1100 Handbook Purpose and Contact Information

Revision 23-4; Effective Sept. 22, 2023

The purpose of the County Indigent Health Care Program (CIHCP) Handbook is to:

  • establish the eligibility standards and application, documentation and verification procedures for counties;
  • define basic and department established optional health care services;
  • establish the payment standards for basic and department established optional health care services; and
  • outline the procedures for administering the state assistance fund.

Contact Information

Mailing Address

County Indigent Health Care Program

North Austin Complex, Mail Code 0224

4601 W. Guadalupe Street, Suite #4.507

Austin, TX 78751-2920

Phone: 512-438-2350

Fax number: 512-776-7417

Email: CIHCP@hhs.texas.gov

Website: https://hhs.texas.gov/services/health/county-indigent-health-care-program

 

1110 Rules

Revision 22-1; Effective April 8, 2022

The Texas Administrative Code (TAC) is the compilation of all state agency rules in Texas.

The County Indigent Health Care Program (CIHCP) rules are in TAC, Title 26 (Health Services), Part 1 (HHSC), Chapter 363 (CIHCP), and the following Subchapters:

  • Program Administration
  • Determining Eligibility
  • Providing Services

The CIHCP rules may be accessed at https://texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=4&ti=26&pt=1&ch=363.

 

1120 Health and Safety Code

Revision 20-0; Effective November 2019

A law was passed by the First Called Special Session of the 69th Texas Legislature in 1985 that:

  • Defines who is indigent;
  • Assigns responsibilities for indigent health care;
  • Identifies health care services eligible people can receive; and
  • Establishes a state assistance fund to match expenditures for counties that exceed certain spending levels and meet state requirements.

Chapter 61, Health and Safety Code, is intended to ensure that needy Texas residents, who do not qualify for other state or federal health care assistance programs, receive health care services.

Chapter 61, Health and Safety Code, may be accessed at: https://statutes.capitol.texas.gov/Docs/HS/htm/HS.61.htm.

 

1130 County Responsibility

Revision 23-4; Effective Sept. 22, 2023

A county not fully served by a public facility must:

  • administer a County Indigent Health Care Program;
  • provide basic health care services to eligible county residents who do not live in a county area served by a public facility;
  • follow either the policies and procedures described in this handbook or less restrictive policies and procedures;
  • establish procedures for administrative hearings that provide for appropriate due process, including procedures for appeals requested by households that are denied;
  • adopt reasonable procedures for:
    • minimizing the opportunity for fraud;
    • establishing and maintaining methods for detecting and identifying situations in which a question of fraud may exist, and
    • administrative hearings to be conducted on disqualifying persons in cases where fraud appears to exist; and
  • 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.

Public Notice. Not later than the beginning of the state fiscal year (Sept. 1), a county not covered by a public facility 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 make reasonable effort to notify the public of the application procedure.

Maintaining Program Information on 2-1-1

Programs must maintain current and correct program information on 211Texas.org for all locations providing services. Program coordinators or administrators will use the Add or Edit Your 2-1-1 Listing link found at the top of the webpage to make any changes to their program location information listing. The information that the program coordinator or administrator shall maintain in their 2-1-1 listing includes, but is not limited to, program phone number, location, hours and services provided.

1140 Public Hospital and Hospital District

Revision 20-0; Effective November 2019

Public Notice. 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.

 

1150 Options

Revision 23-4; Effective Sept. 22, 2023

A county not fully served by a public facility may file for Texas Medicaid reimbursement through the local provider or through Texas Health and Human Services Commission (HHSC) for eligible Supplemental Security Income (SSI) appellant CIHCP recipients who become eligible for retroactive Medicaid. For instructions regarding the filing process through HHSC, request the CIHCP Medicaid Reimbursement Manual.

An entity that chooses to establish an optional work registration procedure may contact its local Texas Workforce Commission (TWC) office to determine how to establish the county’s procedure and to negotiate what type of information can be provided. In addition, a county must follow the guidelines below.

  1. Notify all eligible residents and those with pending applications of the program requirements at least 30 days before the program begins.
  2. Allow an exemption from work registration if applicants or eligible residents meet one of the following criteria:
    • receive SNAP benefits;
    • receive unemployment insurance benefits or have applied but not yet been notified of eligibility;
    • physically or mentally unfit for employment;
    • undocumented alien;
    • distance prohibits walking or transportation is not available;
    • commuting time (not including taking a child to and from a child care facility) is greater than two hours a day;
    • age 15 or younger;
    • age 16 or 17 and not the head of household;
    • age 16, 17 or 18 and attending school, including home school, or on an employment training program on at least a half-time basis;
    • age 60 or older;
    • parent or other household member who personally provides care for a child under age 6 or a disabled person of any age living with the household;
    • employed or self-employed at least 30 hours per week;
    • receive earnings equal to 30 hours per week multiplied by the federal minimum wage;
    • migrant in the mainstream;
    • a regular participant or outpatient in a drug addiction or alcoholic treatment and rehabilitation program; or
    • three to nine months pregnant.
  3. If a nonexempt applicant or CIHCP eligible resident fails without good cause to comply with work registration requirements, disqualify them from CIHCP benefits as follows:
    • for one month or until they agree to comply, whichever is later, for the first noncompliance;
    • for three consecutive months or until they agree to comply, whichever is later, for the second noncompliance; or
    • for six consecutive months or until they agree to comply, whichever is later, for the third or subsequent noncompliance.