4200, Client Eligibility Screening Process

Revision 24-1; Effective Jan. 8, 2024

For a person to receive epilepsy services with HHSC funds, four criteria must be met:

  • diagnosis of epilepsy certified by a licensed physician, or a statement that the applicant is suspected of having epilepsy;
  • gross household income is at or below 200% of Federal Poverty Level (FPL);
  • applicant is a Texas resident; and
  • applicant is not eligible for other programs or benefits providing the same services, such as Medicaid, Medicare or Children with Special Health Care Needs (CSHCN).

If a person is under 21 and on a waiting list for CSHCN, they can receive epilepsy services until removed from the waiting list. If an applicant meets all eligibility requirements except for the financial criteria, the applicant is eligible only for support services.

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

Instead of a client’s signature on the application in the Acknowledgment section of the Application for Program Benefits or on the Statement of Applicant’s Rights and Responsibilities (PDF), the eligibility staff person must read the statements to the applicant and document that the applicant affirms the statements. The documentation must include the date and time of the applicant affirmation and the eligibility staff person’s signature. The client must sign the document at their next visit to the clinic.