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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 24-1; Effective Jan. 1, 2024
Medical Programs except TP 08 and TA 31
A child admitted into a general residential operations facility is an independent child because these facilities have care and control over the children. Facilities that are members of the Texas Coalition of Homes for Children are considered general residential operations facilities.
Once a child is placed in a general residential operations facility, the facility provides a live-in house parent model of care. The house parent(s) assumes responsibility for the child and acts in lieu of the parent(s) to meet the child’s ongoing needs.
A facility may apply for medical assistance on behalf of a child under its care. The facility has limited power of attorney and is considered an alternate payee for a child’s Medicaid EDG.
The facility submits an application listing the child as a case name and a representative from the facility as an authorized representative (AR). If the representative is no longer affiliated with the facility, the facility must name a new representative to serve as the child’s AR.
If an independent child is in a facility that is not a member of the Texas Coalition of Homes for Children:
- submit Form H0005, Policy Clarification Request
- include a copy of the placement contract; and
- the power of attorney from that facility.
When a child moves out of a facility, the facility’s AR must report the change of address and end the AR designation.
Related Policy
Authorized Representatives (AR), A-170
Children’s Living Arrangements, A-241.3.1
Verification Requirements, A-940
Verification Sources, A-941
Reporting Requirements, B-620
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