A-130, Interview Procedures

A—131 Interviews

Revision 21-4; Effective October 1, 2021

TANF, SNAP, TP 08 and TA 31

Conducting Interviews for Applications and Redeterminations

Conduct the interview with the applicant or the applicant's spouse (if the spouse is a member of the household) to determine eligibility.

Exceptions:

  • A household may designate an authorized representative (AR), who must also sign the application.
  • For SNAP, another responsible household member may also be interviewed.
  • For SNAP-SSI redeterminations conducted by Centralized Benefit Services (CBS), no interview is required unless:
    • the household requests an interview;
    • the case contains earned income; or
    • it appears the household is going to be denied.

Note: The spouse or other responsible household member for a SNAP interview does not have to sign the application to be interviewed. Staff must not exempt the household from any program or verification requirements due to interviewing an AR or conducting a phone interview.

Related Policy

Authorized Representatives, A-170
SNAP Programs, B-474.1.1

SNAP and TANF

Conduct a phone interview for all households who provide a phone number. This includes households with a member disqualified for an intentional program violation (IPV) unless the household requests a face-to-face interview.

TP 08 and TA 31

Applicants and recipients must complete a phone interview unless the person requests a face-to-face interview. Applicants and recipients cannot be required to complete a face-to-face interview.

TP 33, TP 34, TP 35, TP 43, TP 44 and TP 48

No interview is required to apply for or renew Children's Medicaid. Schedule an interview only if the person requests an interview.

When a family contacts HHSC to request an application for Children's Medicaid, offer the option to start the application process by phone. The family can complete the application process by phone, but they must provide or return a signed Form H1205, Texas Streamlined Application, with any other required verification to complete the process.

Exceptions:

  • If the applicant was previously denied for failure to provide Form H1024, Subject: Self-Declaration Notice, or for missing an appointment related to Health Care Orientation (HCO) or Texas Health Steps, schedule a face-to-face appointment. Deliver the HCO or remind the person about the importance of the Texas Health Steps checkup at that time. 
  • Conduct a face-to-face interview for an initial application or renewal when HHSC receives conflicting information related to household composition, income or resources that affects eligibility and cannot verify the information through other means, such as an associated case.

Related Policy

Scheduling Appointments, A-122.2
General Reminders, A-1510
Compliance Requirements, A-1531.5
Processing Children's Medicaid Redeterminations, B-123

TP 40 and TP 36

Interviews are not required at application for TP 40 or TP 36. Schedule an interview only if the household requests an interview.

Provide continuous coverage for a pregnant woman without Form H1205 or Form H1010, Texas Works Application for Assistance - Your Texas Benefits, or an interview if she meets the criteria for continuous Medicaid coverage.

Related Policy

Continuous Medicaid Coverage, A-832 

Additional Policy Related to Phone Interviews

If the office initially schedules a phone interview and the person subsequently requests a face-to-face interview before the phone interview appointment time, staff must allow the household to receive a face-to-face interview and must not treat it as a missed appointment.

Staff must ensure that an interpreter or translation service is available if the applicant or recipient indicates the need for such services on an application.

When conducting a phone interview, staff must offer the applicant reasonable assistance in obtaining any required verification.

Staff must indicate in TIERS, in the Voter Registration Information section of the Individual Demographics - Citizen page, to mail Form H0025, HHSC Application for Voter Registration, to applicants who are interviewed by phone, if a voter registration application is requested. If "Yes" is selected in the dropdown, TIERS automatically mails Form H0025 to the household.

If the person declines to register to vote, staff must mail Form H1350, Opportunity to Register to Vote, and ask the person to sign and return the form. Staff must also indicate in TIERS, in the Voter Registration Information section of the Individual Demographics - Citizen page, that the person declined, and document that Form H1350 was mailed to the person.

Related Policy

Joint TANF-SNAP Applications, A-160
Registering to Vote, A-1521
Missed Appointment, B-114
Processing Redeterminations, B-122
Advisor Responsibility for Verifying Information, C-932

TP 45 Retroactive Coverage

Provide retroactive TP 45 coverage for the newborn child without Form H1205 or Form H1010 or an interview with the child's mother if the household meets the criteria for TP 45 retroactive coverage.

Related Policy

TP 45 Retroactive Coverage, A-833 

A—131.1 Home Visits

Revision 15-4; Effective October 1, 2015

All Programs

Advisors must provide notice to the household before making any home visit. Application and redetermination interviews must be scheduled in writing. Notification of other home visits may be:

  • verbal,
  • given or mailed to the individual, or
  • by telephone contact with a responsible household member.

The notification should include the time (at least whether morning or afternoon) and date of the visit. Advisors should route the notification for imaging to add to the electronic case record or document the specific information in TIERS Case Comments. If regions have specialized staff that conduct home visits, the documentation may be maintained in a separate location as long as it is accessible if needed.

Home visits to collateral sources do not have to be scheduled in advance.

No one should be denied for refusing to agree to a home visit unless there is no other sufficient and reliable verification available.

Related Policy

Advisor Responsibility for Verifying Information, C932

A—131.2 Requirement to Provide Interpreter or Translation Service

Revision 15-4; Effective October 1, 2015

All Programs

HHSC is required to provide interpreter and translation (written or verbal) services to applicants and recipients with Limited English Proficiency (LEP). Consider an individual with LEP even if they do not request an interpreter on the application if the individual indicates they would like to speak a language other than English during the interview. HHSC is also required to provide an effective method to communicate with applicants and recipients who indicate they are deaf or hearing impaired. Applicants and recipients may indicate on an application or during an interview that they need interpreter services.

A—131.2.1 Availability of Interpreters/Translation Services

Revision 17-4; Effective October 1, 2017

All Programs

Local offices must set up procedures to ensure that interpreters and translators are available for applicants or recipients who indicate the need for such services on an application.

To meet the requirement for applicants and recipients who indicate they are Limited English Proficiency (LEP), offices can use:

  • Bilingual advisors – when it is reasonably possible to do so, schedule LEP applicant/recipient interviews with bilingual advisors.
  • Bilingual clerical staff – use bilingual clerical staff as interpreters whenever possible.
  • Local community interpreter providers.

Advisors use the following methods for interpretation only after exhausting all local and regional resources:

  • Language Line Services – This service is available to all regions. Staff can access the service by calling 1-800-375-1184 and using their 11-digit employee identification number.
  • Applicants/recipients may provide their own interpreter (only if they wish to do so). Note: Advisors may use minors, age 15 or older, as interpreters only at the individual's request and when the minor accompanies the individual to the interview. Advisors must not use a minor under age 15 as an interpreter.

To meet this requirement for applicants and recipients who indicate they are deaf or hearing impaired, offices can:

  • Schedule a telephone interview if the applicant indicates the contact phone on the application is a TDD/TTY line, unless the applicant requests a face-to-face interview. Note: Relay Texas can be reached at these numbers:
    • 7-1-1, 1-800-RELAYTX (1-800-735-2989), Spanish to English (Spanish speaking callers to English speaking HHSC staff) at 1-888-777-5861;
    • and Spanish to Spanish at 1-800-662-4954.
  • If unable to reach the applicant by phone, advisors must schedule a face-to-face interview and arrange for interpreter services at the interview location.

Note: In situations where an interpreter services vendor is not available, staff may use handwritten notes back and forth with the hearing-impaired individual as long as the notes are an effective means of communication with the individual.

A—131.2.2 Availability of Translated Written Material

Revision 15-4; Effective October 1, 2015

All Programs

Staff must inform applicants/recipients about the availability of translation (written or verbal) services regarding written materials HHSC sends to them by following the two processes below, when applicable.

When staff verbally communicate with LEP applicants/recipients at application, redetermination (including desk reviews) and change actions, staff  must ensure that applicants/recipients understand the eligibility action (Form H1020, Request for Information or Action, and Form TF0001, Notice of Case Action) being taken and the requirements for the  application process (including any missing information being requested). Providing a verbal explanation to all LEP applicants/recipients in their preferred language regarding the eligibility action being taken and/or missing information being requested meets this requirement.

Note: This requirement is not applicable for desk reviews and change actions when staff process the case action without talking with the applicants/recipients.

The Vietnamese Translation Interpreter Form is automatically attached to applicable eligibility notices when clients select Vietnamese as their primary household language.

A—131.3 Interview Requirements

Revision 15-4; Effective October 1, 2015

All Programs

During the interview, the interviewer must:

  • protect the applicant's confidentiality and conduct the interview as a confidential discussion of household circumstances;
  • review the application and resolve unclear and incomplete information with the household;
  • advise the household of their rights and responsibilities, including the right to appeal;
  • advise the household of the application processing time frames;
  • advise the household of their responsibility to report changes;
  • ensure that the address on TIERS reflects the individual's current address; and
  • explain the various policies, rights, and responsibilities as required in A-1500, Reminders.

Advisors must take the following actions and provide the following referrals and information during the interview:

  • Verify that the household agrees that the information is complete and correct on the application form and in the case documentation for household composition, income, and expenses;
  • Verify that the income and expense information obtained for past periods (including self-employment) accurately reflect the amounts that can be anticipated for future income and expenses, according to policy in A-1355, How to Project Income. If the information is inaccurate, the advisor must determine why it is inaccurate;
  • Determine whether households with questionable or negative management, as described in A-1710, General Policy, are able to explain how the household's bills are paid;
  • Determine whether households with other discrepancies in information that could affect eligibility are able to provide information to resolve those discrepancies;
  • Determine whether there is a reason for households who have not provided all verification requested on Form H1020, Request for Information or Action, beyond the household's control that prevents the household from providing verifications. If the advisor designates a collateral source, the advisor should accept the individual statement or use other forms of verification for the missing verifications as required by policy in A-1370, Verification Requirements;
  • Determine whether income verification may be calculated based on year-to-date information from other paychecks provided by the household when income verification is missing for a particular pay period(s), rather than requesting it on Form H1020; and
  • Refer the household to other state or local resources for types of assistance the household requested on the application form, such as child care, child support, utilities, or rent, that are provided by other agencies.

TANF

  • Determine whether any adult household member has received TANF cash assistance from another state since October 1999. Refer to A-1920, Determining the Number of FTL Months Used.
  • Determine whether any member of the household has been disqualified in another state for a felony or drug conviction.
  • Determine whether any member of the household has been disqualified from participating in TANF for an intentional program violation (IPV) in another state. See B942, Disqualifying a Household Member with a Current TANF Out-of-State IPV Disqualification, for policy regarding the IPV information the advisor must gather from the other state.
  • Determine whether applicants must provide information on parent(s) living outside of the home to meet child and medical support requirements, or if applicants meet a good cause exemption, as explained in A-1130, Explanation of Good Cause.

SNAP

  • Determine whether households qualifying for the standard medical expense want to claim actual expenses according to the policy in A-1428.3, Budgeting Options;
  • Determine whether the household wants to prorate an expense or income according to policy in A-1428.3; A-1355.1, Budgeting Options for SNAP Households; and A-1358, How to Budget Expenses;
  • Determine whether any household member claims an exemption to Employment and Training (E&T) work requirements;
  • Provide reminders, including the household's change reporting requirement, regarding E&T requirements, able-bodied adult without dependents (ABAWD) time limit policy (if there is an ABAWD in the household), and how the household can obtain and use SNAP benefits issued via EBT;
  • Determine whether an ABAWD received any countable months of benefits in another state; and
  • Determine whether any member of the household has been disqualified from participating in SNAP for an IPV or a felony drug conviction in another state. Note: Data Broker displays current out-of-state IPV disqualification data.

Medical Programs

Determine whether applicants experiencing family violence are exempt from providing information about a member of their MAGI household composition because they fear physical or emotional harm by that person, as explained in A-241.4, Family Violence Exemption.

TP 08

Determine whether applicants must provide information on parent(s) living outside of the home to meet medical support requirements, or if applicants meet a good cause exemption, as explained in A-1130, Explanation of Good Cause.

A—132 Eligibility Factors

Revision 15-4; Effective October 1, 2015

All Programs

  TANF SNAP Medical Programs
Household Composition X X All Medical Programs*
Citizenship X X All Medical Programs*
Social Security number X X TPs 08, 40, 43, 44, 48, 56
Age X - TP 08, TA 31, TPs 32, 33, 34, 35, 43, 44, 45, 48, 56
Relationship X - TP 08, TA 31, TPs 32, 33, 34, 35, 43, 44, 45, 48, 56
Identity X X All Medical Programs except TA 31, TP 32, TP 33, TP 34, TP 35 and TP 36*
Residence X X All Medical Programs*
Third-Party Resources X - All Medical Programs*
Domicile X - TP 08, TA 31
Deprivation X -  
Resources X X TP 56 (children) or TP 32 (children)
Income/Deductions/Budgeting X X All Medical Programs*
School attendance X - TP 08
Work registration X X  
Management X X TP 08, TA 31
Responsibility Agreement X -  

* TP 08, TA 31, TPs 32, 33, 34, 35, 36, 40, 43, 44, 45, 48 and 56.

Note: For medical programs, the eligibility factors noted above do not necessarily apply in all cases.

A—132.1 Medical Programs Hierarchy

Revision 19-4; Effective October 1, 2019

Medical Programs

Texas Works Medical Programs Hierarchy
Step Eligible Persons With Income Type Program Code Type Program
1 People ages 18 through 25 who have aged out of foster care in Texas and were enrolled in Medicaid on their 18th birthday Not Applicable TP 82 MA Former Foster Care Children (FFCC)
2 People ages 18 through 20 who have aged out of foster care and:
  • are not eligible for FFCC (were not receiving federally funded Medicaid when they aged out of foster care); or
  • who aged out of foster care at age 18 or older, currently reside in Texas, and have had an Interstate Compact on the Placement of Children (ICPC) agreement
At or below program FPL TP 70 MA Medicaid for Transitioning Foster Care Youth (MTFCY)
3 Pregnant Women At or below program FPL TP 40 MA Pregnant Women
4 Pregnant women who are nonimmigrants, undocumented aliens and certain legal permanent residents who have emergency medical conditions and who, except for alien status, would be Medicaid-eligible At or below TP 40 FPL TP 36 MA Pregnant Women - Emergency
5 Newborn children of Medicaid-eligible mothers up to age 1, including mothers receiving TP 36 for the delivery Not Applicable TP 45 MA Newborn Children (Deemed)
6 Children under age 1 At or below program FPL TP 43 MA Children Under Age One
7 Children ages 1 through 5 At or below program FPL TP 48 MA Children 1–5
8 Children ages 6 through 18 At or below program FPL TP 44 MA Children 6–18
9 Children ages 1 through 5 who are nonimmigrants, undocumented aliens and certain legal permanent residents who have emergency medical conditions and who, except for alien status, would be Medicaid-eligible At or below TP 48 FPL TP 33 MA Children 1–5 - Emergency
10 Children ages 6 through 18 who are nonimmigrants, undocumented aliens and certain legal permanent residents who have emergency medical conditions and who, except for alien status, would be Medicaid-eligible At or below TP 44 FPL TP 34 MA Children 6–18 - Emergency
11 Children under age 1 who are nonimmigrants, undocumented aliens and certain legal permanent residents who have emergency medical conditions and who, except for alien status, would be Medicaid-eligible At or below TP 43 FPL TP 35 MA Children Under Age One - Emergency
12 A parent or caretaker relative caring for a dependent child under age 18 or who meets school attendance requirements who receives Medicaid At or below program FPL TP 08 MA Parents and Caretaker Relatives Medicaid
13 Nonimmigrants, undocumented aliens and certain legal permanent residents who have emergency medical conditions and who, except for alien status, would be Medicaid-eligible as a parent or caretaker relative of a Medicaid-eligible child At or below TP 08 FPL TA 31 MA Parents and Caretaker Relatives - Emergency
14 Parents, caretaker relatives and children receiving Medicaid who receive denial due to new or increase in earnings Above the limits for TP 08 TP 07 MA Earnings Transitional
15 Parents, caretaker relatives and children receiving Medicaid who receive denial due to new or increase in spousal support income Above the limits for TP 08 TP 20 MA Child Support Transitional
16 Uninsured women ages 18 through 64 diagnosed with breast or cervical cancer and presumed eligible for Medicaid for Breast and Cervical Cancer (MBCC) Not Applicable TA 66 MA MBCC Presumptive
17 Uninsured women ages 18 through 64 diagnosed with breast or cervical cancer Not Applicable TA 67 MA MBCC
18 Children under age 19 and pregnant women Above the limits for TPs 40, 43, 44, and 48 FPL TP 56 MA Medically Needy with Spend Down
19 Nonimmigrants, undocumented aliens and certain legal permanent residents who have emergency medical conditions and who, except for alien status, would be Medicaid-eligible as a pregnant woman or child under age 19 Above the limits for TPs 40, 44, or 48 FPL and at or below program limit  TP 32 MA Medically Needy with Spend Down - Emergency
20 Children under age 19 ineligible for Medicaid due to income Above the limits for TPs 43, 48, or 44 FPL, and at or below program limit  TA 84 CI CHIP
21 Unborn children whose mother is ineligible for Medicaid or CHIP due to income or immigration status Above the limits for TPs 40 and 36, and at or below program limit  TA 85 CI CHIP - Perinatal
22 Former foster care youth ages 21 through 22 attending school of higher education who:
  • are not eligible for FFCC; or
  • who aged out of foster care at age 18 or older, currently reside in Texas, and have had an ICPC agreement.
At or below program FPL TA 77 Health Care Benefits Health Care - FFCHE
23 Children under age 1 presumed to be eligible for Medicaid as determined by a Qualified Hospital (QH) At or below TP 43 FPL TA 74 MA Children Under Age One - Presumptive
24 Children ages 1 through 5 presumed to be eligible for Medicaid as determined by a QH At or below TP 44 FPL TA 75 MA Children 1–5 - Presumptive
25 Children ages 6 through 18 presumed to be eligible for Medicaid as determined by a QH At or below TP 48 FPL TA 76 MA Children 6–18 - Presumptive
26 Parents and caretaker relatives presumed to be eligible for TP 08 by a QH  At or below TP 08 FPL TA 86 MA Parents and Caretaker Relatives - Presumptive
27 Former Foster Care Children presumed to be eligible for Medicaid by a QH Not Applicable TA 83 MA FFCC - Presumptive
28 Healthy Texas Women At or below program   FPL TA 41 MA Healthy Texas Women
29 Pregnant women presumed to be eligible for TP 40 by a QH or Qualified Entity (QE) At or below TP 40 FPL TP 42   Pregnant Women - Presumptive

Notes:

  • If the pregnant woman or child under age 19 indicates unpaid medical expenses for any of the three months prior to application month or for the application month, determine eligibility under the following programs:
    • TP 56, Medically Needy with Spend Down, for pregnant women and children under age 19 who are ineligible for Medicaid because of income.
    • TP 32 Medically Needy with Spend Down - Emergency, for pregnant women and children under age 19 who are ineligible for Medicaid because of income and alien status.
  • Children ages 0 thru 18 who are ineligible for medical programs because of income are tested for CHIP.

Related Policy

Income Limits, C-131
Qualified Hospital/Qualified Entity Procedures for Presumptive Eligibility Determinations, C-1113
Guidelines for Providing Retroactive Coverage for Children and Medical Programs, C-1114
Type Programs (TP) and Type Assistance (TA), C-1150
Former Foster Care in Higher Education (FFCHE), Part F
Medicaid for Transitioning Foster Care Youth (MTFCY), Part M
Medicaid for Breast and Cervical Cancer (MBCC), Part X
Healthy Texas Women, Part W

A—132.2 Guidelines for Pregnant Women

Revision 15-4; Effective October 1, 2015

See A-240, Medical Programs.

A—133 Rights and Responsibilities

Revision 15-4; Effective October 1, 2015

All Programs except TP 33, TP 34, TP 35, TP 43, TP 44, TP 45 and TP 48

Before completing the interview, advisors must ensure that the applicant:

  • provides all of the information requested on the application;
  • reports any changes that occurred since filling the application; and
  • reads and understands the individual's rights and responsibilities as explained on the application.

TANF and TP 08

Advisors must also ensure that:

  • the applicant reads and understands the rights and responsibilities of the child support program explained on Form H1712, Explanation of Child/Medical Support, Family Violence and Good Cause;
  • TANF applicants read and understand Form H2580, TANF Employment Services Notice, and receive a copy of the form; and
  • TANF applicants read, understand and sign Form H1073, Personal Responsibility Agreement.

SNAP

Advisors must provide the applicant with Form H1805, SNAP Food Benefits: Your Rights and Program Rules.

TP 33, TP 34, TP 35, TP 43, TP 44 and TP 48

Before completing the interview, if requested, ensure the applicant:

  • completes all sections of the application; and
  • reads and understands an individual's and responsibilities as explained on Form H1010, Texas Works Application for Assistance — Your Texas Benefits, and Form H1205, Texas Streamlined Application.

A—134 Documentation Guidelines

Revision 13-2; Effective April 1, 2013

A complete list of documentation requirements for determining eligibility can be found at the conclusion of each eligibility section within the Texas Works Handbook. TIERS Data Collection pages handle a vast majority of the required documentation for case records. For the remaining small percentage of documentation still required by policy, staff must include the information in TIERS Case Comments. For documentation that is not captured within the Data Collection pages, a comprehensive guide, The Texas Works Documentation Guide, has been developed. This documentation guide outlines the requirements for documentation that must be entered in TIERS Case Comments.

A—135 Pending Information

Revision 15-4; Effective October 1, 2015

All Programs except TP 40

If the applicant cannot furnish all required proof during the interview or with the application, advisors must allow the household at least 10 days to provide the information. The due date must be a workday. Advisors must determine what sources of proof are readily available to the household and request that information first as sufficient proof. B-115, Pending Verification on Applications, includes more information on verification procedures.

Advisors must provide the applicant Form H1020, Request for Information or Action, explaining:

  • what is needed,
  • the due date for receipt of the information, and
  • the date the advisor
  •  must deny the application if the advisor does not receive the information.

Advisors should attach to Form H1020 the page of Form H1020-A, Sources of Proof, that corresponds to the verification requested.

Medical Programs

The advisor must not request additional verification if verification is available through electronic data sources.

TP 40

Advisors should not allow 10 days for the applicant to provide verification if doing so exceeds the 15-workday processing time frame and verification can be postponed.

A—136 Eligibility Decision and Privacy Notice

Revision 22-1; Effective January 1, 2022

All Programs

After obtaining all required proof, dispose of the application and provide the applicant Form TF0001, Notice of Case Action, detailing the decision.

Medical Programs

HIPAA requires HHSC to provide a notice of privacy practices that explains:

  • the person's privacy rights;
  • the duties of HHSC to protect the person's health information; and
  • how HHSC may use or disclose the person's health information without an authorization. For example, HHSC may share health information with the person's providers to arrange for services or with other government entities to report suspected abuse or neglect.

Provide Form 0401, Notice of Privacy Practices (English), or Form 0401S, Aviso de Normas Sobre la Privacidad (Spanish), as appropriate, to each household enrolled in a medical program.

Provide Form 0401 or Form 0401S with Form TF0001, Notice of Case Action, to each head of household:

  • at initial certification; and
  • at recertification after a break in services of more than 180 days.

Form 0403, Explanation to Health Information Privacy Rights, provides a reminder of privacy practices and where to find Form 0401.

Provide Form 0403 with Form TF0001 to each head of household:

  • at each recertification;
  • after a break in services of at least 30 days but not more than 180 days; and
  • when a new person is added to a case.

A—137 Prudent Person Principle

Revision 15-4; Effective October 1, 2015

All Programs

The policies and procedures included in the handbook are rules for determining eligibility. It is impossible to provide examples for all policy situations. When staff encounter rare and unusual situations, HHSC encourages them to use reason and apply good judgment in making eligibility decisions. The "prudent person" principle allows staff to make reasonable decisions based on the best available information using:

  • common sense,
  • program knowledge,
  • experience, and
  • expertise.

Staff should document the rationale used to make a decision and any applicable handbook references.