Revision 15-4; Effective October 1, 2015
TANF and Medical Programs
Advisors must not deny assistance because a household member or payee is temporarily out of the home if all of the following conditions are met:
- The person is out of the home due to:
- temporary separation from other family members, and the family has no regular place of residence;
- hospitalization or receipt of outpatient services;
- attending school or training (including schools for the deaf and blind);
- being on vacation;
- being in a home for children not considered to be a public institution; or
- seeking employment away from home.
- The parent or caretaker relative/payee is still responsible for the child's care and control. See A-921, How to Determine Care and Control, to determine whether the caretaker/payee still has care and control.
- The person's absence is not anticipated to be more than the allowable six- or 12-month period.
Advisors must certify or continue eligibility, and review the Eligibility Determination Group (EDG) every three months. Advisors remove the absent household member from the EDG after:- six months (beginning with the first full month of absence from the home); or
- 12 months for situations when a family member is out of the home because the member is:
- hospitalized or receiving outpatient services;
- attending school or training; or
- in a home for children not considered to be an institution.
The allowable six- or 12-month period begins again if the absent person returns to and resides in the home for at least 30 consecutive days. Advisors must not apply the temporary absence time frames when a parent is out of the home solely because of employment. Advisors must include the employed parent in the certified group if the parent meets all other eligibility criteria. See A-1040, Deprivation Based on Absence from the Home.
If a member of the certified group enters a nursing home, advisors leave the member’s needs in the household composition if the member will be there temporarily or until the member is certified for Supplemental Security Income (SSI). Advisors refer the recipient to the Social Security office for an SSI eligibility determination.
TANF
If the advisor removes the caretaker from the EDG, the EDG must be denied, and the advisor must ask another relative in the home that qualifies as caretaker to apply for the child(ren).
Medical Programs
If the advisor denies the parent or caretaker relative’s EDG, this does not impact the other associated Medical Program EDGs, and the other individuals cannot be required to reapply for Medical Programs.
A—921 How to Determine Care and Control
Revision 15-4; Effective October 1, 2015
TANF and Medical Programs
The parent or caretaker relative/payee cannot be considered responsible for the absent child's care and control when the child:
- is placed out of the caretaker/payee's home by the court, and the caretaker/payee has no authority to remove the child; or
- has a court-appointed guardian other than the caretaker/payee.
These children are independent children. The advisor must determine their eligibility for one of the Medical Programs.
Other considerations for care and control include:
- Who has the financial responsibility for the child's medical and dental costs?
- Who makes the decisions about health care, medical care, schooling and other personal care decisions?
- To what extent is the caretaker/payee involved with the child? How often does the caretaker/payee visit the child? What is the caretaker/payee's involvement with decisions for the care, well-being, schooling, etc.?
- To what extent does the caretaker/payee actively participate in the guidance and development of the child?
- What is the caretaker/payee's financial involvement for the child? That is, does the caretaker/payee pay a regular fee for the child's enrollment and participation in the home's programs?
- What restrictions or limitations have been placed on the caretaker/payee's rights?
Based on the responses to these questions, the advisor must make a prudent person decision about the caretaker/payee still being responsible for the child's care and control.
Related Policy
Prudent Person Principle, A-137
A—922 Children Admitted into State Hospitals
Revision 15-4; Effective October 1, 2015
Medical Programs except TP 08 and TA 31
Advisors consider a child admitted into a state hospital as an independent child if the caretaker no longer has care and control and the child was admitted:
- via a court order, or
- voluntarily.
The child is not considered an independent child if the child was admitted voluntarily and the caretaker/payee continues to have care and control.
A—923 Children Residing in General Residential Operations Facilities
Revision 16-4; Effective October 1, 2016
Medical Programs except TP 08 and TA 31
Advisors consider a child admitted into certain general residential operations facilities that are members of the Texas Coalition of Homes for Children as an independent child. These residential care facilities are considered to have care and control over children in their care.
Once a child is placed in one of these facilities, the facility provides a live-in house parent model of care. The house parent(s) assumes responsibility and acts in lieu of the parent(s) in meeting the children’s ongoing needs.
These facilities may apply for medical assistance on behalf of the children under their care. The facilities have limited power of attorney and are considered alternate payees for the children’s Medicaid EDG.
The facilities submit an application listing the child as a case name and a representative from the facility as an authorized representative.
Below is a list of general residential operations facilities that are members of the Texas Coalition of Homes for Children:
- ACH Child and Family Services – Fort Worth
- Arms of Hope – Quinlan and Medina
- Ben Richey Boys Ranch – Abilene
- Boys and Girls Country – Hockley
- The Brownson Home – Victoria
- Buckner Children and Family Services – Dallas
- Cal Farley's Boys Ranch – Amarillo
- Cherokee Home for Children – Cherokee
- Children at Heart Ministries – Round Rock
- The Children's Home of Lubbock – Lubbock
- Children's Village – Tyler
- Christ's Haven – Keller
- Foster's Home for Children – Stephenville
- Hendrick Home for Children – Abilene
- High Plains Children’s Home – Amarillo
- Lee and Beulah Moor Children's Home – El Paso
- Methodist Home for Children – Waco and Waxahachie
- Miracle Farm – Brenham
- Presbyterian Children's Home – Austin, San Antonio, Waxahachie and Itasca
- South Texas Children's Home Ministries – Beeville
- Sunny Glenn Children's Home – San Benito
- Texas Baptist Children's Home – Round Rock
- Texas Boys Ranch – Lubbock
- West Texas Boys Ranch – San Angelo
This list is not all inclusive. Staff must submit a policy clearance request if they receive an application requesting medical assistance for a child from a facility that is not included on this list. Staff must include a copy of the placement contract and the power of attorney from that facility so it can be determined if the child can be considered an independent child.
Related Policy
Authorized Representatives (AR), A-170
Children’s Living Arrangements, A-241.3.1
Verification Requirements, A-940
Verification Sources, A-941
A—924 Disqualification for Failure to Report Temporary Absence
Revision 15-4; Effective October 1, 2015
TANF
If a caretaker relative (a legal parent or other caretaker relative) fails to timely report the temporary absence of a certified child, the caretaker relative is disqualified until the earlier of the following occurs:
- the child returns to the home,
- the child is removed from the certified group, or
- the EDG is denied.
Related Policy
TANF — Budgeting for a Household Member Disqualified for Noncompliance with SSN, TPR, Failure to Timely Report a Certified Child’s Temporary Absence, Intentional Program Violation, Being a Fugitive or a Felony Drug Conviction, A-1362.2
General Policy, A-1210