Texas Health and Human Services Commission
Texas Works Handbook
Revision: 14-2
Effective: April 1, 2014

Part B — Section 100

Processing Time Frames

B—110  Applications

Revision 13-3; Effective July 1, 2013

B—111  Reuse of an Application Form After Denial

Revision 13-3; Effective July 1, 2013

All Programs

Use the original application form until it is 60 days old if an applicant reapplies after being denied for:

  • missing an appointment;
  • failing to furnish information/verification;
  • failure to provide postponed verification; or
  • failure to provide proof of U.S. citizenship.

Notes:

  • If the information on the application form has changed or is more than 45 days old, the individual and advisor must update the form.
  • If the application has been denied for missing an appointment, reopen the denied application using the contact date as the new file date.
  • Do not request additional income verification when reopening a redetermination denied for failure to provide information. Accept the original income verification the individual provided at the interview date, unless the household indicates a change in income.

TANF and Medical Programs except TP 33, TP 34, TP 35 and Children's Medicaid

If an applicant reapplies after being denied for missing an appointment, use the original application form until it is 60 days old.

TP 32 and TP 56

Form H1010, Texas Works Application – Your Texas Benefits, may be used more than one time for TP 56 and TP 32 applicants when both the following conditions exist:

  • the application interview or process date is after the application month, and
  • the household states that it wishes to reapply and reuse an application form.

B—112  Deadlines

Revision 13-3; Effective July 1, 2013

TANF and Medical Programs

Provide Form TF0001, Notice of Case Action, to a denied applicant by the 45th day after the file date.

Ensure that certified applicants have access to benefits by the 45th day after the file date.

For TP 40 expedited Eligibilty Determination Groups (EDGs), see A-140, Expedited Services.

For expedited time frames for medical program applicants with an active duty military connection, see A-147, Expedited Eligibility and Enrollment of Active Duty Military Members and Their Dependents.

Exceptions:

  • For applications requiring medical verification, do not count the total processing time the delay caused by obtaining Form H3038, Emergency Medical Services Certification.

    Document the date the:

    • Form H3038 was sent to the practitioner or given to the applicant; and
    • medical information was received.
  • For Temporary Assistance for Needy Families (TANF) reapplications with open Choices or school attendance penalties, a period of up to 40 days is excluded from timeliness calculations. The individual must demonstrate cooperation for 30 days before the advisor closes the penalty and processes the application.

SNAP

By the 30th day after the file date:

  • deny or certify an application, and
  • ensure that a certified applicant has an opportunity to participate.

Exception: For expedited service, see A-140.

Related Policy
Eligibility Dates and Benefit Amounts, A-2320
Children’s Medicaid Redetermination Expectations, B-123.7

Medical Programs

Provide Form TF0001, Notice of Case Action, the same day eligibility is determined for certified applications, including those with spend down. Do this no later than the 45th day from the file date.

B—113  Delay in Processing Applications

Revision 07-2; Effective April 1, 2007

All Programs

Follow policy below when an application is delayed until the 60th day after the file date.

If ... then ...
the agency is at fault for not completing the application process by the 60th day after the file date and was also at fault for delaying it during the first 30 days after the file date, the advisor must continue to process the original application and provide benefits retroactive to the file date (or the month the individual met all requirements, if later).

If the applicant
  • misses a Supplemental Nutrition Assistance Program (SNAP) appointment and fails to contact the office by the 10th day as noted on Form H1020, Request for Information or Action, to request a second appointment, then deny the application the following workday. The household loses eligibility for all past months and must reapply if they still want to receive benefits.
  • fails to provide all the required verification by the 10th day noted on Form H1020, then deny the application the following workday. If the household subsequently provides the missing verification within 10 days after the Form H1020 due date, reopen the application using the original file date. Otherwise, the household must reapply if they want to receive benefits.
HHSC was at fault in the first 30 days and the individual was at fault in the second 30 days, deny the application on the 60th day after the file date and provide no benefits.
the individual was at fault the first 30 days and HHSC was at fault in the second 30 days, the advisor must continue to process the original application and provide benefits retroactive to the month following the month of application (or the month the individual met all requirements, if later).

B—113.1  Not Held – Agency Fault

Revision 13-3; Effective July 1, 2013

All Programs except TP 33, TP 34, TP 35, TP 36, TP 40 and Children's Medicaid

If the advisor has not contacted the household for the interview either by telephone or for a face-to-face interview by the close of business on the scheduled appointment date, the advisor must mark the Task List Manager (TLM) "Check-In" task associated with the appointment as "Not Held-Agency Fault." This creates a subsequent reschedule task. Do not mark the appointment as "Show" or "No Show" when the advisor has not been able to contact the household for the interview.

Note: This policy applies to applications and redeterminations for all programs that require an interview.

B—114  Missed Appointment

Revision 13-3; Effective July 1, 2013

All Programs except TP 33, TP 34, TP 35, TP 36, TP 40 and Children's Medicaid

For telephone interviews, make at least two attempts to contact the applicant via telephone. Both attempts must be conducted within the time period listed on Form H1830, Application/Review/Expiration/Appointment Notice. Each attempt must be conducted at least 10 minutes apart. If no contact is made with the applicant after two attempts, consider the telephone interview a missed appointment. Document the time of each attempt on the Appointment – Details page..

TANF and Medical Programs except TP 33, TP 34, TP 35, TP 36, TP 40 and Children's Medicaid

If the applicant misses the first appointment and does not contact the office on the appointment day, deny the application no later than the next workday.

If on the appointment date the applicant arrives too late for the appointment or calls to reschedule the appointment (because the individual cannot keep the appointment), offer the applicant a choice of a standby appointment or an opportunity to reschedule. Keep the original file date.

If the applicant contacts the office by the 30th day after the file date to reschedule, reopen the application using the date of contact as the new file date.

When a requested or required interview is scheduled within the 15-workday active duty military member policy but the applicant requests to reschedule the interview, staff must try to accommodate the rescheduled appointment within the 15-workday time frame. If, at the household’s request, the interview is rescheduled after the 15-workday time frame, document the reason for not scheduling the appointment within the required time frame.

Note: For requested interviews, if the applicant requests to be rescheduled, inform the household that an interview is not required and the processing of the application can begin without an interview. Do not deny an application if the household fails to show for the appointment when an interview is not required.

SNAP

If the applicant misses the first appointment, send the applicant Form H1020, Request for Information or Action, on the same day and pend the application. Inform the applicant that it is the applicant's responsibility to request a second appointment.

If on the appointment date the applicant arrives too late for the appointment or calls to reschedule the appointment (because the individual cannot keep the appointment), offer the applicant a choice of a standby appointment or an opportunity to reschedule.

If the household misses an appointment and contacts the office on or before the 30th day after the file date, reschedule the household for another appointment before the 30th day, if possible. If there are no appointment slots available, then schedule another appointment after the 30th day, but by the 45th day, and keep the application pending. If the household keeps that appointment and is determined eligible, use the original file date to provide benefits.

Note: When a household misses a scheduled appointment and subsequently submits another application, consider the second application as a household's request to reschedule the missed appointment.

If the 30th day after the file date is a non-workday, the advisor takes the appropriate action on the following workday. This also must be the final due date on Form H1020.

Additionally, if necessary, hold the application past the 30th day to allow the household at least 10 days to contact the office for a second appointment. If the household does not contact the office by this deadline, deny the EDG no earlier than the following workday.

Notes:

  • The individual has until close of business (COB) on the final due date listed on Form H1020, Request for Information or Action, to contact the office (COB for the vendor if calling 2-1-1) to request another appointment.
  • If a second or subsequent appointment is scheduled because the individual missed the appointment, ensure that second and subsequent appointments have been correctly recorded on the Appoinment – Details page.

See B-160, SNAP Timeliness Charts for Applications and All Redeterminations.

Related Policy
Interviews, A-131
Processing Redeterminations, B-122
Children’s Medicaid Redeterminations Expectations, B-123.7

TP 36 and TP 40

No appointment is required to process an application.

Note: For requested interviews, if the applicant requests to be rescheduled, inform the household an interviews is not required and the processing of the application can begin without an interview. Do not deny an application if the household fails to show for the appointment when interview is not required.

TP 33, TP 34, TP 35 and Children's Medicaid

No appointment is required to process an application or renewal unless the individual non-complies with the Health Care Orientation requirement or Texas Health Steps (THSteps) or information needed to determine eligibility can only be obtained through a face-to-face interview.

Note: For requested interviews, if the applicant requests to be rescheduled, inform the household an interviews is not required and the processing of the application can begin without an interview. Do not deny an application if the household fails to show for the appointment when interview is not required.

Related Policy
Scheduling Appointments, A-122.2
Interviews, A-131
Compliance Requirement,A-1531.5
Processing Children's Medicaid Redeterminations, B-123

B—115  Pending Verification on Applications

Revision 14-2; Effective April 1, 2014

All Programs

If more information/verification is required to complete an application, allow the household at least 10 days to provide it. The due date must be a workday.

Request documents that are readily available to the household if the documents are anticipated to be sufficient verification. Each handbook section lists potential verification sources. C-900, Verification and Documentation, gives information on verification procedures.

Give the applicant Form H1020, Request for Information or Action, explaining:

  • what is required,
  • the date the verification is due, and
  • the date the application will be denied if the verification is not received.

The day Form H1020 is sent is day zero of the pending period.

If the applicant does not provide the verification by the 30th day after the file date, or the next workday if the 30th day is not a workday, deny the application no earlier than the:

  • 30th day if the 30th day is a workday, or
  • following workday if the 30th day is not a workday.

The final due date on Form H1020 must correspond with the 30th day if a workday, or the following workday if the 30th day is not a workday. Take the appropriate action on the final due date.

Exceptions:

  • If necessary, hold the application past the 30th day to allow the household at least 10 days to provide verification. If the household does not provide required verification by this deadline, deny the EDG no earlier than the following workday. This includes situations in which the 10th day falls on the 30th day.
  • If the eligibility factor in question does not affect eligibility of the entire household, disqualify the ineligible member(s) and certify the remaining members.

On an application denied for failure to furnish information or failure to provide postponed verification, if the household provides the required verification by the 60th day after the file date, reopen the application using the date the individual provided verification as the file date.

TANF

For applications in pay for performance with a noncooperation for Choices or school attendance, the final due date is the 40th day from the date of interview. See A-2151, Open Penalty at Reapplication in Pay for Performance.

Note: When an application is pended for other eligibility verification in addition to the verification of Choices or school attendance cooperation, staff should continue to pend the TANF application until the final due date (40th day from the interview) before taking appropriate action on the TANF EDG.

TP 33, TP 34, TP 35 and Children's Medicaid

Check for any associated EDGs and use appropriate verifications from those EDGs when the applicant does not provide verification with the application form. Use proof of alien status, income or deductions (if provided in the 90 days before the file date) from an associated SNAP, Medicaid or TANF EDG as verification for a child's Medicaid application or redetermination.

SNAP

If the applicant is eligible, provide an opportunity to participate by the 30th day after the file date. If not possible, authorize benefits with a priority issuance the day the applicant provides the required verification.

Related Policy
Expedited Service, A-140

B—115.1  Pending Verification for MA – Pregnant Women – Emergency

Revision 13-3; Effective July 1, 2013

TP 36

Deny an application for a TP 36 by the 45th day after the file date if she:

  • or her representative does not provide Form H3038, Emergency Medical Services Certification, or other required verification; and
  • had at least 10 days to provide the verification.

Use the following chart to process, the application for the individual's emergency condition if the required verification is received.

If the emergency condition occurs ... and Form H3038 is received ... then ...
during the month of application, by the 45th day after the file date, dispose the EDG using the original file date.
  after the EDG is denied but by the 60th day after the file date, reopen the EDG, using the same Form H1010, Application for Assistance - Your Texas Benefits, as specified in B-111, Reuse of Application Form After Denial. Use the date Form H3038 is received as the new file date.*
after the application month but by the 60th day after the file date, by the 45th day after the file date, use the date Form H3038 is received as the file date.*
- after the EDG is denied but by the 60th day after the file date, reopen the EDG, using the same Form H1010, as specified in B-111. Use the date Form H3038 is received as the new file date. *

*Do not require Form H1113, Application for Prior Medicaid Coverage, if processing the emergency coverage for a prior month.


B—116  Information Reported During Application Processing

Revision 13-3; Effective July 1, 2013

All Programs

In determining eligibility, the advisor must consider any information the individual reports between the application date and the decision date. Include any information the individual reports in the application decision process. Send Form H1020, Request for Information or Action, if verification of the reported information is required to complete the application process, following procedures in B-115, Pending Verification on Applications.

Add a new household member the month they join the household. For newborns, this is the

  • birth month for TANF and Medical Programs, and
  • month the newborn comes home from the hospital for SNAP.

Related Policy
Receipt of Duplicate Application, A-121.2
Receipt of Identical Application, A-121.3

B—116.1  Information Received During Expedited Application Processing

Revision 03-7; Effective October 1, 2003

SNAP

Use the following chart to determine what action to take when the advisor receives information after certifying an expedited application with postponed verifications.

If, between the certification date and the date you release the hold, ... then ...
  • an individual provides postponed verification that results in lowered or denied benefits; or
  • the advisor discovers information that existed on the interview date but the household failed to report, and the information results in lowered or denied benefits,
  • determine eligibility and benefits using the new information; and
  • release the hold and deny or issue lowered benefits effective the hold month providing adequate notice of adverse action.
an individual reports a change that occurred after the certification date, release the hold and issue benefits based on the originally requested information. Work the change using change policy in B-600, Changes, allowing advance notice of adverse action, if required.

Note: Send a fraud/overpayment referral, if applicable. See B-724, Texas Works Action on Client and Intentional Program Violation Errors.


Related Policy
Expedited Service, A-140
Action on Changes, B-631

B—120  Redeterminations

Revision 13-3; Effective July 1, 2013

Redetermination is the generic term in TIERS and State Portal used to identify:

  • periodic reviews of TANF and TP 08;
  • recertification of SNAP; and
  • renewal of Children's Medicaid.

The packets sent to households for redeterminations are:

  • H1830-R, Texas Works Renewal Notice, for all Texas Works programs, and
  • H1830-L, Children's Medicaid Renewal Notice, for Children's Medicaid only.

B—121  Notice of Redetermination/Certification Expiration

Revision 14-2; Effective April 1, 2014

TANF and TP 08

TIERS Scheduling triggers the Texas Works renewal packet mail-out date in Correspondence 60 days before the review due date for approved Eligibility Determination Groups (EDGs).

Schedule an appointment after the household returns Form H1010-R, Your Texas Works Benefits: Renewal Form.

Children's Medicaid

TIERS Scheduling triggers the Children's Medicaid renewal packet in the fourth month of a child's six-month continuous eligibility period, or the 10th month of a 12-month continuous eligibility period for TP 45.

Related Policy
Processing Children's Medicaid Redeterminations, B-123

SNAP

TIERS Scheduling triggers the Texas Works renewal packet mail-out date in Correspondence during the first week of the month before last benefit month (LBM) of the approved EDG.

Schedule an appointment after the household returns Form H1010-R, Your Texas Works Benefits: Renewal Form. Schedule the appointment no sooner than five days after the Form H1830-I, Interview Notice (Applications or Reviews), mail date, if possible.

For timely redeterminations, schedule the first appointment early enough in the last benefit month to allow at least 13 days after the interview to ensure the EDG can be disposed by the last day of the certification period. This allows two days for Form H1020, Request for Information or Action, to be mailed from the central mail facility; 10 days after the H1020 issue date for the household to provide the information; and one additional day to process a denial for missed appointment, if applicable, in order to be timely.

Note: If the 10th day falls on a non-workday, the due date is the following workday.

Related Policy
Redetermination, B-476.1.6
Children’s Medicaid Redetermination Expectations, B-123.6

B—122  Processing Redeterminations

Revision 14-2; Effective April 1, 2014

TANF and TP 08

Process redeterminations before cutoff in the month:

  • the redetermination date falls, if the redetermination is due on or before cutoff; or
  • after the redetermination date, if the redetermination is due after cutoff.

When the Texas Works Renewal Packet Is Returned and a Packet Received Date Is Entered

If the household must provide verification to complete the redetermination, allow the household at least 10 days to provide it.

For telephone interviews, make at least two attempts to contact the applicant via telephone. Both attempts must be conducted within the time period listed on Form H1830-I, Interview Notice (Applications or Reviews). Each attempt must be conducted at least 10 minutes apart. If no contact is made with the applicant after two attempts, consider the telephone interview a missed appointment. Document the time of each attempt on the Appointment – Details page.

If a household fails to keep a face-to-face or telephone interview appointment, send Form TF0001, Notice of Case Action, to deny the EDG the workday following the scheduled appointment date.

If the individual contacts the office during the adverse action period, reschedule the appointment to process the redetermination as soon as possible to avoid interruption of the benefit issuance cycle for the following month. Do not reactivate the EDG; leave the EDG denied until the individual keeps the second appointment. A second Form TF0001 is not required if the individual misses the second appointment. If the individual keeps the appointment, the EDG must be processed as a Reactivation/Redetermination for correct eligibility determination and timeliness calculation.

Note: Do not deny a TP 08 EDG when the individual fails to keep an appointment in his last month of the 90% earned income deduction if the TP 08 EDG would be denied due to loss of the earned income deduction and a TP 37 EDG would be opened in the next month.

When the Texas Works Renewal Packet Is not Returned and/or a Packet Received Date Is Not Entered

TIERS runs a Mass Update (MU) on the fifth, sixth or seventh day of each month to terminate EDGs with due dates on or before cutoff of the current month.

For example: On July 5, the MU will terminate EDGs with a review due date on or before July cutoff.

Normal MU rules for exceptions may prevent an EDG from being terminated. Staff must process these EDGs online; verify that a Texas Works renewal packet has been sent and not returned.

When the Texas Works renewal packet is:

  • not returned, go to Initiate Interview in Change Action mode, run Eligibility and dispose the TANF or TP 08 EDG.
  • returned, go to Initiate Interview in Ongoing mode, then go to the Miscellaneous Packet Received logical unit of work (LUW) and enter the packet received date.

If the household returns Form H1010–R, Your Texas Works Benefits: Renewal Form, within the adverse action period, schedule an appointment to process the complete redetermination. These EDGs must be processed as a Reactivation/Redetermination for correct eligibility determination and timeliness calculation.

Where to Find the Packet Received Date

In State Portal, the packet received date can be found in PT Inquiry in the EDG Details section in the column labeled Recertification Packet Date.

In TIERS, the packet received date can be found in two places in Data Collection:

  • Miscellaneous Packet Received LUW, which can be viewed in any mode
  • Initiate Interview – Initiate Review page, which can be viewed only in Complete Action mode

Related Policy
Processing Children's Medicaid Redeterminations, B-123
Not Held – Agency Fault, B-113.1

TP 07, TP 20 and TP 37

If the household returns Form H1010-R, Your Texas Works Benefits: Renewal Form, complete the determination for other Medicaid eligibility, including Children's Health Insurance Program (CHIP). Complete the application within 45 days from the file date. If the household does not return Form H1010–R, TIERS denies the EDG on the estimated eligibility end date and no advisor action is required.

Related Policy
The Texas Works Message, A-1527
Data Broker, C-820

SNAP

To reapply in a timely manner, the individual must submit the completed application form by the 15th day of the last month of the certification period. Exception: See B-122.1, SNAP Redeterminations Following a Short Certification.

When an individual misses a timely redetermination appointment, send Form H1020, Request for Information or Action, on the day of the missed appointment but no later than the next workday. Form H1020 advises the household to contact the Health and Human Services Commission (HHSC) before the end of the certification period to request a second appointment, or the application will be denied.

If the household contacts the office on or before the last workday of the last month of its certification period, reschedule the household for a second appointment before the end of the certification period, if possible. If there are no appointment slots available, then schedule a second appointment no later than the 15th day of the following month and keep the application pending. If the household keeps the second appointment and is determined eligible, use the original file date and provide a full month's benefits for the first month of the new certification period.

If the household does not contact HHSC by the last workday of the certification period to request a second appointment, deny the redetermination application on the last workday of the certification period using adequate notice.

For telephone interviews, make at least two attempts to contact the individual via telephone. Both attempts must be conducted within the specified time period listed on Form H1830-I. Each attempt must be conducted at least 10 minutes apart. If no contact is made with the individual after two attempts, consider the telephone interview a missed appointment. Document the time of each attempt on the Appointment – Details page.

Note: When a household misses a scheduled appointment and subsequently submits another application, consider the second application as a household's request to reschedule the missed appointment.

Process timely redeterminations by the last workday of the certification period. If the advisor pends the redetermination for verification, allow the household until the last workday of the month to provide the required verification before taking denial action. Ensure the individual's normal issuance cycle is not interrupted.

Exception: Pend the redetermination past the last workday of the month if necessary to allow the individual at least 10 days to provide requested verification. If the individual:

  • provides verification before the end of the current certification month, then process the action by the last day of the month.
  • provides verification after the end of the certification period but by the end of the 10-day period, then ensure the household receives an opportunity to participate within five workdays of receipt of the verification, if eligible. If not eligible, then process the denial by the fifth workday after receipt of verification.
  • does not provide verification by the end of the 10-day period, deny the redetermination the next workday.

For households that miss the first appointment but keep the second appointment scheduled before the 15th day of the following month, if additional information is requested, allow the household at least 10 days to provide the requested verification. If the household:

  • provides the verification on or before the due date on Form H1020, ensure that the household receives an opportunity to participate within five workdays of receipt of the verification.
  • does not provide the verification by the due date on Form H1020, deny the redetermination the next workday.

See B-160, SNAP Timeliness Charts for Applications and All Redeterminations.

Situations in Which HHSC Fails to Timely Schedule the Redetermination Appointment

If the individual misses an appointment for a timely redetermination scheduled without enough time to allow the household 10 days to respond to the missed appointment notice before the end of the certification period, then on the day of the missed appointment, send Form H1020 informing the individual to contact the office by the 10th day (or the following workday) to schedule a second appointment.

If the individual:

  • fails to contact the office by the due date, deny the application on the workday after the Form H1020 due date; or
  • contacts the office by the due date to request another appointment, schedule a second appointment within 10 days and keep the application pending for the second appointment.

Notes for all policies in B-122:

  • For missed appointments, TIERS notices are mailed from the central mail facility two days after being requested in TIERS, so the Form H1020 due date is 12 days after the request date.
  • The individual has until close of business on the final due date listed on Form H1020 to contact the office (close of business day for the vendor if calling 2-1-1) to request another appointment.

Related Policy
Interviews, A-131
Missed Appointment, B-114
Redetermination, B-476.1.6
Children’s Medicaid Redetermination Expectations, B-123.6
Not Held – Agency Fault, B-113.1

B—122.1  SNAP Redeterminations Following a Short Certification

Revision 13-3; Effective July 1, 2013

SNAP

Advisors must provide eligible households with benefits by the 30th day after the last monthly full benefit was provided if the individual reapplied timely and was previously certified with a short certification. A short certification is defined as a SNAP certification in which the household is certified:

  • for a one-month period; or
  • in the second month of a two-month certification.

The household must reapply within 15 days of receiving Form H1830, Application/Review/Expiration/Appointment Notice, and the application for assistance to be considered timely.

Notes:

  • This policy does not apply to households that are certified in the first month of a two-month certification. These households must continue to file their Form H1010 by the 15th of the last benefit month for a timely redetermination. Advisors must continue to process timely redeterminations on these cases by the last day of the current certification period.
  • Advisors must continue to provide Form H1830 and an application for assistance to households that are certified in the first month of a two-month certification or after cutoff in the first month of a three-month certification, because these households will not receive a redetermination packet even though they are not considered to have received a short certification.

B—122.1.1  Calculating the 30-Day Period After the Last Monthly Full Benefit

Revision 05-4; Effective August 1, 2005

SNAP

To calculate the 30-day period, consider the date the individual received the last full benefit as day zero. If the 30th day falls on a non-workday, the advisor must complete the case by the last workday preceding the 30th day.

B—122.1.2  Determining the Date the Client Must File the Application for a Timely Redetermination Following a Short Certification

Revision 13-3; Effective July 1, 2013

SNAP

To calculate the date the individual must file the application to be considered timely, count 15 days after the individual received Form H1830, Application/Review/Expiration/Appointment Notice, and the application for assistance. This date is known as the Short Certification Timely Due Date. If the 15th day falls on a weekend or a holiday, the individual must submit the application before the 15th day in order for it to be considered a timely redetermination.

If Form H1830 and Form H1010 are ... then count 15 days ...
given to the individual in the office, after the date the individual is given the forms.
mailed to the individual, plus 2 days (17 days) after the date the forms are mailed.

To schedule timely redeterminations properly, scheduling staff need to know the due date on which the application must be submitted to be considered a timely redetermination. Therefore, when providing Form H1830 and Form H1010, Application for Assistance - Your Texas Benefits, at the time a short certification is completed, advisors must manually document the due date in the Short Cert. Timely Due Date box in the Agency Use Only section of Form H1010. Scheduling staff must then follow B-122.2, Procedures for Providing Benefits for All Redeterminations, to properly schedule the appointment.

B—122.1.3  Missed Appointments Following a Short Certification

Revision 13-3; Effective July 1, 2013

SNAP

For timely filed reapplications after a short certification, if an individual misses the appointment, send the household Form H1020, Request for Information or Action, advising the household that the household must contact HHSC by the 30th day from the last month's full benefit issuance to request a second appointment.

If the household contacts HHSC on or before the 30th day after the last month's full benefit issuance, reschedule the household for a second appointment before the end of the 30th day, if possible. If there are no appointment slots available, then schedule the second appointment no later than the 45th day after the last month's full benefit issuance and keep the application pending. If the household keeps the second appointment and is determined eligible, use the original file date and provide full month's benefits for the first month of the new certification period.

The advisor must hold the application past the 30th day after the last month's full benefit issuance to allow the household at least 10 days (or longer if the 10th day falls on a non-workday) to contact the office for a second appointment or to provide missing information/verification. The advisor must notify the household of the due date on Form H1020. When this 10-day due date is on or after the 30th day after the last month's full benefit issuance and the household fails to contact the office or provide missing information/verification by the due date, the advisor must deny the application the next workday. If the household does not contact HHSC by the 30th day to request a second appointment, deny the redetermination application on the 30th day (or the last workday before the 30th day if the 30th day is not a workday).

If the household does not contact HHSC by the 30th day to request a second appointment, deny the redetermination application on the 30th day (or the last workday before the 30th if the 30th day is not a workday).

B—122.2  HHSC Delays in Processing All Timely Redeterminations

Revision 13-3; Effective July 1, 2013

SNAP

If HHSC is at fault for not completing the redetermination process in a timely manner, staff must dispose the EDG the same day the advisor completes the eligibility redetermination. This ensures that benefits are available within 24 hours.

Example 1: A household’s last benefit month is October. The household files the redetermination timely, but HHSC does not give the household an appointment until November. The advisor must dispose the EDG on the same day the eligibility redetermination is completed to ensure that benefits are available within 24 hours.

Example 2: A household’s last benefit month is October. The household files the redetermination timely and provides all requested verification timely. Due to HHSC delay, the advisor does not complete the recertification process timely. The advisor must dispose the EDG on the same day that the eligibility redetermination is completed to ensure that benefits are available within 24 hours.

B—122.3  Delays Caused by Households

Revision 13-3; Effective July 1, 2013

TANF and TP 08

When a redetermination is denied for a missed appointment or failure to provide information, allow the household until 60 days after the file date to schedule a second appointment or provide the missing information.

SNAP

When a timely redetermination is denied for a missed appointment or for failure to provide information, allow the household an additional 30 days after the end of the last benefit month to reschedule a missed appointment or to provide information or verification.

Related Policy
Verification Requirements, A-1370

B—122.3.1  Denied for Missed Appointments

Revision 13-3; Effective July 1, 2013

TANF and TP 08

The date the household requests another appointment is considered the new file date if the household requests a second appointment within 60 days after the original file date.

SNAP

The date the household requests another appointment is considered the new file date if the household requests to reschedule a missed appointment within 30 days after the end of the last benefit month. Prorate benefits using the new file date.

B—122.3.2  Denied for Failure to Provide Information/Verification

Revision 13-3; Effective July 1, 2013

TANF and TP 08

The date the household provides the missing information is the new file date if the household provides the missing information within 60 days of the original file date. If the EDG is reopened within 30 days of the denial, a new interview is not required. For TANF, a new Form H1073, Personal Responsibility Agreement (PRA), is not required if the EDG is reopened within 30 days of the denial.

SNAP

The date the household provides the information/verification is the new file date and a new interview is not required. Prorate benefits using the new file date.

Do not request additional income verification when following reuse of application policy for a redetermination denied for failure to provide information. Accept the original income verification the individual provided at the interview date, unless the household indicates a change in income.

B—123  Processing Children's Medicaid Redeterminations

Revision 13-4; Effective October 1, 2013

Children's Medicaid

TIERS Scheduling generates and mails a redetermination packet to the household in the fourth month of a child's six-month continuous eligibility period, or the 10th month of a 12-month continuous eligibility period for TP 45.

The packet includes Form H1830-L, Children's Medicaid Renewal Notice, explaining the redetermination process, and Form H1014-R, Renewal Application for CHIP and Children's Medicaid. The household must complete all of Form H1014-R, attach proof of changes, and sign and return the form within seven days.

If a household does not return the Medicaid redetermination packet by the first of the fifth month, TIERS mails Form H1014-A, Children's Health Care Benefits – Final Reminder.

Process the redetermination by mail and through telephone contact unless the individual requests an office appointment. There is no interview requirement for Children's Medicaid. The file date is the date the application is received.

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 THSteps, schedule a face-to-face appointment. Deliver the HCO or remind the individual about the importance of the THSteps checkup at that time.
  • Conduct a face-to-face interview at redetermination when HHSC received conflicting information related to household composition, income or resources that affects eligibility and the information cannot be verified through other means, such as an associated EDG.

Verification from an associated EDG can be used if provided within 90 days prior to the file date.

Advisors take the following actions to process redeterminations:

  • Household returns Form H1014-R indicating no changes and there are no associated EDGs — process the redetermination and request new verification via Form H1020, Request for Information or Action, if not provided.

If the household previously reported a change that did not have to be acted on before redetermination but does not send verification with the Form H1014-R, request verification via Form H1020.

  • Household returns Form H1014-R indicating no changes and there are associated EDGs – review the associated EDGs to determine if they have information to clear any conflicting information. Request new verification via Form H1020.
  • Household returns Form H1014-R reporting changes, provides verification with Form H1014-R, and there are no associated EDG's — process the redetermination using the new verification.
  • Household returns Form H1014-R reporting changes, provides verification with Form H1014-R, and there are associated EDGs — review the associated EDGs and use information the household provided for the Medicaid EDG as it is the most recent. It may vary from the other EDG information because less documentation is required.

If the associated EDGs have other information the household did not report for the Medicaid EDG that would impact Medicaid eligibility, contact the household (by telephone or Form H1020 with time frame) to determine if information in the associated EDG is correct before denying the EDG.

If the household reports new information that must be considered for the associated EDGs, such as a new job, request needed verification for the other programs. For example, two pay stubs for the SNAP EDG instead of the one pay stub required for Medicaid.

  • Household returns Form H1014-R reporting changes, did not provide verification with Form H1014-R, and there are associated EDGs — Request new verification via Form H1020.

Do not renew eligibility if the information reported on Form H1014-R is not provided. Do not allow a deduction expense if the individual does not provide verification. If the household reports new information that must be considered for the associated EDGs, such as a new job, request needed verification for the other programs. For example, two pay stubs for the SNAP EDGs instead of the one pay stub required for Medicaid.

  • Household returns Form H1014-R indicating changes, did not provide verification with Form H1014-R, and there are no associated EDGs — request information needed to determine eligibility. If a household does not provide the information, do not renew eligibility.
  • Household returns Form H1014-R but the child is not eligible for another six-month continuous eligibility period — process a denial action to close the Medicaid EDG and determine if the child is eligible for CHIP.  

Note: If the household does not return any redetermination form, take no action. The EDG automatically closes at the end of the six-month eligibility period.

When the redetermination packet is returned, review the Individual – Health Steps/ Health Care Orientation page for each certified child to determine if a health care orientation is needed, or if a certified child is overdue for a THSteps screening.

If the sentence "Individual has met the health care orientation requirements:" is blank, a health care orientation (HCO) is required. Call the caretaker and allow self-declaration the caretaker:

  • had the orientation,
  • is scheduled for one, or
  • has not attended one but has good cause.

If unable to contact the caretaker by phone, send Form H1024, Subject: Self-Declaration Notice, to obtain the information.

If the caretaker returns Form H1024 indicating they have complied, will comply, or have good cause, process the redetermination without a face-to-face contact. If the household does not return Form H1024, deny the EDG failure to provide information. If the household returns Form H1024 indicating non-compliance, the individual must attend the HCO in a face-to-face setting before the redetermination can be processed. Follow local office procedures for scheduling and conducting the HCO. Note: If the EDG is denied, the denial applies to all Children's Medicaid EDGs for the household, except TP 45 coverage for newborns.

Staff must use the appropriate script located in C-1117, Texas Health Steps Quick Reference Guide and Recipient Enrollment Script, or C-1118, Health Care Orientation Quick Reference Guide and Enrollment Script, when a recipient attends a face-to-face interview due to a THSteps/HCO noncompliance.

When the redetermination packet is returned at the second redetermination after the individual is informed of the requirement, or at any subsequent redetermination, if the EDG contains a child who is overdue for a THSteps screening, call the caretaker and allow self-declaration that the child:

  • had the screening;
  • is scheduled for the screening; or
  • has not been screened, but has good cause.

If unable to contact the caretaker by telephone, send Form H1024 to obtain the information.

If the household does not return Form H1024, deny the EDG for failure to provide information. If the household returns Form H1024 indicating non-compliance, schedule the individual for a face-to-face interview. Staff must use the appropriate script located in C-1117 or C-1118 when a recipient attends a face-to-face interview due to a THSteps/HCO noncompliance. If the individual does not keep the appointment, deny the EDG for a missed appointment. The denial applies to all Children's Medicaid EDGs for the household, except TP 45 coverage for newborns.

Related Policy
Continuous Medicaid Coverage, A-832
Compliance Requirement, A-1531.5
Data Broker, C-820

B—123.1  Children's Medicaid Redetermination Due Dates

Revision 14-1; Effective January 1, 2014

Children's Medicaid

Timely Redetermination

A redetermination is considered timely if Form H1014-R, Renewal Application for CHIP and Children's Medicaid, Form H1010, Texas Works Application for Assistance — Your Texas Benefits, or Form H1010-R, Your Texas Works Benefits: Renewal Form, is received by the first calendar day of the fifth benefit month or the first calendar day of the 11th benefit month. A timely redetermination guarantees the individual will not have a gap in medical coverage if determined ineligible for Medicaid, but eligible for CHIP.

Note: If the first calendar day of the fifth or the 11th benefit month falls on a weekend or a holiday and the redetermination is received on the following business day, consider the redetermination timely.

Untimely Redetermination

A redetermination is considered untimely if Form H1014-R, Form H1010 or Form H1010-R is received after the first calendar day of the fifth or 11th benefit month and through the last day of the sixth or 12th benefit month. An untimely redetermination may result in a gap in medical coverage if determined ineligible for Medicaid, but eligible for CHIP.

Related Policy
Eligibility Transition from Medicaid to CHIP, B-123.4

B—123.2 Children’s Medicaid Redetermination Processing Time Frames

Revision 13-3; Effective July 1, 2013

Children's Medicaid

Staff must process redeterminations (received timely or untimely) by the 30th day from the date Form H1014-R, Renewal Application for CHIP and Children’s Medicaid, or Form H1010, Texas Works Application for Assistance — Your Texas Benefits, is received or by cutoff of the last benefit month of the certification period, whichever is later.

Examples:

Children’s Medicaid coverage period is January through June. If the redetermination file date is:

  • April 10, the redetermination must be completed by June cutoff to be considered processed timely.
  • June 1, the redetermination must be completed by July 1 to be considered processed timely.

Note: Staff must process renewals received after the last calendar day of the sixth or 12th benefit month as an application.

B—123.3  Reuse of Form H1014-R After Denial

Revision 14-1; Effective January 1, 2014

Children's Medicaid

If an applicant reapplies after being denied for refusal/failure to furnish information and the individual provides the information within 30 days of the last benefit month, use the original Form H1014-R, Renewal Application for CHIP and Children’s Medicaid, or Form H1010, Texas Works Application for Assistance — Your Texas Benefits. Reopen the EDG using the date the information is provided as the new file date. These individuals are not eligible for gap coverage.

If the information on Form H1014-R or Form H1010 has changed or is more than 45 days old, the individual and the advisor must update the form.

Note: Do not request additional income verification when reopening a redetermination denied for refusal/failure to furnish information. Accept the income verification the individual provided for the original application, unless the household indicates a change in income.

B—123.4  Eligibility Transition from Medicaid to CHIP

Revision 13-4; Effective October 1, 2013

Children's Medicaid

When processing a redetermination, certify a child for CHIP if the child is ineligible for Medicaid due to:

  • excess resources/assets; or
  • income that exceeds the Medicaid Federal Poverty Income Limit (FPIL), but is at or below 200% of the FPIL and the child meets CHIP eligibility.

For children who no longer meet Medicaid eligibility criteria, eligibility for Medicaid continues through the end of the sixth month or at the end of the 12th month for TP 45.

Soon after the child is determined eligible for CHIP, the Enrollment Broker (EB) mails an enrollment packet to the family. If the EB receives the health plan selection with any required enrollment fee before the cutoff date in the sixth month, the child(ren) will be enrolled in CHIP effective the first of the next month with no gap in health coverage. For TP 45 EDGs, if the EB receives the health plan selection and any required enrollment fee before the cutoff date in the 12th month, the child is enrolled in CHIP effective the first of the next month with no gap in health coverage.

If there is a delay in CHIP enrollment because of HHSC error and the redetermination packet was received timely, TIERS extends Medicaid eligibility for one or two additional months to allow the family time to complete the process and still retain coverage. The redetermination is considered timely when the redetermination packet is received by the 1st of the 5th month (or 1st of the 11th month for TP 45) and processed by HHSC by the 30th day from the file date.

If the family is solely responsible for the delay, do not extend Medicaid coverage when a child is determined eligible for CHIP.

Use the following chart to determine when to extend Medicaid coverage.

If a child is ineligible for Medicaid but eligible for CHIP and the family ... but HHSC ... then, provide Medicaid coverage ...
completes the redetermination process timely,* does not process the form by the 15th day of the fifth or 11th month (TP 45), for one additional month.
completes the redetermination process timely,* does not process the form by the 15th day of the sixth or 12th month (TP 45), for two additional months.

*Timely means the redetermination form is received from the family by the 1st of the 5th month (1st of 11th month for TP 45) and any required verification received within specified time frames.

B—123.5  Processing a Redetermination for TP 45 - Transfer to TP 48

Revision 13-4; Effective October 1, 2013

Medical Programs

Use this procedure to provide TP 45 coverage for a child whose TP 45 coverage ends and is eligible for TP 48 coverage.

If the family returns the redetermination packet and the child is eligible for TP 48, initiate the review on the TP 45 EDG so that TIERS will build the TP 48 EDG after cutoff in the 11th month of the certification period. Note: If the individual has an existing TP 48 EDG on another child, add the TP 45 child to the TP 48 EDG effective the month after the TP 45 coverage is scheduled to end.

B—123.6  Children’s Medicaid Redetermination Expectations

Revision 13-4; Effective October 1, 2013

Children's Medicaid

Staff must process Children’s Medicaid redeterminations even if not requested on an associated SNAP application or redetermination, if the SNAP application or redetermination is received in the fourth, fifth or sixth month of a six-month Children’s Medicaid continuous eligibility period or in the 10th, 11th or 12th month of a 12-month Children’s Medicaid continuous eligibility period.

Note: If the individual misses the appointment for a SNAP application or redetermination, staff must continue processing the Children’s Medicaid redetermination even if the Children’s Medicaid program was not requested on the application.

If the SNAP application or redetermination is received in

The first, second or third month of a six-month Children's Medicaid continuous eligibility period, do not process the Children's Medicaid redetermination even if the SNAP application or redetermination is processed in the fourth, fifth or sixth month of the six-month Children's Medicaid continuous eligibility period (unless the household requested those services).
the seventh, eighth or ninth month of a 12-month Children's Medicaid continuous eligibility period, do not process the Children's Medicaid redetermination even if the SNAP application or redetermination is processed in the 10th, 11th or 12th month of the 12-month Children's Medicaid continuous eligibility period (unless the household requested those services).

The recipient must provide an application or redetermination application to process the Children’s Medicaid redetermination if the SNAP application or redetermination is not received within the specified time frames.

Related Policy
Receipt of Application, A-121
Deadlines, B-112
Missed Appointment, B-114
Redeterminations, B-120
Processing Redeterminations, B-122

B—124  Processing Untimely Redeterminations

Revision 13-3; Effective July 1, 2013

SNAP

If an application form is not received by the time frames in Section B-122, Processing Redeterminations, use the initial application processing time frames in Section B-112, Deadlines.

If the individual submits an untimely reapplication and misses a scheduled appointment, use the charts in B-160, SNAP Timeliness Charts for Applications and All Redeterminations, for processing time frames. Inform the individual that it is the individual's responsibility to request a second appointment. Send Form H1020, Request for Information or Action, no later than the next workday, notifying the individual of the missed appointment and pend the application.

Note: If the individual misses an appointment that the agency scheduled untimely, schedule a second appointment if the individual contacts the office by the 10th day after the missed appointment date to request another appointment. Otherwise, the individual must reapply with a new file date.

For telephone interviews, make at least two attempts to contact the individual via telephone. Both attempts must be conducted within the specified time period listed on Form H1830-I, Interview Notice. Each attempt must be conducted at least 10 minutes apart. If no contact is made with the individual after two attempts, consider the telephone interview a missed appointment. Document the time and date of each attempt on the Appointment – Details page.

At the individual's request, HHSC must reschedule a second appointment even if it cannot be scheduled until after the 30th day. The individual does not have to show good cause for missing the first appointment.

If on the appointment date the applicant arrives too late for the appointment or calls to reschedule the appointment (because the individual cannot keep the appointment), offer the applicant a choice of a standby appointment or an opportunity to reschedule.

Notes:

  • If a second or subsequent appointment is scheduled because the individual missed the appointment, ensure that second and subsequent appointments have been correctly recorded on the Appointment – Detail page.

See B-160, SNAP Timeliness Charts for Applications and All Redeterminations.

  • Do not prorate benefits if an eligible individual submits an untimely reapplication because HHSC fails to provide Form H1830 timely. Provide benefits from the first day of the month after the last benefits month (enter a file date of the first day of that month).

See A-2323, Proration, and an exception for seasonal and migrant farm workers.

  • Do not use application verification requirements when processing untimely redeterminations. Verification requirements are the same for all redeterminations whether filed timely or untimely. See C-912, Required Verification for SNAP.

Related Policy
Missed Appointment, B-114

B—125  Processing Special Reviews

Revision 13-3; Effective July 1, 2013

All Programs

Special reviews are contacts with the household outside of the redetermination process. Staff may conduct special reviews by home visits, telephone, or by mailing individuals Form H1020, Request for Information or Action, or a letter.

TANF and Medical Programs except and Children's Medicaid

Contact the household to determine if a change occurred. If the household confirms that no change occurred, document the contact. To clear the special review alert task, the advisor must in Data Collection Initiate Interview in Special Review mode. If the household confirms that a change occurred, follow policy in B-600, Changes.

If the household fails to furnish verification requested on Form H1020 or misses an appointment scheduled for the special review, send, Form TF0001, Notice of Case Action, to begin adverse action.

If the individual contacts the office during the adverse action period, reschedule the appointment to process the review as soon as possible to avoid interruption of the benefit issuance cycle for the following month. A second Form TF0001 is not required if the individual misses the second appointment. If the individual does not keep the second appointment, use the time frame of the original Form TF0001 to determine the effective date of the denial.

Related Policy
Setting Special Reviews, A-2330

B—125.1  Due Dates

Revision 13-3; Effective July 1, 2013

SNAP, TANF and Medical Programs except Children's Medicaid

An alert for a special review is triggered in TIERS, which generates a task in Task List Manager (TLM) for the special review.

TANF and Medical Programs except and Children's Medicaid

Process special reviews before cutoff in the month:

  • the review date falls, if the review is due on or before cutoff;
  • after the review date, if the review is due after cutoff.

SNAP

Process special reviews by cutoff of the month the review date falls.

B—126  Processing Desk Reviews

Revision 13-3; Effective July 1, 2013

SNAP

A desk review is the processing of a timely or untimely filed SNAP redetermination application without scheduling or conducting an interview with the household. A SNAP redetermination may be completed by processing a desk review when all of the following criteria are met:

  • the household's current SNAP certification period is six months or less,
  • the current and new SNAP certification periods combined will not exceed a total of 12 months, and
  • eligibility for the current SNAP certification was determined without using the desk review process.

Exceptions: Staff must conduct an interview when the household:

  • has a member who is receiving or is applying for TANF or TP 08
  • failed to complete the application form sufficiently enough (as determined by the local office) to process without an interview;
  • has a member with an intentional program violation (IPV) disqualification; or
  • lives in a drug/alcohol treatment center, homeless shelter, family violence shelter or group living arrangement.

Begin processing a SNAP redetermination as a desk review within seven calendar days after the Packet Received Date (day zero), and issue either a Form H1020, Request for Information or Action, or a Form TF0001, Notice of Case Action, to the household within the same seven calendar days.

Note: When a SNAP redetermination Packet Received Date is the 10th through the 15th calendar day of the Last Benefit Month, ensure a Form H1020 or a Form TF0001 is sent to the household early enough to allow the household 10 days to provide missing information, while still allowing time for the final case action to be timely. Timeliness for Desk Reviews is calculated the same as if an interview was held.

Related Policy
Processing Redeterminations, B-122
Processing Untimely Redeterminations, B-124

B—130  Changes

Revision 02-1; Effective January 1, 2002

See B-600, Changes, for procedures and time frames for processing changes.

B—140  Summary of Due Dates for Form H1020, Request for Information or Action

Revision 13-4; Effective October 1, 2013

All Programs

The due date and final due date entries are shown in the following table. Note: If the 10th or 30th day falls on a non-workday, the due date is the next workday. If the due date is not an HHSC workday (on a weekend or a holiday), the due date advances to the next HHSC workday.

TANF and Medical Programs except Children's Medicaid and TP 40

EDG Action Due Date Final Due Date
Application 10 days
  • 30 days, or
  • 10th day if 10 days end after 30th day
Complete redetermination 10 days 10 days
Incomplete redetermination (including the addition of a household member) 10 days 10 days

Children's Medicaid

EDG Action Due Date Final Due Date
Application 10 days
  • 30 days, or
  • 10th day if 10 days end after 30th day
Complete redetermination 10 days
  • 30 days,
  • by cutoff in the last benefit month of certification, whichever is later, or
  • 10th day if 10 days end after 30th day
Incomplete redetermination (including the addition of a household member) 10 days 10 days

SNAP

EDG Action Due Date Final Due Date
Application 10 days*
  • 30 days, or
  • 10th day if 10 days end after 30th day
Untimely redetermination (including adding a person at untimely redetermination) 10 days*
  • 30 days, or
  • 10th day if 10 days end after 30th day
Timely redetermination (including adding a person at timely redetermination) 10 days*
  • last workday of last benefit month, or
  • 10th day if 10 days end after last benefit month
Incomplete redetermination (including adding a person at incomplete redetermination) 10 days 10 days

TP 40

EDG Action Due Date Final Due Date
Application 10 days
  • 15 work days, or
  • 10th day if 10 days end after 15th work day

* For SNAP EDGs pended for a missed appointment, the 10-day due date is calculated from the date the form is mailed, usually two days after the H1020-MA is triggered by TIERS or TLM entries. The two additional days for mail time when sending a Form H1020-MA in TIERS is only applicable to SNAP EDGs pended for a missed appointment.

B—150  Avoiding Invalid Denials Related to Missing Information and Missed Appointments

Revision 13-3; Effective July 1, 2013

All Programs

Staff must ensure that correspondence is sent to the individual's current address. This requires updating the address in the system if the individual has reported a new address on an application form or a change of address is pending in the Task List Manager or TIERS.

Staff should make two telephone call attempts at least 10 minutes apart during the appointed time frame listed on Form H1830-I, Interview Notice, before determining a telephone interview is a missed appointment. Document the times and dates of the attempted telephone calls on the Appointment – Details page.

Deny an EDG for failure to furnish information only if:

  • the due date on Form H1020, Request for Information or Action, has expired;
  • the information was requested on Form H1020; and
  • there is confirmation that the requested information is not in the office (front desk, mail room, fax machine, etc.) or imaged and available through the State Portal. Follow local procedures for locating submitted verifications.

Do not deny an EDG for missed appointment if:

  • a second appointment has already been scheduled;
  • the denial is before the final due date on Form H1020 for applications and timely redeterminations;
  • the agency failed to make the telephone call for a telephone interview or failed to call within the specified time listed on Form H1830-I; and
  • the individual files another application after missing the initial appointment. Treat the new application as a request to reschedule a missed appointment. Reschedule a timely redetermination appointment before the end of the certification period, if possible. If there are no appointment slots available, schedule the second appointment no later than the 15th day of the following month.

SNAP Denial Reminders

B—160  SNAP Timeliness Charts for Applications and All Redeterminations

Revision 13-3; Effective July 1, 2013

SNAP

The charts in this section may be used as a guide to determine when appointments must be scheduled and benefits provided for the case action to be reported as timely. The charts detail required actions and due dates in the following type situations:

  • applications and untimely redeterminations,
  • timely redeterminations after a regular certification period, and
  • timely redeterminations after a short certification period.

SNAP Applications and Untimely Redetermination

If … then …
  • the household keeps the first appointment; or
  • the household misses the first appointment, keeps the second appointment on or before the 30th day, and the application is not pended for verification; or
  • the household misses the first appointment, keeps the second appointment, and the application is pended for verification and verification is provided timely on or before the 30th day;
  • if eligible, ensure the household has an opportunity to participate by the 30th day after the file date; or
  • if not eligible, deny the application by the 30th day after the file date. Note: If the 30th day is a non-workday, take appropriate action the following workday.
  • the household misses the first appointment and fails to request a second appointment by the 30th day after the file date; or
  • the household misses the first appointment, keeps a second appointment and the application is pended for verification with a Form H1020, Request for Information or Action, due date before the 30th day and the household fails to provide verification timely; or
  • the household misses the first appointment and misses a second appointment scheduled on or before the 30th day and by the 30th day the household does not request another appointment;

deny the application on the 30th day after the file date (or the following workday if the 30th day is a non-workday).

the household misses the first appointment and keeps a second appointment after the 30th day and the application is not pended for verification;

dispose on the day of the interview. If the household is:

  • eligible, ensure the household has an opportunity to participate on the interview date; or
  • not eligible, deny the application on the interview date.

the household misses the first appointment and keeps a second appointment, and the application is pended for verification with a Form H1020 due on or after the 30th day and the household provides verification before the 30th day;

dispose by the 30th day:

  • if eligible, ensure the household has an opportunity to participate by the 30th day; or
  • if not eligible, deny the application by the 30th day.

the household misses the first appointment and keeps a second appointment, and the application is pended for verification and the household provides it timely on or after the 30th day;

dispose on the day the verification is provided. If the household is:

  • eligible, ensure the household has an opportunity to participate on the day verification is provided; or
  • not eligible, deny the application on the day verification is provided.

the household misses the first appointment and keeps a second appointment, and the application is pended for verification with a Form H1020 with a due date on or after the 30th day and verification is not provided timely;

deny the application on the workday after the Form H1020 due date.

the household misses the first appointment and a second or subsequent appointment scheduled after the 30th day is also missed;

deny the application on the day of the missed second or subsequent appointment.

misses the first appointment, misses the second appointment scheduled on or before the 30th day, and, by the 30th day, requests and is scheduled a third appointment after the 30th day;

dispose/process:

  • on the day of the interview if the application is not pended for information/verification; or
  • on the day the information or verification is received if the EDG was pended and the information is provided, or
  • on the workday after the Form H1020 due date if the EDG was pended and the information was not provided.

Timely SNAP Redeterminations After a Regular Certification Period

If … then …
  • the household keeps the first timely appointment; or
  • the household misses the first timely appointment, keeps the second appointment on or before the last workday of the certification period, and the application is not pended for verification; or
  • misses the first appointment, keeps the second appointment, and verification is provided timely on or before the last day of the certification period;
  • if eligible, dispose/process the redetermination application by the last workday of the certification period; or
  • if not eligible, deny the redetermination application by the last workday of the certification period.

Note: If the last day of the certification period is not a workday, take action the last workday before the end of the certification period.

  • the household misses the first appointment and fails to request a second appointment by the last workday of the certification period; or
  • the household misses the first appointment and misses a second appointment scheduled on or before the last workday of the certification period, and by the last workday of the certification period the household does not request another appointment;

deny the application on the last workday of the certification period.

  • the household misses the first appointment and misses a second or subsequent appointment scheduled on or before the 15th of the month after the last benefit month; or
  • the household misses the first appointment and keeps a second appointment on or before the 15th of the month after the last benefit month, and the application is not pended for verification;

dispose the recertification application on the day of the second (or subsequent) appointment.

the household misses the first appointment and keeps a second appointment on or before the 15th of the month after the last benefit month, and the application is pended for verification with a Form H1020 and the household provides verification timely;

  • if verification was provided by the last workday of the certification period, process by the last workday of the certification period; or
  • If verification was provided by the Form H1020 due date but after the certification period:
    • if eligible, ensure the household has an opportunity to participate within five workdays after receipt of the verification; or
    • if not eligible, deny the application within five workdays after receipt of the verification.

the household misses the first appointment and keeps a second appointment on or before the 15th of the month after the last benefit month, and the application is pended for verification with a Form H1020 and the household fails to provide verification by the final due date;

  • if the Form H1020 due date was before the last workday of the certification period, deny the application on the last workday of the certification period; or
  • if the Form H1020 due date was on or after the last workday of the certification period, deny the application on the workday following the due date on Form H1020.

the household misses the first appointment and also misses a second or subsequent appointment scheduled after the end of the certification period;

deny the application on the day of the missed second appointment.

the household misses the first appointment and also misses a second appointment scheduled on or before the end of the certification period, and by the last workday of the certification period the household requests another appointment and is scheduled a third appointment after the end of the certification period;

  • if the application is not pended or if the household misses the appointment, dispose/process the application on the day of the appointment; or
  • if the EDG is pended:
    • dispose/process within five workdays after the receipt of information/verification, if the pended information is provided; or
    • deny the application on the workday following the Form H1020 due date, if the pended information is not provided.

Timely SNAP Redeterminations After a Short Certification Period

If… then…
  • the household keeps the first appointment; or
  • the household misses the first appointment, keeps a second appointment on or before the 30th day after the last month's full benefit issuance, and the application is not pended for verification; or
  • the household misses the first appointment, keeps a second appointment, and the application is pended for verification and verification is provided timely on or before the 30th day after the last month's full benefit issuance;
  • if eligible, process the redetermination by the 30th day; or
  • if not eligible, deny the application by the 30th day.


Note: If the 30th day is not a work day, take action on the last workday before the 30th day.

  • the household misses the first appointment and fails to request a second appointment by the 30th day after the last month's full benefit issuance; or
  • the household misses the first appointment and also misses a second appointment scheduled on or before the 30th day, and by the 30th day (or last workday before the 30th day) the household does not request another appointment;

deny the application on the 30th day (or the last workday before he 30th day if the 30th day is not a workday).

  • the household misses the first appointment and also misses a second or subsequent appointment scheduled on or before the 45th day after the last month's full benefit issuance; or
  • the household misses the first appointment and keeps a second appointment on or before the 45th day and the application is not pended for verification;

dispose the recertification application on the day of the second (or subsequent) appointment.

the household misses the first appointment and keeps a second appointment on or before the 45th day after the last month's full benefit issuance, and the application is pended for verification with a Form H1020 and the household provides verification timely;

  • if verification was provided by the 30th day after the last month's full benefit issuance, process by the 30th day.
  • if verification was provided by the Form H1020 due date but after the 30th day after the last month's full benefit issuance:
    • if eligible, ensure the household has an opportunity to participate within five workdays after receipt of the verification; or
    • if not eligible, deny the application within five workdays after receipt of the verification.

the household misses the first appointment and keeps a second appointment on or before the 45th day, and the application is pended for verification with a Form H1020 and the household fails to provide verification by the final due date;

  • if the Form H1020 due date was before the 30th day after the last month's full benefit issuance, deny the application on the 30th day.
  • if the Form H1020 due date was on or after the 45th day, deny the application on the workday following the due date on Form H1020.

the household misses the first appointment and misses a second or subsequent appointment scheduled after the 30th day from the last month's full benefit issuance;

deny the application on the day of the missed second or subsequent appointment.

the household misses the first appointment and misses a second appointment scheduled on or before the 30th day, and, by the 30th day of the certification period, the household requests and is scheduled for a third appointment after the 30th day;

  • if the application is not pended or if the household misses the appointment, dispose/process the application on the day of the appointment; or
  • if the case is pended:
    • dispose/process within five workdays after the receipt of information/verification, if the pended information is provided; or
    • deny the application on the workday following the Form H1020 due date, if the pended information is not provided.

B—161  DataMart Reports

Revision 13-3; Effective July 1, 2013

All Programs

DataMart provides a series of online reports accessed through the State Portal. The reports are used as monitoring tools for various EDG action activities for cases in TIERS (including timeliness of those activities). See C-840, DataMart.

B—170  Documentation Requirements

Revision 13-3; Effective July 1, 2013

All Programs

Document the reason(s) for delays in processing an application and advisor action as explained in B-113, Delay in Processing Applications.

For missed telephone interviews, document on the Appointment – Details page the time of each call when attempting to contact the applicant according to policy in B-114, Missed Appointment, B-122, Processing Redeterminations, and B-124, Processing Untimely Redeterminations.

Related Policy
The Texas Works Documentation Guide