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The Gregg Reference Manual and Associated Press Stylebook

Quick Tips and Clarification

Note: HHSC uses Webster's New World College Dictionary, fourth and fifth editions, and The Gregg Reference Manual. For standard style usage, HHSC uses the Associated Press Stylebook.

Agency Name

Use Texas Health and Human Services on first reference. On following references use HHS (not state of Texas or the state). If the audience is providers, use Texas Health and Human Services Commission on first reference, then HHSC on following references. To avoid confusion with the federal Health and Human Services agency, do not use HHS by itself without first spelling out Texas Health and Human Services. An exception is made for articles published on the HHS Connection, a platform only read by HHS team members, where the context is implicit. Including Texas or writing out Health and Human Services on first usage isn’t necessary in Connection articles.

It is preferable to use HHS, HHSC and DSHS as attributive rather than possessive. For example, “HHS efforts empower families,” not “HHS’ and HHSC’s efforts empower families.”

Academic Titles, Degrees, Certifications

  • Lowercase and use an apostrophe in general references (bachelor’s degree, a master’s, etc.), but an associate degree (no possessive). (AP)
  • Capitalize official degree names: Bachelor of Arts or Master of Science. (AP)
  • Abbreviations should follow full names and be offset by commas: John Snow, Ph.D., spoke. (AP)
  • Do not use a title and a degree abbreviation together (either Dr. Jane Smith or Jane Smith, M.D.). (AP)
  • Use sparingly in lists, such as biographies in a conference agenda, remove periods from all degree abbreviations. (AP)
  • Use Dr. before a name only for people who have a doctor of dental surgery, doctor of medicine, doctor of optometry, doctor of osteopathic medicine, doctor of podiatric medicine, or doctor of veterinary medicine. (AP)


  • Refer to the list of HHS official acronyms (PDF).
  • In general, refer to a proper noun by its full official name, not its acronym, on first reference. Exceptions to this include using HHS on first reference for articles on the HHS Connection or some communications when the audience would immediately recognize and understand the acronym such as SNAP or TANF. Some non-HHS acronyms are acceptable on first usage (for example, FBI, CIA) while others are not. This is based on AP guidance.
  • Because HHS is a system with many departments, divisions and programs — many of which are commonly known by their acronym — it is appropriate to have flexibility when including acronyms in text.
  • Because materials may have several or many acronyms, it may be appropriate to include acronyms in parentheses after a fully written-out name on first reference. This is especially true when considering accessibility of materials distributed systemwide or to the public or in longer text such as handbooks.
  • Because some materials, such as GovDelivery alerts, are sent to a specific audience that knows department lingo, it is suggested to omit the acronym in parentheses on first reference.
  • Flexibility is encouraged, with attention paid to the audience and the message. Once a path is chosen, ensure consistency throughout the document.
  • Do not use acronyms in parentheses in titles or section headers. Repeat the full name in the body text and include the acronym in parentheses there if desired. Handbooks may be an exception to this rule.


  • Abbreviate only Avenue (Ave.), Boulevard (Blvd.) and Street (St.) for numbered addresses. (AP)
  • For mailing addresses, include a ZIP code and use the postal abbreviation for the state (TX). (AP)
  • Exception to AP: For numeric streets only, to avoid confusion, spell out “Street.” Example: 701 W. 51st Street. Not: 701 W. 51st St.


  • Always use figures. (AP)
  • If the age is an adjective or a substitute for a noun, hyphenate it. (AP)
  • Clarification on AP: When expressing age ranges using “younger” or “older,” include the minimum or maximum age (not “older than 17” but “18 
    and older”). Examples: A 21-year-old client. The client is 21 years old. The boy, 6, has a sister, 3. The program is for 18-year-olds. She is in her 50s. Only youth 20 and younger qualify.

Agency Department Titles

  • When a department name is followed by words like “team” or “division” or “unit,” these additional words should be lowercased (unless they are part of the official department title).
  • In copy, when HHS, HHSC or DSHS is followed by a program area, do not use an apostrophe to indicate possession or insert a comma or dash. Example: Texas Health and Human Services Medical and Social Services Not: Texas Health and Human Services, Medical and Social Services Not: Texas Health and Human Services’ Medical and Social Services.
  • If the program name appears first, use a comma to set off the agency name. If more text follows, include a second comma after the agency name. Example: Staff in Medical and Social Services, Texas Health and Human Services, help Texans access services.


  • Brackets are permissible instead of parentheses if the item that needs to be set off already uses parentheses. (Gregg) Example: By 2030, there will be 71 million older Americans, accounting for roughly 20 percent of the population (The State of Aging and Health in America 2007, Centers for Disease Control [CDC]).

“Can” or “May”

  • “Can” and “may” can both be used to ask for permission, although “may” is considered more formal. (AP)


  • In general, avoid unnecessary capitalization. (AP) Do not capitalize non-proper nouns, such as individual, local authority, nursing facility, state hospital, etc. Capitalize when it is a full name of a specific location, such as San Angelo State Supported Living Center.
  • Lowercase common nouns when they stand alone in subsequent references: the party, the river, the street, the statute, the state hospital. (AP)


  • In stories, name sources within the text at the point of the citation. (AP) 
    Example: According to the National Institutes of Health, losing just five to 10% of body weight can produce health benefits.
  • Exception to AP and Gregg: For designed materials, place a footnote or endnote without a space after the period of the sentence containing the citation. The source should then be listed at the bottom of the page or the end of the document only with the name of the publishing entity. Examples: Texas Department of State Health Services, Centers for Disease Control and Prevention.
  • Exception to AP and Gregg: For all other documents, use American Psychological Association Style to fully format citations. In text, incorporate citations or use footnotes or endnotes. Example: Millen, B.E., Ohls, J., Ponza, M., & McCool, A.C. (2002). The elderly nutrition program: An effective national framework for preventive nutrition interventions. Journal of the American Dietetic Association, 102(2), 234-240.


  • For dates and years, use figures. (AP)
  • Do not use st, nd, rd, or th with dates. (AP)
  • Capitalize the names of months in all uses. When a month is used with a specific date, abbreviate only Jan., Feb., Aug., Sept., Oct., Nov. and Dec. Spell out when using alone, or with a year alone. (AP)
  • When a phrase lists only a month and a year, do not separate the year with commas. When a phrase refers to a month, day and year, set off the year with commas. (AP) Examples: January 2016 was a cold month. Jan. 2 was the coldest day of the month. His birthday is May 8. Feb. 14, 2013, was the target date. She testified that it was Friday, Dec. 3, when the crash occurred.
  • In tabular material, use these three-letter forms without a period: Jan, Feb, Mar, Apr, May, Jun, Jul, Aug, Sep, Oct, Nov, Dec (AP)

Dashes, Hyphens

  • Use hyphens (-) only for compound words.
  • Use en dashes (–) for ranges. (Gregg) 
    Clarification on Gregg: Add spaces around en dashes if needed for legibility. Use em dashes (—) with spaces to separate ideas or phrases in a sentence (AP). Example: A custom-built wheelchair — one made specifically for the user — can cost $500–$15,000.
  • Microsoft Word allows you to insert an em dash (a long dash) by typing two dashes in a row. If you have this capability turned off, there are three ways you can do this:
    • Press Ctrl+Alt+Minus
    • Hold down the Alt key as you type 0151 on the numeric keypad.
    • Choose Symbol from the Insert menu, and then select Em Dash from the Special Characters tab.

“Health Care”

  • Always two words, unless used as part of a formal title or name. (AP) Examples: The clinic offers health care for Kansas residents over the age of 65. She was a health care professional for 23 years.


  • Use bullets instead of dashes in a list (Gregg) and preferably indent the list.
  • Always use a colon after the element that introduces a list. (AP, Gregg)
  • Capitalize the first letter of each item. The list should have parallel structure, meaning each item uses the same pattern of words (all nouns 
    or all verbs, etc.).
  • Use periods when the items in the list are complete sentences or complete the introductory phrase. No periods are needed if the introductory element is a complete sentence or if the listed items are like an inventory sheet or shopping list.
  • Exception to AP and Gregg: For handbooks only, items in a list that are part of the same sentence may start with a lowercase letter and end with a semicolon, with the second-to-last item ending with a semicolon and a conjunction.


  • In general, spell out one through nine. (AP) Example: She won first place four years in a row.
  • Spell out numbers at the start of a sentence, except years. (AP)
  • Use figures for 10 or above and whenever preceding a unit of measure or referring to ages of people, animals, events or things. (AP) 
    Example: According to a CDC study, more than one in 10 children ages 8 to 15 have been diagnosed with a mental illness.
  • Use figures for addresses, dates, years, decimals, percentages, millions, billions, trillions and page numbers. (AP)


  • Use the % sign when paired with a number, with no space, in most cases. (AP) Example: The medical supply company reported a 40% increase in profits this quarter.

Publication Titles

  • Place titles of published works in quotes. (AP)
  • Capitalize all words in a title except articles (a, an, the); except prepositions of three or fewer letters (for, of, on, up, etc.); and except conjunctions of three or fewer letters (and, but, for, nor, or, so, yet, etc.) unless any of those start or end the title. (AP)
  • Capitalize prepositions of four or more letters (above, after, down, inside, over, with, etc.) and conjunctions of four or more letters (because, while, since, though, etc.) (AP)
  • Capitalize both parts of a phrasal verb: “What To Look For in a Mate;” “Turn Off the Lights in Silence.” But: “A Life of Eating Chocolate for Stamina;” “Living With Both Feet off the Ground.” (Note the different uses of for and off, and thus the different capitalization, in those examples.) (AP)
  • Capitalize to in infinitives: “What I Want To Be When I Grow Up.” (AP)


  • Use a single space after a period. (AP, Gregg)
  • Do not use the serial or Oxford comma (the comma before a conjunction in a simple series), unless needed for clarity. (AP) Example: Accountability, responsiveness and transparency are the values that guide HHS when providing services to millions of Texans.
  • A comma should be used before the terminal conjunction in a complex series, if part of that series also contains a conjunction. (AP) 
    Example: Through the program, clients can receive food, clothing, shelter, financial and emotional support, and first aid.
  • Use the ampersand only when it is part of a company’s formal name or composition title: House & Garden, Procter & Gamble, Wheeling & Lake Erie Railway. (AP)
  • Do not use the ampersand in place of and, except for some accepted abbreviations: B&B, R&B. (AP)
  • Exclamation points should be avoided and used sparingly if at all.

Reading Level

  • For a general audience, write so that as many people as possible will understand. Following the HHS Brand Guide and plain language standards should help achieve the clearest message.

Phone Numbers

  • Use figures and hyphens, not periods. Example: 212-621-1500.
  • The form for toll-free numbers doesn’t include the 1 prefix. Example: 800-111-1000 for toll-free numbers.
  • In the case of vanity phone numbers, present the digit-only version first.Example: 877-847-8377 (877-THSTEPS).

Texas Administrative Code

  • When first referencing statute, provide the full legislative citation (i.e., Texas Government Code, Section 531.151). For subsequent uses, shorten the reference to the specific section of code (i.e., Section 531.151). This goes for both citations and in-text references.
  • There is a long and short way to cite rules, but the short is generally preferred. For example, “40 Texas Administrative Code (TAC), Section 9.021” for the first reference, and for subsequent uses, “40 TAC, Section 9.201.” An example of the long citation would be “40 Texas Administrative Code (TAC) Chapter 9, Intellectual Disability Services-Medicaid State Operating Agency Responsibilities, Subchapter E, Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions Program-Contracting.”
  • Paraphrased language referring to TAC code can be edited, but the TAC language itself cannot be altered when being directly referenced or cited.


  • Use figures except for noon and midnight. Use a colon to separate hours from minutes: 11 a.m., 1 p.m., 3:30 p.m., 9–11 a.m., 9 a.m. to 5 p.m. (AP)
  • Avoid redundancies such as 10 a.m. this morning, 10 p.m. tonight or 10 p.m. Monday night. Use 10 a.m. or 10 p.m. Monday, etc., as required by the norms in time element. (AP)
  • The construction 4 o’clock is acceptable, but time listings with a.m. or p.m. are preferred. (AP)
  • Capitalize the full name of the time in force within a particular zone: Eastern Standard Time, Eastern Daylight Time, Central Standard Time, etc. (AP)
  • Lowercase all but the region in short forms: the Eastern time zone, Eastern time, Mountain time, etc. (AP)
  • Spell out time zone in references not accompanied by a clock reading: Chicago is in the Central time zone. (AP)
  • The abbreviations EST, CDT, etc., are acceptable on first reference for zones used within the continental United States, Canada and Mexico only if the abbreviation is linked with a clock reading: noon EST, 9 a.m. PST. (Do not set off the abbreviations with commas.) (AP)
  • Spell out all references to time zones not used within the contiguous United States: When it is noon EDT, it is 1 p.m. Atlantic Standard Time and 8 a.m. Alaska Standard Time. (AP)


  • Capitalize a formal title if it is used immediately before a person’s name. (AP)
  • Titles are lowercase if they follow the name or no name is present. (AP) Examples: President Abraham Lincoln. Abraham Lincoln, former president, spoke at the meeting. The president met with stakeholders.
  • Abbreviate titles when used before a full name: Dr., Gov., Rep. and Sen. (AP)

Websites, URLs, Email Addresses

  • When writing out URLs, “http://” or “www.” are generally not needed. Only use lowercase letters. (AP) Example:,
  • When writing for the web, all links should be phrased in a way that tells people what to do and what will happen when they click the link. For inclusivity, avoid using terms such as “view.” Examples:
    • Register for meeting here.
    • Review the COVID-19 Behavioral Health Services FAQ (PDF).
    • Visit the HHS YouTube channel.
  • Repetitive links to the same page are not necessary. It’s best to link to a site or file the first instance in the content.
  • In print materials, avoid using long URLs by giving a shorter URL and directions for getting to the webpage or document. You can include the long URL as needed in a footnote or citation. For some webpages, you can request a shortlink from the HHSC Office of Communications.
  • Capitalize the title of websites, webpages and sections. No quotation marks are necessary. Example: See the Support page on Beneplace Discount Purchase Program website.
  • In general, lowercase email addresses. Example:
  • If an internet address, or URL, falls at the end of a sentence, use a period. On some documents, it may be appropriate to leave the period off if it looks like the URL itself includes the period.