5200, Steps for Applying

Revision 20-0; Effective November 2019


5210 Steps for Applying for State Assistance Funds

Revision 23-4; Effective Sept. 22, 2023

Step 1 – Submit Form 3072, Monthly Financial Report, to be received by the HHSC County Indigent Health Care Program (CIHCP) by the 10th day of the month following the report month. Form 3072 must have been submitted for each of the 12 months prior to the month state assistance funds are requested. Submit Form 3086, End of Year Report, to HHSC CIHCP in Austin by Sept. 30.

Step 2 – Submit the county’s General Revenue Tax Levy (GRTL) to the Texas State Comptroller of Public Accounts.

Step 3 – Notify HHSC CIHCP by email within seven days after the date that the county will expend 6% of its General Revenue Tax Levy (GRTL) and follow up with a written notification.

6% Program Review. Upon receiving written notification that a county has expended 6% of its General Revenue Tax Levy (GRTL), HHSC may complete a review of the county's eligibility system and billing and provide the county with a written report on the findings of the review. If inadequacies are identified, the county must correct them within five workdays from the date the inadequacies are identified. The county must subtract any uncorrectable inadequacies from reimbursable expenditures.

Step 4 – Request state assistance funds when the county exceeds the 8% General Revenue Tax Levy (GRTL) expenditure level. Calculate the dollar amount that will be paid when the court authorizes payment. Request 90% of that amount from HHSC.

Contact HHSC by telephone or email to request state assistance funds prior to the Commissioner’s Court authorizing payment of the health care claims. HHSC will provide the county with a State Assistance Request number. Complete and submit to HHSC Form 3088, Request for State Assistance Funds (90 Percent), and supporting documentation within 30 days after the request.