'	)
d^	CD	O
O
r~	O
~	c
o
	g o		Z	~						~					Q ~ O ~
															C O N C N
													O ~ ~
E	~	O	CO	~					~	'4'	'd'		O ~ ~ O O
r
a ~ ~ a	
~	
~	
d'	
t1)	~
(D	f~
~	(D
M	(O
M	
~
r	
r
r	
N
r		-+3~a~u
O) O O N ~
U rai `a													~ 3~ ~~
a
= o ~~													~
~mc~ .n~
V N •~ ~	~	ONO	In	CO		~'	~	O	(+?	CO	O	~,.~	C O) ~ c ~ O

~	
Z	
~	~
N	O
M	r
M	M
d'	rn
rt	cD
ui	N
cD	a0
cD	~
~	
0	p p ~ p
p O 0 O O O
													E ~ E
~
													m
Q Q cu Q tss
														
	~	~	^	~	t`	~	h	n	r~	~	h	n		~ e
		3	rn	0		OD	~	v	~	o	i~			
	L (~			C
v_	in	D
O								
	~													
	~p													lLf (C ~
	co													E ~~
	
i O
'	
~	
^	
n	
h	
~	
n	
~	
n	
n	
h	
~		_
O ~ ~~ O
3
	a ,-	'o	CO	~	~		O			0	N	1~	O
O	U Q
			00			h		C?	CO	7
0			
M	7 tf)
~
	V	Z	~'	r		r	N	' N	N	N	M	M		~~ ~
r
														
														~
	
u9	
~	
n	
N	
r	
O	
M	
M	
h	
O	
Lf')	
d'		N
O) V -O
Q O- (~ +.' ~
			N	^	O	~	0	N	O	O	M	0		N U ~
	C
~	\		c
D			0
0		C
O		^
d	, a
0		~
O
~
	.
+~ ~
LL	
~	
~		
N	
N	
N	
C7	
M	
~t	
~	
d"		v
= ~ ~ ~
	r													=
-
	Co
~		
~"~											O
Q.N
N
~
'v ~
'~
	M	.a		N		o	rn	Oo	r~	c.o	in	~		c
u
p.
		a												
V	U	Z	b9			N	N	r)	c7	c*~	d'	~		~ a7 p p C
														~ ~ O N 7
														

W	
r d	N
.O	
N	
07	
rY
'	
CA	
~
'	
6>	
~	
Q~	
~t	
07		
.~.., D) qj ~ .C
~i
~	~ lb
d E (7	O
~	h	t`
N	C
7
OO	aD
; (*7
~	d
~	Cn
d^	~
O	O
CD	(~
r	
t\		> U
C 'O Cn c
O
	C d r
~	~	~	N	N	`
P')	M	V	~	In	CD	O		c
C d i •- V
														~
~ a
	c = c													O O
i
•- 3 ~
	~' _~	o	o	rn
~	~	rn	~r	rn	~	m	~t	rn		~ a> c c o
	~ O r
d	~
O	~	
'-	t`	N	~	~	OMi	~	O	tOC)	t~	"c .~ O ftS
U .- v7 O
	
V d	
z	
~	
N	
N	
M	
M	
~	
~	
~	
(D	
(D	
~	i
` _~ N -O O
														O O Q~~'~
			'											
	~	p	~	'(D	t.C)	M	t\	N	O	Lf'3	N	i~		O O= '~' O
	Z	~
~	~ .	S'7	c~ri	V	~Y	~	~	~	(~D	(~O		07 ~ C p j O
°
	>.													3;v~
N o ~
														
	~
'	o	'~	cfl	u~	~	r`	N	o	in	N	r`		~ •~ ~ ~ O. ~
	o	~	O
r	
N	r~
N	o
c7	~
~	rn	~	~	c~	cD	~
~	O ~- .a ~ c »-
O O
	~	Z	U
9				c	c7	V	V	~	tt i		m O- ~ N
														
fA-NW											vg	rn'a oa.~y
	r'	N	M	~	Ln	tD	h	DD	O	0	0«« a	~O U ~ O O Q
											•	N
HUMAN RESOURCES CODE
SUBTITLE C. ASSISTANCE PROGRAMS
CHAPTER 31. FINANCIAL ASSISTANCE AND SERVICE PROGRAMS
SUBCHAPTER A. ELIGIBILITY FOR FINANCIAL ASSISTANCE AND SERVICES
Sec. 31.001. AID TO FAMILIES WITH DEPENDENT CHILDREN. The
department shall provide financial assistance and services to
families with dependent children in accordance with the provisions
of this chapter. The department shall give first priority in
~1r+ administering this chapter to assisting an adult recipient of or
unemployed applicant for the financial assistance and services in
finding and retaining a job.
Acts 1979, 66th Leg., p. 2343, ch. 842, art. 1, Sec. 1, eff. Sept_ 1,
1979. Amended by Acts 1995, 74th Leg., ch. 655, Sec. 1.01, eff.
Sept. 1, 1995.
Sec. 31.002. DEFINITION OF DEPENDENT CHILD. (a) In this
chapter, the term "dependent child" applies to a child:
(1) who is a resident of this state;
(2) who is under 18 years of age or is under 19 years of
age and is a full-time student in a secondary school or at the
equivalent level of vocational or technical training if, before the
child's 19th birthday, the child may reasonably be expected to
complete the secondary school or training program;
(3} who has been deprived of parental support or care
because of the death, continued absence from home, or physical or
mental incapacity of a parent;
(4) who has insufficient income or other resources to
provide a reasonable subsistence compatible with health and
decency; and
(5) who is living in the home residence of his or her
father, mother, grandfather, grandmother, brother, sister,
stepfather, stepmother, stepbrother, stepsister, uncle, aunt,
first cousin, nephew, or niece.
(b) In this chapter, the term "dependent child" also applies
to a child:
(1) who meets the specifications set forth in
Subdivisions {1)-(4} of the preceding subsection;
(2) who has been removed from the home of a relative
specified in Subdivision (5) of the preceding subsection as a
result of a judicial determination that the child's residence there
is contrary to his or her welfare;
(3) whose placement and care are the responsibility of
the department, the Department of Protective and Regulatory
,,: Services, or an agency with which the department or the Department
of Protective and Regulatory Services has entered into an agreement
for the care and supervision of the child;
(4) who has been placed in a foster home or child-care
institution by the department or the Department of Protective and
Regulatory Services; and
{5) for whom the state may receive federal funds for
the purpose of providing foster care in accordance with rules
promulgated by the department.
Acts 1979, 66~h Leg., p. 2343, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979. Amended by Acts 1993, 73rd Leg., ch. 395, Sec. 1, eff. June 2,
1993; Acts 1995, 74th Leg., ch. 76, Sec. 8.014, eff. Sept. 1, 1995.
Sec. 31.0021. DEFINITION OF NONRECIPIENT PARENT.
{a) Except as provided by Subsection (b), in this chapter,
"nonrecipient parent" means an adult or minor parent who is not a
recipient of financial assistance but who is living with the
person's child who is a recipient of financial assistance.
(b) "Nonrecipient parent" does not include:
(1) a minor parent who is not the head of household;
(2) a person who is ineligible for financial
assistance because of the person's immigration status; or
(3) a parent who cares for a disabled family member
living in the home if the family member does not attend school
full-time and the need for the care is supported by medical
documentation.
Added by Acts 2007, 80th Leg., R.S., Ch. 1300, Sec. 1, eff. June 15,
2007.
Sec. 31.003. AMOUNT OF FINANCIAL ASSISTANCE. (a) The
department shall adopt rules governing the determination of the
amount of financial assistance to be granted for the support of a
dependent child. The amount granted, when combined with the income
and other resources available for the child's support, must be
sufficient to provide the child with a subsistence compatible with
decency and health.
. (b) In considering the amount of income or other resources
available to a child or a relative claiming financial assistance on
the child's behalf, the department shall also consider reasonable
expenses attributable to earning the income. The department may
permit all or part of the earned or other income to be set aside for
the future identifiable needs of the child, subject to limitations
prescribed by the department.
(c) The department's agents employed in the region or county
in which the dependent child resides shall determine the amount to
be paid in accordance with the rules promulgated by the department.
Acts 1979, 66th Leq., p. 2343, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979.
Sec. 31.0031. RESPONSIBILITY AGREEMENT. (a) The
department shall require each adult recipient to sign a bill of
responsibilities that defines the responsibilities of the state and
of the recipient and encourages personal responsibility. The
department shall explain to the applicant the work requirements and
time-limited benefits in addition to the other provisions of the
agreement before the applicant signs the agreement. The department
shall provide each applicant with a copy of the signed agreement.
The agreement shall include pertinent case information, including
the case number and a listing of the state's benefits.
(b) The responsibilities of the state shall include
administering programs, within available resources, that:
(1) promote clear and tangible goals for recipients;
(2) enable parents to provide for their children's
basic necessities in atime-limited benefits program;
(3) promote education, job training, and workforce
development;
(4) support the family structure through life and
parenting skills training;
{5) are efficient, fraud-free, and easily accessible
by recipients;
(6) gather accurate client information; and
(7) give communities the opportunity to develop
alternative programs that meet the unique needs of local
recipients.
(c) The department shall adopt rules governing sanctions
and penalties under this section to or for:
(1) a person who fails to cooperate with each
applicable requirement of the responsibility agreement prescribed
r,r by this section; and
(2) the family of a person who fails to cooperate with
each applicable requirement of the responsibility agreement.
(d) The responsibility agreement shall require that:
(1) the parent of a dependent child cooperate with the
department and the Title IV-D agency if necessary to establish the
paternity of the dependent child and to establish or enforce child
support;
(2) if adequate and accessible providers of the
services axe available in the geographic area and subject to the
availability of funds, each dependent child, as appropriate,
complete early and periodic screening, diagnosis, and treatment
checkups on schedule and receive the immunization series prescribed
by Section 161.004, Health and Safety Code, unless the child is
exempt under that section;
(3) each adult recipient, or teen parent recipient who
has completed the requirements regarding school attendance in
Subdivision (6), not voluntarily terminate paid employment of at
least 30 hours each week without good cause in accordance with rules
adopted by the department;
{4) each adult recipient for whom a needs assessment
is conducted participate in an activity to enable that person to
become self-sufficient by:
(A) continuing the person's education or
becoming literate;
(B) entering a job placement or employment skills
training program;
{C) serving as a volunteer in the person's
community; or
(D) serving in a community work program or other
work program approved by the department;
(5) each caretaker relative or parent receiving
assistance not use, sell, or possess marihuana or a controlled
substance in violation of Chapter 481, Health and Safety Code, or
abuse alcohol;
(6) each dependent child younger than 18 years of age
or teen parent younger than 19 years of age attend school regularly,
unless the child has a high school diploma or high school
equivalency certif icate or is specifically exempted from school
attendance under Section 25.086, Education Code;
(7) each recipient comply with department rules
regarding proof of school attendance; and
(8} each recipient attend appropriate parenting
skills training classes, as determined by the needs assessment.
(e) In conjunction with the Texas Education Agency, the
department by rule shall ensure compliance with the school
attendance requirements of Subsection (d)(6) by establishing
criteria for:
(1) determining whether a child is regularly attending
school;
(2) exempting a child from school attendance in
accordance with Subchapter C, Chapter 25, Education Code; and
(3) determining when an absence is excused.
(f} The department by rule may provide for exemptions from
Subsection (d}(4) or for a teen parent under Subsection (d}(6). The
department may not require participation in an activity under
Subsection (d)(4) or for a teen parent under Subsection (d)(6) if
funding for support services is unavailable.
(g) In this section:
(1) "Caretaker relative" means a person who is listed
as a relative eligible to receive assistance under 42 U.S.C.
Section 602(a).
(2) "Payee" means a person who resides in a household
with a dependent child and who is within the degree of relationship
with the child that is required of a caretaker but whose needs are
not included in determining the amount of financial assistance
provided for the person's household.
(h) The department shall require each payee to sign a bill
of responsibilities that def fines the responsibilities of the state
and of the payee. The responsibility agreement must require that a
payee comply with the requirements of Subsections (d)(1), (2), (5),
(6), and (7).
Added by Acts 1995, 74th Leg., ch. 655, Sec. 2.02(a), eff. Sept. 1,
1995. Amended by Acts 1997, 75th Leg., ch. 165, Sec. 6.53, eff.
Sept. 1, 1997; Acts 1997, 75th Leg., ch. 682, Sec. 1, eff. Sept. 1,
1997; Acts 2003, 78th Leg., ch. 198, Sec. 2.86(a), 2.87, eff. Sept.
1, 2003.
Sec. 31.0032. PAYMENT OF ASSISTANCE FOR PERFORMANCE.
(a) Except as provided by Section 231.115, Family Code, if after
an investigation the department or the Title IV-D agency determines
that a person is not cooperating with a requirement of the
responsibility agreement required under Section 31.0031, the
department shall immediately apply a sanction terminating the total
amount of financial assistance provided under this chapter to or
for the person and the person's family.
(a-1) The department shall apply a sanction or penalty
imposed under Subsection (a) for a period ending when the person
demonstrates cooperation with the requirement of the
responsibility agreement for which the sanction was imposed or for
a one-month period, whichever is longer.
(b) The department shall immediately notify the caretaker
relative, second parent, or payee receiving the financial
assistance if the department will not make the financial assistance
payment for the period prescribed by Subsection (a-1) because of a
person's failure to cooperate with the requirements of the
responsibility agreement during a month.
(c) To the extent allowed by federal law, the Health and
Human Services Commission or any health and human services agency,
as defined by Section 531.001, Government Code, may deny medical
assistance for a person who is eligible for financial assistance
but to whom that assistance is not paid because of the person's
failure to cooperate. Medical assistance to the person's family
may not be denied for the person's failure to cooperate. Medical
assistance may not be denied to a person receiving assistance under
this chapter who is under the age of 19, a pregnant adult, or any
other person who may not be denied medical assistance under federal
law.
(d) This section does not prohibit the Texas Workforce
3
Commission, the Health and Human Services Commission, or any health
and human services agency, as defined by Section 531.001,
Government Code, from providing child care or any other related
social or support services for an individual who is eligible for
financial assistance but to whom that assistance is not paid
because of the individual's failure to cooperate.
(e} The department by rule shall establish procedures to
determine whether a person has cooperated with the requirements of
the responsibility agreement.
Added by Acts 1995, 74th Leg., ch. 655, Sec. 2.02(a), eff. Sept. 1,
1995. Amended by Acts 1999, 76th Leg. , ch. 556, Sec. 74, eff . Sept.
1, 1999; Acts 2003, 78th Leg., ch. 198, Sec. 2.88(a), eff. Sept. 1,
2003.
Sec. 31.0033. GOOD CAUSE HEARING FOR FAILURE TO COOPERATE.
(a) If the department or Title IV-D agency determines that a
person has failed to cooperate with the requirements of the
responsibility agreement under Section 31.0031, the person
determined to have failed to cooperate or, if different, the person
receiving the financial assistance may request a hearing to show
good cause for failure to cooperate not later than the 13th day
after the date the notice is sent under Section 31.0032. If the
person determined to have failed to cooperate or, if different, the
person receiving the financial assistance requests a hearing to
show good cause not later than the 13th day after the date on which
the notice is sent under Section 31.0032, the department may not
withhold or reduce the payment of financial assistance until the
department determines whether the person had good cause for the
person's failure to cooperate. On a showing of good cause for
failure to cooperate, the person may receive a financial assistance
payment for the period in which the person failed to cooperate, but
had good cause for that failure to cooperate.
(b) The department shall promptly conduct a hearing if a
timely request is made under Subsection (a).
(c) If the department finds that good cause for the person's
failure to cooperate was not shown at a hearing, the department may
not make a financial assistance payment in any amount to the person
for the person or the person's family for the period prescribed by
Section 31.0032(a-1).
(d) The department by rule shall establish criteria for good
cause failure to cooperate and guidelines for what constitutes a
good faith effort on behalf of a recipient under this section.
(e} Except as provided by a waiver or modification granted
under Section 31.0322, a person has good cause for failing or
refusing to cooperate with the requirement of the responsibility
agreement under Section 31.0031(d)(1) only if:
(1) the person's cooperation would be harmful to the
physical, mental, or emotional health of the person or the person's
dependent child; or
(2) the person's noncooperation resulted from other
circumstances the person could not control.
Added by Acts 1995, 74th Leg., ch. 655, Sec. 2.02(a), eff. Sept. 1,
1995. Amended by Acts 1999, 76th Leg., ch. 556, Sec. 75, eff. Sept.
1, 1999; Acts 2003, 78th Leg., ch. 198, Sec. 2.88(a}, eff. Sept. 1,
2003.
Sec. 31.00331. ADDITIONAL PENALTY FOR CONTINUOUS FAILURE TO
COOPERATE. A person who fails to cooperate with the responsibility
agreement for two consecutive months becomes ineligible for
financial assistance for the person or the person's family. The
person may reapply for financial assistance but must cooperate with
the requirements of the responsibility agreement for a one-month
period before receiving an assistance payment for that month.
Added by Acts 2003, ?8th Leg., ch. 198, Sec. 2.88(b), eff. Sept. 1,
2003.
Sec. 31.0034. ANNUAL REPORT. The department shall prepare
and submit an annual report to the legislature that contains
statistical information regarding persons who are applying for or
receiving financial assistance or services under this chapter,
including the number of persons receiving assistance, the type of
assistance those persons are receiving, and the length of time
those persons have been receiving the assistance. The report also
must contain information on:
(1) the number of persons to whom time limits apply;
(2) the number of persons under each time limit
category;
(3) the number of persons who are exempt from
4
participation under Section 31.012(c);
(4) the number of persons who were receiving financial
assistance under this chapter but are no longer eligible to receive
that assistance because they failed to cooperate with the
requirements prescribed by Section 31.0031;
(5) the number of persons who are no longer eligible to
receive financial assistance or transitional benef its under this
chapter because:
(A) the person's household income has increased
due to employment; or
(B) the person has exhausted the person's
benefits under this chapter;
(6) the number of persons receiving child care, job
training, or other support services designed to assist the
transition to self-sufficiency; and
(7) the number of persons who were eligible to receive
financial assistance under this chapter for each one-month period
but to whom that financial assistance was not paid because the
person failed to cooperate with the requirements of the
responsibility agreement under Section 31.0031.
Added by Acts 1995, 74th Leg., ch. 655, Sec. 2.02{a), eff. Sept. 1,
1995. Amended by Acts 2003, 78th Leg., ch. 198, Sec. 2.88(a), eff.
Sept. 1, 2003.
Sec. 31.0035. TRANSITIONAL CHILD-CARE SERVICES. (a) The
department shall provide necessary transitional child-care
services, in accordance with department rules and federal law, to a
person who was receiving financial assistance under this chapter
but is no longer eligible to receive the assistance because:
(1) the person's household income has increased; or
(2) the person has exhausted the person's benefits
under Section 31.0065.
(b) Except as provided by Section 31.012(c), the department
may provide the child-care services only until the earlier of
(1) the end of the applicable period prescribed by
Section 31.0065 for the provision of transitional benefits; or
(2) the first anniversary of the date on which the
person becomes ineligible for financial assistance because of
increased household income.
(c) The department by rule shall adopt a system of
co-payments in order to have a person who receives child-care
services under this section contribute an amount toward the cost of
the services according to the person's ability to pay.
(d) The department by rule shall provide for sanctions for a
person who is financially able to contribute the amount required by
Subsection (c) but fails to pay.
Added by Acts 1995, 74th Leg., ch. 655, Sec. 3.02, eff. Sept. 1,
1995.
Sec. 31.0036. DEPENDENT CHILD'S INCOME. The department may
not consider any income earned by a dependent child who is attending
school and whose income is derived from the child's part-time
employment for purposes of determining:
{1) the amount of financial assistance granted to an
individual under this chapter for the support of dependent
children; or
(2) whether the family meets household income and
resource requirements for eligibility for financial assistance
under this chapter.
Added by Acts 1995, 74th Leg., ch. 655, Sec. 1.02(a), eff. Sept. 1,
1995. Renumbered from Human Resources Code Sec. 31.0031 by Acts
1997, 75th Leg., ch. 165, Sec. 31.01(61), eff. Sept. 1, 1997.
Sec. 31.0037. EARNED INCOME FROM WORK PROGRAM. The
department may not consider any income earned by a recipient of
financial assistance under the Texans Work program established
under Chapter 308, Labor Code, for purposes of determining:
(1) the amount of financial assistance granted to an
individual under this chapter for the support of dependent
children; or
(2) whether the family meets household income and
resource requirements for financial assistance under this chapter.
Added by Acts 1997, 75th Leg. , ch. 456, Sec. 2, eff. Sept. 1, 1997.
Sec. 31.0038. TEMPORARY EXCLUSION OF NEW SPOUSE'S INCOME.
(a) Subject to the limitations prescribed by Subsection (b),
income earned by an individual who marries an individual receiving
financial assistance at the time of the marriage may not be
considered by the department during the six-month period following
the date of the marriage for purposes of determining:
{1) the amount of financial assistance granted to an
individual under this chapter for the support of dependent
children; or
(2) whether the family meets household income and
resource requirements for financial assistance under this chapter.
(b) To be eligible for the income disregard provided by
Subsection (a), the combined income of the individual receiving
financial assistance and the new spouse cannot exceed 200 percent
of the federal poverty level for their family size.
Added by Acts 2003, 78th Leg., ch. 198, Sec. 2.89, eff. Sept. 1,
2003.
Sec. 31.004. FOSTER CARE. The Department of Protective and
Regulatory Services may accept and spend funds available from any
source to provide foster care in facilities approved by the
Department of Protective and Regulatory Services for dependent
children who meet the specifications set out in Section 31.002 (b) .
Acts 1979, 66th Leg., p. 2344, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979. Amended by Acts 1995, 74th Leg., ch. 76, Sec. 8.015, eff.
Sept. 1, 1995.
Sec. 31.0041. SUPPLEMENTAL FINANCIAL ASSISTANCE FOR
CERTAIN PERSONS. (a) To the extent funds are appropriated for
this purpose, the department may provide supplemental financial
assistance in addition to the amount of financial assistance
granted for the support of a dependent child under Section 3.1.003 to
a person who:
(1} is 45 years of age or older;
(2) is the grandparent of the dependent child, as
defined by Section 31.002, who lives at the person's residence;
(3) is the primary caretaker of the dependent child;
(4) has a family income that is at or below 200 percent
of the federal poverty level; and
(5) does not have resources that exceed the amount
allowed for financial assistance under this chapter.
(b) Supplemental financial assistance provided to a person
under this section may include one or more cash payments, not to
exceed a total of $1,000, after determination of eligibility for
supplemental financial assistance under this section.
(c) The department shall inform an applicant for financial
assistance under this chapter who meets the eligibility
requirements under Subsection (a) of the availability of
supplemental financial assistance.
(d) The department shall maintain complete records and
compile statistics regarding the number of households that receive
supplemental financial assistance under this section.
(e) After a person receives supplemental financial
assistance under Subsection (b) on behalf of a dependent child, no
other person is eligible under Subsection (a} to receive
supplemental financial assistance on behalf of that child.
Added by Acts 1999, 76th Leg., ch. 471, Sec. 1, eff. Sept. 1, 1999.
Amended by Acts 2001, 77th Leg., ch. 346, Sec. 1, eff. Sept. 1,
2001.
Sec. 31.005. DEPENDENT CHILD RESIDING WITH RELATIVES.
(a) If after an investigation the department determines that a
family with a dependent child is needy and that the child resides
with the family, the department shall provide financial assistance
and services for the support of the family.
(b) The department shall formulate policies for studying
and improving the child's home conditions and shall plan services
for the protection of the child and for the child's health and
educational needs.
(c) A dependent child who is between 18 and 21 years of age
and whose family is receiving financial assistance or services on
his or her behalf must enroll in school during the regular school
term unless the department finds that good cause exists for the
nonattendance of the child at school. Failure to comply with this
requirement constitutes good cause for the termination of the
financial assistance or services.
(d) The department shall develop a plan for the coordination
of the services provided for dependent children under this chapter
and other child welfare services for which the department is
responsible.
Acts 1979, 66th Leg., p. 2344, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979.
Sec. 31.0051. MINOR PARENT RESIDING WITH RELATIVES. If the
6
department determines based on documentation provided that a minor
caretaker who is receiving financial assistance and services under
this chapter on behalf of a dependent child benefits from residing
with an adult family member who is also receiving assistance under
this chapter, the department shall provide assistance and services
to both persons as if they were living separately.
Added by Acts 1993, 73rd Leg., ch. 841, Sec. 3, eff. Sept. 1, 1993.
Sec. 31.006. WELFARE AND RELATED SERVICES. {a) The
department shall develop and implement a program of welfare and
related services for each dependent child which, in light of the
particular home conditions and other needs of the child, will best
promote the welfare of the child and his or her family and will help
to maintain and strengthen family life by assisting the child's
parents or relatives to attain and retain their capabilities for
maximum self-support and personal independence consistent with the
maintenance of continued parental care and protection.
(b) The department shall coordinate the services provided
under the program with other services provided by the department
and by other public and private welfare agencies for the care and
protection of children.
(c) The department may promulgate rules which will enable it
to fully participate in work and training programs authorized by
federal law, to provide for all services required or deemed
advisable under the provisions of the program, and to accept,
transfer, and expend funds made available from public or private
sources for the purpose of carrying out the provisions of this
section.
Acts 1979, 66th Leg., p. 2344, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979.
Sec. 31.0065. TIME-LIMITED BENEFITS. (a) The department
may provide financial assistance under this chapter only in
accordance with the time limits specified by this section. The
department by rule may provide for exceptions to these time limits
if severe personal hardship or community economic factors prevent
the recipient from obtaining employment or if the state is unable to
provide support services.
(b) The department shall limit f financial assistance and
transitional benefits in accordance with the following schedule:
(1) financial assistance is limited to a cumulative
total of 12 months and transitional benefits are limited to 12
months if the person receiving financial assistance on behalf of a
dependent child has:
(A) a high school diploma, a high school
equivalency certificate, or a certificate or degree from a two-year
or four-year institution of higher education or technical or
vocational school; or
(B) recent work experience of 18 months or more;
(2) financial assistance is limited to a cumulative
total of 24 months and transitional benefits are limited to 12
months if the person receiving financial assistance on behalf of a
dependent child has:
(A) completed three years of high school; or
(B) recent work experience of not less than six
or more than 18 months; and
(3) financial assistance is limited to a cumulative
total of 36 months and transitional benefits of 12 months if the
person receiving financial assistance on behalf of a dependent
child has:
(A) completed less than three years of high
school; and
(B) less than six months of work experience.
(c) If the recipient has completed less than three years of
high school and has less than six months work experience, the
department shall perform an in-depth assessment of the needs of
that person and that person's family. If the recipient cooperates
with the department's assessment, the time period prescribed by
Subsection (b)(3) begins on the first anniversary of the date on
which the department completes the assessment, as determined by the
department.
(d} The computation of time limits under Subsection (b)
begins when the adult or teen parent recipient receives
notification under Section 31.012(b) of the availability of an
opening in and eligibility for the job opportunity and basic skills
(JOBS) program Part F, Subchapter IV, Social Security Act (42
U.S.C. Section 682).
7
(e) In implementing the time-limited benef its program, the
department:
(1) shall provide that a participant in the program
may reapply with the department for financial assistance on or
after the fifth anniversary of the date on which the participant is
totally disqualified from receiving assistance because of the
application of Subsection (b}; and
(2) shall establish the criteria for determining what
constitutes severe personal hardship under Subsection (a).
(f) If the department is imposing time-limited benefits on
an individual, the department shall consider:
(1) the assessment of the individual's need that was
conducted by the department, provided that if the needs assessment
indicates discrepancies between a client's self-reported
educational level and the client's functional abilities, the time
limits shall be based upon the functional educational level; and
(2) the prevailing economic and employment conditions
in the area of the state where the individual resides.
Added by Acts 1995, 74th Leg., ch. 655, Sec. 3.01(a), eff. Sept. 1,
1995.
Sec. 31.0066. HARDSHIP EXEMPTIONS FROM FEDERAL TIME
LIMITS. (a) The department, the Texas Workforce Commission, and
the Health and Human Services Commission shall jointly adopt rules
prescribing circumstances that constitute a hardship for purposes
of exempting a recipient of financial assistance from the
application of time limits imposed by federal law on the receipt of
benefits.
(b) The rules must include a broad range of circumstances
that reasonably prevent recipients of financial assistance from
becoming self-supporting before expiration of the period specified
by federal law.
Added by Acts 2001, 77th Leg. , ch. 1217, Sec. 1, eff. Sept. 1, 2001.
Sec. 31.007. FINANCIAL ASSISTANCE TO INDIVIDUALS IN
INSTITUTIONS. A person who is in an institution is eligible to
receive financial assistance under this chapter if the person would
be eligible to receive the financial assistance if he were not in an
institution and if the payments are made in accordance with the
department's rules promulgated in conformity with federal law and
rules.
Acts 1979, 66th Leg., p. 2344, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979.
Sec. 31.008. COUNSELING AND GUIDANCE SERVICES. (a) If the
department believes that financial assistance to a family with a
dependent child is not being, or may not be, used in the best
interest of the child, the department may provide counseling and
guidance services to the relative receiving financial assistance
with respect to the use of the funds and the management of other
funds in the child's best interest.
(b) The department may advise the relative that continued
failure to use the funds in the child's best interest will result in
the funds being paid to a substitute payee. If the department
determines that protective payments are required to safeguard the
best interest of the child, the department may pay the funds to a
substitute payee on a temporary basis in accordance with the
department's rules.
(c) If the situation in the home which made the protective
payments necessary does not improve, and if the department
determines that the relative with whom the child is living is unable
or does not have the capacity to use the funds for the best interest
of the child, then the department may make arrangements with the
family for other plans for the care of the child. The other plans
may include:
(1) removing the child to the home of another
relative;
(2) appointment of a guardian or legal representative
for the relative with whom the child is living;
(3) imposition of criminal or civil penalties if a
court determines that the relative is not using, or has not used,
the payments for the benefit of the child; or
(4) referral of the case to a court for the removal of
the child and the placement of the child in a foster home.
(d) The department may make payments on .behalf of a
dependent child residing in a foster family home or a child-care
institution in accordance with the provisions of this chapter and
the rules of the department.
Acts 1979, 66th Leg., p. 2345, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979.
Sec. 31.009. REQUIRED REGISTRATION WITH TEXAS EMPLOYMENT
COMMISSION. (a) A person who is required to register with the
Texas Employment Commission under the Employment Incentive Act is
not eligible to receive financial assistance under this chapter
until the person is registered.
(b) Before making a payment, the department shall determine
whether the person to whom the payment is to be made is required to
register with the Texas Employment Commission under the Employment
Incentive Act, and if the person is required to register, whether
the person is registered. If the department finds that a person who
is required to register is not registered, the department may not
make the payment.
(c) On receipt of notice from the Texas Employment
Commission that a person has failed to comply with the Employment
Incentive Act, the department shall immediately terminate the
person's financial assistance.
(d) The department shall maintain a current record of all
persons found to be ineligible to receive financial assistance for
failure to comply with the Employment Incentive Act. The
department shall distribute the record to each division within the
department in which the record is or may be relevant in determining
eligibility for any welfare benefits.
(e) The department shall arrange placement of the dependent
children of an ineligible person with another person or with an
institution if the department determines that alternative care is
in the best interest of the children.
Acts 1979, 66th Leg., p. 2345, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979.
Sec. 31.0095. NEEDS ASSESSMENT. The Health and Human
Services Commission shall assist a recipient or a nonrecipient
parent in assessing the particular needs of that person and the
person's family upon notification of entry into a Temporary
Assistance for Needy Families employment program established under
Part A, Subchapter IV, Social Security Act (42 U.S.C. Section 601 et
seq.). The Texas Workforce Commission and the recipient or the
nonrecipient parent shall develop an employability plan to help the
recipient or nonrecipient parent achieve independence from public
assistance granted to the recipient and the recipient's family, or
to the child of the nonrecipient parent, as applicable.
Added by Acts 1995, 74th Leg., ch. 655, Sec. 1.03, eff. Sept. 1,
1995.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 1300, Sec. 2, eff. June 15,
2007.
Sec. 31.010. SUPPORT SERVICES. (a) Subject to the
availability of funds, the Texas Workforce Commission shall provide
a recipient or a nonrecipient parent with support services designed
to assist the recipient or nonrecipient parent and the person's
family to attain and retain the capability of independence and
self-care.
(b) The department shall consider the needs assessment and
employability plan developed under Section 31.0095 in determining
the support services needed.
(c) Support services include:
(1) education, using public or private schools as
necessary;
(2) child care;
(3) transportation assistance;
(4) work skills and job readiness training;
(5) instruction in job search techniques;
(6) job placement; and
(7) job retention assistance.
(d) The department by rule shall provide for implementation
of the support services.
(e) The department may contract with other state agencies,
community colleges, technical schools, residence training
facilities, or public or private entities to provide support
services under this section.
(f) In providing work skills and job readiness training, the
Texas Workforce Commission shall:
(1) emphasize training for sustainable wage jobs;
(2) promote understanding of nontraditional work
opportunities for recipients and nonrecipient parents; and
9
(3) offer micro-enterprise development and
self-employment assistance in rural areas and other areas in which
jobs are scarce.
Acts 1979, 66th Leg., p. 2346, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979. Amended by Acts 1995, 74th Leg., ch. 655, Sec. 1.04, eff.
Sept. 1, 1995; Acts 1997, 75th Leg. , ch. 82$, Sec. 3, eff. Sept. 1,
1997.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 1300, Sec. 3, eff. June 15,
2007.
Sec. 31.012. MANDATORY WORK OR PARTICIPATION IN EMPLOYMENT
ACTIVITIES THROUGH THE JOB OPPORTUNITIES AND BASIC SKILLS PROGRAM.
(a) The department shall require that, during any one-month period
in which an adult is receiving financial assistance under this
chapter, the adult shall during that period:
(1} work not less than 30 hours a week; or
(2) participate for not less than 20 hours a week in an
activity established under the job opportunities and basic skills
(JOBS) training program under Part F, Subchapter IV, Social
Security Act (42 U.S.C. Section 682).
(b) The department by rule shall establish criteria for good
cause failure to cooperate and for notification procedures
regarding participation in work or employment activities under this
section.
(c) A person who is the caretaker of a physically or
mentally disabled child who requires the caretaker's presence is
not required to participate in a program under this section. A
single person who is the caretaker of a child is exempt until the
caretaker's youngest child at the time the caretaker first became
eligible for assistance reaches the age of one. Notwithstanding
Sections 31.0035(b} and 32.0255(b), the department shall provide to
a person who is exempt under this subsection and who voluntarily
participates in a program under Subsection (a)(2) six months of
transitional benefits in addition to the applicable limit
prescribed by Section 31.0065.
(d) A state program operated under this section shall be
administered by the division of workforce development of the Texas
Workforce Commission when the program is transferred to that
commission.
(e) The department shall allow a person who is participating
in work or employment activities under this section to complete
those activities if the person becomes ineligible to receive
financial assistance under this chapter because the person receives
child support in an amount that makes the person ineligible for that
assistance. The department shall provide to the person necessary
child care services until the date on which the person completes
work or employment activities under this section.
(f} In this section, "caretaker of a child" means the parent
or relative of a dependent child with whom the child primarily
resides, including a parent or relative who has been appointed
under a court order as sole managing conservator or joint managing
conservator of the child.
Added by Acts 1991, 72nd Leg., 1st C.S., ch. 15, Sec. 5.23, eff.
Sept. 1, 1991. Amended by Acts 1995, 74th Leg., ch. 655, Sec.
4.01(a}, 11.63, eff. Sept. 1, 1995; Acts 1997, 75th Leg., ch. 602,
Sec. 1, eff. Sept. 1, 1997; Acts 1997, 75th Leg., ch. 681, Sec. 1,
eff. Sept. 1, 1997; Acts 1999, 76th Leg., ch. 1224, Sec. 1, eff.
Sept. 1, 1999; Acts 2003, 78th Leg., ch. 198, Sec. 2.90, eff. Sept.
1, 2003.
Sec. 31.0121. SKILLS ASSESSMENT AND DEVELOPMENT FOR CERTAIN
RECIPIENTS AND CERTAIN NONRECIPIENT PARENTS. (a) The Texas
Workforce Commission shall ensure that each local workforce
development board assesses the skills development needs of
recipients and of nonrecipient parents referred to the CHOICES
program administered by the board.
(b) If, after assessing the skills development needs of a
recipient or a nonrecipient parent, a local workforce development
board determines that the recipient or the nonrecipient parent
requires job-specific training for placement in a job paying wages
that equal or exceed the self-sufficiency wage developed for the
board under the Workforce Investment Act of 1998 (29 U.S.C. Section
2801 et seq.) , as amended, the board shall
(1) to the extent allowed by federal law, place the
recipient or the nonrecipient parent in training activities
designed to improve employment and wage outcomes and job retention
10
rates; and
(2} ensure that the training activities under
Subdivision (1) target occupations that are in demand by local
employers.
(c) A local workforce development board may use a single
list of targeted occupations that is developed for other training
programs for purposes of meeting the requirements of Subsection
(b)(2}.
(d) A recipient or a nonrecipient parent participating in
the CHOICES program who is placed in training activities under
Subsection (b) may concurrently engage in those training activities
and in work activities.
(e) To meet the requirements of this section, the Texas
Workforce Commission shall use CHOICES program funds and, to the
extent possible, existing funds from other training programs for
which a recipient or a nonrecipient parent participating in the
CHOICES program may qualify, including funds from:
(1) other training programs provided under the
Workforce Investment Act of 1998 (29 U.S.C. Section 2801 et seq.),
as amended, or their successor programs;
(2) the skills development fund created under Chapter
303, Labor Code; or
(3) the self-sufficiency fund created under Section
309.002, Labor Code.
Acts 2003, 78th Leg., ch. 817, Sec. 4.04, eff. Sept. 1, 2003.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 1300, Sec. 4, eff. June 15,
2007.
Acts 2007, 80th Leg., R.S., Ch. 1300, Sec. 5, eff. June 15,
2007.
Sec. 31.0124. REFERRAL TO EDUCATIONAL PROGRAMS. The
department shall determine whether a person who registers to
participate in the job opportunities and basic skills training
program needs and is eligible for adult education services provided
under Section 11.2093, Education Code. If the person is eligible
for the adult education services, the department shall determine
the person's needs and goals and refer the person to the appropriate
adult education service provided under Section 11.2093, Education
Code.
Added by Acts 1995, 74th Leg., ch. 655, Sec. 7.02, eff. Sept. 1,
1995.
Sec. 31.0125. VOLUNTEER WORK EXPERIENCE PROGRAM.
(a) Subject to the availability of appropriations for client
support services, the department by rule shall develop and
implement a volunteer work experience program in accordance with
federal law as a part of the job opportunities and basic skills
(JOBS) training program under Part F, Subchapter IV, Social
Security Act (42 U.S.C. Section 682).
(b) In adopting rules under this section, the department
shall:
(1) establish the criteria for determining which
recipients of financial assistance under this chapter who are
eligible to participate in the JOBS training program will be
required to participate in the volunteer work experience program;
(2) ensure that participation in the volunteer work
experience program will not result in the displacement of an
employee from an existing position or the elimination of a vacant
position;
(3) ensure that the volunteer work experience program
will not impair an existing service contract or collective
bargaining agreement;
(4) ensure that an entity or agency that enters into an
agreement with the department under this section provides to a
participant, without paying the participant a salary, job training
and work experience in certain areas within the entity or agency;
(5) require that each entity or agency that enters
into a cooperative agreement with the department under this section
identify positions within the entity or agency that will enable a
participant to gain the skills and experience necessary to be able
to compete in the labor market for comparable positions; and
(6) amend the service delivery system of the JOBS
training program to require a participant in the JOBS training
program who is unemployed after completing the JOBS readiness
activities outlined in the participant's employability plan,
including job search, to participate in the volunteer work
11
experience program.
(c) To implement the volunteer work experience program, the
department shall enter into written nonfinancial cooperative
agreements with entities that receive funds under a federal Head
Start program, state agencies, including institutions of higher
education, other entities of state or local government, or private
sector or nonprofit organizations or foundations.
(d) The department and an entity or agency that enters into
an agreement under this section must establish participation
requirements for the entity or agency under the volunteer work
experience program. The requirements must be contained in the
agreement.
Added by Acts 1993, 73rd Leg., ch. 841, Sec. 1, eff. Sept. 1, 1993.
Amended by Acts 1995, 74th Leg., ch. 655, Sec. 4.02{a), eff. Sept.
1, 1995_
Sec. 31.0126. EMPLOYMENT PROGRAMS. (a) The Texas
Workforce Commission by rule shall develop the following programs
to assist recipients of financial assistance and services under
this chapter and nonrecipient parents in finding and retaining
employment:
(1) a work first program that provides a participant
job readiness training and employment information and services that
will motivate the participant to find and apply for a job through
job clubs, job readiness activities, and job search activities;
(2) a business internship program that provides a
participant the opportunity to obtain marketable job skills through
an internship in a participating business;
(3) a Texas works program that:
{A) is operated by a nonprofit group or local
governmental entity;
(B) provides to a participant motivational and
job readiness training by placing the participant in a job for a
period of several months;
(C) ensures that the participant is visited at
work and receives counseling and help in resolving any work-related
or personal problems; and
(D) receives funding on the basis of participants
who are successfully hired for employment;
(4) a community work experience program that provides
a participant job training and work experience through a temporary
job in the public sector;
{5) a subsidized employment program that provides to a
participant job training and work experience through a job in the
private sector that pays the participant a subsidized salary; and
(6) a self-employment assistance program that
provides to a participant entrepreneurial training, business
counseling, and technical and financial assistance so that the
participant can establish a business and become self-employed.
(b) The department shall develop the programs prescribed by
this section in accordance with federal law as a part of the job
opportunities and basic skills (JOBS) training program under Part
F, Subchapter IV, Social Security Act (42 U.S.C. Section 682) .
(c) In adopting rules governing a program prescribed by this
section, the executive commissioner of the Health and Human
Services Commission shall:
(1) establish the criteria for determining which
recipients and nonrecipient parents who are eligible to participate
in the Temporary Assistance for Needy Families employment programs
established under Part A, Subchapter IV, Social Security Act (42
U.S.C. Section 601 et seq.), may be required to participate in a
particular program; and
(2) ensure that a recipient or a nonrecipient parent
who is incapable of participating in a particular program is not
required to participate in that program.
(d) A local workforce development board may implement in a
workforce development area one or more programs prescribed by this
section.
(e) The department shall submit a waiver application or a
renewal waiver application that a federal agency may require before
a local workforce development board can implement one or more of the
programs prescribed by this section in a workforce development
area.
(f) In this section, a "local workforce development board"
means a local workforce development board created under Chapter
2308, Government Code.
12
Added by Acts 1995, 74th Leq., ch. 655, Sec. 4.03, eff. Sept, 1,
1995. Amended by Acts 2003, 78th Leg., ch. $18, Sec. 6.08, eff.
Sept. 1, 2003.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 1300, Sec. 6, eff. June 15,
2007_
Sec_ 31.01261. PROVISION OF EMPLOYMENT SERVICES TO CERTAIN
NONRECIPIENT PARENTS. The Texas Workforce Commission shall
provide employment services, including needs assessment, job
training, postemployment, and related support services, to
nonrecipient parents to the same extent the services are provided
to recipients under this chapter.
Added by Acts 2007, 80th Leg., R.S., Ch. 1300, Sec. 7, eff. June 15,
2007.
Sec. 31.0127. COORDINATION OF SERVICES TO CERTAIN CLIENTS.
(a) The Health and Human Services Commission is the state agency
designated to coordinate between the department and another state
agency providing child care services, Temporary Assistance for
Needy Families work programs, and Food Stamp Employment and
Training services to an individual or family who has been referred
for programs and services by the department. The purpose of this
section is to accomplish the following:
(1) increase the self-sufficiency of recipients of
Temporary Assistance for Needy Families and improve the delivery of
services to those recipients; and
(2) improve the effectiveness of job-training
programs funded under the Job Training Partnership Act (29 U.S.C.
Section 1501 et seq.) or a successor program in obtaining
employment for individuals receiving Temporary Assistance for
Needy Families cash assistance.
(b) The Health and Human Services Commission shall require a
state agency providing program services described by Subsection (a)
to comply with Chapter 531, Government Code, solely for:
(1) the promulgation of rules relating to the programs
described by Subsection (a);
(2) the expenditure of funds relating to the programs
described by Subsection (a), within the limitations established by
and subject to the General Appropriations Act and federal and other
law applicable to the use of the funds;
(3) data collection and reporting relating to the
programs described by Subsection (a); and
(4) evaluation of services relating to the programs
described by Subsection (a).
(c) The department and a state agency providing program
services described by Subsection (a) shall jointly develop and
adopt a memorandum of understanding, subject to the approval of the
Health and Human Services Commission. The memorandum of
understanding must:
(1) outline measures to be taken to increase the
number of individuals receiving Temporary Assistance for Needy
Families cash assistance who are using job-training programs funded
under the Job Training Partnership Act {29 U.S.C. Section 1501 et
seq.), or a successor program; and
(2) identify specific measures to improve the delivery
of services to clients served by programs described by Subsection
(a).
(d) Not later than January 15 of each odd-numbered year, the
Health and Human Services Commission shall provide a report to the
governor, the lieutenant governor, and the speaker of the house of
representatives that:
(1) evaluates the efficiency and effectiveness of
client services in the Temporary Assistance for Needy Families
program;
(2) evaluates the status of the coordination among
agencies and compliance with this section;
(3) recommends measures to increase self-sufficiency
of recipients of Temporary Assistance for Needy Families cash
assistance and to improve the delivery of services to these
recipients; and
(4) evaluates the effectiveness of job-training
programs funded under the Job Training Partnership Act (29 U.S.C.
Section 1501 et seq.) or a successor program in obtaining
employment outcomes for recipients of Temporary Assistance for
Needy Families cash assistance.
(e) Subsection (b) does not authorize the Health and Human
13
Services Commission to require a state agency, other than a health
and human services agency, to comply with Chapter 531, Government
Code, except as specifically provided by Subsection (b). The
authority granted under Subsection (b) does not affect Section
	301.041, Labor Code.
	(f) If the change in law made by this section with regard to
	any program or service conflicts with federal law or would have the
	effect of invalidating a waiver granted under federal law, the
~/	state agency is not required to comply with this section with regard
	to that program or service.
	(g) This section does not authorize the Health and Human
	Services Commission to change the allocation or disbursement of
	funds allocated to the state under the Workforce Investment Act of
	1998 (29 U.S.C. Section 2801 et seq.) in a manner that would result
	in the loss of exemption status.
	(h) This section does not authorize the Health and Human
	Services Commission to transfer programs to or from the department
	and another agency serving clients of the Temporary Assistance for
	Needy Families program or the federal food stamp program
	administered under Chapter 33 without explicit legislative
	authorization.
	(i) The Health and Human Services Commission and any state
	agency providing program services described by Subsection (a) may
	not promulgate rules in accordance with Subsection (b)(1) without
	holding a public hearing.
	Added by Acts 1999, 76th Leg., ch. 1460, Sec. 10.01, eff. Sept. 1,
	1999.
	Sec. 31.0128. COORDINATED INTERAGENCY PLAN. (a) The
	department and the Texas Workforce Commission shall jointly develop
	and adopt a memorandum of understanding, subject to the approval of
	the Health and Human Services Commission. The memorandum of
	understanding must establish guidelines for a coordinated
	interagency case management plan to:
	(1) identify each recipient of financial assistance
	who has, in comparison to other recipients, higher levels of
	barriers to employment; and
	(2) provide coordinated services that address those
	barriers to assist the recipient in f finding and retaining
	employment.
	(b) The department and the Texas Workforce Commission
	shall:
	(1) jointly develop and adopt a memorandum of
	understanding, subject to the approval of the Health and Human
	Services Commission, that establishes a coordinated interagency
	case management plan consistent with the guidelines established
	under Subsection (a); and
	(2) using existing resources, by rule implement the
	plan to the maximum extent possible through local department and
	commission offices in local workforce development areas in which a
	local workforce development board is not established.
	(c) Each agency by rule shall adopt the memoranda of
	understanding required by this section and all revisions to the
	memoranda.
	(d) In a local workforce development area in which a local
	workforce development board is established, the Texas Workforce
	Commission shall require in the commission's contract with the
	board that the board, in cooperation with local department offices,
	develop and implement a coordinated interagency case management
	plan consistent with the guidelines established under Subsection
	(a).
	(e) On the department's formulation of recommendations and
	strategies under Section 31.0129(b), the department and the Texas
	Workforce Commission shall, as necessary, revise and update a
	memorandum of understanding and coordinated interagency case
	management plan under this section to include the recommendations
	and strategies.
	Added by Acts 2001, 77th Leg., ch. 84, Sec. 1, eff. Sept. 1, 2001.
	Amended by Acts 2003, 78th Leg., ch. 1169, Sec. 12, eff. Sept. 1,
	2003.
	Sec. 31.0129. COORDINATED PLAN TO IMPROVE INTERAGENCY
	TRANSITIONS. (a) The department, the Texas Workforce
	Commission, and representatives of local workforce development
	boards shall conduct a survey of best practices used to transition
	clients between local department offices and workforce centers.
	(b) The department shall:
	14
	(1) analyze information collected by a survey under
	Subsection (a); and
	(2) formulate recommendations and strategies to
	improve practices used to transition clients between local
	department offices and workforce centers.
	(c) Using existing resources, the department and local
	workforce development boards shall adopt policies to implement the
	recommendations and strategies contained in the revised and updated
~	memorandum of understanding under Section 31.0128.
	Added by Acts 2003, 78th Leq., ch. 1169, Sec. 13, eff. Sept. 1,
	2003.
	Sec. 31.0135. PARENTING SKILLS TRAINING. (a) The
	department, in cooperation with the Texas Education Agency, the
	Department of Protective and Regulatory Services, the Texas
	Agricultural Extension Service, or any other public or private
	entity, shall develop a parenting skills training program to assist
	a recipient of assistance under this chapter, including a child who
	receives assistance on behalf of a dependent child. The program
	shall include nutrition education, budgeting and survival skills,
	and instruction on the necessity of physical and emotional safety
	for children.
	(b) The department shall require that a caretaker relative
	or parent who is receiving assistance under this chapter on behalf
	of a dependent child receive appropriate parenting skills training
	as needed. The training must include one or more components of the
	parenting skills training program that the department determines
	will be useful to the caretaker relative or parent.
	(c) In this section, "caretaker relative" means a person who
	is listed as a relative eligible to receive assistance under 42
	U.S.C. Section 602(a).
	Added by Acts 1993, 73rd Leg., ch. 841, Sec. 2, eff. Sept. 1, 1993.
	Amended by Acts 1995, 74th Leg., ch. 655, Sec. 1.05, eff. Sept. 1,
	1995; Acts 1997, 75th Leg., ch. 165, Sec. 6.54, eff. Sept. 1, 1997;
	Acts 1997, 75th Leg., ch. 682, Sec. 2, eff. Sept. 1, 1997.
	Sec. 31.014. TWO-PARENT FAMILIES. {a) The department
	shall provide financial assistance, in accordance with department
	rules, to a two-parent family if the primary wage earner parent is
	registered in the job opportunities and basic skills (JOBS)
	training program under Part F, Subchapter IV, Social Security Act
	(42 U.S.C. Section 682), or is registered with the Texas Employment
	Commission.
	(b) A family is eligible for assistance under this section
	without regard to:
	{1) the number of hours worked per month by the primary
	wage earner parent; or
	(2) the work history of the primary wage earner
	parent_
	(c) An adult caretaker of a child younger than three years
	of age is exempt from the requirement of Subsection (a).
	Added by Acts 1993, 73rd Leg. , ch. 841, Sec. 1, eff. Sept. 1, 1993.
	Sec. 31.015. HEALTHY MARRIAGE DEVELOPMENT PROGRAM.
	(a) Subject to available federal funding, the department shall
	develop and implement a healthy marriage development program for
	recipients of financial assistance under this chapter.
	(b) The healthy marriage development program shall promote
	and provide three instructional courses on the following topics:
	(1) premarital counseling for engaged couples and
	marriage counseling for married couples- that includes skill
	development for:
	(A) anger resolution;
	(B) family violence prevention;
	(C) communication;
	(D) honoring your spouse; and
	{E) managing a budget;
	(2) physical f fitness and active lifestyles and
	nutrition and cooking, including:
	(A) abstinence for all unmarried persons,
	including abstinence for persons who have previously been married;
	and
	(B) nutrition on a budget; and
	(3) parenting skills, including parenting skills for
	character development, academic success, and stepchildren.
	(c) The department shall provide to a recipient of financial
	assistance under this chapter additional financial assistance of
	not more than $20 for the recipient's participation in a course
	15
offered through the healthy marriage development program up to a
maximum payment of $60 a month.
(d) The department may provide the courses or may contract
with any person, including a community or faith-based organization,
for the provision of the courses. The department must provide all
participants with an option of attending courses in a
non-faith-based organization.
(e) The department shall develop rules as necessary for the
administration of the healthy marriage development program.
(f) The department must ensure that the courses provided by
the department and courses provided through contracts with other
organizations will be sensitive to the needs of individuals from
different religions, races, and genders.
Added by Acts 2003, 78th Leg., ch. 198, Sec. 2.91, eff. Sept. 1,
2003.
Sec. 31.016. SERVICE REFERRALS FOR CERTAIN RECIPIENTS. To
the extent practicable using existing revenue, the department, by
rule, shall develop and implement a plan to:
(1) identify recipients of financial assistance that
are at risk of exhausting their benefits under Section 31.0065; and
(2) provide referrals for the recipient and the
recipient's family to appropriate preventive and support services,
including faith-based services.
Acts 2003, 78th Leg., ch. 1169, Sec. 14, eff. Sept. 1, 2003.
Renumbered from Human Resources Code, Section 31.015 by Acts 2005,
79th Leg., Ch. 728, Sec. 23.001(56), eff. September 1, 2005.
Sec. 31.017. HEALTHY MARRIAGES AND STRONG FAMILIES GRANT
PROGRAM. (a) The Health and Human Services Commission may
administer a grant program to provide grants in amounts not to
exceed $50,000 to programs that provide marriage education services
and support the development of healthy marriages or strengthening
of families. Grant recipients may use grant money to provide
direct services to participants, develop a program, enlarge program
capacity, or pay other program expenses, including provider
training and technical assistance expenses.
(b) In selecting grant recipients, the Health and Human
Services Commission shall give preference to applicants:
(1) whose programs will contribute to the geographic
diversity of program locations; or
(2) who operate small programs, but who seek to
maximize service delivery and build capacity.
(c) The Health and Human Services Commission shall require
that each grant recipient provide program services at no cost to
participants.
(d) The Health and Human Services Commission may contract
with private entities to provide marriage education training and
curriculum, technical assistance, and other support to grant
recipients. In selecting entities to provide these services, the
commission shall consider whether a prospective provider has
knowledge and understanding of the needs of grant recipients
operating programs in different areas of this state.
(e) The executive commissioner of the Health and Human
Services Commission may adopt rules to implement this section.
Added by Acts 2007, 80th Leg., R.S., Ch. 1249, Sec. 1, eff.
September 1, 2007.
Sec. 31.018. MARRIAGE AND FAMILY PROGRAM FUNDING. (a) To
the extent authorized by federal law, the Health and Human Services
Commission shall spend a minimum of one percent of money received
under the federal Temporary Assistance for Needy Families block
grant during each state fiscal year to fund programs that support
the development of healthy marriages or the strengthening of
families, including the healthy marriage development program under
Section 31.015 and the healthy marriages and strong families grant
program under Section 31.017.
(b) Using not more than 10 percent of the money required to
be spent as provided by Subsection (a), the Health and Human
Services Commission, through a contract or agreement with a public
senior college or university, as defined by Section 61.003,
Education Code, shall establish a process for evaluating the best
practices and outcomes of programs funded under Subsection (a).
Added by Acts 2007, 80th Leg., R.S., Ch. 1249, Sec. 1, eff.
September 1, 2007.
SUBCHAPTER B. ADMINISTRATION OF FINANCIAL ASSISTANCE AND SERVICES
Sec. 31.031. APPLICATION FOR ASSISTANCE. (a) The
department by rule shall prescribe the form for applications for
,: 16
assistance authorized by this chapter and the manner of their
submission.
(b) The department may require the applicant to state the
amount of property in which he or she has an interest, the amount of
income which he or she has at the time the application is filed, and
other information.
(c) The department shall require the applicant to provide
proof to the department that each person who will receive
assistance under this chapter is:
(1) a United States citizen or has a satisfactory
immigration status as defined in Title IV, Social Security Act (42
U.S.C. Section 602(a)(33)), in effect as of the effective date of
this Act; and
(2) a resident of this state.
(d) The department shall require the applicant to provide
proof to the department that each child five years of age or
younger, or a child who is not enrolled in public school, for whom
the applicant will receive assistance:
(1) has been immunized in accordance with Section
161.004, Health and Safety Code;
(2) is currently receiving an immunization series in
accordance with Section 161.004, Health and Safety Code, if the
child is of sufficient age; or
(3) is exempted under Section 161.004(d), Health and
Safety Code.
(e) An applicant who cannot provide the proof required by
Subsection (d) at the time of application shall provide the proof
not later than the 180th day after the date the department
determines the applicant is eligible for financial assistance.
(f) The department shall provide the applicant with
information regarding immunization services available in the
applicant's residential area. If the applicant does not read or
comprehend English, the department shall provide the information in
a language that the applicant reads or comprehends.
(g) The department by rule shall provide sanctions for a
financial assistance recipient's failure to comply with Subsection
(d) or (e).
Acts 1979, 66th Leg., p. 2346, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979. Amended by Acts 1995, 74th Leg., ch. 655, Sec. 2.01(a), 2.04,
eff. Sept. 1, 1995.
Sec. 31.0315. DETERMINATION OF PARENTAGE. (a) A parent
applying for assistance on behalf of a child shall identify the
parent's spouse or, if unmarried, shall provide the name and last
known address of the mother or alleged father of the child, as
applicable.
(b) If the applying parent is under 18 years of age and
resides with relatives, the applicant's relatives shall cooperate
in identifying the other parent.
(c) A person who is not a parent and who is applying for
assistance on behalf of a child shall provide the name and last
known address of the mother and alleged father of the child.
(d) The department may waive the requirements of this
section if it determines that there exists a reasonable explanation
why it is impossible to provide the information required under
Subsection (a), (b), or (c) or if it would not be in the best
interests of the child to provide the information. In determining
whether the best interests of the child warrant waiving the
information requirements of this section, the department shall
consider all relevant provisions of federal law and regulations.
(e) The department shall forward to the attorney general's
office information received under this section.
(f) If the parent of a dependent child is under 17 years of
age and the Title IV-D agency determines that the child's birth may
be the result of sexual conduct that constitutes a criminal offense
under the Penal Code, that agency shall refer the case to the
appropriate law enforcement agency for further investigation.
Added by Acts 1993, 73rd Leg., ch. 721, Sec. 1, eff. Sept. 1, 1993.
Amended by Acts 1995, 74th Leg., ch. 655, Sec. 1.06, eff. Sept. 1,
1995.
Sec. 31.032. INVESTIGATION AND DETERMINATION OF
ELIGIBILITY. (a) On receipt of an application for assistance
authorized by this chapter, the department shall investigate and
record the applicant's circumstances in order to ascertain the
facts supporting the application and to obtain other information it
may require.
17
(b) After completing its investigation, the department
shall determine whether the applicant is eligible for the
assistance, the type and amount of assistance, the date on which the
assistance shall begin, and the manner in which payments shall be
made.
(c) The department shall promptly notify the applicant of
its final action.
(d) In determining whether an applicant is eligible for
assistance, the department shall exclude from the applicant's
available resources:
(1) $1,000 for the applicant's household, including a
household in which there is a person with a disability or a person
who is at least 60 years of age ; and
(2) the fair market value of the applicant's ownership
interest in a motor vehicle, but not more than the amount determined
according to the following schedule:
(A) $4,550 on or after September 1, 1995, but
before October 1, 1995;
(B) $4,600 on or after October 1, 1995, but
before October 1, 1996;
(C) $5,000 on or after October 1, 1996, but
before October 1, 1997; and
(D) $5,000 plus or minus an amount to be
determined annually beginning on October 1, 1997, to reflect
changes in the new car component of the Consumer Price Index for All
Urban Consumers published by the Bureau of Labor Statistics.
(e) If federal regulations governing the maximum allowable
resources under the food stamp program, 7 CFR Part 273, are revised,
the department shall adjust the standards that determine available
resources under Subsection (d) to reflect those revisions.
Acts 1979, 66th Leg., p. 2346, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979. Amended by Acts 1995, 74th Leg., ch. 655, Sec. 1.07, eff.
Sept. 1, 1995; Acts 2003, 78th Leg., ch. 198, Sec. 2.201(x), eff.
Sept. 1, 2003; Acts 2003, 78th Leg., ch. 1251, Sec. 5(a), eff. June
20, 2003.
Sec. 31.0322. VICTIMS OF FAMILY VIOLENCE. (a) The
department, the Texas Workforce Commission, and the Title IV-D
agency by rule shall adopt procedures under which requirements
relating to financial assistance and related services, including
time limits, child support enforcement, paternity establishment,
work activity, and residency, may be waived or modified for an
individual who is a victim of family violence if application of the
requirements would:
(1) adversely affect the individual's ability to
attain financial independence;
(2) make it more difficult for the individual to
escape family violence; or
(3) place the individual at greater risk for
additional family violence.
(b) The procedures must provide that:
(1) a requirement may be waived or modified only after
a case-by-case determination and documentation of good cause and
only to the extent necessary considering an individual's
circumstances;
(2) a requirement may not be waived or modified for an
individual for a period longer than one year;
(3) the appropriate agency shall refer an individual
to a family violence program if necessary for assistance in
developing a safety plan to protect the individual from further
family violence; and
(4) confidentiality of information about the
identification and location of victims of family violence and their
children is maintained when necessary to prevent additional family
violence.
(c) The department, the Texas Workforce Commission, and the
Title IV-D agency may not deny an individual access to education,
training, employment, or other services because the individual is a
victim of family violence.
(d) The department shall coordinate the development and
implementation of procedures under this section in collaboration
with the Texas Workforce Commission, the Title IV-D agency, and at
least one statewide advocacy group for victims of family violence.
(e) The department, the Texas Workforce Commission, the
Title IV-D agency, and each local workforce development board,
using existing resources, shall provide not less than four hours of
18
training regarding family violence to each employee or other person
who on behalf of the department, commission, agency, or board:
(1) provides information relating to requirements
described by Subsection (a) and the availability of waivers or
modifications of those requirements to an individual seeking or
receiving financial assistance;
(2) recommends or grants waivers or modifications
authorized by this section of requirements described by Subsection
(a);
(3) recommends or imposes sanctions for
noncooperation or noncompliance with requirements described by
Subsection (a); or
(4) assesses employment readiness or provides
employment planning or employment retention services to an
individual receiving financial assistance.
(f) The training required by Subsection (e) must:
(1) be developed in collaboration with at least one
organization with expertise in family violence issues; and
(2} include information relating to:
(A) the potential impact of family violence on:
(i) the safety of an individual seeking or
receiving financial assistance; and
(ii) the ability of that individual to make
a successful transition into the workforce;
(B) state laws and agency rules regarding options
available to an individual receiving financial assistance for whom
family violence poses a danger or impediment to attaining financial
independence; and
(C) statewide and local resources available from
state and local governmental agencies and other entities that could
assist a victim of family violence in safely and successfully
entering the workforce.
(g) Before the application of a sanction or penalty based on
an individual's failure to cooperate with the department or Title
IV-D agency, as required by Section 31.0031(d)(1), or failure to
comply with the work or participation requirements imposed by
Section 31.012, the agency recommending or applying the sanction or
penalty must make reasonable attempts to contact the individual to
determine the cause of the failure to cooperate or comply. If the
agency determines that family violence contributed to the failure,
the agency shall ensure that a person trained in family violence
issues in accordance with Subsection (e) interviews the individual
to identify the types of services necessary to assist the
individual in safely and successfully entering the workforce.
(h) In this section:
{1) "Family violence" has the meaning assigned by
Section 71.004, Family Code.
(2) "Title IV-D agency" has the meaning assigned by
Section 101.033, Family Code.
Added by Acts 1997, 75th Leg., ch. 1442, Sec. 1, eff. Sept. 1, 1997.
Renumbered from Sec. 31.0321 by Acts 1999, 76th Leg., ch. 62, Sec.
19.01(71), eff. Sept. 1, 1999. Amended by Acts 2001, 77th Leg., ch.
197, Sec. 1, eff. Sept. 1, 2001.
Sec. 31.0324. ASSIGNMENT OF PROTECTIVE PAYEE. (a) In this
section, "protective payee" means a person who:
(1) is interested in or concerned with the welfare of a
child or relative of a child receiving financial assistance; and
(2) acts for the recipient of financial assistance in
receiving or managing the financial assistance payment.
(b) The department by rule shall develop and implement a
process that provides for the grandparent of a child receiving
financial assistance under this chapter to serve as a protective
payee to:
(1) receive and use the assistance on behalf of the
child; and
(2) apply for financial assistance and be interviewed
instead of the child's parent at any subsequent review of
eligibility required by the department.
(c) The department shall:
(11 limit the use of the process established by
Subsection (b) to situations in which the department determines the
parent is not using the assistance for the child's needs as required
by Section 31.0355(a); and
{2) establish by rule the circumstances under which
the grandparent may be removed as a protective payee.
19
Added by Acts 2001, 77th Leg., ch. 1316, Sec. 1, eff. Sept. 1, 2001.
Sec. 31.0325. ELECTRONIC IMAGING PROGRAM. (a) In
conjunction with other appropriate agencies, the department by rule
shall develop a program to prevent welfare fraud by using a type of
electronic fingerprint-imaging or photo-imaging of adult and teen
parent applicants for and adult and teen parent recipients of
financial assistance under this chapter or food stamp benefits
under Chapter 33.
(b) In adopting rules under this section, the department
shall:
(1} provide for an exemption from the electronic
imaging requirements of Subsection (a) for a person who is elderly
or disabled if the department determines that compliance with those
requirements would cause an undue burden to the person;
(2) establish criteria for an exemption under
Subdivision (1); and
(3) ensure that any electronic imaging performed by
the department is strictly confidential and is used only to prevent
fraud by adult and teen parent recipients of financial assistance
or food stamp benefits.
(c) The department shall:
(1) establish the program in conjunction with an
electronic benefits transfer program;
(21 use an imaging system; and
(3) provide for gradual implementation of this section
by selecting specific counties or areas of the state as test sites.
(d) Each fiscal quarter, the department shall submit to the
governor and the legislature a report on the status and progress of
the programs in the test sites selected under Subsection (c)(3).
Added by Acts 1995, 74th Leg., ch. 655, Sec. 8.07(a), eff. Sept. 1,
1995. Amended by Acts 2001, 77th Leg., ch. 782, Sec. 1, eff. June
14, 2001.
Sec. 31.033. REINVESTIGATION AND REDETERMINATION OF
ELIGIBILITY. (a) The department may require periodic
reconsideration of continued eligibility for assistance.
(b) After reconsideration of continuing eligibility, the
department may change the amount of assistance or withdraw it if the
department finds that the recipient's circumstances have altered
sufficiently to warrant that action.
(c) The department may cancel or suspend assistance for a
period of time if the department finds that the recipient is
currently ineligible to receive it.
!d) The department shall notify the recipient immediately
of its decision to change or withdraw assistance.
(e) A recipient of assistance must notify the department
immediately if he or she comes into possession of income or
resources in excess of the amount previously reported.
Acts 1979, 66th Leg., p. 2346, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979.
Sec. 31.034. APPEAL FROM LOCAL ADMINISTRATIVE UNITS.
(a) An applicant for or recipient of financial assistance
authorized by this chapter may appeal to the department an action or
failure to act by a local administrative unit relating to the
financial assistance. The department shall grant the applicant or
recipient an opportunity for a hearing after reasonable notice.
(b) An applicant or recipient, or his or hex authorized
agent, may submit a written request for the information contained
in the unit's records on which the action being appealed is based,
and the unit shall advise the person making the request of the
information within a reasonable time prior to the hearing.
Information not provided to the requesting. party may not be
considered by the department at the hearing as a basis for decision.
Acts 1979, 66th Leg., p. 2346, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979.
Sec. 31.035. METHOD OF PAYMENT. (a) The department shall
periodically furnish the comptroller with a list of persons
eligible for financial assistance under this chapter and the amount
to which each person is entitled.
(b) The comptroller shall draw warrants for the specified
amounts on the proper accounts of the Texas Department of Human
Services fund and shall transmit the warrants to the commissioner.
The commissioner shall supervise the delivery of the warrants to
the persons entitled to them.
Acts 1979, 66th Leg., p. 2346, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979. Amended by Acts 1985, 69th Leg., ch. 264, Sec. 11, eff. Aug.
20
26, 1985.
Sec. 31.0355. USE OF FINANCIAL ASSISTANCE. (a) Financial
assistance granted to a person under this chapter may be used only
to purchase goods and services that are considered essential and
necessary for the welfare of the family, including food, clothing,
housing, utilities, child care, and incidentals such as
transportation and medicine or medical supplies or equipment not
covered by Medicaid. The department by rule shall define what
constitutes essential and necessary goods and services for purposes
of this subsection.
(b) If a recipient of financial assistance who receives the
assistance by electronic benefits transfer to an account is
authorized to make a cash withdrawal from the account through a
provider of the goods or services described by Subsection (a), the
recipient may make the cash withdrawal only at the customer service
department of the provider and not at the provider's point-of-sale
terminal.
(c) The department shall encourage housing authorities,
utility companies, public transportation companies, and other
nonfood retailers to accept payment for goods and services
described by Subsection (a) through the state's electronic benefits
transfer (EBT) system.
(d) To determine the feasibility of using the EBT system to
accept payment for goods and services described by Subsection (a),
the department shall conduct a pilot project in which utility
companies, housing agencies, and other retailers use the EBT system
to accept payment for medicine, medical supplies, and medical
equipment not covered by Medicaid and other goods and services
described by Subsection (a). The cost of the point-of-sale (POS)
devices in the pilot project shall not be a state expense, except
for POS devices located in retail businesses that sell medicine or
medical supplies or medical equipment. The department shall work
in conjunction with the office of client transportation services of
the Health and Human Services Commission to determine if EBT
transportation applications are feasible.
(e) If the department determines that the pilot projects
show that use of the EBT system is feasible and useful for the
businesses and clients participating in the pilot project, the
department shall promote the use of the EBT system to appropriate
businesses statewide with the goal of securing the participation of
all those businesses in using the EBT system to accept payment for
goods and services described by Subsection (a) .
(f) The department shall evaluate the pilot project and
report to the 76th Legislature on the effectiveness of the pilot
project not later than January 15, 1999.
Added by Acts 1997, 75th Leg., ch. 637, Sec. 1, eff. Sept. 1, 1997.
Sec. 31.036. ELIGIBILITY OF PERSON LEAVING THE STATE. A
recipient of assistance who moves out of the state is no longer
eligible for the assistance. However, a recipient's temporary
absence from the state for reasons and for periods of time approved
by the department does not terminate the recipient's eligibility
for assistance.
Acts 1979, 66th Leg., p. 2346, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979.
Sec. 31.037. PAYMENT OF FINANCIAL ASSISTANCE FUNDS ON DEATH
OF RECIPIENT. (a) If a person dies during a month for which the
person is eligible for financial assistance and has not endorsed or
cashed the warrant issued for financial assistance during that
month, the department may pay financial assistance to the person
who was responsible for caring for the recipient at the time of his
or her death and who is responsible for paying the obligations
incurred by the recipient.
(b) The department shall adopt rules prescribing the method
of determining the person entitled to receive the deceased
recipient's financial assistance, the manner of payment of the
funds, and limitations on the payments.
(c) Payments to persons responsible for deceased recipients
under this section may be made only in the manner and to the extent
permissible under the laws and regulations governing the
disbursement of funds received through the Department of Health,
Education, and Welfare.
Acts 1979, 66th Leg., p. 2347, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979.
Sec. 31.038. CANCELLATION OF UNCASHED WARRANTS. The
department may cancel a financial assistance warrant that has not
21
been cashed within a reasonable period of time after issuance. The
cancellation must be performed in the manner required by rules of
the comptroller.
Acts 1979, 66th Leg., p. 2347, ch. 842, art. 1, Sec. 1, eff_ Sept. 1,
1979. Amended by Acts 1999, 76th Leg., ch. 1467, Sec. 1.33, eff.
June 19, 1999.
Sec_ 31.039. ISSUANCE OF REPLACEMENT ASSISTANCE WARRANTS.
The comptroller may issue a replacement financial assistance
warrant to a recipient who has failed to receive or has lost the
original warrant in accordance with Section 403.054, Government
Code.
Acts 1979, 66th Leg., p. 2347, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979. Amended by Acts 1985, 69th Leg., ch. 794, Sec. 12, eff. Aug.
26, 1985; Acts 1993, 73rd Leg., ch. 449, Sec. 35, eff. Sept. 1,
1993_
Sec. 31.040. NONTRANSFERABILITY OF ASSISTANCE FUNDS. The
right to financial assistance granted to recipients under this
chapter may not be transferred or assigned at law or in equity, and
the funds are not subject to execution, levy, attachment,
garnishment, or other legal process or to the operation of an
insolvency law.
Acts 1979, 66th Leg., p. 2347, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979.
Sec. 31.041. RIGHT TO ASSISTANCE NOT VESTED. (a) The
provisions of this chapter providing assistance shall not be
construed as vesting a right in the recipient to the assistance.
(b) Assistance granted under this chapter is subject to
modification or repeal by the legislature, and a recipient has no
claim for compensation or otherwise because the law authorizing the
assistance is amended or repealed_
Acts 1979, 66th Leg_, p. 2347, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979.
Sec. 31.042. PRORATION OF FINANCIAL ASSISTANCE. If at any
time state funds are not available to pay in full all financial
assistance authorized in this chapter, the department may direct
the proration of the financial assistance.
Acts 1979, 66th Leg., p. 2348, ch. 842, art. 1, Sec. 1, eff. Sept. 1,
1979.
Sec. 31.043. FILL-THE-GAP BUDGETING. (a) To extend the
period of supported employment for families who receive financial
assistance under this chapter, the department may use a form of
fill-the-gap budgeting or another method under which the department
disregards earnings of family members who obtain employment while
receiving the assistance.
(b) The department may limit the percentage of earnings
disregarded, impose a time limit on how long the earnings are
disregarded, or gradually reduce the percentage of earnings
disregarded in order to remain within available funding.
(c) Funding for earnings disregards may also come from
savings associated with sanctions related to noncompliance with the
personal responsibility agreement and work requirements in this
chapter, from savings resulting from caseload declines below
projections specified in the appfopriations bill, and from
Temporary Assistance for Needy Families (TANF) block grant funds.
(d) In this section, "fill-the-gap budgeting" means a
system of budgeting in which benefits are gradually lowered using a
percentage of the difference between the standard of need and the
countable income to calculate the grant benefit.
Added by Acts 1997, 75th Leg. , ch. 878, Sec. 1, eff. Sept. 1, 1997.
Sec. 31.044. INACTIVE ELECTRONIC BENEFITS TRANSFER
ACCOUNT. (a) This section applies only to an account to which
financial assistance provided under this chapter has been
transferred under the electronic benefits transfer system for
access and use by a recipient of that assistance.
(b) The department shall close an account that has not been
used by the account holder during the preceding 12 months.
(c) The comptroller shall withdraw any unused benefits
remaining in the account and disburse the benefits as authorized by
federal and state law.
Added by Acts 1997, 75th Leg., ch. 322, Sec. 4, eff. May 26, 1997;
Acts 1997, 75th Leg., ch. 458, Sec. 1, eff. Sept. 1, 1997.
Renumbered from Sec. 31.043 by Acts 1999, 76th Leg., ch. 62, Sec.
19.01(72), eff. Sept. 1, 1999_
SU$CHAPTER C. LIMITATION ON AMOUNT OF FINANCIAI,ASSISTANCE
Sec. 31.051. DEFINITION. In this subchapter, "state
22
budget" shall equal the amount appropriated by the legislature for
the biennium from funds subject to the limitations set forth in the
Texas Constitution, including any appropriated federal funds in the
amounts estimated in the Act making such appropriations.
Added by Acts 1983, 68th Leg., p. 1667, ch. 312, Sec. 1, eff. Aug.
29, 1983.
Sec. 31.052. LIMITATION ON AMOUNT OF FINANCIAL ASSISTANCE.
For each fiscal biennium, the maximum amount that may be paid out of
state funds for assistance grants to or on behalf of needy dependent
children and their caretakers may not exceed one percent of the
state budget.
Added by Acts 1983, 68th Leg., p_ 1667, ch. 312, Sec. 1, eff_ Aug.
29, 1983.
Sec. 31.053. DETERMINATION BY LEGISLATIVE BUDGET BOARD.
{a) With regard to the general appropriations bill introduced in
each house in each regular session, it shall be the duty of the
legislative budget director, not later than the seventh day of the
session, to inform in writing the lieutenant governor and the
speaker of the house of representatives of three items of
information:
(1) the biennial amount of the "state budget," as
defined for the purposes of this subchapter, based on the general
appropriations bills as introduced;
(2) the maximum biennial amount of one percent of the
state budget; and
(3) the biennial amount which would be appropriated by
the general appropriations bills for assistance to or on behalf of
needy dependent children and the caretakers of such children and
Which is subject to the limitation.
(b) At the request of the lieutenant governor or speaker the
legislative budget director shall update this information and shall
provide a statement of other legislation affecting appropriations.
(c) The Legislative Budget Board may adopt rules necessary
to perform its duties under this subchapter.
Added by Acts 1983, 68th Leg., p. 1667, ch. 312, Sec. 1, eff. Aug.
29, 1983.

,, 2 3
Search - 11 Kesults - 61.003
Page 1 of 2
' Sv/i±ch Ciient ! Preferences ~ Sign Out ;?~ Help
earch ,Research Tasks ~ et a Document; ~'Shepard's~Alerts T Transactional AdvisorTCounsel Selector H
__... _ _
FOCUST"' Terms si oos ;Search Within Original Results (1 u)
____ _
Advanced...
_ ~ _ _ . __
Source: Legal > States Legal - U.S. > Texas > Find Statutes. Regulations Administrative_Materials & Court Rules > TX -
Texas Statutes & Codes Annotated by LexisNexis -Selected Documents i~~.§
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER A. GENERAL PROVISIONS > § 61.003. Residence
Terms: 61.003 (Edit Search I Suggest Terms for My Search)
'Select for FOCUST"' or Delivery
Tex. Health & Safety Code § 61.003
TEXAS STATUTES AND CODES ANNOTATED BY LEXISNEXIS(R)
*** CURRENT THROUGH THE 2007 REGULAR SESSION ***
* Annotations current through cases posted on lexis.com as of June 26, 2008
HEALTH AND SAFETY CODE
TITLE 2. HEALTH
SUBTITLE C. PROGRAMS PROVIDING HEALTH CARE BENEFITS AND SERVICES
CHAPTER 61. INDIGENT HEALTH CARE AND TREATMENT ACT
SUBCHAPTER A. GENERAL PROVISIONS
GO TO TEXAS CODE ARCHIVE DIRECTORY
Tex. Health & Safety Code § 61.003 (2007)
§ 61.003. Residence
(a) For purposes of this chapter, a person is presumed to be a resident of the
governmental entity in which the person's home or fixed place of habitation to which the
person intends to return after a temporary absence is located. However, if a person's home
or fixed place of habitation is located in a hospital district, the person is presumed to be a
resident of that hospital district.
(b) If a person does not have a residence, the person is a resident of the governmental entity
or hospital district in which the person intends to reside.
(c) Intent to reside may be evidenced by any relevant information, including:
(1) mail addressed to the person or to the person's spouse or children if the spouse or
children live with the person;
(2) voting records;
(3) automobile registration;
(4) Texas driver's license or other official identification;
(5) enrollment of children in a public or private school; or
http://www:lexis.com/researeh/retrieve? m=b5fc58a3096b4906f1?f79dbfl~7d54ff8&docnu... 10/1/2008
rage ~ or ~
(6) payment of property tax.
(d) A person is not considered a resident of a governmental entity or hospital district if the
person attempted to establish residence solely to obtain health care assistance.
(e) The burden of proving intent to reside is on the person requesting assistance.
(f) For purposes of this chapter, a person who is an inmate or resident of a state school or
institution operated by the Texas Department of Corrections, Texas Department of Mental
Health and Mental Retardation, Texas Youth Commission, Texas School for the Blind, Texas
School for the Deaf, or any other state agency or who is an inmate, patient, or resident of a
school or institution operated by a federal agency is not considered a resident of a hospital
district or of any governmental entity except the state or federal government.
Source: Legal > States Legal - U.S. > Texas > Find Statutes, Regulations. Administrative Materials & Court Rules > TX
- Texas Statutes 8 Codes Annotated by LexisNexis -Selected Documents '.,i (
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER A. GENERAL PROVISIONS > § 61.003. Residence
Terms: 61.003 (Edit Search ~ Suggest Terms for My Search)
View: Full
Date/Time: Wednesday, October 1, 2008 - 8:47 AM EDT
Search ~ Research Tasks ~ Get a Document ~ Shepard's®~ Alerts ~ Transactional Advisor ~ Counsel Selector
History I Deliver~Manager I Switch Client I Preferences I Sign Out I He1a
About LexisNexis I Terms & Conditions I Contact Us
~~5~~'~C15~~ Copyright © 2008 LexisNexis, a division of Reed Elsevier Inc. All rights
reserved.
http://www.lexis.com/reseazch/retrieve? m=b5fc58a3096b4906fl~f79dbfb7d54ff8&docnu... 10/1/2008
~eazcn - s Kesults - b1.VU4
Yage 1 of 3
Switch Client Preferences i Sign Out ~ ~ ? -leip
Search ,iResearch Tasks,,., et a Document~5f ;, Shepard's~' ~ Alerts ~ Transactional Advisor Counsel Selector ~ H
FOCUST"" Terms s~.ooa Search Within Original Results (1 - 3)
Advanced...
Source: Legal > States Legal - U.S. > Texas > Find Statutes, Regulations, Administrative_Meterials & Court Rules > TX -
Texas Statutes & Codes Annotated by LexisNexis -Selected Documents _
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER A. GENERAL PROVISIONS > § 61.004. Residence or
Eligibility Dispute
Terms: 61.004 (Edit Search ~ Suggest Terms for My Search)
Select for FOCUST"' or Delivery
Tex. Health & Safety Code § 61.004
Practitioner`s Toolbox [?] [~R
TEXAS STATUTES AND CODES ANNOTATED BY
LEXISNEXIS(R) ~' Case Notes
*** CURRENT THROUGH THE 2007 REGULAR SESSION + History
***
* Annotations current through cases posted on lexis.com as of June 26, 2008
HEALTH AND SAFETY CODE
TITLE 2. HEALTH
SUBTITLE C. PROGRAMS PROVIDING HEALTH CARE BENEFITS AND SERVICES
CHAPTER 61. INDIGENT HEALTH CARE AND TREATMENT ACT
SUBCHAPTER A. GENERAL PROVISIONS
GO TO TEXAS CODE ARCHIVE DIRECTORY
Tex. Health & Safety Code § 61.004 (2007)
§ 61.004. Residence or Eligibility Dispute
(a) If a provider of assistance and a governmental entity or hospital district cannot agree
on a person's residence or whether a person is eligible for assistance under this chapter, the
provider or the governmental entity or hospital district may submit the matter to the
department.
(b) The provider of assistance and the governmental entity or hospital district shall submit all
relevant information to the department in accordance with the application, documentation,
and verification procedures established by the department under Section 61.006.
(c) If the department determines that another governmental entity or hospital district may
be involved in the dispute, the department shall notify the governmental entity or hospital
district and allow the governmental entity or hospital district to respond.
(d) From the information submitted, the department shall determine the person's residence
or whether the person is eligible for assistance under this chapter, as appropriate, and shall
notify each governmental entity or hospital district and the provider of assistance of the
decision and the reasons for the decision.
http://www.lexis.com/reseazch/retrieve? m=06a711e97f585341bc20f~a3194d953e&docnu... 10/1/2008
rage t or s
(e) If a governmental entity, hospital district, or provider of assistance does not agree with
the department's decision, the governmental entity, hospital district, or provider of
assistance may file an .appeal with the department. The appeal must be filed not later than
the 30th day after the date on which the governmental entity, hospital district, or provider of
assistance receives nofiice of the decision.
(f) The department shall issue a final decision not later than the 45th day after the date on
which the appeal is filed.
(g) A governmental entity, hospital district, or provider of assistance may appeal the final
order of the department under Chapter 2001, Government Code, using the substantial
evidence rule on appeal.
(h) Service may not be denied pending an administrative or judicial review of residence.
t History:
Stats. 1995 74th Leg. Sess. Ch. 76~ Stats. 1999 76th Leg. Sess. Ch. 1377, effective
September 1, 1999.
NOTES:
1999 Note:
(a) The change in law made by Ch. 1377 to Chapter 61, Health and Safety Code, applies
only to:
(1) health care services under Chapter 61, Health and Safety Code, as amended by this
article, that are delivered on or after January 1, 2000; and
(2) state assistance under Chapter 61, Health and Safety Code, as amended by this article,
for the services described by Subdivision (1) of this subsection.
(b) Health care services under Chapter 61, Health and Safety Code, as amended by this
article, that are delivered before January 1, 2000, and state assistance for those services are
governed by the law as it existed immediately before that date and that law is continued in
effect for this purpose. Acts 1999 76th Leg., Ch. 1377§ 1.28.
LexisNexis (R) Notes:
~- Case Notes:
~~ Civil Procedure >Pleading & Practice > Defenses, Demurrers, & Obiections > Motions
to Dismiss
# Healthcare Law > Actions Against Facilities > Governmental & Nonprofit Liability >
State, County & Municipal Liability
~ Public Health & Welfare Law > Healthcare > General Overview
http://www.lexis.coxn/research/retrieve? m=06a711e97f585341bc20f9a3194d953e&docnu... 10/1/2008
~earcn - s xesults - b1.VU4 Yage :i o1 .~
+' Civil Procedure > Pleading & Practice > Defenses, Demurrers, & Objections > Motions
to Dismiss
1. Because a dispute between two hospitals regarding the payment of indigent services did
not involve a disagreement about the patient's ability to pay or a residence, jurisdiction was
not limited to county courts or an administrative agency; therefore, a trial court erred by
granting a plea to the jurisdiction. Tomball Hosp. Auth. v. Harris County Hosp. Dist., 178
S.W.3d 244, 2005 Tex App LEXIS 5839 (Tex ~p Houston 14th Dist 2005
+ Healthcare Law > Actions Against Facilities > Governmental_&_Nonprofit Liability >
State, County & Municipal Liability
2. Because a dispute between two hospitals regarding the payment of indigent services did
not involve a disagreement about the patient's ability to pay or a residence, jurisdiction was
not limited to county courts or an administrative agency; therefore, a trial court erred by
granting a plea to the jurisdiction. Tomball Hosp. Auth. v. Harris County Hosp. Dist., 178
S. W.3d 244, 2005 Tex. App. LEXIS 5839 (Tex. App. Houston 14th Dist. 2005
+ Public Health & Welfare Law > Healthcare > General Overview
3. Because a dispute between two hospitals regarding the payment of indigent services did
not involve a disagreement about the patient's ability to pay or a residence, jurisdiction was
not limited to county courts or an administrative agency; therefore, a trial court erred by
granting a plea to the jurisdiction. Tomball Hosp. Auth. v. Harris County Hosp. Dist., 178
S.W.3d 244, 2005 Tex. App. LEXIS 5839 (Tex. App. Houston 14th Dist. 2005

Source: Legal > States Legal - U.S. > Texas > Find Statutes. Regulations. Administrative Materials & Court Rules > TX
- Texas Statutes 8< Codes Annotated by LexisNexis -Selected Documents ,_~ ,';
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER A. GENERAL PROVISIONS > § 61.004. Residence or
Eligibility Dispute
Terms: 61.004 (Edit Search ~ Suggest Terms for My Search)
View: Full
Date/Time: Wednesday, October 1, 2008 - 8:48 AM EDT
Search ~ Research Tasks ~ Get a Document ~ Shepard's®(Alerts ~ Transactional Advisor ~ Counsel Selector
His o I Delivery Manager I Switch Client (Preferences I Sign Out I Hela
About LexisNexis I Terms & Conditions I Contact Us
~~IE~~~~5~ Copyright © 2008 LexisNexis, a division of Reed Elsevier Inc. All rights
reserved.
http://www.lexis.com/research/retrieve? m=06a711e97f585341bc20fl9a3194d953e&docnu... 10/1/2008
rake 1 or ~
Switch Client Preferences ~ Sign Out (;?;Help
`Search ~rResearch Tasks Get a Document < Shepard's®~Alerts ~ Transactional Advisor Counsel Selector ~ H
FOCUSTM Terms ~~s
Advanced...
Search Within Original Results (1 - 114)
Source: Legal > States Legal - U.S. > Texas > Find Statutes, Regulations Administrative Materials & Court Rules > TX -
Texas Statutes & Codes Annotated by LexisNexis -Selected Documents ¢,,
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER A. GENERAL PROVISIONS > § 773.003. Definitions
Terms: 773 (Edit Search ~ Suggest Terms for My Search)
•~Select for FOCUST"' or Delivery
Tex. Health & Safety Code § 773.003
Practitioner's Toolbox ~ 0~
TEXAS STATUTES AND CODES ANNOTATED BY
LEXISNEXIS(R) + Case Notes
*** CURRENT THROUGH THE 2007 REGULAR SESSION
***
* Annotations current through cases posted on lexis.com
as of June 26, 2008
HEALTH AND SAFETY CODE
TITLE 9. SAFETY
SUBTITLE B. EMERGENCIES
CHAPTER 773. EMERGENCY MEDICAL SERVICES
SUBCHAPTER A. GENERAL PROVISIONS
GO TO TEXAS CODE ARCHIVE DIRECTORY
Tex. Health & Safety Code § 773.003 (2007)
§ 773.003. Definitions
In this chapter:
(1) "Advanced life support" means emergency prehospital
care that uses invasive medical acts.
'~ More...
(2) "Basic life support" means emergency prehospital care that uses noninvasive medical
acts.
(3) "Board" means the Texas Board of Health.
(4) "Bureau" means the department's bureau of emergency management.
(5) "Bureau chief' means the chief of the bureau of emergency management.
(6) "Commissioner" means the commissioner of health.
(7) "Department" means the Department of State Health Services.
History
Resources & Practice Tools
Treatises and Analytical
Materials
> 6-126 Texas Criminal Practice
Guide § 126.02, SUBSTANTIVE
LAW, BURGLARY AND PROPERTY
DAMAGE, Criminal Trespass, Texas
Criminal Practice Guide.
> 6-126 Texas Criminal Practice
Guide ~ 126.02, SUBSTANTIVE
LAW, BURGLARY AND PROPERTY
DAMAGE, Criminal Trespass, Texas
Criminal Practice Guide.
> 7-102 Dorsaneo, Texas Litioation
Guide § 102.05, Pretrial Practice
(Chs. 1-114), Pretrial Disposition
{Chs. 100-104), Effect of
Settlement in Particular Cases,
Darsaneo, Texas Litigation Guide.
http://www.lexis.com/research/retrieve? m=a8944d3331b031e2c7933f57faf2849c&docnu... 10/1/2008
~earcn - t i4 xesuns - i is rage ~ of ~
(8) "Emergency medical services" means services used to respond to an individual's
perceived need for immediate medical care and to prevent death or aggravation of
physiological or psychological illness or injury.
~"' (9) "Emergency medical services and trauma care system" means an arrangement of
available resources that are coordinated for the effective delivery of emergency health care
services in geographical regions consistent with planning and management standards.
(10) "Emergency medical services personnel" means:
(A) emergency care attendant;
(B) emergency medical technicians;
(C) emergency medical technicians. intermediate;
(D) emergency medical technicians. paramedic; or
(E) licensed paramedic.
(11) "Emergency medical services provider" means a person who uses or maintains
emergency medical services vehicles, medical equipment, and emergency medical services
personnel to provide emergency medical services.
(12) "Emergency medical services vehicle" means:
(A) a basic life-support emergency medical services vehicle;
(B) an advanced life-support emergency medical services vehicle;
{C) a mobile intensive-care unit; or
(D) a specialized emergency medical services vehicle.
(13) "Emergency medical services volunteer" means emergency medical services personnel
who provide emergency prehospital care without remuneration, except reimbursement for
expenses.
(14) "Emergency medical services volunteer provider" means an emergency medical services
provider that has at least 75 percent of its total personnel as volunteers and is recognized as
a Section 501(c)(3) nonprofit corporation by the Internal Revenue Service.
(15) "Emergency prehospital care" means care provided to the sick or injured before or
during transportation to a medical facility, and includes any necessary stabilization of the sick
or injured in connection with that transportation.
(15-a) "Executive commissioner" means the executive commissioner of the Health and
Human Services Commission.
(16) "First responder organization" means a group or association of certified emergency
medical services personnel that, working in cooperation with a licensed emergency medical
services provider, provides immediate on-scene care to ill or injured persons but does not
transport those persons.
(17) "Governmental entity" means a county, municipality, school district, or special district or
authority created in accordance with the Texas Constitution.
http://www.lexis.com/research/retrieve? m=a8944d3331b031e2c7933f$7fafZ849c&docnu... 10/1/2008
~earcn - 1 14 Kesults - ~/'/:S
Page 3 of 5
(18) "Medical supervision" means direction given to emergency medical services personnel by
a licensed physician under Subtitle B, Title 3, Occupations Code, [1] and the rules adopted
under that subtitle by the Texas State Board of Medical Examiners.
(19) "Trauma facility" means a health care facility that is capable of comprehensive
treatment of seriously injured persons and is a part of an emergency medical services and
trauma care system.
(19) "Emergency medical care" means bona fide emergency services provided after the
sudden onset of a medical or traumatic condition manifesting itself by acute symptoms of
sufficient severity, including severe pain, such that the absence of immediate medical
attention could reasonably be expected to result in:
(A) placing the patient's health in serious jeopardy;
(B) serious impairment to bodily functions; or
(C) serious dysfunction of any bodily organ or part.
(20) "Trauma patient" means a critically injured person who has been:
(A) evaluated by a physician, a registered nurse, or emergency medical services personnel;
and
(B) found to require medical care in a trauma facility.
(21) [Blank].
`"~'` (22) "Trauma services" includes services provided to a severely or seriously injured patient
who has a principal diagnosis listed in the Injuries and Poisonings Chapter of the
International Classification of Diseases, Clinical Modification.
[1] Tex. Occupations Code § 151.001 et seq.
4 History:
Stats. 1995 74th Leg. Sess. Ch. 915, Stats. 1997 75th Leg. Sess. Ch. 435, effective
September 1, 1997 Stats. 1999 76th Leg. Sess. Ch. 1377, effective September 1, 1999;
Stats. 2001 77th Leg. Sess. Ch. 1420, effective September 1, 2001 Stats. 2005 79th Leg.
Sess, Ch. 299 (S.B. 330), § 2, effective September 1, 2005.
NOTES:
1999 Note:
It appears the legislature in advertently enacted a subsection (22) without enacted a
subsection (21).
2005 amendment,
deleted "Texas" before "Department" in (7); added "State" after "Department of" in (7);
added "Services" at end of (7); and added (15-a).
http://www.lexis.com/research/retrieve? m=a8944d3331b031e2c7933f57faf2849c&docnu... 10/1/2008
rage 4 or ~
LexisNexis (R) Notes:
Case Notes:
Healthcare Law > Good Samaritan Laws
1. Former Tex. Civ. Prac. & Rem. Code Ann. § 74.002, the Good Samaritan provision, applies
to emergency medical services (EMS) personnel because emergency medical services are
properly excluded from the definition of the "healing arts" as used in that provision. Under
Tex. Health & Safety Code Ann. ~~ 773.003, 773.007, 773.043, medical supervision was
mandatory with respect to the care administered. Dunlap v. Young, 187 S.W.3d 828, 2006
Tex. App. LEXIS 1683 (Tex. App. Texarkana 2006
f Treatises and Analytical Materials:
1. 6-126 Texas Criminal Practice Guide § 126.02, SUBSTANTIVE LAW, BURGLARY AND
PROPERTY DAMAGE, Criminal Trespass, Texas Criminal Practice Guide.
2. 6-126 Texas Criminal Practice Guide § 126.02, SUBSTANTIVE LAW, BURGLARY AND
PROPERTY DAMAGE, Criminal Trespass, Texas Criminal Practice Guide.
3. 7-102 Dorsaneo, Texas Litigation Guide § 102.OS, Pretrial Practice (Chs. 1-114), Pretrial
~"' Disposition (Chs. 100-104), Effect of Settlement in Particular Cases, Dorsaneo, Texas
Litigation Guide.
4. 1-11 Texas Torts and Remedies § 11.04, PROFESSIONAL LIABILITY, HEALTH CARE
PROVIDERS, Defenses, Texas Torts and Remedies.
LexisNexis 50 State Surveys, Legislation & Regulations
Nongovernmental Ambulance and Emergency Services
Source: Legal > States Legal - U.S. > Texas > Find Statutes. Regulations, Administrative Materials & Court Rules > TX
- Texas Statutes 8 Codes Annotated by LexisNexis -Selected Documents
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER A. GENERAL PROVISIONS > § 773.003. Definitions
Terms: 773 (Edit Search ~ Suggest Terms for My Search)
View: Full
Date/T'ime: Wednesday, October 1, 2008 - 8:49 AM EDT
Search ~ Research Tasks ~ Get a Document ~ Shepard's®~ Alerts (Transactional Advisor ~ Counsel Selector
History I Delivery Manager I Switch Client I Preferences I Sign Out (Hela
http://www.lexis.com/research/retrieve? m=a8944d3331b031e2c7933f57faf2849c&docnu... 10/1/2008
rage ~ or ~
About LexisNexis ~ Terms & Conditions ~ Contact Us
L~'X1SN@XIS~ Copyright © 2008 LexisNexis, a division of Reed Elsevier Inc. All rights
reserved.
http://www.lexis.com/research/retrieve? m=a8944d3331b031e2c7933f57faf2849c&docnu... 10/1/2008
rage ~
Syvitch Client Preferences ~ Sign Out I ? :Help
'Search .;Research Tasks -Get a Document ; Shepard's~"~ Alerts ~ Transactional Advisor. Counsel Selector ~
___
F OCUSTM Terms s~ 005 Search Within Original Results (1 - 1)
_.
_.
Source: Le al > States Legal - U.S. > Texas > Find Statutes, Regulations, Administrative Materials & Court Rules > TX -
Texas Statutes & Codes Annotated by LexisNexis -Selected Documents , i_;
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER A. GENERAL PROVISIONS > § 61.005. Contribution
Toward Cost of Assistance
Terms: 61.005 (Edit Search I Suggest Terms for My Search)
Tex. Health & Safety Code § 61.005
TEXAS STATUTES AND CODES ANNOTATED BY LEXISNEXIS(R)
*** CURRENT THROUGH THE 2007 REGULAR SESSION ***
* Annotations current through cases posted on lexis.com as of June 26, 2008
HEALTH AND SAFETY CODE
TITLE 2. HEALTH
SUBTITLE C. PROGRAMS PROVIDING HEALTH CARE BENEFITS AND SERVICES
CHAPTER 61. INDIGENT HEALTH CARE AND TREATMENT ACT
SUBCHAPTER A. GENERAL PROVISIONS
GO TO TEXAS CODE ARCHIVE DIRECTORY
Tex. Health & Safety Code § 61.005 (2007)
§ 61.005. Contribution Toward Cost of Assistance
(a) A county, public hospital, or hospital district may request an eligible resident receiving
health care assistance under this chapter to contribute a nominal amount toward the cost of
the assistance.
(b) The county, public hospital, or hospital district may not deny or reduce assistance to an
eligible resident who cannot or refuses to contribute.
Source: Legal > States Legal - U.S. > Texas > Find Statutes. Regulations, Administrative Materials & Court Rules > TX
- Texas Statutes & Codes Annotated by LexisNexis -Selected Documents '~;i
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER A. GENERAL PROVISIONS > § 61.005. Contribution
Toward Cost of Assistance
Terms: 61.005 (Edit Search ~ Suggest Terms for My Search)
View: Full
DatelTime: Wednesday, October 1, 2008 - 9:47 AM EDT
Search ~ Research Tasks ~ Get a Document ~ Sh~ard's~ ~ Alerts ~ Transactional Advisor ~ Counsel Selector
History I Delivery Manager I Switch Client I Preferences I Sian Out I Hela
~' About LexisNexis I Terms & Conditions I Contact Us
Copyright © 2008 LexisNexis, a division of Reed Elsevier Inc. All rights
http://www.lexis.com/research/retrieve? m=57b63a098c4abfn58e669023875ff5dc&csvc=... 10/1/2008
rage
reserved.
Lex~s~l~~is
http://www.lexis.com/research/retrieve? m=57b63a098c4abf058e669023875ff5dc&csvc=... 10/1/2008
acai~ii - i i nwuitw - vi.vvv
rake i vi .~
Sv/itch Client ;Preferences }Sign Out ! `? Help
. Search ,,Research Tasks ~~,Get a Document .Shepard's~'~, Alerts T Transactional Advisor Counsel Selector H
_ _ __
FOCUST"" Terms si.oos Search Within o~i9n,ai Results (1 - ill
Advanced
Source: Legal > States Legal - U.S. > Texas > Find Statutes. Regulations, Administrative Materials & Court Rules > TX -
Texas Statutes & Codes Annotated by LexisNexis -Selected Documents
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER A. GENERAL PROVISIONS > § 61.006. Standards and
Procedures
Terms: 61.006 (Edit Search I Suggest Terms for M rLSear~
Select for FOCUST"' or Delivery
Tex. Health & Safety Code § 61.006
Practitioner's Toolbox C] [Q~
TEXAS STATUTES AND CODES ANNOTATED BY
LEXISNEXIS(R) ~ Historv
*** CURRENT THROUGH THE 2007 REGULAR SESSION ***
* Annotations current through cases posted on lexis.com as of June 26, 2008
HEALTH AND SAFETY CODE
TITLE 2. HEALTH
SUBTITLE C. PROGRAMS PROVIDING HEALTH CARE BENEFITS AND SERVICES
CHAPTER 61. INDIGENT HEALTH CARE AND TREATMENT ACT
SUBCHAPTER A. GENERAL PROVISIONS
GO TO TEXAS CODE ARCHIVE DIRECTORY
Tex. Health & Safety Code § 61.006 (2007)
§ 61.006. Standards and Procedures
(a) The department shall establish minimum eligibility standards and application,
documentation, and verification procedures for counties to use in determining eligibility under
this chapter.
(b) The minimum eligibility standards must incorporate a net income eligibility level equal to
21 percent of the federal poverty level based on the federal Office of Management and
Budget poverty index.
(b-1) Expired.
(b-2) Repealed by Acts 2001, 77th Leg., ch. 1128, § 7, eff. Sept. 1, 2001.
(c) The department shall also define the services and establish the payment standards for the
categories of services listed in Sections 61.028(a) and 61.0285 in accordance with Texas
Department of Human Services rules relating to the Temporary Assistance for Needy
Families-Medicaid program.
(d) The department shall establish application, documentation, and verification procedures
that are consistent with the analogous procedures used to determine eligibility in the
http://www.lexis.com/research/retrieve? m=ec96e62f595e04b89de93f77988c20ff&docnu... 10/1/2008
ra~c t, vi ~
Temporary Assistance for Needy Families-Medicaid program. The department may not adopt
a standard or procedure that is more restrictive than the Temporary Assistance for Needy
Families-Medicaid program or procedures.
(e) The department shall ensure that each person who meets the basic income and resources
requirements for Temporary Assistance for Needy Families program payments but who is
categorically ineligible for Temporary Assistance for Needy Families will be eligible for
assistance under Subchapter B. [1] Except as provided by Section 61.023(b), the department
by rule shall also provide that a person who receives or is eligible to receive Temporary
Assistance for Needy Families, Supplemental Security Income, or Medicaid benefits is not
eligible for assistance under Subchapter B even if the person has exhausted a part or all of
that person's benefits.
(f) The department shall notify each county and public hospital of any change to department
rules that affect the provision of services under this chapter.
(g) Notwithstanding Subsection (a), (b), or (c) or any other provision of law, the department
shall permit payment to a licensed dentist for services provided under Sections 61.028(a)(4)
and (6) if the dentist can provide those services within the scope of the dentist's license.
(h) Notwithstanding Subsection (a), (b), or (c), the department shall permit payment to a
licensed podiatrist for services provided under Sections 61.028(a)(4) and (6), if the podiatrist
can provide the services within the scope of the podiatrist's license.
[1) Tex. Health and Safety Code § 61.021 et seq.
History:
Stats. 1995 74th Leg. Sess. Ch. 76~ Stats. 1999 76th Leg. Sess. Ch. 1377, effective
September 1, 1999 Stats. 2001 77th Leg. Sess. Ch. 1128, effective September 1, 2001.
NOTES:
1999 Note:
(a) The change in law made by Ch. 1377 to Chapter 61, Health and Safety Code, applies
only to:
(1) health care services under Chapter 61, Health and Safety Code, as amended by this
article, that are delivered on or after January 1, 2000; and
(2) state assistance under Chapter 61, Health and Safety Code, as amended by this article,
for the services described by Subdivision (1) of this subsection.
(b) Health care services under Chapter 61, Health and Safety Code, as amended by this
article, that are delivered before January 1, 2000, and state assistance for those services are
governed by the law as it existed immediately before that date and that law is continued in
effect for this purpose. Acts 1999 76th Leg., Ch. 1377§ 1.28.
Source: Legal > States Legal - U.S. > Texas > Find Statutes, Regulations, Administrative Materials & Court Rules > TX
- Texas Statutes 8 Codes Annotated by LexisNexis -Selected Documents (,
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER A. GENERAL PROVISIONS > § 61.006. Standards
and Procedures
Terms: 61.006 (Edit Search ~ Suggest Terms for My Search
View: Full
DateTme: Wednesday, October 1, 2008 - 9:55 AM EDT
http://www.lexis.com/research/retrieve?_m=ec96e62f595e04b89de93 f 77988c20ff&docnu... 10/1 /2008
r arc ~ ut ~
Search ~ Research Tasks ~ Get a Document ~ Shepard's®~ Alerts ~ Transactional Advisor ~ Counsel Selector
History I Delivery Manager I Switch Client I Preferences I Si n Out I Help
About LexisNexis I Terms & Conditions I Contact Us
~~ ~.~l~s~'`dC'XjS~ Copyright © 2008 LexisNexis, a division of Reed Elsevier Inc. All rights
reserved.

http://www.lexis.com/reseazch/retrieve? m=ec96e62f595e04b89de93f77988c20ff&docnu... 10/1/2008
ra~~ivl~
Swita`~ Client Preferences ~ Sign Out ~ ; ?;Help
„Search .Research Tasks .Get a Document Shepard's~ ~ Alerts T Transactional Advisor Counsel Selector ~ ~
FOCUST"4 Terms st.oo~ ;Search Within Original Results (1 - 2)
Advanced... _ _
Source: Legal > States Legal - U.S. > Texas > Find Statutes. Regulations Administrative Materials & Court Rules > TX -
Texas Statutes 8~ Codes Annotated by LexisNexis -Selected Documents
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER A. GENERAL PROVISIONS > § 61.007. Information
Provided by Applicant
Terms: 61.007 (Edit Search ~ Suggest Terms for My Search)
(Select for FOCUSTM' or Delivery
Tex. Health & Safety Code § 61.007
~Practitianer's Toolbox 0~
TEXAS STATUTES AND CODES ANNOTATED BY
LEXISNEXIS(R) ~ History
*** CURRENT THROUGH THE 2007 REGULAR SESSION ***
* Annotations current through cases posted on lexis.com as of )une 26, 2008
HEALTH AND SAFETY CODE
TITLE 2. HEALTH
SUBTITLE C. PROGRAMS PROVIDING HEALTH CARE BENEFITS AND SERVICES
CHAPTER 61. INDIGENT HEALTH CARE AND TREATMENT ACT
SUBCHAPTER A. GENERAL PROVISIONS
~r-`
GO TO TEXAS CODE ARCHIVE DIRECTORY
Tex. Health & Safety Code § 61.007 (2007)
§ 61.007. Information Provided by Applicant
The department by rule shall require each applicant to provide at least the following
information:
(1) the applicant's full name and address;
(2) the applicant's social security number, if available;
(3) the number of persons in the applicant's household, excluding persons receiving
Temporary Assistance for Needy Families, Supplemental Security Income, or Medicaid
benefits;
(4) the applicant's county of residence;
(5) the existence of insurance coverage or other hospital or health care benefits for which the
applicant is eligible;
(6) any transfer of title to real property that the applicant has made in the preceding 24
months;
http://www.lexis.com/reseazch/retrieve? m=291496f346584f7c6f6d2fda90c22e21&docnu... 10/1/2008
ra~c ~ vi ~
(7) the applicant's annual household income, excluding the income of any household member
receiving Temporary Assistance for Needy Families, Supplemental Security Income, or
Medicaid benefits; and
(8) the amount of the applicant's liquid assets and the equity value of the applicant's car and
real property.
~ History:
Stats. 1999 76th Leg. Sess. Ch. 1377,_effective September 1, 1999.
NOTES:
1999 Note:
(a) The change in law made by Ch. 1377 to Chapter 61, Health and Safety Code, applies
only to:
(1) health care services under Chapter 61, Health and Safety Code, as amended by this
article, that are delivered on or after January 1, 2000; and
(2) state assistance under Chapter 61, Health and Safety Code, as amended by this article,
for the services described by Subdivision (1) of this subsection.
(b) Health care services under Chapter 61, Health and Safety Code, as amended by this
article, that are delivered before January 1, 2000, and state assistance for those services are
governed by the law as it existed immediately before that date and that law is continued in
effect for this purpose. Acts 1999 76th Leg., Ch. 1377§ 1.28.
Source: Le al > States Legal - U.S. > Texas > Find Statutes. Regulations, Administrative Materials & Court Rules > TX
-Texas Statutes 8~ Codes Annotated by LexisNexis -Selected Documents ~,
TOC: Texas Statutes and Codes > ! ... / > SUBCHAPTER A. GENERAL PROVISIONS > § 61.007. Information
Provided by Applicant
Terms: 61.007 (Edit Search ~ Suggest Terms for My Search)
View: Full
Date~T'ime: Wednesday, October 1, 2008 - 9:57 AM EDT
Search ~ Research Tasks ~ Get a Document ~ She~ard's®~ Alerts ~ Transactional Advisor ~ Counsel Selector
History I Delivery Manager I Switch Client I Preferences I Sign Out I Hela
About LexisNexis I Terms & Conditions I Contact Us
~X~~~1~' Copyright © 2008 LexisNexis, a division of Reed Elsevier Inc. All rights
reserved.
http://www.lexis.com/research/retrieve? m=291496f346584f7c6f6d2fda90c22e21&docnu... 10/1/2008
ra~c i
• - Switcl} Client Preferences ~ Sign Qut `~ ? E-lelp
:Search ;.Research Tasks ,Get a Document Shepard's~' ~ Alerts ~ Transactional Advisor, Counsel Selector H
_ __
FOCUSTM' Terms si oos Search Within or~9inai Resuics (i - a> ,
Advanced...
Source: LeQa1 > States Legal - U.S. > Texas > Find Statutes. Regulations, Administrative Materials & Court Rules > TX -
Texas Statutes & Codes Annotated by LexisNexis -Selected Documents `''.
TOC: Texas Statutes and Codes > / ... ! > SUBCHAPTER A. GENERAL PROVISIONS > § 61.008. Eligibility Rules
Terms: 61.008 (Edit Search ~ Suggest Terms for My Search)
Select for FOCUST"' or Delivery
Tex. Health & Safety Code § 61.008
TEXAS STATUTES AND CODES ANNOTATED BY LEXISNEXIS(R)
*** CURRENT THROUGH THE 2007 REGULAR SESSION ***
* Annotations current through cases posted on lexis.com as of June 26, 2008
HEALTH AND SAFETY CODE
TITLE 2. HEALTH
SUBTITLE C. PROGRAMS PROVIDING HEALTH CARE BENEFITS AND SERVICES
CHAPTER 61. INDIGENT HEALTH CARE AND TREATMENT ACT
SUBCHAPTER A. GENERAL PROVISIONS
GO TO TEXAS CODE ARCHIVE DIRECTORY
Tex. Health & Safety Code § 61.008 (2007)
§ 61.008. Eligibility Rules
(a) The department by rule shall provide that in determining eligibility:
(1) a county may not consider the value of the applicant's homestead;
(2) a county must consider the equity value of a car that is in excess of the amount
exempted under department guidelines as a resource;
(3) a county must subtract the work-related and child care expense allowance allowed under
department guidelines;
(4) a county must consider as a resource real property other than a homestead and, except
as provided by Subsection (b), must count that property in determining eligibility; and
(5) if an applicant transferred title to real property for lest market value to become
eligible for assistance under this chapter, the county may not credit toward eligibility for state
assistance an expenditure for that applicant made during atwo-year period beginning on the
date on which the property is transferred.
(b) A county may disregard the applicant's real property if the applicant agrees to an
enforceable obligation to reimburse the county for all or part of the benefits received under
this chapter. The county and the applicant may negotiate the terms of the obligation.
http://www.lexis.com/research/retrieve? m=8f22dc86d37d5cb6ed9e70059bd9f~l4&docn... 10/1/2008
,~carcii - ~r icesui[s - oi.vva
rage ~ of L
Source: Legal > States Legal - U.S. > Texas > Find Statutes Regulations Administrative Materials & Court Rules > TX
-Texas Statutes & Codes Annotated by LexisNexis -Selected Documents
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER A. GENERAL PROVISIONS > § 61.008. Eligibility
Rules
Terms: 61.008 (Edit Search ~ Suggest Terms for My Search)
View: Full
DatelTime: Wednesday, October 1, 2008 - 10:15 AM EDT
Search ~ Research Tasks ~ Get a Document ~ Shepard`sO ~ Alerts ~ Transactional Advisor ~ Counsel Selector
History I Delivery Manager I Switch Client I Preferences I Sign Out I Help
About LexisNexis i Terms & Conditions I Contact Us
L~S~~'htS' Copyright © 2008 LexisNexis, a division of Reed Elsevier Inc. All rights
reserved.
http://www.lexis.com/researeh/retrieve? m=8f22dc86d37d5cb6ed9e70059bd9f014&docn... 10/1/2008
~Carc;n - ~ icesui~s - oi.v~s
rage i or
Switch Client Preferences ~ Sign C7ut ?;help
'Search Research Tasks ..,.Get a Document;, Shepard's~.TAlerts T,Transactional Advisor Counsel Selector ~
~r- _
Search Within original Res~i~ (1 - sl
FOCUS"' Terms si.oz3
__
__ _ _
Advanced...
Source: Legal > States Legal - U.S. > Texas > Find Statutes, Regulations. Administrative Materials & Court Rules > TX -
Texas Statutes & Codes Annotated by LexisNexis -Selected Documents
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT
RESIDING IN AN AREA SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT > § 61.023. General
Eligibility Provisions
Terms: 61.023 (Edit Search ~ Suggest Terms for My Search)
(Select for FOCUSTM' or Delivery
Tex. Health & Safety Code § 61.023
Practitioner's Toolbox [] (~~
TEXAS STATUTES AND CODES ANNOTATED BY
LEXISNEXIS(R) ± History
*** CURRENT THROUGH THE 2007 REGULAR SESSION ***
* Annotations current through cases posted on lexis.com as of June 26, 2008
HEALTH AND SAFETY CODE
TITLE 2. HEALTH
SUBTITLE C. PROGRAMS PROVIDING HEALTH CARE BENEFITS AND SERVICES
CHAPTER 61. INDIGENT HEALTH CARE AND TREATMENT ACT
SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT RESIDING IN AN AREA
SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT
GO TO TEXAS CODE ARCHIVE DIRECTORY
Tex. Health & Safety Code § 61.023 (2007)
§ 61.023. General Eligibility Provisions
(a) A person is eligible for assistance under this subchapter if:
(1) the person does not reside in the service area of a public hospital or hospital district;
(2) the person meets the basic income and resources requirements established by the
department under Sections 61.006 and 61.008 and in effect when the assistance is
requested; and
(3) no other adequate source of payment exists.
(b) A county may use a less restrictive standard of eligibility for residents than prescribed by
Subsection (a). A count}~niay credit toward eligibility for state assistance under this
subchapter the services provided to each person who is an eligible resident under a standard
that incorporates a net income eligibility level that is less than 50 percent of the federal
poverty level based on the federal Office of Management and Budget poverty index.
(c) A county may contract with the department to perform eligibility determination services.
http://www.lexis.com/research/retrieve? m=lae955d6ddf~e01b0102c9cf483f4175&docnu... 10/2/2008
~caictt - ~ i~GJUttJ - Vt.VGJ
Yage L OT L
(d) Not later than the beginning of a state fiscal year, the county shall adopt the eligibility
standards it will use during that fiscal year and shall make a reasonable effort to notify the
public of the standards. The county may change the eligibility standards to make them more
~"` or less restrictive than the preceding standards, but the standards may aot be more
restrictive than the standards established by the department under Section 61.006.
History:
Stats. 1999 76th Leg. Sess. Ch. 1377~effective Se_~tember 1, 1999.
NOTES:
1999 Note:
(a) The change in law made by Ch. 1377 to Chapter 61, Health and Safety Code, applies
only to:
(1) health care services under Chapter 61, Health and Safety Code, as amended by this
article, that are delivered on or after January 1, 2000; and
(2) state assistance under Chapter 61, Health and Safety Code, as amended by this article,
for the services described by Subdivision (1) of this subsection.
(b) Health care services under Chapter 61, Health and Safety Code, as amended by this
article, that are delivered before January 1, 2000, and state assistance for those services are
governed by the law as it existed immediately before that date and that law is continued in
effect for this purpose. Acts 1999 76th Leg., Ch. 1377§ 1.28.
Source: Legal > States Legal - U.S. > Texas > Find Statutes. Regulations, Administrative Materials & Gourt Rules > TX
- Texas Statutes 8< Codes Annotated by LexisNexis -Selected Documents _~_~
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT
RESIDING IN AN AREA SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT > § 61.023. General
Eligibility Provisions
Terms: 61.023 (Edit Search J Suggest Terms for My Search)
View: Full
Date/Time: Thursday, October 2, 2008 - 9:01 AM EDT
Search ~ Research Tasks ~ Get a Document ~ Shepard's®~ Alerts ~ Transactional Advisor ~ Counsel Selector
History I Delivery Manager I Switch Client I Preferences I Sign Out I Help
About LexisNexis I Terms & Conditions (Contact Us
~~,~+~~"~~ Copyright © 2008 LexisNexis, a division of Reed Elsevier Inc. All rights
reserved.
http://www.lexis.com/reseazch/retrieve? m=lae955d6ddf9e01b0102c9cf483f4175&docnu... 10/2/2008
~ S~nifch Client Prefe~encas ;Sign Out i ~~' Neip
:Search ,.:Research Tasks . rGet a Document < Shepard's®~ Alerts ~ Transactional Advisor T Counsel Selector N
FOCUST"' Terms si.oza 'Search Within Original Results (1 - 2) `~
_. __
Advanced...
Source: Legal > States Legal - U.S. > Texas > Find Statutes Regulations Administrative Materials & Court Rules > TX -
Texas Statutes & Codes Annotated by LexisNexis -Selected Documents
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT
RESIDING IN AN AREA SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT > § 61.024. County
Application Procedure
Terms: 61.024 (Edit Search I Suggest Terms for My Search)
Select for FOCUST"" or Delivery
Tex. Health & Safety Code § 61.024
TEXAS STATUTES AND CODES ANNOTATED BY LEXISNEXIS(R)
*** CURRENT THROUGH THE 2007 REGULAR SESSION ***
* Annotations current through cases posted on lexis.com as of June 26, 2008
HEALTH AND SAFETY CODE
TITLE 2. HEALTH
SUBTITLE C. PROGRAMS PROVIDING HEALTH CARE BENEFITS AND SERVICES
CHAPTER 61. INDIGENT HEALTH CARE AND TREATMENT ACT
SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT RESIDING IN AN AREA
SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT
GO TO TEXAS CODE ARCHIVE DIRECTORY
Tex. Health & Safety Code § 61.024 (2007)
§ 61.024. County Application Procedure
(a) A county shall adopt an application procedure.
(b) The county may use the application, documentation, and verification procedures
established by the department under Sections 61.006 and 61.007 or may use a less
restrictive application, documentation, or verification procedure.
(c) Not later than the beginning of a state fiscal year, the county shall specify the procedure
it will use during that fiscal year to verify eligibility and the documentation required to
support a request for assistance and shall make a reasonable effort to notify the public of the
application procedure.
(d) The county shall furnish an applicant with written application forms.
(e) On request of an applicant, the county shall assist the applicant in filling out forms and
completing the application process. The county shall inform an applicant of the availability of
assistance.
(f) The county shall require an applicant to sign a written statement in which the applicant
http://www.le~cis.com/research/retrieve? m=b3692490cOc2f13dd03bd0eb16e8bd41&docn... 10/2/2008
.~cai~ii - ~ nc~ui~~ - v1.vG~t Yage G OI L
swears to the truth of the information supplied.
(g) The county shall explain to the applicant that if the application is approved, the applicant
must report to the county any change in income or resources that might affect the applicant's
eligibility. The report must be made not later than the 14th day after the date on which the
change occurs. The county shall explain the possible penalties for failure to report a change.
(h) The county shall review each application and shall accept or deny the application not later
than the 14th day after the date on which the county receives the completed application.
(i) The county shall provide a procedure for reviewing applications and for allowing an
applicant to appeal a denial of assistance.
(j) The county shall provide an applicant written notification of the county's decision. If the
county denies assistance, the written notification shall include the reason for the denial and
an explanation of the procedure for appealing the denial.
(k) The county shall maintain the records relating to an application at least until the end of
the third complete state fiscal year following the date on which the application is submitted.
(I) If an applicant is denied assistance, the applicant may resubmit an application at any time
circumstances justify a redetermination of eligibility.
Source: Legal > States Legal - U.S. > Texas > Find Statutes Regulations Administrative Materials & Court Rules > TX
- Texas Statutes 8~ Codes Annotated by LexisNexis -Selected Documents ~ i_`
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT
RESIDING IN AN AREA SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT > § 61.024. County
Application Procedure
Terms: 61.024 (Edit Search ~ Suggest Terms for My Search)
View: Full
Date/Time: Thursday, October 2, 2008 - 9:32 AM EDT
Search ~ Research Tasks ~ Get a Document ~ Shepard's®~ Alerts ~ Transactional Advisor ~ Counsel Selector
History I Delivery Manager I Switch Client I Preferences I Sign Out I Helg
About LexisNexis I Terms & Conditions I Contact Us
L~~tS~~~~~a Copyright © 2008 LexisNexis, a division of Reed Elsevier Inc. All rights
reserved.
http://www.lexis.com/research/retrieve? m=b3692490cOc2f73dd03bd0eb16e8bd41&docn... 10/2/2008
Switch Clienf Preferences ~ Sign Out ~? Heip
E~Search ,, Research Tasks : Get a Document"' _ Shepard`s~'~Alerts~Transactional Advisor Counsel Selector ~
~ F OCUSTM Terms si.oz~
Search Within Original Results (i - 1) ,
Advanced... ~ ~'
Source: Legal > States Legal - U.S. > Texas > Find Statutes. Regulations. Administrative Materials & Court Rules > TX -
Texas Statutes >3< Codes Annotated by LexisNexis -Selected Documents i
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT
RESIDING IN AN AREA SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT > § 61.027. Change in
Eligibility Status
Terms: 61.027 (Edit Search ~ Suggest Terms_for My Search)
Tex. Health & Safety Code § 61.027
TEXAS STATUTES AND CODES ANNOTATED BY LEXISNEXIS(R)
*** CURRENT THROUGH THE 2007 REGULAR SESSION ***
* Annotations current through cases posted on lexis.com as of June 26, 2008
HEALTH AND SAFETY CODE
TITLE 2. HEALTH
SUBTITLE C. PROGRAMS PROVIDING HEALTH CARE BENEFITS AND SERVICES
CHAPTER 61. INDIGENT HEALTH CARE AND TREATMENT ACT
SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT RESIDING IN AN AREA
SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT
GO TO TEXAS CODE ARCHIVE DIRECTORY
Tex. Health & Safety Code § 61.027 (2007)
§ 61.027. Change in Eligibility Status
(a) An eligible resident must report any change in income or resources that might affect
the resident's eligibility. The report must be made not later than the 14th day after the date
on which the change occurs.
(b) If an eligible resident fails to report a change in income or resources as prescribed by this
section and the change has made the resident ineligible for assistance under the standards
adopted by the county, the resident is liable for any benefits received while ineligible. This
section does not affect a person's criminal liability under any relevant statute.
Source: Legal > States Legal - U.S. > Texas > Find Statutes. Regulations. Administrative Materials & Court Rules > TX
- Texas Statutes & Codes Annotated by LexisNexis -Selected Documents
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT
RESIDING IN AN AREA SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT > § 61.027. Change
in Eligibility Status
Terms: 61.027 (Edit Search ~ Suggest Terms for My Search)
Cearch - 1 Result - 61.032
Page 1 of 2
Switcn Client ~ Preferences ;Sign Out i , ? ;Help
~ Search ` Research Tasks ~ Get a Document ~, Shepard's©~ Alerts Total Litigator Transactional Advisor Cour
_ _ _ _
FOCUST"' Terms si.os2 Search Within'. original Results (i - i~
Advanced _
Source: Legal > States Legal - U.S. > Texas > Find Statutes, Regulations Administrative Materials & Court Rules > TX -
Texas Statutes 8~ Codes Annotated by LexisNexis -Selected Documents
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT
RESIDING_I_N AN AREA SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT > § 61.032. Notification
of Provision of Emergency Services
Terms: 61.032 (Edit Search ~ Suggest Terms_for M_y_Search)
Tex. Health & Safety Code § 61.032
r Practitioner`s Toolbox Q 0,
TEXAS STATUTES AND CODES ANNOTATED BY
LEXISNEXIS(R) ~' History
*** CURRENT THROUGH THE 2007 REGULAR SESSION ***
* Annotations current through cases posted on lexis.com as of June 26, 2008
HEALTH AND SAFETY CODE
TITLE 2. HEALTH
SUBTITLE C. PROGRAMS PROVIDING HEALTH CARE BENEFITS AND SERVICES
CHAPTER 61. INDIGENT HEALTH CARE AND TREATMENT ACT
SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT RESIDING IN AN AREA
SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT
GO TO TEXAS CODE ARCHIVE DIRECTORY
Tex. Health & Safety Code § 61.032 (2007)
§ 61.032. Notification of Provision of Emergency Services
(a) If a n,~nmandated provider delivers emergency services to a patient who the provider
suspects r~rlg.ht be eligible for assistance under this subchapter, the provider shall notify the
patient's county of residence that emergency services have been or will be provided to the
patient. The notice shall be made:
(1) by telephone not later than the 72nd hour after the provider determines the patient's
county of residence; and
(2) by mail postmarked not later than the fifth working day after the date on which the
provider determines the patient's county of residence.
(b) The provider shall attempt to determine the patient's county of residence when the
patient first receives services.
(c) The provider, the patient, and the patient's family shall cooperate with the county of
which the patient is presumed to be a resident in determining if the patient is an eligible
resident of that county.
(d) Not later than the 14th day after the date on which the patient's county of residence
receives notification and sufficient information to determine eligibility, the county shall
http://www.lexis.com/research/retrieve? m=b6dc7e4c131c23a8e1c08610284b66df&csvc... 10/15/2008
Search - 1 Result - 61.032
Page 2 of 2
determine if the patient is eligible for assistance from that county. If the county does not
determine the patient's eligibility within that period, the patient is considered to be eligible.
The county shall notify the provider of its decision.
(e) If the county and the provider disagree on the patient's residence or eligibility, the county
or the provider may submit the matter to the department as provided by Section 61.004.
(f) If a provider delivers emergency services to a patient who is eligible for assistance under
this subchapter and fails to comply with this section, the provider is not eligible for payment
for the services from the patient's county of residence.
History:
Stats. 1999 76th Leq. Sess. Ch. 1377, effective September 1, 1999 Stats. 2001 77th Leq.
Sess. Ch. 1128 effective September 1, 2001.
NOTES:
1999 Note:
(a) The change in law made by Ch. 1377 to Chapter 61, Health and Safety Code, applies
only to:
(1) health care services under Chapter 61, Health and Safety Code, as amended by this
article, that are delivered on or after January 1, 2000; and
(2) state assistance under Chapter 61, Health and Safety Code, as amended by this article,
for the services described by Subdivision (1) of this subsection.
(b) Health care services under Chapter 61, Health and Safety Code, as amended by this
article, that are delivered before January 1, 2000, and state assistance for those services are
governed by the law as it existed immediately before that date and that law is continued in
effect for this purpose. Acts 1999 76th Leg., Ch. 1377§ 1.28.
Source: Legal > States Legal - U.S. > Texas > Find Statutes Regulations Administrative Materials & Court Rules > TX
- Texas Statutes 8 Codes Annotated by LexisNexis -Selected Documents (~
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT
RESIDING IN AN AREA SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT >
§ 61.032. Notification of Provision of Emergency Services
Terms: 61.032 (Edit Search I Suggest Terms for My Search)
View: Full
Date/Time: Wednesday, October 15, 2008 - 2:24 PM EDT
Search ~ Research Tasks ~ Get a Document ~ Shepard's~ ~ Alerts ~ Total Litigator ~ Transactional Advisor ~
Counsel Selector
Histonr I Delivery Manager I Switch Client I Preferences I Sign Out I Help
About LexisNexis I Terms & Conditions I Contact Us
~~~~~i5~ Copyright © 2008 LexisNexis, a division of Reed Elsevier Inc. All rights
reserved.
http://www.lexis.com/research/retrieve? m=b6dc7e4c131c23a8e1c08610284b66df&csvc... 10/15/2008
i acv
Switch Client Pre`erences ~ Sign Ouf i . ? f~leip
Search ~~ Research Tasks Get a Document . Shepard's®~ Alerts T Transactional Advisor T Counsel Selector ~ ~+
FOCUSTM Terms s~.o3s Search Within' original Results (1 - z~
Advanced..
Source: Legal > States Legal - U.S. > Texas > Find Statutes Regulations Administrative Materials & Court Rules > TX -
Texas Statutes 8~ Codes Annotated by LexisNexis -Selected Documents .
TOC: Texas Statutes and Codes > /... / > SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT
RESIDING IN AN AREA SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT > § 61.033. Payment
for Services
Terms: 61.033 (Edit Search I Suggest Terms for My Search)
Select for FOCUST^" or Delivery
Tex. Health & Safety Code § 61.033
TEXAS STATUTES AND CODES ANNOTATED BY LEXISNEXIS(R)
*** CURRENT THROUGH THE 2007 REGULAR SESSION ***
* Annotations current through cases posted on lexis.com as of June 26, 2008
HEALTH AND SAFETY CODE
TITLE 2. HEALTH
SUBTITLE C. PROGRAMS PROVIDING HEALTH CARE BENEFITS AND SERVICES
CHAPTER 61. INDIGENT HEALTH CARE AND TREATMENT ACT
SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT RESIDING IN AN AREA
SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT
GO TO TEXAS CODE ARCHIVE DIRECTORY
Tex. Health & Safety Code § 61.033 (2007)
§ 61.033. Payment for Services
(a) To the extent prescribed by this chapter, a county is liable for health care services
provided under this subchapter by any provider, including a public hospital or hospital
district, to an eligible county resident. A county is not liable for payment for health care
services provided:
(1) by any provider, including a public hospital or hospital district, to a resident of that
county who resides in the service area of a public hospital or hospital district; or
(2) to an eligible resident of that county who does not reside within the service area of a
public hospital or hospital district by a hospital having aHill-Burton or state-mandated
obligation to provide free services and considered to be in noncompliance with the
requirements of the Hill-Burton or state-mandated obligation.
(b) To the extent prescribed by this chapter, if another source of payment does not
adequately cover a health care service a county provides to an eligible county resident, the
county shall pay for or provide the health care service for which other payment is not
available.
http://www.lexis.com/research/retrieve? m=75bdc50dcf4e~58e6b6418ee6cd74b9&docnu... 10/2/2008
UVCII VII - G 1\GJU1W - V1.VJJ
ra~c i ui ~
' Switch Client Preferences ~ Sian Qut .? Hslp
Search ,Research Tasks Get a Document<,v Shepard's~' Alerts Transactional Advisor Counsel Selector ~
__
F OCUSTM Terms s~.oss ;Search Within Original Results (1 - 2)
Advanced... __ __
Source: Legal > States Legal - U.S. > Texas > Find Statutes, Regulations Administrative Materials & Court Rules > TX -
Texas Statutes & Codes Annotated by LexisNexis -Selected Documents
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT
RESIDING IN AN AREA SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT > § 61.035. Limitation
of County Liability
Terms: 61.035 Edit Search I Suggest Terms for My Search
Select for FOCUST"° or Delivery
Tex. Health & Safety Code § 61.035
TEXAS STATUTES AND CODES ANNOTATED BY LEXISNEXIS(R)
*** CURRENT THROUGH THE 2007 REGULAR SESSION ***
* Annotations current through cases posted on lexis.com as of June 26, 2008
HEALTH AND SAFETY CODE
TITLE 2. HEALTH
SUBTITLE C. PROGRAMS PROVIDING HEALTH CARE BENEFITS AND SERVICES
CHAPTER 61. INDIGENT HEALTH CARE AND TREATMENT ACT
SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT RESIDING IN AN AREA
SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT
GO TO TEXAS CODE ARCHIVE DIRECTORY
Tex. Health & Safety Code § 61.035 (2007)
§ 61.035. Limitation of County Liability
The maximum county liability for each state fiscal year for health care services provided by
all assistance providers, including a hospital and a skilled nursing facility, to each eligible
county resident is:
(1) $30,000; or
(2) the payment of 30 days of hospitalization or treatment in a skilled nursing facility, or
both, or $30,000, whichever occurs first, if the county provides hospital or skilled nursing
facility services to the resident.
Source: Legal > States Legal - U.S. > Texas > Find Statutes. Regulations. Administrative Materials & Court Rules > TX
- Texas Statutes ~ Codes Annotated by LexisNexis -Selected Documents
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT
RESIDING IN AN AREA SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT >
§ 61.035. Limitation of County Liability
Terms: 61.035 (Edit Search (Suggest Terms for My Search)
View: Full
Date/Time: Thursday, October 2, 2008 - 12:22 PM EDT
http://www.lexis.com/research/retrieve? m=255629fe778905b8e7610ce16bbfZf8d&docnu... 10/2/2008

'" 8vaitch CEient i Preferences ~ Sign Out ~? i-3Gfp
Search .Research Tasks ,Get a Document Shepard's~'~ Alerts ~ Transactional Advisor,T Counsel Selector ~ ~i
FOCUST"' Terms si.oaa
Advanced...
__
Search Within original Results (i - i>
Source: Legal > States Legal - U.S. > Texas > Find Statutes. Regulations, Administrative Materials & Court Rules > TX -
Texas Statutes 8~ Codes Annotated by LexisNexis -Selected Documents t
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NO_ T
RESIDING IN AN AREA SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT >
§ 61.044. Subrogation
Terms: 61.044 (Edit Search I Suggest Terms for My Search)
Tex. Health & Safety Code § 61.044
TEXAS STATUTES AND CODES ANNOTATED BY LEXISNEXIS(R)
*** CURRENT THROUGH THE 2007 REGULAR SESSION ***
* Annotations current through cases posted on lexis.com as of June 26, 2008
HEALTH AND SAFETY CODE
TITLE 2. HEALTH
SUBTITLE C. PROGRAMS PROVIDING HEALTH CARE BENEFITS AND SERVICES
CHAPTER 61. INDIGENT HEALTH CARE AND TREATMENT ACT
SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT RESIDING IN AN AREA
SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT
GO TO TEXAS CODE ARCHIVE DIRECTORY
Tex. Health & Safety Code § 61.044 (2007)
§ 61.044. Subrogation
(a) The filing of an application for or receipt of services constitutes an assignment of the
applicant's or recipient's right of recovery from:
(1) personal insurance;
(2) other sources; or
(3) another person for personal injury caused by the other person's negligence or wrong.
(b) A person who applies for or receives services shall inform the county, at the time of
application or at an ime during eligibility, of any unsettled tort claim that may affect
medicaTneeds and of any private accident or sickness insurance coverage that is or may
become available. An applicant or eligible resident shall inform the county of any injury that
is caused by the act or failure to act of some other person. An applicant or eligible resident
shall inform the county as required by this subsection within SO days of the date the person
learns of the person's insurance coverage, tort claim, or potential cause of action.
(c) A claim for damages for personal injury does not constitute grounds for denying or
discontinuing services under this chapter.
(d) A separate and distinct cause of action in favor of the county is hereby created, and the
http://www.lexis.com/research/retrieve? m=13220c35fc6c3eb109eda7de373e5794&csvc=... 10/2/2008
a u~
county may, without written consent, take direct civil action in any court of competent
jurisdiction. A suit brought under this section need not be ancillary to or dependent on any
other action.
(e) The county's right of recovery is limited to the amount of the cost of services paid by the
county. Other subrogation rights granted under this section are limited to the cost of the
services provided.
(f) An applicant or eligible resident who knowingly and intentionally fails to disclose the
information required by Subsection {b) commits a Class C misdemeanor.
(g) An applicant or eligible resident is subject to denial of services under this chapter
following an administrative hearing.
Source: Legal > States Legal - U.S. > Texas > Find Statutes. Regulations Administrative Materials & Court Rules > TX
-Texas Statutes & Codes Annotated by LexisNexis -Selected Documents
TOC: Texas Statutes and Codes > / ... / > SUBCHAPTER B. COUNTY RESPONSIBILITY FOR PERSONS NOT
RESIDING IN AN AREA SERVED BY A PUBLIC HOSPITAL OR HOSPITAL DISTRICT >
§ 61.044. Subrogation
Terms: 61.044 (Edit Search ~ Suggest Terms for My Search)
View: Full
DatelTime: Thursday, October 2, 2008 - 2:01 PM EDT
Search ~ Research Tasks ~ Get a Document ~ Shepard`s®~ Alerts ~ Transactional Advisor ~ Counsel Selector
History I Delivery Manager I Switch Client I Preferences I Sign Out I Help
About LexisNexis I Terms & Conditions I Contact Us
~~15~+I~~C Copyright © 2008 LexisNexis, a division of Reed Elsevier Inc. All rights
reserved.
http://www.lexis.com/research/retxieve? m=13220c35fc6c3eb109eda7de373e5794&csve=... 10/2/2008
HEALTH & SAFETY CODE
SUBTITLE C. PROGRAMS PROVIDING HEALTH CARE BENEFITS AND SERVICES
CHAPTER 61. INDIGENT HEALTH CARE AND TREATMENT ACT
SUBCHAPTER A. GENERAL PROVISIONS
Sec. 61.001. SHORT TITLE. This chapter may be cited as the
Indigent Health Care and Treatment Act.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 61.002. DEFINITIONS. In this chapter:
(1} + eans the Texas Department of Health.
(2) ~~""s'r~.~:~~~~~'`'^~' means an eligible
resident of a county who does not reside in the service area of a
public hospital or hospital district.
(3) "Eligible resident" means a person who meets the
income and resources requirements established by this chapter or by
the governmental entity, public hospital, or hospital district in
whose jurisdiction the person resides.
(4) "Emergency services" has the meaning assigned by
Chapter 773.
(5) "General revenue levy" means:
(A) the property taxes imposed by a county that are
not dedicated to the construction and maintenance of farm-to-market
e
roads or to flood control under Article VIII, Section 1-a, of the
Texas Constitution or that are not dedicated to the further
maintenance of the public roads under Article VIII, Section 9, of
the. Texas Constitution; and
(B) the sales and use tax revenue to be received by
the county during the calendar year in which the state fiscal year
begins under Chapter 323, Tax Code, as determined under Section
(7) "Hospital district" means a hospital district
``r.-• created under the authority of Article IX, Sections 4-11, of the
Texas Constitution.
(8) "Mandated provider" means a person who provides
health care services, is selected by a county, public hospital, or
hospital district, and agrees to provide health care services to
eligible residents, including the primary teaching hospital of a
state medical school located in a county which does not have a
public hospital or hospital district, and the faculty members
practicing in both the inpatient and outpatient care facilities
affiliated with the teaching hospital.
(9) "Medicaid" means the medical assistance program
provided under Chapter 32, Human Resources Code.
err (10) "Public hospital" means a hospital owned, operated,
or leased by a governmental entity, except as provided by Section
61.051.
(11) "Service area" means the geographic region in which
a governmental entity, public hospital, or hospital district has a
legal obligation to provide health care services.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
by Acts 1991, 72nd Leg., ch. 14, Sec. 14, eff. Sept. 1, 1991; Acts
1995, 74th Leg., ch. 76, Sec. 8.119, eff. Sept. 1, 1995; Acts
1999, 76th Leg., ch. 1377, Sec. 1.01, eff. Sept. 1, 1999.
(a) For purposes of this chapter, a
person is presumed to be a resident of the governmental entity in
which the person's home or fixed place of habitation to which the
person intends to return after a temporary absence is located.
However, if a person's home or fixed place of habitation is located
the person intends to reside.
(c) Intent to reside may be evidenced by any relevant
information, including:
(1) mail addressed to the person or to the person's
spouse or children if the spouse or children live with the person;
(2) voting records;
(3) automobile registration;
(4) Texas driver's license or other official
identification;
(5) enrollment of children in a public or private
school; or
(6) payment of property tax.
(d) A person is not considered a resident of a governmental
,,, entity or hospital district if the person attempted to establish
residence solely to obtain health care assistance.
(e) The burden of proving intent to reside is on the person
requesting assistance.
(f) For purposes of this chapter, a person who is an inmate
or resident of a state school or institution operated by the Texas
Department of Corrections, Texas Department of Mental Health and
Mental Retardation, Texas Youth Commission, Texas School for the
Blind, Texas School for the Deaf, or any other state agency or who
is an inmate, patient, or resident of a school or institution
operated by a federal agency is not considered a resident of a
hospital district or of any governmental entity except the state or
federal government.
Acts 1989, 71st Leg., ch.. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 61.004. RESIDENCE OR ELIGIBILITY DISPUTE. (a) If a
the department.
(b) The provider of assistance and the governmental entity or
hospital district shall submit all relevant information to the
department in accordance with the application, documentation, and
verification procedures established by the department under Section
61.006.
(c) If the department determines that another governmental
entity or hospital district may be involved in the dispute, the
department shall notify the governmental entity or hospital
district and allow the governmental entity or hospital district to
respond.
(d) From the information submitted, the department shall
determine the person's residence or whether the person is eligible
for assistance under this chapter, as appropriate, and shall notify
each governmental entity or hospital district and the provider of
assistance of the decision and the reasons for the decision.
(e) If a governmental entity, hospital district, or provider
of assistance does not agree with the department's decision, the
governmental entity, hospital district, or provider of assistance
may file an appeal with the department. The appeal must be filed
not later than the 30th day after the date on which the
governmental entity, hospital district, or provider of assistance
receives notice of the decision.
(f) The department shall issue a final decision not later
than the 45th day after the date on which the appeal is filed.
(g) A governmental entity, hospital district, or provider of
assistance may appeal the final order of the department under
Chapter 2001, Government Code, using the substantial evidence rule
by Acts 1995, 74th Leg., ch. 76, Sec. 5.95(49), eff. Sept. 1, 1995;
Acts 1999, 76th Leg., ch. 1377, Sec. 1.02, eff. Sept. 1, 1999.
s.>'~{~a~4~- INFORMATION NECESSARY TO DETERMINE ELIGIBILITY.
(a) Any provider, including a mandated provider, public hospital,
or hospital district, that delivers health care services to a
patient who the provider suspects is an eligible resident of the
service area of a county, hospital district, or public hospital
under this chapter '~~~~=~~u~~~th '
(1) provide }4: information necessary to establish that
the patient is an eligible resident of the service area of the
county, hospital district, or public hospital; and
(2) authorize the release of information relating to
the patient, including medical information and information obtained
under Subdivision (1), to permit the provider to submit a claim to
the county, hospital district, or public hospital that is liable
for payment for the services as described by Section 61.033 or
61.060.
(b) A county, hospital district, or public hospital that
receives information obtained under Subsection (a) shall use the
information to determine whether the patient to whom services were
provided is an eligible resident of the service area of the county,
hospital district, or public hospital. and, if so, shall pay the
claim made by the provider in accordance with this chapter.
The application, documentation, and verification
procedures established by the department for counties under Section
61.006 may include a standard format for obtaining information
under Subsection (a) to facilitate eligibility and residence
determinations.
eligible resident receiving health care assistance under this
chapter to contribute a nominal amount toward the cost of the
assistance.
(b) The county, public hospital, or hospital district may not
deny or reduce assistance to an eligible resident who cannot or
refuses to contribute.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
. _ _ ._. ~~S ~~ ~~~~~ ,. ~ The department
,~
nd a lication
shall establish minimum eli ibilit standards a pp ,
g Y
,~----
documentation, and verification procedures for counties to use in
determining eligibility under this chapter.
(b) The minimum eligibility standards must incorporate aria
~~ a_ . _ . ;"._ ? ~ _ _ equal to 21 percent of the federal poverty
level based on the federal Office of Management and Budget poverty
index.
(b-1) Expired.
(b-2) Repealed by Acts 2001, 77th Leg., ch. 1128, Sec. 7,
eff. Sept, 1, 2001.
(c) The department shall also define the services and
establish the payment standards for the categories of services
listed in Sections 61.028(a) and 61.0285 in accordance with Texas
Department of Human Services rules relating to the Temporary
ssistance for Needy Families-Medicaid program.
(d) The department shall establish application,
documentation, and verification procedures that are consistent with
the analogous procedures used to determine eligibility in the
Temporary Assistance for Needy Families-Medicaid program. The
department may not adopt a standard or procedure that is more
Assistance for Needy Families program payments but who is
categorically ineligible for Temporary Assistance for Needy
Families will be eligible for assistance under Subchapter B. Except
as provided by Section 61.023(b), the department by rule shall also
provide that a person who receives or is eligible to receive
Temporary Assistance for Needy Families, Supplemental Security
Income, or Medicaid benefits is not eligible for assistance under
-----
Subchapter B even if the person has exhausted a part or all of that
person's benefits.
(f) The department shall notify each county and public
hospital of any change to department rules that affect the
provision of services under this chapter.
(g) Notwithstanding Subsection (a), (b), or (c) or any other
provision of law, the department shall permit payment to a licensed
dentist for services provided under Sections 61.028(a)(4) and (6}
if the dentist can provide. those services within the scope of the
dentist's license.
(h) Notwithstanding Subsection (a), (b), or (c), the
department shall permit payment to a licensed podiatrist for
services provided under Sections 61.028(a)(4) and (6), if the
podiatrist can provide the services within the scope of the
podiatrist's license.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eft. Sept. 1, 1989. Amended
by Acts 1989, 71st Leg., ch. 1100, Sec. 5.09(a), eff. Sept. 1,
1989; Acts 1991, 72nd Leg., ch. 14, Sec. 15, eff. Sept. 1, 1991;
Acts 1995, 74th Leg., ch. 76, Sec. 8.120, eff. Sept. 1, 1995; Acts
1999, 76th Leg., ch. 1377, Sec. 1.04, eff. Sept. 1, 1999; Acts
2001, 77th Leg., ch. 1128, Sec. 1, 7 eff. Sept. J., 2001.
(2) the applicant's social security number, if
available;
(3) the number of persons in the applicant's household,
excluding persons receiving Temporary Assistance for Needy::
Families, Supplemental Security Income, or Medicaid benefits;
(4) the applicant's county of residence;
(5) the existence of insurance coverage or other
hospital or health care benefits for which the applicant is
eligible;
(6) any transfer of title to real property that the
applicant has made in the preceding 24 months;
(7) the applicant's annual household income, excluding
the income of any household member receiving Temporary Assistance
for Needy Families, Supplemental Security Income, or Medicaid
r;
benefits; and "u
(8) the amount of the applicant's liquid assets and the
~x
equity value of the applicant's car and real property. ~'
~>
~;~^'
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
'.5:~
.tle t
by Acts 1999, 76th Leg., ch. 1377, Sec. 1.04, eff. Sept. 1, 1999.
Sec. 61.008. (a) The department by rule
shall provide that in determining eligibility:
(1) a county may not consider the value of the
applicant`s homestead;
(2) a county must consider the equity value of a car
that is in excess of the amount exempted under department
,,. guidelines as a resource;
(3) a county must subtract the work-related and child
care expense allowance allowed under department guidelines;
for less than market value to become eligible for assistance under
this chapter, the county may not credit toward eligibility for
state assistance an expenditure for that applicant made during a
two-year period beginning on the date on which the property is
transferred.
(b) A county may disregard the applicant's real property if
the applicant agrees to an enforceable obligation to reimburse the
county for all or part of the benefits received under this chapter.
The county and the applicant may negotiate the terms of the
"; obligation.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 61.009. REPORTING REQUIREMENTS. (a) The department
shall establish uniform reporting requirements for governmental
entities that own, operate, or lease public hospitals providing
assistance under this chapter and for counties.
(b) The reports must include information relating to:
(1) expenditures for and nature of hospital and health
care provided to eligible residents;
(2) eligibility standards and procedures established by
counties and governmental entities that own, operate, or lease
public hospitals; and
(3) relevant characteristics of eligible residents.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
by Acts 1995, 74th Leg., ch. 76, Sec. 8.121, eff. Sept. 1, 1995.
Sec. 61.010. DEDICATED TAX REVENUES. If the governing body
of a governmental entity adopts a property tax rate that exceeds
the rate calculated under Section 26.04, Tax Code, by more than
eight percent, and if a portion of the tax rate was designated to ~
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 61.011. SERVICES BY STATE HOSPITAL OR CLINIC. A state
hospital or clinic shall be entitled to payment for services
rendered to an eligible resident under the provisions of this
chapter applicable to other providers. The department may adopt
rules as necessary to implement this section.
Added by Acts 1999, 76th Leg., ch. 1377, Sec. 1.05, eff. Sept. 1,
1999.
~ ..
:.. : ~~ka
.. _f _. ~ _ -. -~~. .-
Sec. 61.021. APPLICATION OF SUBCHAPTER. This subchapter
applies to health care services and assistance provided to a person
who does not reside in the service area of a public hospital or
,A hospital district.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 61.022. COUNTY OBLIGATION. (a) A county shall provide
health care assistance as prescribed by this subchapter to each of
its eligible county residents.
--------
{b) and shall provide
assistance "cif other adequate public or private sources of
payment are not available.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 61.0221. AUTHORITY RELATING TO OTHER ASSISTANCE
PROGRAMS. This subchapter does not affect the authority of the
commissioners court of a county to provide eligibility standards or
other requirements relating to assistance programs or services that
are not covered by this subchapter.
Added by Acts 1999, 76th Leg., ch. 62, Sec. 13.11{g), eff. Sept. 1,

public hospital or hospital district;
(2) the person meets the rba-s~;~°--: ~~3co~te;, •anc~ res~urc~s
_~,~:r.e~ne~.ts:=; established by the department under Sections 61 .006
and 61.008 and in effect when the assistance is requested; and
(3) no other adequ~source of payment exists.
(b) A county may use a less restrictive standard of
eligibility for residents than prescribed by Subsection (a). A
county may credit toward eligibility for state assistance under
this subchapter the services provided to each person who is an
eligible resident under a standard that incorporates a net income
eligibility level that is less than 50 percent of the federal
poverty level based on the federal Office of Management and Budget
poverty index.
°~,r (c) A county may contract with the department to perform
eligibility determination services.
(d) Not later than the beginning of a state fiscal year, the
county shall adopt the eligibility standards it will use during
that fiscal year and shall make a reasonable effort to notify the
public of the standards. The county may change the eligibility
standards to make them more or less restrictive than the preceding
standards, but the standards may not be more restrictive than the
standards established by the department under Section ~`
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
_,by Acts 1989, 71st Leg., ch. 1100, Sec. 5.10 (a), eff. Sept. 1,
{ ..
1989; Acts 1999, 76th Leg., ch. 1377, Sec. 1.06, eff. Sept. 1,
1999.
S~~ :x.024. (a) A county
shall adopt an application procedure.
{c) Not later than the beginning of a state fiscal year, the
county shall specify the procedure it will use during that fiscal
year to verify eligibility and the documentation required to
support a request for assistance and shall make a reasonable effort
to notify the public of the application procedure.
(d) The county shall furnish an applicant with .written
,~ "~a~~ion. ~ca-r~sa.
(e) pri~ ~ f ~~ ap~xl~ the county shall assist the
applicant in filling out forms and completing the application
process . The county .~la~all- ~n-f~i~n'~~~ ~f`;e~~xl'~~il ~t
of assistance.
(f) The county shall require an applicant to sign a written
statement in which the applicant ._.~~..._ °. _ e.'?~.~:r~~h> of the
y~r information supplied.
(g) The county ~Y explain to the applicant that if the
application is approved, the applicant report to the county
or deny the application .after the date
on which the county receives the completed application.
(i) The
~nd for allowing an applicant to appeal a denial of
`fir assistance.
(j) The county provide an applicant written
notification of the county's decision. If the county denies
application at least until the end of the third complete state
fiscal year following the date on which the application is
submitted.
(1) If an applicant is denied assistance, the applicant may
resubmit an application at any time circumstances justify a
redetermination of eligibility.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 61.025. COUNTY AGREEMENT WITH MUNICIPALITY. (a) This
section applies to a municipality that has a population of less
than 15,000, that owns, operates, or leases a hospital, and that
has made a transfer agreement before August 31, 1989, by the
adoption of an ordinance, resolution, or order by the commissioners
court and the governing body of the municipality.
(b) The transfer agreement may transfer partial
responsibility to the county under which the municipal hospital
continues to provide health care services to eligible residents of
the municipality, but the county agrees to assume the hospital's
responsibility to reimburse other providers who provide:
(1) mandatory inpatient or outpatient services to
eligible residents that the municipal hospital cannot provide; or
(2) emergency services to eligible residents.
(c) The hospital is a public hospital for the purposes of
this chapter, but it does not have a responsibility to provide
reimbursement for services it cannot provide or for emergency
services provided in another facility.
(d) Expenditures made by the county under Subsection (b) may
be credited toward eligibility for state assistance under this
subchapter if the person who received the health care services
(e) The agreement to transfer partial responsibility to a
county under this section must take effect on a September 1 that
occurs not later than two years after the date on which the county
and municipality agree to the transfer. A county and municipality
may not revoke or amend an agreement made under this section,
except that the county may revoke or amend the agreement if a
hospital district is created after the effective date of the
agreement and the boundaries of the district cover all or part of
the county.
(f) The county, the hospital, and any other entity in the
county that provides services under this chapter shall adopt
coordinated application and eligibility verification procedures.
In establishing the coordinated procedures, the county and other
'fir entities shall focus on facilitating the efficient and timely
referral of residents to the proper entity in the county. In
addition, the procedures must comply with the requirements of
Sections 61.024 and 61.053. Expenditures made by a county in
establishing the coordinated procedures prescribed by this section
may not be credited toward eligibility for state assistance under
this subchapter.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
by Acts 1997, 75th Leg., ch. 1103, Sec. 1, eff. Sept. 1, 1997;
Acts 1999, 76th Leg., ch. 1377, Sec. 1.07, eff. Sept. 1, 1999.
Sec. 61.026. A county review at
least once every six months the eligibility of a resident for whom
an application for assistance has been granted and who has received
assistance under this chapter.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
(b) If an eligible resident fails to report a change in
`trrr. income or resources as prescribed by this section and the change
has made the resident ineligible for assistance under the standards
adopted by the county, the xesi:den~' is '~}~l~e for any benefits
received while ineligible. This section does not affect a person's
criminal liability under any relevant statute.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 61 .028. ?I'~ ;CAS °~~r» ~~` (a) A county
,> ~$
s~-in accordance with department rules adopted under Section
61.006, provide the following basic health care services:
(1) primary and preventative services designed to meet
the needs of the community, including:
(A) immunizations;
(B) medical screening services; and
(C) annual physical examinations;
(2) inpatient and outpatient hospital services;
(3) rural health clinics;
(4) laboratory and X-ray services;
(5) family planning services;
(6) physician services;
(7) payment for three prescription drugs a
month; and
(8) skilled nursing facility services, regardless of the
patient's age.
(b) The county may provide additional health care services,
but may not credit the assistance toward eligibility for state
assistance, except as provided by Section 61.0285.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
under Section 61.006, provide ether medical=ly ri~cessary serv-ices, or
._~,..
.,
supplies t ~ ,~:~~. rI~'~"~~.'~`1Qt~~rm~~i~`~' t~ ~~~~ ~ cr~s~~~~~~~;~`~~.~~~;n~_:
including:
(1) ambulatory surgical center services;
(2) diabetic and colostomy medical supplies and

v
equipment;
(3) durable medical equipment;
(4) home and community health care se
(5) social work services;
(6) psychological counseling services
(7) services provided by physician assistants, nurse
practitioners, certified nurse midwives, clinical nurse
specialists, and certified registered nurse anesthetists;
(8) dental care;
(9) vision care, including eyeglasses;
(10) services provided by federally qualified health
centers, as defined by 42 U.S.C. Section 1396d(1)(2)(B);
(11) emergency medical services; and
(12) any other appropriate health care service
identified by board rule that may be determined to be cost-
effective.
(b) A county must notify the department of the county's
intent to provide services specified by Subsection (a). If the
services are approved by the department under Section 61.006, or if
the department fails to notify the county of the department's
disapproval before the 31st day after the date the county notifies
the department of its intent to provide the services, the county
may credit the services toward eligibility for state assistance
department, but may not credit the services toward eligibility for
`~""" state assistance .
Added by Acts 1999, 76th Leg., ch. 1377, Sec. 1.09, eff. Sept. 1,
1999. Amended by Acts 2001, 77th Leg., ch. 874, Sec. 9, eff. Sept.
1, 2001; Acts 2003, 78th Leg., ch. 892, Sec. 24, eff. Sept. 1,
2003.
Sec . 61.02 9 . ~~Ri3y _ ~"A7~~?~' CARE ~~#~R'~ti~~ESr. ( a ) A
county,~11~~arrange to provide health care services through a local
health department, a publicly owned facility, or a contract with a
private provider regardless of the provider's location, or through
the purchase of insurance for eligible residents.
(b) The county .ffiliate with other governmental entities
or with a public hospital or hospital district to provide regional
``~' administration and delivery of health care services.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 19$9.
Sec. 61.030. .'A county select one or
more providers of health care services. The county require
eligible county residents to obtain care from a mandated provider
ex+~c^ept
(1) in an emergency;
(2) when medically inappropriate; or
(3) when care is not available.
Acts 1989, 71st Leg., ch. 678, Sec, 1, eff. Sept. 1, 1989.
patient's county of residence that health care services have been
or will be provided to the patient. The notice shall be made:
{1) by telephone not later than the 72nd hour after the
provider determines the patient's county of residence; and
(2) by mail postmarked not later than the fifth working
day after the date on which the provider determines the patient's
county of residence.
(c) If the provider knows that the patient's county of
residence has selected a mandated provider or if, after contacting
the patient's county of residence, that county requests that the
patient be transferred to a mandated provider, the provider shall
transfer the patient to the mandated provider unless it is
medically inappropriate to do so.
(d) Not later than the 14th day after the date on which the
patient's county of residence receives sufficient information to
determine eligibility, the county shall determine if the patient is
eligible for assistance from that county. If the county does not
determine the patient's eligibility within that period, the patient
is considered to be eligible. The county shall notify the provider
of its decision.
Sec. 61.032. NOTIFICATION OF PROVISION OF EMERGENCY SERVICES.
provided to the patient. The notice shall be made:
(1) by telephone not later than the 72nd hour after the
provider determines the patient`s county of residence; and
(2) by mail postmarked not later than the fifth working
day after the date on which the provider determines the patient's
county of residence.
(b) The provider shall attempt to determine the patient's
county of residence when the patient first receives services.
(c) The provider, the patient, and the patient's family shall
cooperate with the county of which the patient is presumed to be a
resident in determining if the patient is an eligible resident of
that county.
(d) Not later than the 14th day after the date on which the
patient's county of residence receives notification and sufficient
information to determine eligibility, the county shall determine if
the patient is eligible for assistance from that county. If the
county does not determine the patient`s eligibility within that
period, the patient is considered to be eligible. The county shall
notify the provider of its decision.
(e) If the county and the provider disagree on the patient's
residence or eligibility, the county or the provider may submit the
matter to the department as provided by Section 61.004.
If a provider delivers emergency services to a patient
who is eligible for assistance under this subchapter and fails to
comply with this section, the provider is not eligible for payment
for the services from the patient's county of residence.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
by Acts 1999, 76th Leg., ch. 1377, Sec. 1.11, eff. Sept. 1, 1999;

a public hospital or hospital district, to an eligible county
resident. ~~y~~y~'s'~nQt- Zab.~.e`~~~ for payment for health care
services provided:
(1) by any provider, including a public hospital or
hospital district, to a resident of that county who resides in the
service area of a public hospital or hospital district; or
(2) to an eligible resident of that county who does not
reside within the service area of a public hospital or hospital
district by a hospital having a Hill-Burton or state-mandated
obligation to provide free services and considered to be in
noncompliance with the requirements of the Hill-Burton or state-
mandated obligation.
(b) To the extent prescribed by this chapter, if another
source of payment does not adequately cover a health care service a
county provides to an eligible county resident, the county shall
pay for or provide the health care service for which other payment
is not available.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 61.034. (a)
A county is not liable for the cost of a health care service
provided under Section 61.028 or 61.0285 that is in excess of the
payment standards for that service established by the department
under Section 61.006.
(b) A county may contract with a provider of assistance to
provide a health care service at a rate below the payment standard
set by the department.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
by Acts 1999, 76th Leg., ch. 1377, Sec. 1.12, eff. Sept. 1, 1999.
is:
(1) $30,000; or
(2) the payment of 30 days of hospitalization or
treatment in a skilled nursing facility, or both, or $30,000,
whichever occurs first, if the county provides hospital or skilled
nursing facility services to the resident.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 61.036. DETERMINATION OF ELIGIBILITY FOR PURPOSES OF
"' ~ (a) A county may not credit an expenditure made
,.
,~
to assist an eligible county resident toward eligibility for state
assistance under this subchapter unless the county complies with
the department's application, documentation, and verification
procedures.
(b) Except as provided by Section 61.023(b), a county may not
credit an expenditure for an applicant toward eligibility for state
assistance if the applicant does not meet the departments
eligibility standards.
(c) Regardless of the application, documentation, and
verification procedures or eligibility standards established by the
department under Subchapter A, a county may credit an expenditure
for an eligible resident toward eligibility for state assistance if
the eligible resident received the health care services at:
___.
(1) a hospital maintained or operated by a state agency
that has a contract with the county to provide health care
services; or
(2) a federally qualified health center delivering
federally ~.ified health center services, as those terms are
defined in 42 U.S.C. Sections 1396d(1) (2) (A) and (B), that has a
1999.
`fir Amended by:
Acts 2005, 79th Leg., Ch. 1133, Sec. 1, eff. September 1,
2005.
Sec. 61.037. ~~~ ~~IGTBI~I=T~ FOR STATE ASSISTANCE. (a)
The department may distribute funds as provided by this subchapter
to eligible counties to assist the counties in providing health
care services under Sections 61.028 and 61.0285 to their eligible
county residents.
(b) Except as provided by Subsection (c), (d), (e), or (g),
to be eligible for state assistance, a county must:
(1) spend in a state fiscal year ' 9~cexi;~;'`
.. _... ..
of the county general revenue levy for that year to provide health
care services described by Subsection (a) to its eligible caunty
residents who qualify for assistance under Section 61.023; and
(2) notify the department, not later than the seventh
day after the date on which the county reaches the expenditure
level, that the county has spent at least six percent of the
applicable county general revenue levy for that year to provide
health care services described by Subsection (a) to its eligible
county residents who qualify for assistance under Section 61.023.
(c) If a county and a health care provider signed a contract
on or before January 1, 1985, under which the provider agrees to
furnish a certain level of health care services to indigent
persons, the value of services furnished in a state fiscal year
under the contract is included as part of the computation of a
county expenditure under this section if the value of services does
dot exceed the payment rate established by the department under
the hospital district. In determining eligibility for state
assistance, that county shall consider only the county general
revenue levy resulting from the property located outside the
hospital district. A county is eligible for state assistance if:
(1) the county spends in a state fiscal year at least
eight percent of the county general revenue levy for that year
resulting from the property located outside the hospital district
to provide health care services described by Subsection (a) to its
eligible county residents who qualify for assistance under Section
61.023; and
(2) the county complies with the other requirements of
this subchapter.
(e) A county that provides health care services described by
Subsection (a) to its eligible residents through a hospital
established by a board of managers jointly appointed by a county
and a municipality under Section 265.011 is eligible for state
assistance if:
(1) the county spends in a state fiscal year at least
eight percent of the county general revenue levy for the year to
provide the health care services to its eligible county residents
who qualify for assistance under Section 61.052; and
(2) the county complies with the requirements of this
subchapter.
{f) If a county anticipates that it will reach the eight
percent expenditure level, the county must notify the department as
soon as possible before the anticipated date on which the county
will reach the level.
(g) The department may waive the requirement that the county
unable to satisfy the eight percent expenditure level:
(1) because, although the county's general revenue tax
levy has increased significantly, expenditures for health care
services described by Subsection (a) have not increased by the same
percentage;
(2) because the county is at the maximum allowable ad
valorem tax rate, has a small population, or has insufficient
taxable property; or
(3) because of a similar reason.
(h) The department shall adapt rules governing the
circumstances under which a waiver may be granted under Subsection
(g) and the procedures to be used by a county to apply for the
waiver. The procedures must provide that the department shall make
a determination with respect to an application for a waiver not
later than the 90th day after the date the application is submitted
to the department in accordance with the procedures established by
the department. To be eligible for state assistance under
Subsection (g), a county must submit monthly financial reports, in
the form required by the department, covering the 12-month period
preceding the date on which the assistance is sought.
(i) The county must give the department all necessary
information so that the department can determine if the county
meets the requirements of Subsection (b), (d), (e), or (g).
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
by Acts 1997, 75th Leg., ch. 651, Sec. 1, eff. June ll, 1997; Acts
1999, 76th Leg., ch. 272, Sec. 1, eff. May 28, 1999; Acts 1999,
76th Leg., ch. 1377, Sec. 1.14, eff. Sept. 1, 1999.
Sec. 61.038. DISTRIBUTION OF ASSISTANCE FUNDS. (a) If the
health care services under Sections 61.028 and 61.0285 to its
eligible county residents who qualify for assistance as described
by Section 61.037.
(b) State funds provided under this section to a county must
be equal to at least 90 percent of the actual payment for the
health care services for the county's eligible residents during the
remainder of the state fiscal year after the eight percent
expenditure level is reached.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
by Acts 1999, 76th Leg., ch. 272, Sec. 2, eff. May 28, 1999; Acts
1999, 76th Leg., ch. 1377, Sec. 1.14, eff. Sept. 1, 1999.
Sec. 61.039. FAILURE TO PROVIDE STATE ASSISTANCE. If the
department fails to provide assistance to an eligible county as
prescribed by Section 61.038, the county is not liable for payments
for health care services provided to its eligible county residents
after the county reaches the eight percent expenditure level.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
by Acts 1999, 76th Leg., ch. 1377, Sec. 1.14, eff. Sept. 1, 1999.
Sec. 61.0395. LIMITED TO APPROPRIATED FUNDS. (a) The total
amount of state assistance provided~to counties under this chapter
for a fiscal year may not exceed. the amount appropriated for that
purpose for that fiscal year.
(b) The department may adopt rules governing the distribution
of state assistance under this chapter that establish a maximum
annual allocation for each county eligible for assistance under
this chapter in compliance with Subsection (a).
(c) The rules adopted under this section:
(1) may consider the relative populations of the service
county is not eligible to receive and the distributian of that
money to other eligible counties.
Added by Acts 1999, 76th Leg., ch. 1377, Sec. 1.15, eff. Sept. 1,
1999. Amended by Acts 2001, 77th Leg., ch. 1128, Sec. 3, eff.
Sept. 1, 2001.
Sec. 61.040. TAX INFORMATION. The comptroller shall give the
department information relating to:
(1) the taxable value of property taxable by each county
and each county's applicable general revenue tax levy for the
relevant period; and
(2) the amount of sales and use tax revenue received by
each county for the relevant period.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
by Acts 1991, 72nd Leg., 2nd C.S., ch. 6, Sec. 64, eff. Sept. 1,
1991.
Sec. 61.041. COUNTY REPORTING. (a) The department shall
establish _ requirements for a county seeking state
assistance and establish procedures necessary to determine if the
county is eligible for state assistance.
(b) The department shall establish requirements relating to:
(1) documentation required to verify the eligibility of
residents to whom the county provides assistance; and
(2) county expenditures for health care services under
Sections 61.028 and 61.0285.
(c) The department may audit county records to determine if
the county is eligible for state assistance.
(d) The department shall establish annual reporting
requirements for each county that is required to provide indigent
under the Agreement Regarding Disposition of Settlement Proceeds
filed on July 24, 1998, in the United States District Court,
Eastern District of Texas, in the. case styled The State of Texas v.
The American Tobacco Co., et al., No. 5-96CV-91.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
by Acts 1999, 76th Leg., ch. 1377, Sec. 1.16, eff. Sept. 1, 1999.
.
Sec. 61.042 . ~~ ,~ ;~ '~. .. ,~. t=a? ~.~,.,, couzity .may,
"~~~ ~ ~ ~r
spx,oce.ir~rs•kx~~c~~~~;~~#;~~zt .~~ ,~,,~.Z~~?r3.. ~~,~,.~.::the~..--~'eX-a-s
T1FP~'1~.Yaf~i#Padlr~~~"-%~7.IR~~';?~~1~'£'S`~". ~'S"I1F~llc~1''".~'E'SCD~LlL~~;S'
r
C ~c x, -_a~m~.~:~s~l~~ z='~a~ . ~``e~it~~~rv~~`c~~s,. ~p~.fl~~r-am~ `a'rid
. _
~ ~ ~,~
r~a~r~~~~~.s~~~j~~~1=~$3'~~~y.~02x~'~`~~'Z ~ -~~3'7, _ bs" r' t~ S~ f`C~T C~O~~'
;s-u,~.. y ~ ~
(b) The county shall notify all persons with pending
applications and eligible residents of the employment service
program requirements not less than 30 days before the program is
established.
Added by Acts 1993, 73rd Leg., ch. 880, Sec. 1, eff. Sept. 1, 1993.
Amended by Acts 1995, 74th Leg., ch. 76, Sec. 8.122, eff. Sept. 1,
1995.
... .
___._-_
Sec. 61.043. (a? The
county shall adopt reasonable procedures for minimising the
opportunity for fraud, for establishing and maintaining methods for
detecting and identifying situations in which a question of fraud
may exist, and for administrative hearings to be conducted on
disqualifying persons in cases where fraud appears to exist.
(b) Procedures established by a county for administrative
hearings conducted under this section shall provide for appropriate
due process, including procedures for appeals.
,~ -~~
~~
(1) personal insurance;
(2) other sources; or
(3) another person for personal injury caused by the
other person's negligence or wrong.
A person who applies for or receives services shall
inform the county, at the time of application or at any time during
eligibility, of any unsettled tort claim that may affect medical
yk;~3
y p - ~eilt or sickness insurance < <~v~r~g~_
needs and of an ~ hate ~< < ~ ..~~,~~~..;,
that is or may k~e~-ome availaule. An applicant or eligible resident
,. ~ ~~r. ~. ..
shall inform the county of any injury that is caused by the act or
failure to act of some other person. An applicant or eligible
resident shall inform the county as required by this subsection
within 10 days of the date the person learns of the person's
insurance coverage, tort claim, or potential cause of action.
(c) A claim for damages for personal injury does not
constitute grounds for denying or discontinuing services under this
chapter.
(d) A separate and distinct cause of action in favor of the
county is hereby created, and the county may, without written
consent, take direct civil action in any court of competent
jurisdiction. A suit brought under this section need not be
ancillary to or dependent on any other action.
(e) The county's right of recovery is limited to the amount
of the cost of services paid by the county. Other subrogation
rights granted under this section are limited to the cost of the
services provided.
(f) An applicant or eligible resident who knowingly and
intentionally fails to disclose the information required by
SUBCHAPTER C. PERSONS WHO RESIDE IN AN AREA SERVED BY A PUBLIC
HOSPITAL OR HOSPITAL DISTRICT
Sec. 61.051. APPLICATION OF SUBCHAPTER. (a) This subchapter
applies to health care services and assistance provided to a person
who resides in the service area of a public hospital or hospital
district.
(b) For the purposes of this subchapter, a hospital is not
considered to be a public hospital and is not responsible for
providing care under this subchapter if the hospital:
(1) is owned, operated, or leased by a municipality with
a population of less than 5,500;
(2) was leased before January 1, 1981, by a municipality
that at the time of the lease did not have a legal obligation to
provide indigent health care; or
(3) was established under Section 265.031.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
by Acts 1991, 72nd Leg., ch. 14, Sec. 16, eff. Sept. 1, 1991.
Sec. 61.052. GENERAL ELIGIBILITY PROVISIONS. (a) A public
hospital or hospital district shall provide health care assistance
to each eligible resident in its service area who meets:
(1) the basic income and resources requirements
established by the department under Sections 61.006 and 61.008 and
in effect when the assistance is requested; or
(2) a less restrictive income and resources standard
adopted by the hospital or hospital district serving the area in
which the person resides.
(b) If a public hospital used an income and resources
standard during the operating year that ended before January 1,
(c) If a public hospital did not use an income and resources
standard during the operating year that ended before January 1,
1985, but had a Hill-Burton obligation during part of that year,
the hospital shall adopt the standard the hospital used to meet the
Hill-Burton obligation to determine eligibility under this
subchapter.
(d) A public hospital established after September 1, 1985,
shall provide health care services to each resident who meets the
income and resources requirements established by the department
under Sections 61.006 and 61.008, or the hospital may adopt a less
restrictive income and resources standard. The hospital may adopt
a less restrictive income and resources standard at any time.
(e) If because of a change in the income and resources
requirements established by the department under Sections 61.006
and 61.008 the standard adopted by a public hospital or hospital
district becomes stricter than the requirements established by the
department, the hospital or hospital district shall change its
standard to at least comply with the requirements established by
the department.
(f) A public hospital or hospital district may contract with
the department to perform eligibility determination services.
(g) A county that provides health care services to its
eligible residents through a hospital established by a board of
managers jointly appointed by a county and a municipality under
Section 265.011 and that establishes an income and resources
standard in accordance with Subsection (a)(2) may credit the
services provided to all persons who are eligible under that
standard toward eligibility for state assistance as described by
or hospital district shall adopt an application procedure.
(b) Not later than the beginning of a public hospital's or
hospital district's operating year, the hospital or district shall
specify the procedure it will use during the operating year to
determine eligibility and the documentation required to support a
request for assistance and shall make a reasonable effort to notify
the public of the procedure.
(c) The public hospital or hospital district shall furnish an
applicant with written application forms.
(d) On request of an applicant, the public hospital or
hospital district shall assist an applicant in filling out forms
and completing the application process. The hospital or district
shall inform an applicant of the availability of assistance.
(e) The public hospital or hospital district shall require an
applicant to sign a written statement in which the applicant swears
to the truth of the information supplied.
(f) The public hospital or hospital district shall explain to
the applicant that if the application is approved, the applicant
must report to the hospital or district any change in income or
resources that might affect the applicant's eligibility. The
report must be made not later than the 14th day after the date on
which the change occurs. The hospital or district shall explain
the possible penalties for failure to report a change.
(g} The public hospital or hospital district shall review
each application and shall accept or deny the application not later
than the 14th day after the date on which the hospital or district
receives the completed application.
(h) The public hospital or hospital district shall provide a
decision. If the hospital or district denies assistance, the
`~.-' written notification shall include the reason for the denial and an
explanation of the procedure for appealing the denial.
(j) The public hospital or hospital district shall maintain
the records relating to an application for at least three years
after the date on which the application is submitted.
(k) If an applicant is denied assistance, the applicant may
resubmit an application at any time circumstances justify a
redetermination of eligibility.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 61.054. BASIC HEALTH CARE SERVICES PROVIDED BY A PUBLIC
HOSPITAL. (a) Except as provided by Subsection (c), a public
hospital shall endeavor to provide the basic health care services a
county is required to provide under Section 61.028.
(b) If a public hospital provided additional health care
services to eligible residents during the operating year that ended
before January 1, 1985, the hospital shall continue to provide
those services.
(c) A public hospital shall coordinate the delivery of basic
health care services to eligible residents and may pravide any
basic health care services the hospital was not providing on
January 1, 1999, but only to the extent the hospital is financially
able to do so.
(d) A public hospital may provide health care services in
addition to basic health care services.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
by Acts 1999, 76th Leg., ch. 1377, Sec. 1.18, eff. Sept. 1, 1999.
Sec. 61.055. BASIC HEALTH CARE SERVICES PROVIDED BY HOSPITAL
statute creating the district.
(b) A hospital district shall coordinate the delivery of
basic health care services to eligible residents and may provide
any basic health care services the district was not providing on
January 1, 1999, but only to the extent the district is financially
able to do so.
(c) This section may not be construed to discharge a hospital
district from its obligation to provide the health care services
required under the Texas Constitution and the statute creating the
district.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
by Acts 1999, 76th Leg., ch. 1377, Sec. 1.19, eff. Sept. 1, 1999.
Sec. 61.056. PROVISION OF HEALTH CARE SERVICES. (a) A
wr public hospital or hospital district may arrange to provide health
care services through a local health department, a publicly owned
facility, or a contract with a private provider regardless of the
provider's location, or through the purchase of insurance for
eligible residents.
(b) The public hospital or hospital district may affiliate
with other public hospitals ox hospital districts or with a
governmental entity to provide regional administration and delivery
of health care services.
(c) A hospital district created in a county with a population
of more than 800,000 that was not included in the boundaries of a
hospital district before September 1, 2003, may affiliate with any
public or private entity to provide regional administration and
delivery of health care services. The regional affiliation, in
accordance with the affiliation agreement, shall use money
Acts 2007, 80th Leg., R.S., Ch. 164, Sec. 3, eff. September 1,
2007.
Sec. 61.057. MANDATED PROVIDER. A public hospital may select
one or more providers of health care services. A public hospital
may require eligible residents to obtain care from a mandated
provider except:
(1) in an emergency;
(2) when medically inappropriate; or
(3) when care is not available.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 61.058. NOTIFICATION OF PROVISION OF NONEMERGENCY
SERVICES. (a) A public hospital may require any provider,
including a mandated provider, to obtain approval from the hospital
before providing nonemergency health care services to an eligible
resident in the hospital's service area.
(b) If the public hospital does not require prior approval
and a provider delivers or will deliver nonemergency health care
services to a patient who the provider suspects might be eligible
for assistance under this subchapter, the provider shall notify the
hospital that health care services have been or will be provided to
the patient. The notice shall be made:
{1) by telephone not later than the 72nd hour after the
provider determines that the patient resides in the hospital's
service area; and
{2) by mail postmarked not later than the fifth working
day after the date on which the provider determines that the
patient resides in the hospital's service area.
(c) If the provider knows that the public hospital serving
unless it is medically inappropriate to do so.
(d) Not later than the 14th day after the date on which the
public hospital receives sufficient information to determine
eligibility, the hospital shall determine if the patient is
eligible far assistance from the hospital. If the hospital does
not determine the patient's eligibility within that period, the
patient is considered to be eligible. The hospital shall notify
the provider of its decision.
(e) If a provider delivers nonemergency health care services
to a patient who is eligible for assistance under this subchapter
and fails to comply with this section, the provider is not eligible
for payment for the services from the public hospital serving the
area in which the patient resides.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
by Acts 1999, 76th Leg., ch. 1377, Sec. 1.20, eff. Sept. 1, 1999.
Sec. 61.059. NOTIFICATION OF PROVISION OF EMERGENCY SERVICES.
{a) If a nonmandated provider delivers emergency services to a
patient who the provider suspects might be eligible for assistance
under this subchapter, the provider shall notify the hospital that
emergency services have been or will be provided to the patient.
The notice shall be made:
(1) by telephone not later than the 72nd hour after the
provider determines that the patient resides in the hospital's
service area; and
{2) by mail postmarked not later than the fifth working
day after the date on which the provider determines that the
patient resides in the hospital's service area.
(b) The provider shall attempt to determine if the patient
an eligible resident of the hospital's service area.
~r (d) Not later than the 14th day after the date on which the
public hospital receives sufficient information to determine
eligibility, the hospital shall determine it the pau eii~ 1~
eligible for assistance from the hospital. If the hospital does not
determine the patient's eligibility within that period, the patient
is considered to be eligible. The hospital shall notify the
provider of its decision.
(e) If the public hospital and the provider disagree on the
patient's residence or eligibility, the hospital or the provider
may submit the matter to the department as provided by Section
61.004.
(f) If a provider delivers emergency services to a patient
who is eligible for assistance under this subchapter and fails to
comply with this section, the provider is not eligible for payment
for the services from the public hospital serving the area in which
the patient resides.
(g) If emergency services are customarily available at a
facility operated by a public hospital, that hospital is not liable
for emergency services furnished to an eligible resident by another
provider in the area the hospital has a legal obligation to serve.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
by Acts 1999, 76th Leg., ch. 1377, Sec. 1.21, eff. Sept. 1, 1999;
Acts 20.01, 77th Leg., ch. 1128, Sec. 4, eff. Sept. 1, 2001.
Sec. 61.060. PAYMENT FOR SERVICES. (a) To the extent
prescribed by this chapter, a public hospital is liable for health
care services provided under this subchapter by any provider,
including another public hospital, to an eligible resident in the
(2) an eligible resident of the hospital's service area
by a hospital having a Hill-Burton or state-mandated obligation to
provide free services and considered to be in noncompliance with
the requirements of the Hill-Burton or state-mandated obligation.
(b) A hospital district is liable for health care services as
provided by the Texas Constitution and the statute creating the
district.
(c) A public hospital is the payor of last resort under this
subchapter and is not liable for payment or assistance to an
eligible resident in the hospital's service area if any other
public or private source of payment is available.
(d) If another source of payment does not adequately cover a
health care service a public hospital provides to an eligible
resident of the hospital's service area, the hospital shall pay for
or provide the health care service for which other payment is not
available.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 61.061. PAYMENT RATES AND LIMITS. The payment rates and
limits prescribed by Sections 61.034 and 61.035 that relate to
county services apply to inpatient and outpatient hospital services
a public hospital is required to provide if:
(1) the hospital cannot provide the services or
emergency services that are required; and
(2) the services are provided by an entity other than
the hospital.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989.
Sec. 61.062. RESPONSIBILITY OF GOVERNMENTAL ENTITY. A
governmental entity that owns, operates, or leases a public
Sec. 61.063. PROCEDURE TO CHANGE ELIGIBILITY STANDARDS OR
SERVICES PROVIDED. (a) A public hospital may not change its
eligibility standards to make the standards more restrictive and
may not reduce the health care services it offers unless it
complies with the requirements of this section.
(b) Not later than the 90th day before the date on which a
change would take effect, the public hospital must publish notice
of the proposed change in a newspaper of general circulation in the
hospital's service area and set a date for a public hearing on the
change. The published notice must include the date, time, and
place of the public meeting. The notice is in addition to the
notice required by Chapter 551, Government Code.
(c) Not later than the 30th day before the date on which the
change would take effect, the public hospital must conduct a public
meeting to discuss the change. The meeting must be held at a
convenient time in a convenient location in the hospital's service
area. Members of the public may testify at the meeting.
(d) If, based on the public testimony and on other relevant
information, the governing body of the hospital finds that the
change would not have a detrimental effect on access to health care
for the residents the hospital serves, the hospital may adopt the
change. That finding must be formally adopted.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
by Acts 1995, 74th Leg., ch. 76, Sec. 5.95(82), eff. Sept. 1, 1995.
Sec. .61.064. TRANSFER OF A PUBLIC HOSPITAL. (a) A
governmental entity that owns, operates, or leases a public
hospital and that closes, sells, or leases the hospital:
(1) has the obligation to provide basic health care
would have been required to provide under this chapter on the date
of the closing, sale, or lease.
(b} If the governmental entity owned, operated, or leased the
public hospital before January 1, 1985, and sold or leased the
hospital on or after that date but before September 1; 1986, the
obligation retained is the obligation the hospital would have had
on September 1, 1986.
(c) Notwithstanding Subsections (a) and (b), if a hospital
district that owns, operates, or leases a public hospital
dissolves, the district has no responsibility under this chapter.
If on or before dissolution the district sold or transferred its
hospital to another governmental entity, that governmental entity
assumes the district`s responsibility to provide health care
r services in accordance with this subchapter. If the district did
not sell or transfer the hospital to another governmental entity,
the county shall provide health care services to the residents of
the district's service area in accordance with Subchapter B.
(d) This section does not apply to a governmental entity that
sold or leased a public hospital to a hospital district or a
hospital authority on or after January 1, 1985, but before
September 1, 1986. If a governmental entity sold or leased a
hospital as provided by this subsection, the hospital ceased being
a public hospital for the purposes of this chapter on the date it
was sold or leased, and neither the governmental. entity nor the
hospital district or hospital authority has any responsibility
under this chapter.
Acts 1989, 71st Leg., ch. 678, Sec. 1, eff. Sept. 1, 1989. Amended
by Acts 1999, 76th Leg., ch. 1377, Sec. 1.23, eff. Sept. 1, 1999.
of the sale to a person who is not a governmental entity.
(b) On the date the hospital is sold, the hospital ceases
being a public hospital for the purposes of this chapter, and the
county shall provide health care services to county residents in
accordance with Subchapter B.
(c) If the contract for the sale of the hospital provides for
the provision by the hospital of health care services to county
residents, the value of the health care services credited or paid
in a state fiscal year under the contract is included as part of
the computation of a county expenditure under Section 61.037 to the
extent that the value of the services does not exceed the payment
standard established by the department for allowed inpatient and
outpatient services.
r Added by Acts 1989, 71st Leg., ch. 1100, Sec. 5.10(c), eff. Sept.
1, 1989.
Sec. 61.066. PREVENTION AND DETECTION OF FRAUD. (a) A
hospital district may adopt reasonable procedures for minimizing
the opportunity for fraud, for establishing and maintaining methods
for detecting and identifying situations in which a question of
fraud may exist, and for administrative hearings to be conducted on
disqualifying persons in cases where fraud appears to exist.
(b) Procedures established by a hospital district for
administrative hearings conducted under this section shall provide
for appropriate due process, including procedures for appeals.
Added by Acts 2001, 77th Leg., ch. 563, Sec. 1, eff. Aug. 27, 2001.

Order No. 28168
APPROVAL TO INCLUDE CRNA SERVICE AS AN OPTIONAL SERVICE UNDER
THE INDIGENT HEALTH CARE PROGRAM
On this the 14th day of July, 2003 upon motion made by Commissioner Williams and
seconded by Commissioner Nicholson, the Court unanimously approved by a vote 4-0-
0 to include CRNA services as an Optional Service under the Indigent Health Care
Program, and authorize County Judge to sign the same.
COMMISSIONERS' COURT AGENDA REQUEST
~~ `~~ 1 ~ ~
~,v FLEASE FURNISH ONE ORIGINAL AND NINE COPIES OF THIS REQUEST AND DOCUMENTS TO BE
REVIEWED BY THE COURT.
MADE BY: Pat Tinley OFFICE: Coun Jud
MEETING DATE: Jul~l4.2003 TIlvIE PREFERRED:
SUBJECT: (PLEASE BE SPECIFIC)
Consider and discuss approval of the inclusion of CRNA services as an Optional Service under
the Indigent Health Care Program, and authorize County Judge to request approval of such
inclusion by Texas Department of Health.
EXECUTIVE SESSION REQUESTED: (PLEASE STATE REASON)
NAME OF PERSON ADDRESSING THE COURT:
ESTIMATED LENGTH OF PRESENTATION:
IF PERSONNEL MATTER -NAME OF EMPLOYEE:
County Judge
Time for submitting this request for Court to assure that the matter is posted in accordance with Title 5, Chapter
S51 and 552, Government Code, is as follows:
Meeting scheduled for Mondays: 5:00 P.M. previous Tuesday.
THIS REQUEST RECEIVED BY:
THIS REQUEST RECEIVED ON:

All Agenda Requests will be screened by the County Judge's Office to determine if adequate information has been
prepared far the. Court's formal consideration and action at time of Court Meetings. Your cooperation will be
appreciated and contribute towards you request being addressed at the earliest opportunity. See Agenda Request Rules
Adopted by Commissioners' Court.
)ct-30-02 02:44P Anesthesia Associates 210 896-1363 P.O1
~p :. ~tXit~
October 29, 2002
o~'$ ']byf
The Honorable Fred Henneke
700 Main St
Kerrville TX 78028
Dear Judge Henneke:
The purpose of this letter is to request your assistance is add
group is having with the Kerr County Indigent Health Care ~
charges for anesthesia services provided by CRNA (Certifed
are being denied -and remaining unpaid.
Anesthesia Associates is the medical group that provides anesthesia
Peterson Memorial Hospital and Peterson Regional Ambulatory C.
have four physician anesthesiologists and three CRNAs working in
arc employees of our group. The physician anesthesiologists and C]
the team care framework although the nurses are not medically der
in the strictest sense as defned by Medicare. In genera[, anesthesi
performed by either the physician or the CRNA and we bill in the z
CRNA providing the service.
The following health plans and programs fully approve and pay
provided by CRNA acting alone:
Medicare
Medicaid
Blue Gross Blue Shield
Workers Compensation
Texas Rehabilitation Commission
Texas CHIP Program
Commercial and PPO Plans too numerous to
In fact, in routinely dealing with almost 400 health plans and p
encounter a plan that does not approve and pay for the CRNA
a problem our medical
a. Specifically, our
:red Nurse Anesthetist)
care and services at Sid
re Center We presently
cur group. The CRNAs
NAs work together in
acted by the physicians
services are personally
ame of the physician or
anesthesia services
it is Nighty unusual to
pct-30-02 02:44P Anesthesia Associates 210 896-1363 p.O2
Pagc Two
October 29, 2002
Unfortunately, it has come to our at#ention that the Kerr County J
program will not pay for the CRNA service. Enclosed is a copy of
this issue obtained from the administrator of the program - Vericl
We are requesting that the charges for anesthesia personally perf~
approved and paid by the Kerr County Indigent Health Care Pro
universal standard is the anesthesia and medical payor business.
A possible solution to the problem is for Anesthesia Associates to I
name of a physician, with the disclosure to you and the County th;
personally providing the service but as an employee of Anesthesia
framework of the anesthesia team concept of care.
To provide further Information to you, I am also enclosing a copy
from the program. The claim reports onr standard rate, but let a
approved by the indigent program, which mirrors Medicaid, the 1
be approximately $ 340 fora 3 hour surgery,
Sincerely,
,gent Health Care
manual addressing
by CRNA be
as this is virtually a
1 the charge in the
the CRNA is
and within the
f a claim and denial
advise yon that if
yment amoant would
John Massey
Practice Manager, Anesthesia Associates
FORM 120
Page 1
C[HCP Optional Service Request
Please read optional service definitions on the back of this pa4e.

Types of Optional Services: (circle the numbers of fhe services your county wishes to provide)
	1.	Advanced Practice Nurse (APN)
	2.	Ambulatory Surgical Center (ASC)
	3.	Certified Nurse Midwife (CNM)
	4.	Certified Registered Nurse Anesthetist {CRNA}
5.	Colostomy Medical Supplies and/or Equipment (colostomy bags/pouches, cleansing irrigation kits, paste
	or powder, and wafers)
6.	Counseling Services: (check the ones your county wishes to provide)
	A. Licensed Professional Counselor (LPC)
	B. Licensed Marriage Family Therapist (LMFT)
	C. Licensed Master Social Worker-Advanced Clinical Practitioner (LMSW ACP)
	D. Ph.D. Clinical Psychologist
7.	Dental Care (annual routine exam, annual routine cleaning, one set of annual x-rays, and the least costly
	service for emergency dental conditions for the removal or filling of a tooth due to abscess, infection, or
	extreme pain)
8.	Diabetic Supplies and/or Equipment (syringes, lancets, test strips, alcohol prep pads, glucometers, humulin
	pens, and the needles required for the humulin pens.)
9.	Durable Medical Equipment: (check the apes your county wishes to provide)
	A. Cnrtches D. Standard wheel chairs G. Home oxygen equipment
	B. Canes E. Hospital beds H. Blood pressure measuring appliances
	C. Walkers F. TENS units
10.	Federally Qualified Health Center (FQHC)
1 t.	Home and Community Health Care
12.	Physician Assistant (PA)
13.	Vision Care (one exam by refraction and one pair of prescribed glasses every 24 months)
14.	Emergency Medical Services (ground transportation only)
CHANGE [Check here If your county wishes to discontinue any of the optional services that you are currently
providing this state fiscal year. Circle the optional services above that you will continue providing.
Complete and submit this form.j
July, 14 , 2003
`'-" Signat roof County Judge/Designee Date
Name:	Title:
)°at Tinle	Kerr County Judge
County: Kerx County	Mailing Address: 700 Main
Phone Number (Include area code.):	CitylState/Zip:
830-792-2211	Kerrville, Texas 78028
CIHCP 02-6
November, 2002
FORM 120
Page 2
CIHCP Optional Service Definitions
it All of these optional services will count towards the cfrent's 530, 000 or 30 day inpatient hospftaUskilled nursing limitation
Some of these services are not SS!-Medicaid reimbursable through the Indigent Nealth_t,,are Division of 1'pH.
1. Advanced Practice Nurse (APN) services must be medically necessary and provided within the scope of practice of an APN and covered by the
Texas Medicaid Program when provided by a licensed physidan.
2. Ambulatory Surgical Center (ASC) services must be provided in a Title XIX Mecticaid-enrolled ASC, and are limited to items and services furnished in
reference to an ambulatory surgical procedure, inducting those services on the HCFA approved list and selected Medicaid-only procedures.
3. Certified Nurse Midwife (CNM) services must be medically necessary, provided within the scope of practice of a CNM, and covered by the Texas
Medicaid Program when provided by a licensed physician.
4. Certified Registered Nurse Anesthetist (CRNA) services must be medically necessary; provided within the scope of practice of a GRNA; prescribed
and supervised by a physidan, dentist, or podiatrist who must be licensed in the state in which they practice.
5. Colostomy medical supplies and/or equipment must be medically necessary and prescribed by a physidan or an-APN it this is within the scope of
their practice in accordance with the standards established by the Board of Nurse Examiners and published in 22 TAC §221.13. Items covered are
colostomy bags/pouches, deansing irrigation kits, paste or powder, and wafers. The county may require the supplier to receive prior authorization.
6. Counseling (psychotherapy) services must be medically necessary based on a referral from a physidan or an APN if this is within the scope of their
practice in accordance with the standards established by the Board of Nurse Examiners and published in 22 TAC §221.13. Psychotherapy services must
be provided by a Licensed Professional Counsebr (LPC), Ucensed Marriage Family Therapist (L.MFT), l.k:ensed Master Sodas Worker-Advanced Clinical
Practitioner (LMSW-ACP), or a Ph.O. Psydwiogist.
7. Dental care must be medically necessary and provided by a DDS, DMD, or OOM. Items covered are an annual routine exam, annual routine leaning,
one set of annual x-rays, and the least costly service for emergency dental conditions for the removal or filling of a tooth due to abscess, infection, or
extreme pain. The county may require prior authorization.
8. Diabetic supplies andlor equipment must be medically necessary and prescribed by a physidan or an APN if this is within the scope of their practice
in accordance with the standards established by the Board of Nurse Exanners and published in 22 TAC §221.13. Items covered are syringes, lancets,
~' test strips, alcohol prep pads, gluoometers, humulin pens, and the needles required for the hunarlin pens. The county may require the supplier to receive
prig authaization. These do NOT count as one of the three prescribed drugs per month.
9. Durable medical equipment must be -nedlcaity necessary; meet the MedicarelMedicaid requirements; and be provided under a written, signed and
dated prescription from a physidan ar an APN if this is within the scope of their practice in accordance with the standards established by the Board of
Nurse Examiners and published in 22 TAC §221.13. Items maybe purchased or rented, whidtiever is least costly. items covered are crutches, canes,
walkers, standard wheel chairs, hospital beds, TENS units, home oxygen equipment (inducting masks, oxygen hose, and nebulizers), and reasonable and
appropriate appliances for measuring blood pressure. The county may require the supplier to receive prror authorization. These do NOT count as one of
three prescribed drugs per month.
10. Federally t2rralified Health Center (FQHC) services must be provided in an approved FQHC by a physidan, physician's assistant, nurse
practitioner, dinical psychologist, or dinical soda) worker.
11. Home and community health wre must be medically necessary; meet the Medigre/Med'~caid requirements; and be provided by a certified home
health agency. A plan of cue must be recommended, signed, and dated by the redpient's attending physidan prior to care being given. Items covered
are RN. visits for skilled nursing observation, assessment, evaluatan, and treatment provided by a physidan who spedf'~catly requests the RN. visit for
this purpose. A home health aide to assist with administering medication is also covered. Ysits made for performing housekeeping services are not
covered. A county may require prior authorization.
12. Physician Assistant (PA) services must be medically necessary and provided by a PA under the direction of an M.D. or a 0.0. and must be billed by
and paid to the supervising physidan,
13. Vlslon care covers 1 exam by refraction and 1 pair of prescribed glasses every 24 months that meet Medicaid criteria.
14. Emergency medical service covers ground transportation Doty for medically necessary life-threatening conditions.
CIHCP 02-6
November, 2002
06/18/2003 11:21 830-792-2238 KERR COLRJTY AUDITOR PAGE 02
c~xrx.r J~,ncc
~ ME~ce
s~Rt C,o4Rr
H. A.'tlVtttlt" ~µ~ryR4 tk7. t
tJU1~t (7JtM'PIN, t~ 4
Mr. John Massey
PraCtict Maga}-tr,
Ancsthcsat Associates, LLP
420 WAter Stttjet, Suite 1U513
Kcrcviii~ Texrs 78Q28
itF,: CttNA Reunhte~~t
Ucar Mr. Mas_~:
~•
THE COUNTY COURT
c~
Kt~ttt COlJ1Y?y, TEXAS
71101.1~w 7(nRVR~t. Toes'l~02i
~x:!.n~ m.tru Ci~c
• Fnt:lRJ01792.2i1a !^+~sTrPrs' ER
R•+~`: FMK c^w
~r~~-oaeroR
Tea &w~.
rv~,~,~ r8, xvtrz
Thank you for your lcttcr datt:d ()Cti~ber 29.2402, regarding the isx:tusion of CRNAs in tho Kerr Cotenty
indigent Health Care t~ga+n.
After tookit~g inter the issue, (havo dctautit~od that the issnt of inclusion of CitNA
indigeax Hdirth Cate pro~rsm falls undcx the umtx'dla ot'O services in the County
contract with the Texas ~partmait of Health dcxs not Fnct dep uclt ~lfor whitev~er tea.con. tic County's
CKNAs are not digibk under the cusrcrk progtaitt, ~• • Ttktt`f~ swiccs by
Howcrcr, ~ cax.ract botwetn the Ttxa4 [~epartaieut of Hearth :ad Kerr Count cart be
such OQtioaal Services. Unfortunat , such a Y nnre+tdexl to incFnde
fiscal air or ~` madntax will only be efroetivu wt the stArt of the States rrcact
Y 8~tertzbex I, 2003. As such, ttxxc is 1it21c that caa be aacomplishotl sl ~ ~_
lsy copy of ttsis later, l :n notifying County Judge-Ltxt ps~t Tinlry u qcp ~ ~~k t3t~
Care Coorditttitor, of this sitwfiort along with sty raxxttinc»dalicxf that 1lte contt~ct with' D ~i~i nezt
sumrncr to include such Options! Sorviccs.
Jfyau haul: any questions, please glut: ct~e a calf.
Sittcc_rdyfyours
/~'r~
'rod Nen»cica
Kerr Gounty Judge
Cc: Comaussiorters
County Judg~a-L•lxt Pat Tintcy
ladle i3ladsoc
ORDER N0.29948
RESOLUTION AUTHORIZING SENDING NOTICE TO ALL
HEALTHCARE PROVIDERS AND PHARMACIES AND
AUTHORIZING COUNTY TO PAY INDIGENT AND MEDICAID
RATES FOR CARE OF INMATES IN CUSTODY OF KERR COUNTY
Came to be heard this the 25th day of September, 2006, with a motion made
by Commissioner Letz, seconded by Commissioner Williams. The Court
unanimously approved by vote of 4-0-0 to:
Adopt a Resolution authorizing sending notice to all Healthcare Providers
and Pharmacies, and authorizing the County to pay Indigent and Medicaid
Rates for the care of inmates in the custody of Kerr County.


~ 99yd'
1. ~ COMMISSIONERS' COURT AGENDA REQUEST
PLEASE FURNISH ONE ORIGINAL AND TEN COPIES OF THIS
MADE BY: Pat Tinley OFFICE: county
MEETING DATE: September 25, 2006 TIME PREFERRED:
SUBJECT: Consider, discuss and take appropriate action to adopt Resolution
Authorizing sending notice to all Healthcare Providers and Pharmacies and Authorizing
the County to pay Indigent and Medicaid Rates for the care of inmates in the custody of
Kerr County.
EXECUTIVE SESSION REQUESTED: (PLEASE STATE REASON)
NAME OF PERSON ADDRESSING THE COURT: County Judge
ESTIMATED LENGTH OF PRESENTATION:
IF PERSONNEL MATTER -NAME OF EMPLOYEE:
Time for submitting this request for Court to assure that the matter is posted in
accordance with Title 5, Chapter 551 and 552, Government Code, is as follows:
Meeting scheduled for Mondays:
THIS REQUEST RECEIVED BY:

THIS REQUEST RECEIVED ON:
5:00 P.M. previous Tuesday.

All Agenda Requests will be screened by the County Judge's Office to determine if adequate
information has been prepared for the Court's formal consideration and action at time of Court
Meetings. Your cooperation will be appreciated and contribute towards your request being
addressed at the earliest opportunity. See Agenda Request Rules Adopted by Commissioners'
Court.
#z~yas
Resolution

A WRITTEN RESOLUTION AUTHORIZING SENDING NOTICE TU ALL
HEALTHCARE PROVIDERS AND PHARMACIES AND AUTHORIZING THE
COUNTY TO PAY INDIGENT AND MEDICAID RATES FOR THE CARE OF
INMATES IN THE CUSTODY OF ICERR COUNTY
On this 25~' day of September, 2006, the Kerr County Commissioners Court convened in
meeting of said Court, at Commissioners Courtroom, 700 Main Street, Kerr County, 'texas with
the following members present, to wit:
County Judge
Commissioner, Pct. 1
Commissioner, Pct. 2
Commissioner, Pct. 3
Commissioner, Pct. 4
Pat Tinley
H.A. "Buster" $aldwitt
William H. Williams
Jonathan Letz
Dave Nicholson
and among other proceedings, on motion of Commissioner Lett ,seconded by
Commissioner Williams ,duly put and carried, ltaving found that all prerequisites of taw
have been met, the following Resolution was passed.
Be it resolved that, pursuant to prior Commissioner Court action and applicable law, the
Commissioners' Court of Kerr County hereby resolves and authorizes that effective on October
1, 2006, Kerr County will only pay current indigent or Medicaid rates for all healthcare and
drugs provided to inmates who are in the custody of Kerr County and hereby authorizes the
sending of written notice by the Kerr County Auditor to alt healthcare providers and pharmacies
notifying them that Kerr County will only pay current indigent or Medicaid rates for all
healthcare and drugs provided to inmates who are in the custody of Kerr County.
ADOPTED TH[S 25m DAY OF SEPTEMBER, 2406
H. A. "Buster' Baldwin,
Commissioner, Preci ct 1
Junath z,
Commi si r, Precinct 3
Z.. Pat' my Judge ~'~
~~~' T
William H. Williams,
Commissioner, Precinct 2
~~SStONEgso ,f
c~ ~ `~9t have Nicholson,
.~/ = ommissioner, Precinct 4
1 i
~ =. ~/ ~
COUNS`t~~
Scp 12 06 08:47a ] H S 936.786.6741 p.l
fndigonE,rHealthcare Solutions
Phone: ~~~' T; ~ ~'~~•~~/~>%Fax: ~~:...) ;~-~.~-~ !~ r,1
From: (ROBERT gAIRD! BRAT] Sf6l.EY _.
ROBERTCAMPgEW KRISTIE HARRlSf~I,QtJYA LUTHEF:t
• , --•--
pafe: cl I.,~~„~~! C~ ~._
Subject: '3 1 / ~ t~`'"7 ~~ ~ 1~~d 1
Pages: ~-~~ including cover page
Notes:

2040 LOOP 336. SUITE 304
CONROE, TEXAS 77304
936.736.67.20 PHONE
936.756.6747 FAX
800.834.OS60 TOt.I FREE
Sep 1c' 06 08:47a
rea O~ 04 QO:SOw
T H S 336.756.6741 p.2
layette Co A~riitors 070 OGO F1501 p.l
RECEIVED
SfP 2 3 2003
OBiea d CowMyAtaditor
Fayette County Cammi~sioners Court `'y°t'°0o°"`~t;•~"
/'. -vitJ'1"TEJr RESOLUTION AiT!'HURIZL*1G SENDING NOTTCE TO AI.L
lBALTHCARE PROYIDL•`ItS AND PHAIL'~1AClt'S qND AU'THORI7.IFtG TI-ff;.'
CUUhTY TO PAY INDIGENT AND M$DICAlD RA'l1iS FOR THE CARb OF
INMA1'1;S 1N TTiz CUSTObY QF FAYETTF rUtJNTY
Un this the 22'"' day ofSeptember, 2003, the Fayette t.:otmty CArnmissioners
CAUrt convened in a ,pedal rneaing of avid Court, at the Auxiliary Cvwtlwuxe bcated•u
1a0S W State Hwy 71, I.a Grange, Texas, with the. foitowirtK tttemben pre,ont, w w;t:
County Judge	I:dwrtrd Jarn:cka
Commissioner Prccitttx 1	David Hoak
Commissiontr Prwinct 2	Crary Weishuhn
Commissioner Precinct 3	Witbe.rt Gross
Commdsiona:r Precinct a	Tom Mtuaz
end among othrr imoceedmgs, on motion ofCommissioner Nuraw , seconded by
Coatmicsionax Ct•oss~ duly put and cxrritd, having found that al! prerpquisitars of
iaw have been mei, the tbllowing Resolution was passed
~r
lie it r+eaoivsQ that, pursuant to priorCotctmission<r Couri atxion and applicable
iaw, the Commiscioncrs Court of Fayette County hereby resolves and authorizes that
etfactivc vn October f ,2003, Fay+etie County witi only pay cttrrcnt indigarc or Medicaid
rags for ai! hoattlacarc and tl:ttgs provided w ;restates who arc in the custody ot'i:'ayeuc
County and horeby atuhcxnes thr. sending oi'w*aten noucc by the Faycao C:ouncy
Auditor to al] healthcare providers and phamlacies notifying them that Fayette Cnumy
w611 only pay cutTent indigent or Medicaid rates for all hcahhcare acrd drugs provided to
inmatts who arc to the custody of Fayette County.

Sep 12 06 178:47a I N S
935.756.6741 p.3
B1.LI5 CUUN"I-Y C;UMMISSIONEI2C CUUI2T
RFSULU'i'tC)N NU. ~~
A WRITTEN RI;SOLUTiUN AUTHURIZINC SENDING: NO'I'ICk: TO ALi.
HEALTiIC-ARIr PROVIDERS AND PHARMACIES ANI~ AUTIIORiZINC:
THE CUUN7'Y TO PAV iNbiCEN7' AND MEDICAID RATES R()R THk:
CAR E OF INMATES IN THE C(1,4'fODY ()E' @LLIS COUfVTY
Un this the 14 th day of 1uly, 2004, the County Commissioners Court of Lillis County,Tcxas,
convened in a special meeting of said Court, at Comm,ssiorrers Courtroom, IU1 West Main Streci
(2nd Floor)• Waxahachie, 'Texas, with the following members present, to-wit:
County Judge	Chad Adams
C'ommissionrr Precinct ?l l	I lallie toe 12obinson
Commissioner Precinct it2	l~,rrylnncx
Commissioner Precinct N 3	Jackie Miller
Commissioner Precinct r/4	Ron Rrown
and among other pmceedings, on motion afCommssioner __,_ _ . scwnticd by
C'ommissiorx:r_ ___ __ ,duty' put and carried, having finrnd [hat alt prerequisites
nrlaN' hove ixxn met, the following Kcsulutiou was passed'
Be it resolved that, pursuant to prior Commissioner Court action and applicable
law, the Commissioners Court of Ellis County hereby resolves and authorizes that effective
nn <.h'IVt~:r 1. ?.UU:~, F,Ilis County will only pay currant indigent or medicaid rates for ul! hcalthcarc
and drug:: provided m inmates who are in the custody c~1' f•:Ilis County and :rcretry ut,thorizes the
scndinb nr'wri[trn notice by thr. Director of Purchasing, to all healthcare providers and pht,rnractes
notityink; tncm that Ellis County will only pay currcrri indigent or medicaid rates for all healthcare
and dnrgs ;xov,dcd to inmates who arc in the custody of F.Ilis County

..y„ ~ ,w
Sep 1Z U6 48:47a I H S 936.756.6741
Apprnvctl 13y:
I`!;i~ {'aunty ('ununis.iancr; ('Hurt un Au~trsl I I lit, ?Qty)
--l lonora}•Ir; (:1 ,u 4dams
Lillis 'run. • Jt.dgc
('ununititiirntcr tlallr~ .Luc hobmu>n
I'rcc; nc r .!
l'uuun~s.4m4r•lau.kir Mi;lcr, tir --
I'rQ~ un l 113
A n r.C
<'incty Pa11cy
('uanty Clerk
~`
('corn ssuater L,urY lone.
Commrssionrr R.~n Brown
Prcxinct 114
p.4
rG.rr.z~» z
ORDER N0.29660
REVIEW STATUS OF INDIGENT HEALTH CARE POLICY
PROVISIONS
Came to be heard this the 8th day of May, 2006, with a motion made by
Commissioner Letz seconded by Commissioner Williams. The Court
unanimously approved by vote of 4-0-0 to:
Adopt the four outlined suggestions as follows:
1. If an applicant to the IHCP does not appear for apre-scheduled
appointment, or call ahead of the appointment time to re-schedule, that
applicant may not re-apply to the IHCP for a period of six (6} months from
date of the missed appointment.
2. If an IHCP client does not respond to the written request for
review, or fails to provide requested information to complete review within
the designated time frame, helshe may not reapply for a period of six (6)
months from the date set for review.
3. If an applicant or client gives false information to IHCP, helshe
may not re-apply for a period of one (1) year from time the false information
was identified.
4. If an IHCP client fails to report a change within 14 days of the
change, and that change affects their eligibility, he/she may not reapply for a
period of one (1) year from date the change was identified by IHCP.
), i
COMMISSIONERS' COURT AGENDA REQUEST
a~6bv
PLEASE FURNISH ONE ORIGINAL AND TEN COPIES OF THIS
MADE BY: Pat Tinley
MEETING DATE: May 8, 2006
OFFICE: County Judge
TIME PREFERRED: 9:00 a.m.
SUBJECT: Status of the Kerr County Indigent HealthCaze Program; Consider, discuss
and take appropriate action to modify or revise Kerr County Indigent Health Care Policy
provisions.
EXECUTIVE SESSION REQUESTED: (PLEASE STATE REASON)
NAME OF PERSON ADDRESSING THE COURT: County Judge/Beth Taylor
ESTIMATED LENGTH OF PRESENTATION:
IF PERSONNEL MATTER -NAME OF EMPLOYEE:
Time for submitting this request for Court to assure that the matter is posted in
accordance with Title 5, Chapter 551 and 552, Government Code, is as follows:
Meeting scheduled for Mondays: 5:00 P.M. previous Tuesday.
THIS REQUEST RECEIVED BY:
THIS REQUEST RECEIVED ON: @
All Agenda Requests will be screened by the County 3udge's Office to determine if adequate
information has been prepared for the Court's formal consideration and action at time of Court
Meetings. Your cooperation will be appreciated and contribute towards your request being
addressed at the earliest opportunity. See Agenda Request Rules Adopted by Commissioners'
Court.
Ta Jcrdge Tinley and the Kerr Caen ~~ Commissioners Court.-
To my knowledge, Ure Kerr County ~ HCP currently has rh7 estabiis.aerl pn/ay regarrlin9
problematic /sscnes that mme upon .a fairly constant frosts When I offender/ the !NC training
'~irrr in Austin at the end aflanuary, I was told that each county cr~u/o initiate,c~/kres re+9arding
issues oat addressed in the CounlylffC Harrdbaek
Plc~se be aware D7at in each of the sc~reanros below, dte IftC Hanrl6ook states that bhe
d~r'apX.yicant is IneliQit~te arrd a Fz~r-.m 117IS Issued, whrch is atone. Bux by (raving these
'p~ena/thes"in place, I think lrie amount of~perHbnfr generated will be rzdrueed, as well as
rneate tfae atmosa+rere that ~ IHCP is a 'YrQht/y run ship"and everything Invol-~d with
determin/ng and ma/ntain/rrq a/lgibi7it;~ should be taken serfousty.
It seems there !squill an ac[yve revoy~ving dour here, and I rvrxrkl like lv reduce the cast
load (and thus doe ex~xfitures) and help make thisstate-mandatrd dram run move
srncathi)r and ur>a~ qunhgr
Please aodvlse.
Beth Taylor, Caorr/inatnr
Ken- County IHCP
9-18-06
~ucr<aaested I~~rr Caun I CP Policies s A i r
t~raarom Han~,agg~
1. If an applicant to ~ he IHCP does oar appear for apre-scheduled appointment, or caU to
ahead of the appoint:;ient time to re-SCftedufe, that applicant may not n°-apply to the ICHP
for a period of six {S) months from date of the missed appointment.
~. If an IHCP Client dfres not respond to the written request for review, or fails to provide
requested information to complete review within the de~,iQnated time frame, he/she may not
reapply for a period of six (6) months from the date set for review.
3. If an applicant or client gives false inf>ormaton to INC. he/she may rwt re-apply for a
period of one (1) year from tirrte the false information was identified.
4. If an IHCP client faits to report a change within 14 da,~s of the d~ange, and that change
affects their eligibility, he/she may riot reapply for d period of one (1) year from date the
change was identified by iEHC.
A~~n,~i suaaestions 1For Kerr County IHCP
2. Need a plan for appeal (l.e., who will review application and denial
-7when applicant appeals a decision made by IHC Coordinator)
7. Create anon-cumkiersome pnxess by which the IHC office can
obtain information From the Tax Assessor's office regarding
vehicles registered Lo an IHC applicant. (i.e., create a form that
could be faxed on a weekly basis)
3. possibility to purchase software to create a picture IHC ID card?
Set a small fee for replacements?
4. Possibility of designating discretionary funds to check online, etc
for background info or: some applicants
5. Possibility of designating funds to cover travel expense to
applicant's home for int~°rview only when ae~aessary M
detiCrmine eliyibi/ity.
OTHER IDENTIFIED C.ONCERlVS
• IHC c~ients who con,istently use the 1=R as a physician