A-2130, Form H1073, Personal Responsibility Agreement
Revision 12-3; Effective July 1, 2012
TANF
Form H1073, Personal Responsibility Agreement, lists the recipient's and HHSC's responsibilities. A caretaker, second parent, payee, or disqualified adult must sign Form H1073 before being certified. This includes a minor parent applying as an adult. If a caretaker, second parent, payee, or disqualified adult is not present to sign the agreement during the interview, pend the EDG to obtain the required signature.
Explain Form H1073 responsibilities and penalties for noncooperation at each periodic review.
Once the caretaker or second parent signs Form H1073, they do not have to sign the form again unless they are:
- denied and reapply; or
- added to the EDG.
Note: A disqualified member (as listed in A-222 #4) who cooperates must sign Form H1073 before being added to the TANF EDG. See A-2132.2. A member ineligible for Medicaid because of a Choices or child support noncooperation is not required to sign Form H1073 to reinstate benefits if the cooperation is completed before the end of the second month of noncooperation.
A—2131 Processing the PRA at Application
Revision 12-3; Effective July 1, 2012
A—2131.1 Initial Application
Revision 12-3; Effective July 1, 2012
TANF
At initial application, the individual must:
- sign the PRA; and
- be informed of its requirements and full-family sanction for noncooperation.
Impose a PRA noncooperation if the individual fails to comply with child support, voluntary quit or school attendance requirements after signing Form H1073 but before certification. If the individual cures the noncooperation before the eligibility determination, do not impose the full-family sanction and do not record the penalty.
The month the advisor discovers the noncooperation is also the first month of noncooperation. The applicant must cooperate by the end of the second noncooperation month to avoid reapplying in pay for performance. The forfeit month is the first month the household is otherwise eligible to receive a benefit, including a prorated benefit.
If the individual cooperates by the end of the second noncooperation month, certify the household with a future effective month equal to the month after the forfeit month.
After initial certification, impose a penalty for any PRA noncooperation discovered at complete review or when processing another case action.
If the required member(s) fails or refuses to sign the PRA, deny the application.
Continue to process the application for Medical Programs for Families and Children.
A—2131.2 Applicants Who Previously Received TANF
Revision 12-3; Effective July 1, 2012
TANF
Do not require a member who previously signed Form H1073 to sign it again unless the EDG is denied and the individual reapplies. In this situation, the member must sign Form H1073 again or the application must be denied.
A—2131.2.1 Verifying Prior Cooperation Status at TANF Reapplication
Revision 19-3; Effective July 1, 2019
TANF
When a household reapplies for TANF in the last month the household receives TANF assistance, or the two months following, staff must verify the household was in cooperation with all PRA requirements in the last month the household received TANF cash assistance. If the household was not in cooperation with all PRA requirements in their last month of TANF eligibility, impose a full-family sanction for a minimum of one month or until cooperation, whichever is longer. The month staff discover the noncooperation is also the first month of noncooperation. The applicant must cooperate by the end of the second noncooperation month to avoid reapplying in pay for performance. The forfeit month is the first month the household is otherwise eligible to receive a benefit (including a prorated benefit). If the person cooperates by the end of the second noncooperation month, certify the household with a future effective month equal to the month after the forfeit month. If the household reapplies for TANF later than two months following the month the household last received TANF benefits, treat the household like an initial application.
Related Policy
Texas Health Steps Overdue Month at Application, A-2124.4
Initial Application, A-2131.1
A—2131.3 Imposing a Sanction on a New TANF Household When a Noncooperating Member Moves In
Revision 19-3; Effective July 1, 2019
TANF
When a noncooperating household member certified as an adult moves from an existing household into a new household that is not receiving TANF, but subsequently applies, determine which PRA requirement(s) the member did not cooperate with and use the following chart to determine what action to take.
| If the adult ... | then ... | Follow policy in ... |
|---|---|---|
| did not cooperate with Choices, child support or voluntary quit, | the new household is considered to be applying in pay for performance. | A-2151, Open Penalty at Reapplication in Pay for Performance. |
| did not cooperate with parenting skills and moves into a household that includes a child under age 5, | the new household is considered to be applying in pay for performance. | A-2151, Open Penalty at Reapplication in Pay for Performance. |
| did not cooperate with parenting skills and moves into a household that does not include a child under age 5, | treat the household as an initial application. | A-2131.1, Initial Application. |
| moves from an existing household with a child who is not meeting Texas Health Steps, immunization, school attendance, or parenting skills requirements, | the household is considered to be applying in pay for performance. | A-2151, Open Penalty at Reapplication in Pay for Performance. |
| did not cooperate with any other PRA requirement, | treat the household as an initial application. | A-2131.1, Initial Application. |
Note: If a noncooperating minor parent certified as a caretaker, second parent or disqualified person is not in compliance with school attendance and moves from an existing household into a new household, follow policy in A-2151, Open Penalty at Reapplication in Pay for Performance.
When a household member certified as a child moves from an existing household into a new household that currently is not receiving TANF, but subsequently applies and the child has an open PRA noncooperation for immunizations, Texas Health Steps or school attendance, do not impose a full-family sanction on the new household. Follow policy in A-2131.1, Initial Application.
If the noncooperating household member moves back into the original household, follow policy A-2132.5.
Related Policy
Open Penalty at Reapplication in Pay for Performance, A-2151.
A—2132 Processing Changes
Revision 12-3; Effective July 1, 2012
A—2132.1 Addition of a Caretaker or Second Parent at Incomplete Review
Revision 12-3; Effective July 1, 2012
TANF
Require the new member to sign Form H1073 within 10 days of the report date when adding a caretaker, second parent, payee or disqualified adult at incomplete review. If the new member refuses or fails to sign Form H1073, deny the EDG. Apply the full-family sanction policy if the member noncooperates with the PRA requirements after signing the PRA.
A—2132.2 Disqualification of a Caretaker or Second Parent
Revision 12-3; Effective July 1, 2012
TANF
If, after the PRA is signed, the caretaker is disqualified or both parents are disqualified in a two-parent household, inform the household of the payee/disqualified adult PRA requirements.
When the household consists of both the caretaker and second parent who have signed Form H1073 and only one parent is disqualified, the PRA requirements still apply to the household. When the disqualified member cooperates, the individual must sign Form H1073 before being added to the TANF EDG.
Note: This policy does not apply to members who are ineligible for Medicaid because of a noncooperation with PRA Choices or child support.
A—2132.3 Removing a Penalized Member During the First Noncooperation Month
Revision 12-3; Effective July 1, 2012
TANF
| If the household reports the move ... | then... |
|---|---|
| before the PRA noncooperation is imposed, | do not apply a full-family sanction to the household. Record the penalty for the noncooperating individual.* |
| after the PRA noncooperation is imposed and the advisor verifies the member moved out of the household before the second month, | apply a full-family sanction to the household for one forfeit month only. |
*Note: The noncooperation is recorded with the individual's information only. TIERS will not set a Non Cooperation One (NC1) month until the individual reapplies.
A—2132.4 Removing a Penalized Member During the Second Noncooperation Month
Revision 12-3; Effective July 1, 2012
TANF
Deny the TANF EDG if the penalized member failed to cooperate and moved out during the second noncooperation month or afterwards. The household must reapply for TANF.
If the household reapplies for TANF and a member of the applying household
- has an open PRA penalty, the household must demonstrate PRA cooperation for one month through pay for performance.
- does not have an open penalty, the household does not have to demonstrate cooperation.
A—2132.5 Adding a Penalized Member to a Household
Revision 12-3; Effective July 1, 2012
TANF
A household currently receiving TANF cannot receive a benefit for the new penalized member for the identified forfeit month(s). Pend the EDG to add the penalized member for 30 or 40* days after the change is reported to allow demonstrated cooperation.
| If the penalized member ... | then ... |
|---|---|
| demonstrates cooperation by the 30th or 40th day, | add the new member to the TANF EDG following current change policy, but no earlier than the month after the forfeit month(s). |
| fails to demonstrate cooperation by the 30th or 40th day, | Deny the EDG.** |
*Follow policy in A-2151, Open Penalty at Reapplication in Pay for Performance, to determine if the EDG should be pended for 30 or 40 days.
**TIERS will transfer sanction information on the individual to the new case/EDG from the old case/EDG so there will be no change to NC1, Non Cooperation 2 (NC2), Forfeit 1 or Forfeit 2.
Provide a separate Form H1020, Request for Information or Action, Request for Information or Action, if other eligibility verification is required. If all eligibility information is provided except PRA cooperation, add the new member to the SNAP or Medicaid EDG as appropriate.
Example: On May 3, the Smith household requests that Sarah, who is a new member of the household and currently penalized, be added to their EDG. The advisor sends form H1020 to the household informing them that Sarah has an open penalty and cannot be added until she cooperates with the PRA. If the household fails to provide verification of cooperation by June 2, the advisor sends Form TF0001, Notice of Case Action, to deny the TANF cash assistance. Take action on any associated Medicaid or SNAP EDGs following existing policy.
A—2132.6 Certified Children Who Age Out Before/After the Caretaker or Payee Fails to Cooperate with PRA Requirements
Revision 12-3; Effective July 1, 2012
TANF
Once a certified child ages out of the certified group, the caretaker or payee is not required to cooperate with the PRA requirements for that particular child even if timely action has not been taken to remove the child from the EDG.
| When a caretaker or payee receives a noncooperation for a certified child ... | then ... |
|---|---|
| and the certified child ages out before the noncooperation discovery month, | do not sanction the household. |
| and the certified child ages out during or after the noncooperation discovery month, | ensure the child is removed from the EDG and apply one forfeit month to the household. |
Notes:
- Process an overpayment referral if the child was not removed timely from the EDG.
- A child ages out in the month the child turns 18 or the month the child graduates if graduating before or during the month of the individual's 19th birthday.