Revision 15-2; Effective April 1, 2015
185% of Federal Poverty Income Level — Transitional Medicaid test on seventh and 10th month Medicaid reports.
401(k) — A retirement plan allowing an employee to postpone receiving a portion of current income until retirement.
Able Bodied Adult Without Dependents (ABAWD) — A Supplemental Nutrition Assistance Program (SNAP) individual age 18-50 not meeting any of the exemption criteria in Texas Works policy.
Absent Parent — A child's parent who is missing from the home.
Accessibility Date — The date benefits are deposited into the EBT account.
Active Duty Military Member — An individual in the U.S. Armed Forces/Reserves (Army, Marine Corps, Navy, Air Force or Coast Guard), National Guard (Army, Marine Corps, Navy, Air Force, Coast Guard or Reserve Guard) or the State Military Forces/Texas State Guard.
Adequate Notice — A notice of adverse action that expires the same day it is sent.
Administrative Review — A desk review of the fair hearing record by an HHSC attorney to determine if the hearing officer's decision is correct. A request for an administrative review must be submitted in writing within 30 calendar days from the date of the hearing officer's decision.
Administrative Terminal Application (ATA) — A software program loaded on one or more HHSC desktop computers in each office and used for EBT card issuance and replacement. The Administrative Terminal Application allows access to the EBT system and may also be used for inquiry on EBT-related information, priority SNAP priority benefit authorization, and account transaction update to the EBT database.
Advanced Authentication — Personal security questions generated by third-party software to perform authentication of an application’s identity before granting the individual an account through the Self-Service Portal (SSP) with Case Visibility.
Advance Notice — A notice of adverse action that expires 13 days after it is sent.
Advanced Nurse Practitioner — A registered nurse with additional training and certification in a specific area of medicine. Examples are certified nurse-midwives, clinical nurse specialists, and pediatric nurse practitioners.
Adverse Action — Any HHSC action resulting in denial, suspension, reduction, or termination of assistance. The term is also applied to decisions regarding protective and restricted payments.
Agriculturally Related Activities — Employment:
- on a farm or ranch performing field work related to planting, cultivating or harvesting operations; or
- in canning, packing, ginning, seed conditioning, or related research or processing operations.
Aid — A benefit, coverage or service in programs that HHSC administers.
Alert — A system or user-generated reminder of an action that needs to be taken on a case or a notification that an action on a case has taken place.
Alerts — A functional area where eligibility staff can view outstanding and processed alerts and request an alert.
Alien Sponsor — A person who signed an affidavit of support (USCIS Form I-864 or I-864-A) on or after Dec. 19, 1997, agreeing to support an alien as a condition of the alien's entry into the U.S.
Note: Not all aliens must obtain a sponsor before being admitted into the U.S.
Alternate Payee — The alternate payee receives the benefits for the EDG when the EDG name is unable or ineligible to receive them. The alternate payee is allowed to make managed care choices on behalf of the client. Types of alternate payees include a court appointed guardian, EBT representative, FMIS payee, LTC payee, protective payee, representative payee, and power of attorney. An alternate payee is not necessarily the authorized representative.
Annualize — Averaging income over a 12-month period.
Annuity — An amount payable yearly or at other regular intervals.
Annulment — A court order declaring a marriage invalid.
Appeal — A request for a fair hearing concerning an HHSC action. Appeals are logged and updated in the Hearing functional area.
Application — Form that an individual or household uses to apply for assistance, such as Form H1010, Texas Works Application for Assistance - Your Texas Benefits, or Form H1840, SNAP Food Benefits Renewal Form. HHSC must accept any application that contains at least the applicant's name, address and signature; or for SNAP, the signature of a responsible household member or authorized representative. The applicant must answer all the questions on the application before the advisor certifies the household.
Application Registration — The functional area in which an individual's application for assistance is recorded. This area is used for new households or when the household members' EDGs are denied.
Application Visibility — Type of SSP account given to an applicant who has selected not to go through Advanced Authentication. Those with Application Visibility accounts may only apply for benefits and view and modify applications created under their user name.
Applied Income — The countable amount of income after allowing deductions for tax dependents, child support, alimony and persons a legal parent is legally obligated to support.
Assets — All items of monetary value owned by an individual.
Assignable — Time periods that are available to be used to schedule appointments using the Scheduling functional area.
Authorization Code — A code that identifies a retailer as an FNS participating store and is used to request permission to use the Lone Star Card in a transaction.
Authorized Representative (AR) — For:
- Supplemental Nutrition Assistance Program (SNAP) — A person chosen by the household to apply for benefits on the household's behalf.
- Temporary Assistance for Needy Families (TANF) — Someone acting responsibly for the individual in the application and redetermination processes at the:
- individual's request when the individual is incapable or incompetent, or
- grandparent's request when the advisor determines the individual is not using the TANF for the child's needs. When this situation occurs, the grandparent is also designated alternate payee (protective payee).
The AR does not receive or monitor the household's TANF and Medicaid benefits. These functions are the responsibilities of a protective payee or a representative payee.
- Family Medical Assistance (FMA) — A person chosen by the household to apply for benefits on the household's behalf. The AR does not receive and monitor the household's Medicaid benefits. This is the responsibility of a protective payee and a representative payee. An FMA individual does not have to be incompetent or incapacitated to name an AR.
Availability Date — The date benefits are deposited into the EBT account.
Balance Receipt — A paper receipt that shows the available balance in the individual's cash and/or food account.
Basic — Temporary Assistance for Needy Families.
Basic Utility Allowance (BUA) — Deduction given to a household that has utility costs, but does not qualify for the Standard Utility Allowance (SUA).
Batch Processing — Actions postponed until a later time when they can be processed by the system more efficiently. In many instances batch processing occurs overnight, when HHSC offices are closed and the system is not being heavily used throughout the state. Examples of batch processing: scheduling system-generated correspondence to be printed at and mailed from a central site, mailing out review packets at scheduled intervals from the central mail facility, and gathering information and sharing it through interfaces with other agencies.
Batch Scheduling — The process in which application packets mailed from the central mail facility include an appointment date and time with eligibility staff. See Batch Processing.
Bendex (Beneficiary Data Exchange) — A computer tape from the Social Security Administration giving Social Security and Medicare information about HHSC individuals. An Alert is generated when the amount on file does not match the information on the Bendex file.
Beneficiary — The person named to receive benefits.
Benefit Issuance — The functional area that supports the issuance and tracking of benefits that were calculated in EDBC and authorized by staff in Disposition. See Dispose.
Blocked — Time periods that are designated for specific purposes and cannot be used to schedule appointments using the Scheduling functional area.
Boarder — A person paying reasonable compensation for room and meals. A boarder can receive SNAP only with the household he boards with. Note: This does not include anyone who otherwise qualifies as a resident of a drug/alcohol treatment center, federally subsidized housing for the elderly, a qualifying GLA, a shelter for battered women or a shelter for the homeless.
Bona Fide Agent — A person who is familiar with the individual and knowledgeable of the individual's financial affairs.
Budget Group — Members of a household whose needs, income, resources and medical expenses are considered in determining eligibility for medical programs. The budget group includes both members who are eligible and members who are not eligible for a medical program.
Budgetary Needs — The full basic needs amount as defined by HHSC necessary for a family to obtain food, clothing, housing, utilities and incidentals such as telephone, laundry and recreation. This is based on family size and is used in the TANF 100% Budgetary Needs gross income test.
Budgeting — The method used to determine eligibility and benefits for TANF, FMA and SNAP by calculating income and deductions.
Bureau of Vital Statistics (BVS) — The Texas Bureau of Vital Statistics inquiry system used by eligibility staff to verify birth information.
Cafeteria Plan — A term used to refer to flexible fringe benefit plans offered to employees by their employers.
Capital Assets — The accumulated possessions (property, goods and products) used to produce income or other goods.
Capital Gain — The financial profit from sale or transfer of capital assets.
Cardholders — Persons authorized to use the Lone Star Card to access benefits in the EBT account(s). There are two types of cardholders: primary cardholders and secondary cardholders.
Card Sleeve — A durable paper envelope folded to the dimensions of the plastic EBT card so that the card can be slid in and out of the sleeve. The primary use of the sleeve is to protect the magnetic stripe from being damaged by scratches. The sleeve also has important information printed on it for easy reference, such as the Lone Star help desk number.
Caretaker — For
- TANF – An adult whose needs are included in a TANF grant because the adult is within the required degree of relationship and is financially eligible according to TANF policy.
- FMA – An adult who is present in the home and supervises and cares for a child. The child must meet the definition of a dependent child and the caretaker must meet the TANF relationship requirement for the adult to qualify as a Medicaid-eligible caretaker.
Caretaker Relative — A disqualified legal parent or a person certified as caretaker or second parent.
Carryover Standby List — Applicants from a previous day's Standby List who have not been interviewed.
Cascade Logic — A hierarchy of logic used to build EDGs and evaluate eligibility for HHSC programs and types of assistance. The EDG is built and eligibility is established at the highest level. If there are no eligible members after cascade logic is applied, the household is ineligible for the program. See EDBC, Rebuild EDG, Run EDBC and Wrap Up.
Case — All the persons living together, and alien sponsors, who are related by EDG affiliation. The persons may or may not be included in EDGs as certified members.
Case Mode — Identifies:
- action initiated on an EDG in a case (Intake, Complete Action, Change Action, Special Review, Conversion);
- all of the EDGs in a case are approved (Ongoing); and
- all of the EDGs in a case are denied (Ongoing).
Case Number — A unique 10-digit number that identifies a group of EDGs. See Case.
Case Visibility — Type of SSP account given to an applicant who has been through Advanced Authentication and therefore granted a Case Visibility level account. With this type of access, individuals can view and modify an application created under their user name and any case data for cases in which they are the head of household, an adult member within the household, or an authorized representative.
Catchment Area — The area covered by service.
Categorically Eligible Household — A SNAP household whose members are all approved for TANF or Supplemental Security Income (SSI). This includes members authorized to receive TANF non-cash (TANF-NC) services and the household's gross income is less than 165% Federal Poverty Income Limit (FPIL) for its size. A household member is a TANF or SSI recipient if he is approved for TANF or SSI but the benefit:
- has not yet been received,
- is suspended, or
- is being recouped.
Certificate of Coverage — Proof of a Medicaid recipient's most recent period of Medicaid coverage. The certificate, a requirement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), is sent to denied recipients by the Texas Department of State Health Services. HIPAA mandates that prior health insurance coverage must be counted toward reducing or eliminating any applicable pre-existing condition exclusion period when a person enrolls in a new health insurance plan. Former Medicaid recipients may request a certificate within 24 months after their Medicaid is denied by calling 1-800-723-4789.
Certification Date — The date eligibility staff dispose the EDG to certify an applicant as eligible.
Certification Period — The begin to end dates of eligibility established at disposition. Not all HHSC programs and types of assistance have certification periods.
Certified Group — The members in an EDG whose participation status is Eligible.
Change Action — A Data Collection interview mode that allows eligibility staff to navigate to pages on which they want to record information. See Case Mode.
Child in a Two-Parent Family — For:
- TANF — A child who lives with either one or both parents, or a parent and stepparent, and one or both of the parents/stepparent do not receive TANF benefits.
- TANF-SP — A child who lives with both parents or a parent and stepparent, and both parents and stepparent (if included in the certified group) receive TANF benefits.
- FMA — A child living with both parents may or may not be deprived.
Child Support Disregard — For:
- TANF — The first $75 of the total child support collected in a month that is subtracted before determining TANF eligibility or benefits. After certification, the Office of Attorney General (OAG) sends the individual the first $75 received on monthly child support collections. If the total collection is less than $75, then the amount of the collection is sent to the individual.
- FMA — An amount up to $75 subtracted from monthly child support received before determining eligibility for FMA.
Children's Health Insurance Program (CHIP) — Medical coverage for children under age 19 whose family income and/or resources exceeds limits for Children's Medicaid.
CHIP Perinatal — Medical services to unborn children of pregnant women ineligible for Medicaid.
Children's Medicaid — Medical coverage for children whose family income is under 185% FPIL. In most instances, Children's Medicaid relates to comprehensive policy for TPs 43, 44, 45, 47 and 48, unless specifically stated otherwise in a particular handbook section.
Choices County Service Levels — The Texas Workforce Commission (TWC) has designated all counties in Texas as Choices counties. TWC and the Local Workforce Development Boards (LWDBs), after coordination with HHSC state office, assign a service level designation for each county depending upon services available in that county. The two levels of service are:
- full service — having a significant presence of Choices staff; or
- minimum service — have little or no presence of Choices staff.
Claims — An amount owed by an individual for an overpayment of benefits.
Clearinghouse — A centrally located site that processes medical bills submitted by applicants for Medically Needy with spend down. Functions of the clearinghouse include:
- determining if a medical bill can be counted for spend down,
- corresponding with the applicant about eligible and ineligible medical bills,
- determining if and when the applicant meets spend down, and
- notifying the applicant and the eligibility system when spend down is met.
Collateral Contact — A person the advisor can contact to verify individual information. The person must have no vested interest in the household's situation.
Colonias — Unincorporated and unregulated settlements (neighborhoods) along the U.S./Mexico border.
Combat Pay — Includes items such as incentive payments for hazardous duty and special pay for duty subject to hostile fire or imminent danger.
Combat Zone — Includes places such as Iraq, Afghanistan, Kuwait, Saudi Arabia, Bahrain, Gulf of Aden, Gulf of Oman, Persian Gulf, Qatar, Oman, United Arab Emirates, Pakistan and others.
Commingled Resources — Resources of a TANF or SSI recipient combined with those of a non-TANF or SSI household member.
Common Law Marriage — Relationship in which the parties age 18 or older:
- are free to marry;
- live together; and
- hold out to the public that they are husband and wife.
A minor child in Texas is not legally allowed to enter a common law marriage unless the claim of common law marriage began before Sept.1, 1997.
Communal dining — A public or non-profit establishment approved by FNS, which prepares and serves meals to elderly persons or SSI recipient, and their spouses.
Complete Action — A Data Collection interview mode that sets up the driver flow for a complete review of all eligibility requirements in an ongoing case. See Case Mode and Interview Mode.
Complete Review — A reevaluation of ongoing eligibility.
Comprehensive Energy Assistance Program (CEAP) — A utility assistance program funded annually by the Low Income Home Energy Assistance Program (LIHEAP). CEAP replaced the Home Energy Assistance Program (HEAP).
Continued Benefits — Continuing or restoring benefits to the level authorized immediately before the notice of adverse action.
Continuing Scheme — When a recipient commits two or more acts (such as a falsified document, falsified interview or a falsified statement) with the intent to commit fraud. Failure to report a required HHSC program change in conjunction with one or more of the aforementioned acts may be considered a basis to commit fraud.
Conversion — The process for converting SAVERR case and individual data to TIERS. Conversion is a functional area where you can view SAVERR history or initiate an Interim (Conversion) Request.
Convertible Bond — A bond that can be converted to cash according to program policy. Convertible bonds are countable resources.
Copayment — Payment made directly to a provider according to a fee schedule.
Correspondence — The functional area in which system- and user-generated notices and forms are processed. The notices and forms that are processed in this functional area are also called correspondence. All notices and forms processed in this functional area are linked to a specific case. System-generated correspondence cannot be deleted. See Batch Processing, Pending Correspondence, Print Mode, Print Type, System-Generated and User-Generated.
Crime Victim's Compensation — Payments from the funds authorized by state legislation to assist a person who:
- has been a victim of violent crime;
- was the spouse, parent, sibling or adult child of a victim who died as a result of a violent crime; or
- is the guardian of a victim of a violent crime.
The payments are distributed by the OAG in monthly payments or in a lump-sum payment.
Data Broker — An intranet application used by eligibility staff to access online data about individuals. The information is compiled from a number of sources into one combined report. This information is compared to the application and details from the interview to identify case discrepancies, reducing the possibility of case error and fraud. See Permissible Purpose.
Data Collection — The functional area where individual household, non-financial, resource, income and deduction information is recorded for use in building EDGs and determining eligibility for types of assistance. See EDBC and Driver Flow.
Dependent Child — A child who meets the TANF definition of deprivation and who lives with a relative who meets the TANF relationship requirement.
Deprivation — Loss of parental support caused by death, incapacity, continued absence of one or both natural or adoptive parents, or because of unemployment or underemployment of both parents in a two-parent family.
Derivative Citizenship — U.S. citizenship that is claimed by a person born outside of the U. S. to one or both U.S. citizen parents.
Detail Page — Click the Edit or View icon to edit or view details of a record listed on a Summary Page.
Dialog Box — A box that allows communication with the computer. Use a dialog box to enter information, select options or give commands to computer program. A scroll bar may appear in the box to allow the user to view all options in a list. If multiple choices are allowed from the list, the user selects them by holding the Control key down and clicking on (highlighting) each choice. See Drop Down Menu.
Disabled — When a field, button or icon is not available to be changed by the user. Disabled features are shaded gray or grayed out.
Discovery Date — The date the individual learns of a change. The Discovery Date is compared with the Report Date to determine whether a change is reported timely.
Dispose — To process an EDG so eligibility is established or denied.
Disqualified Person — Someone who normally would be considered a participating member of a household but whose needs are not considered because the person failed to meet or comply with a program requirement.
Domicile — A TANF/FMA policy that requires that a child live with a relative who is within the required degree of relationship. Independent children do not have to meet this requirement to be eligible for Medicaid.
Dormant Account — Term used when an active EBT account has not been accessed by an individual for:
- three consecutive months for TANF and SNAP; or
- six consecutive months when the household received a SNAP issuance of less than $20 for the previous calendar month.
Dormant EDG — An EDG becomes dormant when the EBT account is dormant. See Dormant Account.
Driver Flow — The logical sequence of Data Collection pages that appear as a case is completed or read. The driver flow is determined by the programs, types of assistance and answers to questions as the case is worked. In some Interview Modes, staff cannot advance to pages that have not yet been accessed as part of the driver flow.
Drop-Down Menu — A list of items that appears when a triangle within a dialog box is clicked with the mouse. The user is limited to choosing only one item from the list by clicking on the item.
Duplicate Application — An application filed after another application has already been filed and:
- does not include a request for programs different from programs requested on the initial application submitted;
- does not include a request for programs different from programs currently received by the applicant; and
- is not needed for a recertification, review or renewal.
Earned Income — Income an individual receives for a certain degree of activity or work. Earned income entitles the individual to work-related deductions.
Earned Income Tax Credits (EIC) — Payments from IRS to people with tax dependents and gross monthly earnings at or below levels established by the IRS.
Effective Month — The first month benefits can be affected based on the monthly cutoff date or applicable policy regarding advance and adequate notice of adverse action.
Electronic Benefit Transfer (EBT) — A system that uses electronic technology to complete some or all of a benefit program's functional requirements. EBT involves computers, a variety of cards or types of cards, electronic funds transfer (EFT) techniques, ATMs, point-of-sale (POS) terminals, or other types of terminals, and software to complete the EBT process without the loss of program integrity or individual confidentiality.
Electronic Benefit Transfer (EBT) Account — A benefit account established by the EBT system in which HHSC deposits the household's benefits. There are two types of benefit accounts:
- a food account that contains the household's SNAP benefits, and
- a cash account that contains the household's TANF grant amount.
The individual or his representative uses the Lone Star Card and a PIN to access benefits in the account(s).
Electronic Benefit Transfer (EBT) Card — A plastic card called the Lone Star Card issued to primary and secondary cardholders that allows them access to the benefits in the EBT system. A stripe of magnetic material, which is machine-readable and allows for the activation of POS equipment, is affixed to the back of the card at the time of manufacture.
Electronic Benefit Transfer (EBT) Coordinator — A regional manager designated to lead regional planning and be a point of contact for EBT.
Electronic Benefit Transfer (EBT) Issuance Staff — An HHSC employee who answers EBT questions and accomplishes EBT card and PIN issuance for individuals in the local HHSC office.
Electronic Benefit Transfer (EBT) Regional Manager — A regional manager designated to oversee, monitor, lead regional planning and be a point of contact for EBT.
Electronic Benefit Transfer (EBT) Representative — A primary cardholder other than the case name. This person has access to the EBT account for the EDG. This may be a TANF representative payee or protective payee, or a SNAP authorized representative for a resident of a Drug/Alcohol Treatment Center or Group Living Arrangement. See Alternate Payee.
Electronic Benefit Transfer (EBT) Vendor — One of the companies that performs EBT-related services for the state of Texas.
Electronic Case File (ECF) — The computer record of a GWS eligibility determination for TANF, SNAP and/or FMA. TIERS replaces GWS and ECF.
Eligibility — The functional area that supports EDBC.
Eligibility Determination Benefit Calculation (EDBC) — The process of applying program policy to household, non-financial, resource, income and deduction information entered in the Data Collection functional area. This information is used in the EDBC process to build EDGs and determine eligibility for programs and types of assistance. See Cascade Logic.
Eligibility Determination Group (EDG) — Members of a household whose needs, resources, incomes and deductions are considered in determining eligibility for benefits. The EDG includes members who are eligible, and may include members who are not eligible for benefits.
Emancipated Minor — A person under age 18 who has been married. The marriage must not have been annulled.
Emergency Medical Condition — An eligibility requirement for Non-Immigrant and Undocumented Alien Medical Assistance for non-immigrants, undocumented aliens and certain legal permanent resident aliens. It is a medical condition (including emergency labor and delivery) manifesting itself by acute symptoms of sufficient severity (including severe pain) that the absence of immediate medical attention could reasonably have been expected to result in:
- placing the patient's health in serious jeopardy,
- seriously impairing his bodily functions, or
- causing serious dysfunction of any bodily organ or part.
Emergency Medicaid — Term that refers to all types of emergency Medicaid coverage programs for individuals who are nonimmigrants, undocumented aliens, or certain legal permanent residents who have emergency medical conditions and who, except for alien status, would be Medicaid-eligible. When the term is used in the handbook, it means all of the following programs combined:
- TANF Level Families – Emergency (TA 31)
- Medically Needy with Spend Down – Emergency (TP 32)
- Children 1-5 – Emergency (TP 33)
- Children 6-18 – Emergency (TP 34)
- Children Under 1 – Emergency (TP 35)
- Pregnant Women – Emergency (TP 36)
Employable Household Member — A person whose earnings are countable and:
- is age 16 through 59,
- does not meet the criteria in B-432, Definition of Disabled, and
- is currently unemployed.
Employer-Paid Taxes — Taxes that are paid by the employer on behalf of the employee rather than deducting the tax amount from the employee's wages. The amount the employer pays is counted as part of the individual's gross income.
Employment Services Program (ESP) — The program for employment assistance and work registration of TANF and SNAP individuals. ESP includes Choices and Employment and Training (E&T).
Equity — The fair market value of an item minus all money owed on it and the cost associated with its sale or transfer.
Essential Person — The need for a particular member of a household to be in the home on a continuous basis because of the (certified) mental or physical impairment of another member.
Evaluative Conclusion — An advisor's decision, subject to supervisory approval, to accept something other than a birth or hospital certificate or baptismal record as proof of age and relationship.
Excess Payment — A payment sent to a TANF recipient by the OAG. When the OAG receives a child support collection on the current monthly obligation and that payment exceeds the TANF grant plus any unreimbursed assistance, the excess is sent to the individual.
Excluded Provider — A Medicaid provider who is not allowed to continue participating in the Texas Medicaid program because of patient abuse or neglect, fraud conviction, program abuse, and other reasons. If Medicaid recipients live in areas affected by the exclusion of the provider, as well as the services or prescriptions he orders, they are notified on their Form H3087, Medicaid Identification.
Expedited Service — Special faster processing of SNAP applicants who qualify for an emergency food allotment.
Expunged Benefits — A process in which benefits in an EBT account are removed from the account.
Fair Hearing — A meeting conducted by a regional hearing officer with an applicant or individual who disagrees with and wishes to appeal some action taken on the individual's case.
Fair Market Value — Amount of money an item would bring if sold in the current local market.
Falsified Document — Form H1010-A, Application for Assistance - Part A: Information You Need to Know, Form H1019, Report of Change, or other signed and dated document that does not report all current income or circumstances.
Falsified Interview — An interview with agency personnel at which time the individual does not report all current income or accurate circumstances.
Falsified Statement — A statement made by an individual, orally or in writing, that is not true (e.g., individual states he/she has not worked since a certain date, but in fact has worked since that date).
Family Medical Assistance (FMA) — State-paid medical insurance (Medicaid) for eligible recipients. Certified members are grouped by age and circumstance.
Family Violence — An act by a member of a family or household against another member of the family or household that is:
- intended to result in physical harm, bodily injury or assault, or that is a threat that reasonably places the member in fear of imminent physical harm, bodily injury or assault, but does not include defensive measures to protect oneself; or
- intended to inflict emotional harm including an act of emotional abuse.
File Clearance — This feature determines if an applicant has a case record with HHSC. When an individual is added, File Clearance can be done in Application Registration. If File Clearance is not done in Application Registration, the system will perform it in Data Collection. File Clearance compares the individual's demographic information against databases for potential matches. These databases contain TIERS and SAVERR information for individuals who are currently on assistance and for individuals who have applied for or received assistance in the past.
First Cousin Once Removed — A person's first cousin once removed is either his (1) first cousin's child, or (2) parent's first cousin.
Fixed Income — Unearned income that does not vary.
Flexible Support Payments — Financial assistance provided to relative caregivers in the conservatorship of the Department of Family and Protective Services (DFPS). The purpose of the payments is to reimburse caregivers for expenses such as summer school tuition, tutoring, school supplies, school activities, car insurance for adolescents and other necessary expenses. The amount of the reimbursement will not exceed $500 annually per child.
Fluctuating Income — Income in which the amount varies because of an increase or decrease in hours worked, rate of pay or inclusion of a bonus.
Four Months Post-Medical — Medicaid coverage extended for a maximum of four months after denial of a case because of child support income.
Fugitive — An individual fleeing to avoid prosecution of, or confinement for a felony criminal conviction; or found by a court to be violating federal or state probation or parole.
Functional Area — Functional areas appear on the Left Navigation Bar and represent a particular business process. Each functional area contains pages that allow authorized staff to perform activities related to the business process. The functional areas that are available to the user are determined by the user's job title and security role(s). Click on a functional area to bring up related pages.
General Equivalency Diploma (GED) — A high school equivalency certificate issued after an individual completes a State Board of Education-approved high school equivalency program.
General Residential Operations Facility — Residential care facilities that provide a live-in house parent model of care for children under their care. The house parent(s) assumes responsibility and acts in lieu of the parent(s) in meeting the children’s ongoing needs. These facilities have limited power of attorney to obtain health care and educational services for the children under their care.
Generic Worksheet (GWS) — A computer application used for documentation and determination of eligibility for TANF, SNAP and FMA. TIERS replaces GWS.
Good Cause — A term used to indicate that an individual has an acceptable reason for not complying with a program requirement.
Grandparent Payment System (GPS) — An electronic, web-based data system used to inquire, request and record the issuance of One-Time Grandparent payments.
Grant in Jeopardy — OAG's designation for a case that is potentially ineligible for the TANF grant because the OAG received a child support collection on the current monthly obligation and it equals or exceeds the TANF grant plus the disregard.
Grayed Out — When a field, button or icon is disabled, it is not available for the user to change and is shaded gray. See Disabled.
Health Insurance Premium Payment (HIPP) — The HIPP Reimbursement Program is administered by HHSC Third-Party Resource Unit, which pays for the cost of premiums, coinsurance and deductibles. The program reimburses the policy holder for private health insurance payroll deductions for Medicaid-eligible persons when HHSC determines it is cost-effective.
Hearing — The functional area where individual appeals are recorded and tracked.
Help — See Page/Field Level Help, User Guide, and Wizards.
High School Diploma — A high school diploma must be issued by a state-accredited school to a student who successfully completes the curriculum requirements for secondary school as approved by the State Board of Education.
Historical Correspondence — Records of forms and notices that have been printed. See Correspondence, Print Mode and Print Type.
Historical Data — Records of case, EDG and individual information.
Home Energy Assistance Program (HEAP) — This federal program pays benefits to help eligible people pay utility costs.
Home School — A type of education in which a child is taught by his parents, or someone acting in parental authority, in or through his home using a set curriculum. The parent oversees the curriculum and ensures that the child is actually being educated.
Homeless Household — Households that have no regular nighttime residence, or that live in:
- a supervised shelter that provides temporary living quarters,
- a place not intended for regular sleeping quarters, or
- temporary quarters in another person's residence for 90 days or less. After 90 days in the same person's residence, the household is no longer considered homeless.
Hotline (TANF/SNAP/Complaints) — Toll-free number (1-800-252-9330) where staff accept complaints for TANF and SNAP cases.
Housing and Urban Development (HUD) — U.S. Department of Housing and Urban Development.
Icon — A picture used to identify a shortcut to a certain object or program. The help icon is a question mark. The edit icon is a pencil in a small circle. The delete icon is an x in a small circle. There are numerous icons in the TIERS application.
Identical Application — One or more exact copies of an application previously submitted by an applicant.
Illegal Alien — A non-citizen living in the U.S. without proper approval from the U.S. Citizenship and Immigration Services (USCIS) and who has received a final order of deportation.
Immigrant — An alien who is abandoning his residence in a foreign country to live in the U.S. as a permanent resident, for example a lawful permanent resident (LPR).
Inaccessible Resources — Resources not legally available to the individual.
Independent Child — A child who does not live with a parent and who:
- is able to apply for Medicaid on his own behalf, or
- is eligible for Medicaid because a responsible person who is not within the degree of relationship required for TANF applies on the child's behalf.
Independent Living Payments — Payments from Title IV-E funds that are distributed by Child Protective Services to certain individuals when they leave foster care. Payments:
- are received for a minimum of three months;
- cannot exceed $300 a month;
- cannot total more than $800; and
- are intended for expenses other than room and board.
Indian Tribal Household — A household in which at least one household member is recognized as a tribal member by any Indian tribe.
Indigent Alien — An indigent alien is a sponsored alien whose total income in the month of application does not exceed 130% of the poverty income guidelines for his household size. When determining the alien's total income, consider:
- the alien's own income;
- cash contributions of the sponsor or others; and
- the value of in-kind assistance provided by the sponsor or others.
Individual Development Accounts (IDAs) — An account similar to a savings account that enables an individual to save earned income for a qualifying purpose. IDAs are generally matched dollar-for-dollar with funds from private citizen, corporations, banks, communities or charitable organizations. The matching funds are inaccessible to the individual if the funds are paid directly to a bank or loan institution, an individual selling a home, or a business account.
Individual Number — A unique nine-digit number that identifies any person known to TIERS.
Individual Retirement Account (IRA) — An account in which an individual contributes an amount of money to supplement his retirement income (regardless of his participation in a group retirement plan).
Individually Identifiable Health Information — Information that identifies or could be used to identify an individual and that relates to the:
- past, present or future physical or mental health or condition of the individual;
- provision of health care to the individual; or
- past, present or future payment for the provision of health care to the individual.
Ineligible Alien — A non-citizen whose alien status makes him ineligible for program benefits.
Initial Benefits — Benefits issued for the first month of eligibility. Also benefits issued for the first month of eligibility after a break in eligibility of at least one month.
In-Kind Contribution — Any gain or benefit to a person that is not in the form of money payable directly to the individual such as clothing, public housing or food.
Inquiry — TANF and SNAP — Toll-free number (1-800-448-3927) where individuals may call and inquire about their case, benefit mail date and amount of benefits. The client case number is used to access the Automated Voice Response (AVR) System.
Also refers to the functional area that allows access to case, EDG and individual information.
Institution of Higher Education — One that usually requires a high school diploma or equivalency certificate such as GED to enter.
Integrated Voice Response (IVR) — Also known as Audio Voice Response (AVR). A dial-in inquiry system that provides access to automated account information via a digital telephone. General program information and individual specific information is available. The individual must enter his case number to obtain individual-specific information.
Intentional Program Violation (IPV) — When a household member has intentionally made a false or misleading statement, or misrepresented, concealed or withheld facts for the purpose of receiving assistance under the SNAP, TANF and/or Medicaid program or when a household member is trafficking in SNAP benefits. A household member may be charged with an IPV even if he has not actually received benefits to which he is not entitled.
Interfaces — The functional area that exchanges information with other systems and agencies.
Interim Request — An eligibility staff-initiated process for converting an active SAVERR case to TIERS. Access the Interim Request page in the Conversion functional area.
Interview Mode — A designation in Data Collection that sets the driver flow through appropriate pages for a type of action.
Judicial Review — A review of the fair hearing decision by a district court in Travis County to determine if the agency decision is correct. A petition for judicial review must be filed by the appellant in a district court in Travis County within 30 calendar days after the date the administrative decision is issued.
Keogh — An IRA for a self-employed individual.
Legal Parents — Mother, by having given birth to the child, or by proof of adoption; father, by proof of adoption, legal document, court adjudication or his acknowledgement of paternity.
Legal Requirements — The non-financial eligibility requirements for a TANF/FMA child such as age, relationship, domicile, citizenship, SSN and deprivation.
Legally Obligated Child Support — Court-ordered or a legally recorded document requiring the payments of child support to be made in the form of cash, medical support or to a third party. The official document indicates to and for whom the support is paid, the frequency and the amount of payment.
Licensed Practitioner — A person licensed in the state of Texas who must meet certain educational requirements, pass an exam and whose conduct is regulated by a state board.
Liquid Resources — Resources that are readily negotiable (such as cash, checking or savings accounts, EBT cash account, savings certificates, stocks, or bonds).
Lock-in — To help contain Medicaid costs, HHSC created a lock-in status for certain individuals. It allows added review of high Medicaid users. Those who see several doctors each month and make questionable visits to hospital emergency rooms are limited to seeing one doctor or using one pharmacy for a minimum of six months. Individuals with illnesses that require expensive treatment are not subject to lock-in.
Logical Unit of Work — A set of TIERS pages that must be completed before information entered on these pages is saved. The logical unit of work is represented by a set of tabs at the top of a TIERS page. To ensure that information has been saved in a logical unit of work in Data Collection, click on the button that advances you to the Next or returns you to the Previous logical unit of work. When you reach the Case Assignment page, you have reached the end of the driver flow and must use the Left Navigation Bar to return to pages in the case. Clicking the Add, Update or Submit button saves information in other functional areas.
Lone Star Card — See EBT Card.
Low Income Home Energy Assistance Act (LIHEAA) — The federal act that funds energy assistance for low-income households.
Lump Sum Payment — A financial settlement that often involves funds accumulated over an extended period and paid in a single payment.
Manage Office Resources (MOR) — The functional area that supports the administrative structure in TIERS and relationships between regional offices and their local offices, units and employees.
Managed Care — A health care delivery system with the aim of controlling costs, which relies on a primary care physician who acts as a gatekeeper through whom the patient goes to obtain other health services such as specialty medical care, surgery or physical therapy. Models of managed care include the health maintenance organization (HMO) and the primary care case management (PCCM).Management — The way a household pays its expenses with available income.
Managing Conservator — A person designated by a court to have daily legal responsibility for a child.
Manual Voucher Transaction — A paper-based debit transaction completed by the food retailer when the automated EBT system is down or unavailable. If a telephone is available, it can be used to pre-authorize the transaction.
Married Minor — An individual, age 14-17, who is married. These individuals must have parental consent or court permission. An individual under age 18 may not be a party to an informal (common law) marriage.
Meal delivery services — A non-profit establishment approved by FNS, which prepares and delivers meals to elderly persons or persons who are housebound, physically handicapped or otherwise disabled to adequately prepare all their meals.
Medicaid — State-paid insurance for eligible TANF grant members, Medical Programs for Families and Children recipients, and SSI recipients.
Medicaid Card – (Form H3087) — A notice issued monthly by the computer to certified TANF/MP and SSI individuals that verifies Medicaid coverage.
Medicaid Report – (Form H1146) — In Statewide Demonstration Control Groups, a form completed by a transitional Medicaid household in the fourth, seventh and 10th months of medical coverage to report earnings, child care expenses and household composition changes.
Medical Occurs — The Medical Occurs page allows you to view converted SAVERR Medical Assistance history. Medical Occurs is in the Conversion functional area.
Medical Support — The absent parent will be ordered to obtain health insurance for their children who receive Medicaid when it is available at reasonable cost. Available at reasonable cost is usually defined as being available through the employer.
Migrant Farm Worker in the Workstream — Farm workers who travel to work in agriculture or a related industry and who are presently employed away from their permanent residence or home base.
Migrant Farm Worker Not in the Workstream — Farm workers who travel to work in agriculture or a related industry during part of the year but who are presently residing at their permanent residence or home base.
Military Member — An individual in the U.S. Armed Forces/Reserves (Army, Marine Corps, Navy, Air Force or Coast Guard), National Guard (Army, Marine Corps, Navy, Air Force, Coast Guard or Reserve Guard) or the State Military Forces/Texas State Guard.
Minor Child — A person under 18 years old.
Minor Parent — A person under age 18 who has a dependent.
Mixed Households — A SNAP household consisting of some members who are certified for TANF or a combination of TANF and SSI and some who are not.
Modified SNAP Resources Criteria — The resource policy and procedures applicable to children through 18 on medical assistance and the non-immigrant and undocumented alien children through age 18. Use the SNAP resources policy and procedures when determining eligibility for these persons with the following modifications:
- Exclude the value of the family's primary vehicle.
- Apply SNAP policy for determining and counting the value of additional vehicles. This includes a $4,650 exemption for the first family car in addition to the primary vehicle exemption.
- Do not deny applicants or individuals who transfer resources in order to qualify for assistance.
- Use the resource limit for households with no members age 60 or over.
- Use the TANF resource policy for loans.
Molar Pregnancy — Considered to be a degenerating pregnancy. Conception occurs, but no fetus ever develops. Treat a woman with a molar pregnancy like a pregnant woman whose pregnancy terminates early because of miscarriage or abortion. If eligible for the month the pregnancy terminates, she is eligible for the two months after the pregnancy terminates.
Monthly Obligation — The amount of child support which the absent parent has been ordered to pay each month.
Newborn Child — A child receiving Medical Assistance for Newborn Children because the child's mother was eligible for and received Medicaid coverage at time of the child's birth, or whose mother was eligible for and received Medicaid coverage retroactively for the time of the child's birth. The newborn Medicaid coverage can continue through the month of the child's first birthday as long as the child continues to reside in Texas.
Non-Convertible Bond — A bond that cannot be converted to cash according to program policy. Non-convertible bonds are exempt resources.
Non-Employment and Training (E&T) Counties — Those Texas counties in which the Texas Workforce Commission (TWC) determines it does not have sufficient offices to assist individuals who are mandatory work registrants. SNAP applicants and individuals in these counties are still subject to E&T work registration requirements with TWC but are exempt from E&T participation, and are not subject to SNAP federal time limits.
Non-Immigrant — An alien temporarily admitted to the U.S. for a purpose other than permanent residency, for example a religious worker or the fiancé/fiancée of a U.S. citizen.
Nonliquid Resources — Nonliquid resources include vehicles, buildings, land, or certain other property. The equity value of nonliquid resources is countable (except as explained in Vehicles) unless the resource is specifically exempted.
Non-Public Assistance (NPA) Household — SNAP households in which no one receives TANF or only some of the members receive TANF.
Non-Secure Facility — A publicly operated community residence that serves no more than 16 residents, such as a county emergency shelter or non-public facility such as a group or foster home.
Non-Traditional Retailer — A food retailer who operates in a farmer's market or as a roadside vendor.
Normal Living Expense — Items necessary for a SNAP household to carry on its normal daily activities. These items include housing, utilities, deposits for housing or utilities, food, clothing, and incidentals. Incidentals include such things as normal day-to-day transportation, telephone, laundry, medical supplies not paid by Medicaid, home remedies, recreation, and household equipment.
Notice of Adverse Action — A notice provided to the household on TF 0002 explaining the proposed adverse action, reason for the action, right to a fair hearing, availability of continued benefits, etc.
Off-Line Transaction — A term used to refer to the processing of EBT transactions using a manual voucher.
Office of Inspector General (OIG) — Created by the 78th Texas Legislature, Regular Session, 2003, the Health and Human Services Commission's Office of Inspector General works to prevent and reduce waste, abuse and fraud within the Texas health and human services system.
One-Time Integration Payment — Financial assistance provided to relative caregivers of children in the conservatorship of DFPS. The purpose of the one-time payment of not more than $1,000 for a sibling group is to defray costs incurred by the caregiver for essential child care items at the time of placement such as beds, bedding, clothing and other necessities. The payment is provided once to each sibling group. No additional payments are made if the group moves to the home of another relative.
Ongoing Benefits — Benefits issued for months after the initial benefit month.
Opportunity to Participate — Providing a certified applicant with benefits, a Lone Star Card, PIN and EBT training material.
Other-Related TANF/MP Child — An eligible child living with a relative other than the child's legal parent.
Overpayment — The amount of benefits issued in excess of what should have been issued.
Override — A TIERS procedure that allows the user to make a change to the system-determined EDG results. This procedure can be used when policy has changed and TIERS has not yet been updated to process the policy change correctly. Overrides always require Second Level Review before they can be disposed.
Parental Control — A minor living with an adult is under parental control if one of the following conditions applies:
- the adult provides more than half of the minor's total support (housing is not included as support),
- the adult states he has parental control of the minor, or
- the minor lives with an adult other than the minor's parent or legal guardian and that the minor's parent or legal guardian states the adult has parental control of the child.
DFPS foster care parents have parental control of the foster child even if the foster child's parent moves into the home. Note: The name of the foster parent is displayed as Alternate Payee on the foster care Eligibility Determination Group summary page in TIERS.
Participation Status — A designation of an EDG member as an eligible or ineligible member of the certified group. The participation status indicates the individual is considered an adult or a child according to policy.
Passive Renewal — A process by which TIERS automatically re-certifies a Medicaid for Transitioning Foster Care Youth (MTFCY) or Former Foster Care in Higher Education (FFCHE) active EDG for another certification period. This process occurs through a mass update and does not require advisor action. See Part M, Medicaid for Transitioning Foster Care Youth, and Part F, Former Foster Care in Higher Education, for specific policy.
Payee — EDG name. A person to whom the TANF benefits are issued if no one in the household qualifies or wants to be a caretaker. The payee must be within the required degree of relationship.
Payments to Civilians Relocated During Wartime — Payments made to Aleuts or individuals of Japanese ancestry (or their heirs) who were relocated during World War II.
Pending — Awaiting conclusion.
Pending Correspondence — Forms or notices that have been generated on a case and are waiting to be processed in batch. All system-generated correspondence is sent to pending correspondence, but it can be retrieved and printed locally. Once correspondence is printed, whether in batch or locally, the record of the printing is stored in History Correspondence. See Print Mode.
Permissible Purpose — Refers to a federal requirement that staff may legally request a credit report from the data broker only for a SNAP or TANF applicant, recipient or household member (including a disqualified member) who has filed an application for assistance. Staff who request credit information without permissible purpose are subject to fines and/or imprisonment in addition to disciplinary action from HHSC.
Personal Account Number (PAN) — The 19-digit number on the front of the Lone Star Card representing the individual's EBT account number on the EBT data base. The PAN is not related to the individual's HHSC case number.
Personal Identification Number (PIN) — A four-digit numeric code assigned to each cardholder and used to control access to the individual's account. The PIN must be entered on a key pad before any electronic transaction can be processed.
Personal Identification Number (PIN) Security — Actions cardholders should take to prevent others from gaining access to their PIN and EBT account. Instructions include not writing their PIN on the card sleeve or anything they carry in their purse or wallet, not revealing their PIN to anyone, or letting anyone use their card.
Personal Possessions — Include furniture, appliances, jewelry, clothing, livestock, farm equipment and other items if the applicant uses them to meet personal needs essential for daily living.
Personal Representative — One who can exercise the individual's rights with respect to individually identifiable health information. Only the individual's personal representative may authorize the use or disclosure of individually identifiable health information or obtain individually identifiable health information on behalf of an individual.
Personal Responsibility Agreement (PRA) — A TANF requirement that certain individuals must be in compliance with the conditions of the agreement. Non-compliance with the PRA results in a sanction.
Point-of-Sale (POS) Transaction — A process where a magnetic stripe reader is used to make an EBT card purchase, a cash withdrawal or inquiry.
Portable Document Format (PDF) — A file format created with Adobe System's Acrobat software. It presents documents in a format that is independent of the original software, operating system, etc., in which they were originally created. PDF preserves the original fonts, images, graphics and layout of the source document. PDF documents cannot be reformatted, only viewed and printed.
Power of Attorney (POA) — A legal instrument allowing one to act as another's attorney or agent.
Practitioner — An individual who holds a license to practice medicine, including physician (MD), osteopathic medical physician (DO), dentist (DDS), advance nurse practitioner (ANP) or registered nurse (RN). Note: A licensed vocational nurse (LVN) or licensed practical nurse (LPN) does not meet the definition of practitioner.
Prepaid Burial Insurance — Insurance that pays for a specific funeral arrangement. Also known as pre-need plan or prepaid funeral agreement.
Preschool Children — Children who are under age six.
Primary Cardholder (PCH) — The person designated to receive and be responsible for the household's Lone Star Card. A household may designate a secondary cardholder who has a Lone Star Card and access to the household's EBT account. The primary cardholder is usually the EDG name but the EDG may have an alternate payee who is the primary cardholder.
Print Mode — Indicates where historical correspondence was printed. Batch and Online are the types of print modes. Batch is correspondence managed by batch processing and printed at a central mail facility. All system-generated correspondence is scheduled for batch printing although it can be retrieved from Pending Correspondence and printed locally.
Print Type — Denotes whether a historical correspondence is the original record or a reprint of the original. Each original correspondence is given a unique Correspondence ID (identifying number). Each reprint of an original has the same Correspondence ID as the original.
Priority SNAP Issuances — Expedited SNAP benefits, benefits issued on or after the 25th day from the date of application, and issuances ordered by a hearing officer decision that must be made available in order to meet fair hearing timeliness requirements. These issuances are available to the individual the same day the EDG is disposed.
Processing Time Frames — Number of days eligibility staff has to complete a particular action.
Program — There are five programs: Community Care, SNAP, Long Term Care Medicaid, Medicaid and TANF. See Type of Assistance (TOA).
Proration — Portion of total monthly benefits a household is entitled to receive.
- TANF – Proration is based on the number of days between the begin date of eligibility and the end of the first month of eligibility.
- SNAP – Proration is based on the number of days between the file date and the end of the month.
Prospective Budgeting — A way to determine eligibility and amount and type benefits using the best estimate of the household's current and future circumstances and income.
Protective Payee — Person selected to receive and manage the TANF benefit when the caretaker is not using the TANF payments for the children's benefit. See Alternate Payee.
Prudent Person Principle — Reasonable decision made by staff based on the best information available and common sense in a particular situation.
Public Assistance (PA) Household — A SNAP EDG in which:
- all eligible members receive TANF or Refugee Cash Assistance (RCA); or
- some eligible members receive TANF or RCA, and all other eligible members receive SSI, including SSI essential persons.
Public Institution — A facility that is either an organizational part of a governmental entity, or over which a governmental unit exercises final administrative control. Examples of public institutions include county and city jails and Texas Department of Corrections prisons. Inmates of facilities that meet this definition of public institution are not eligible for TANF or Medicaid. Note: See Publicly Operated Community Residence for additional information about a public facility not considered to be a public institution.
Publicly Operated Community Residence — A facility designed to serve no more than 16 residents, and provide some services beyond food and shelter, such as social services, training in socialization and life skills. An example of a publicly operated community residence that is not a public institution is a county homeless shelter with a capacity for 16 people or less. Residents of a publicly operated community residence are potentially eligible for TANF and Medicaid. They are not considered inmates of a public institution.
Even if designed to serve no more than 16 residents, the following facilities are not considered publicly operated community residences:
- a facility located on the grounds of, or immediately adjacent to, any large institution or multiple complex;
- an educational or vocational training institution; and
- a correctional or holding facility for individuals who
- are prisoners;
- have been arrested or detained pending disposition of charges, or
- are held under court order as material witnesses or juveniles.
Qualified Health Professional — A person who provides care under the supervision of a licensed practitioner or medical or dental practice that is state regulated.
Quality Control — The functional area that supports the state's approach to quality control and allows authorized staff to enter sample selection criteria. Based on the criteria, TIERS generates a sample list.
Questionable Information — Information that is contradictory or incomplete.
Radiation Exposure Payments — A program to compensate individuals for injuries or deaths resulting from the exposure to radiation from nuclear testing and uranium mining. When the affected individual is deceased, payments are made to the surviving spouse, children, parents, grandchildren or grandparents.
Radio Button — A small round button you can click in a dialog box to select one of several choices. You can select only one radio button at a time. If you select another button, the original button is deselected.
Range of Payment — The highest to the lowest representative pay amounts used to determine the current ongoing budget.
Reactivation Date — The effective date on which benefits for an EDG should be reinstated. This date is entered for various situations including denied in error, continued benefits for a denied EDG, reinstating Transitional Medicaid Assistance (TMA) and reactivating an EDG without requiring a new application form.
Real Property — Land and any improvements on it.
- Timely – SNAP application filed by the 15th of the last month of certification. This is also called a timely recertification.
- Untimely – SNAP application filed after the 15th of the last certification month. An untimely reapplication is treated the same as an initial application.
Note: Verification requirements are the same for both timely and untimely applications.
Reapplication Date — Date a new application for redetermination or complete review of eligibility is received by HHSC.
Reasonable Opportunity — A period of time from the certification date until the next eligibility determination that Medicaid applicants or recipients who declare themselves to be U.S. citizens are allowed to provide verification of citizenship.
Rebuild EDG — A button in Wrap Up used to apply cascade logic by reforming EDGs until eligibility or ineligibility is established. See EDBC and Run EDBC.
Reception Log — The functional area where office contacts by telephone, mail, fax and in person can be recorded.
Recognizable Needs — The maximum needs amount allowed by HHSC when determining eligibility.
Recoupment — Withholding part of an individual's current benefit because of a previous overpayment.
Redetermination — A complete action to determine eligibility for a new certification period in SNAP.
Reimbursement — Repayment for a specific item or service.
Reinstatement — Process of providing TMA to a household that was denied because of failure to return a complete Medicaid Report.
Report Date — The date on which information is reported to HHSC. EDBC uses the Discovery and Report dates to determine whether a required report of change is reported timely.
Reports — The functional area that collects information from throughout TIERS and produces reports that meet HHSC, state and federal reporting requirements.
Representative Payee — In TANF and FMA, a person designated to receive and manage the household's benefits for an individual who is incapacitated or incompetent. See Alternate Payee.
Resident Seasonal Farmworkers — Farmworkers who do not leave their permanent residence to work in agriculture or a related industry.
Resources — Both liquid and non-liquid assets an individual can convert to meet his immediate needs.
Restored Benefits — Full- or partial-months benefits for a past month that are owed to a household that resulted from an agency error.
Retroactive Benefits — Initial benefits issued for a month before the application is certified.
Review — TANF evaluative interview that must take place before the individual receives his seventh warrant.
Royalty — A payment to an individual for permitting another to use or market his property (such as mineral rights, patents, or copyrights).
RSDI — Retirement, Survivors and Disability Insurance benefits or Social Security.
Run EDBC — A button in Wrap Up used to determine eligibility of the EDG. See EDBC.
Sanction — Either a disqualification or a penalty applied to a case program because an individual failed to comply with a program requirement.
Scheduling — The functional area that manages eligibility staff appointments. See Batch Scheduling.
Second Chance Home — An adult-supervised living arrangement that provides independent living services to teen mothers and their children. Independent living services include, but are not limited to, case management, counseling, mentoring, parenting skills, child development, child care services, school-to-work transition services or family reunification services.
Second Level Review — Review of a case by a second party before the EDG is disposed. The second party selects Second Level Review Interview Mode.
Second Parent — When a child lives with both legal parents and both parents are included in the certified or budget group, the parent that is not the caretaker.
In the Medical Programs, a child's stepparent is included in the budget and/or certified group with the child, the child's legal parent and the stepparent's deprived children.
Secondary Cardholder — A person designated by the individual (primary cardholder) as eligible to access the individual's EBT account with a second EBT card and PIN.
Secure Facility — Secure boot camp settings, such as a county holding facility for juveniles or a facility that a government unit exercises final administrative authority.
Self-Employment Income — Earned or unearned income available from one's own business, trade or profession rather than from an employer.
Self-Service Portal (SSP) — A web-based application available to applicants and community partners assisting applicants to:
- perform initial self-screening to check for potential eligibility,
- apply for benefits online,
- check application status,
- check benefit/appointment status, and
- view general benefit program information.
Sibling — Brother or sister, including legally adopted, and half-brothers and half-sisters.
Special Review — A procedure to explore one or more areas of eligibility, such as management, medical, etc., at a specified time other than at application or complete action. A special review is conducted in Special Review mode. See Interview Mode and Case Mode.
Spend Down — The amount of excess income that the applicant must deplete with incurred medical bills before he can be certified as medically needy.
Standard Medical Expense — A $137 deduction applied to a SNAP budget and given to an elderly and/or disabled household member who incurs medical expenses of more than $35 but less than or equal to $137.
Standard of Need — Basic needs of TANF families represented by a figure predetermined by the state of Texas according to the number of certified persons in the group. This figure represents food, clothing, housing, utilities, and incidentals. Incidentals include such things as normal day-to-day transportation, telephone, laundry, medical supplies not paid by Medicaid, home remedies, recreation and household equipment.
Standard Utility Allowance (SUA) — A standard deduction for the cost of utilities given to a household that either incurs a heating or cooling cost separate from the rent, or receives or anticipates receiving assistance under the Low Income Home Energy Assistance Act (LIHEAA) in any of the next 12 months. For households that receive the SUA based on LIHEAA assistance, allow the SUA even if the household does not have an out-of-pocket expense.
Standby List — Applicants who are awaiting an interview without a specific appointment. See Carryover Standby List.
State Data Exchange (SDX) — Computer tape from the Social Security Administration giving SSI and Medicaid information on HHSC individuals. Social Security information is also available on individuals who receive SSI and/or Medicaid. SDX information can be used as a source of verification and is available to advisors through the HHSC computer terminal.
Step Grandparent — The spouse of a blood-related grandparent.
Streamlined Reporting (SR) — Households in which all adults are exempt from the 18-50 work requirements due to disability (work registration code E-incapacitated); having a child under age 18 (or is a member of a SNAP case where a household member is under age 18); or being pregnant, meet the streamlined reporting (SR) criteria. These households receive a six-month certification period.
Subsistence — Life supporting; survival.
Sufficient Employment — Earnings from a job, other than seasonal work such as migrant or seasonal farm work, that would result in TANF ineligibility without including the 90% earned income disregard.
Summary Page — A page that lists a summary of all records available for that TIERS page. See Detail Page.
Supplemental Benefit — Additional benefits for a current month provided to a household during a month HHSC already issued initial or ongoing benefits.
Supplemental Nutrition Assistance Program (SNAP) — Program previously called the Food Stamp Program.
Supplemental Nutrition Assistance Program Combined Application Project (SNAP-CAP) — A six-year demonstration project that outreaches elderly SSI recipients who are not currently certified for SNAP.
Supplemental Nutrition Assistance Program - Supplemental Security Income (SNAP-SSI) Caseload — The CBS unit administers the SNAP-SSI caseload. Households are automatically converted to the SNAP-SSI caseload following an initial certification by a local eligibility office if all household members receive SSI and there is no earned income in the case. There is no age requirement and households are certified for three years.
Supplemental Security Income (SSI) — A needs-tested program administered by the Social Security Administration (SSA) providing monthly income to aged, blind and disabled individuals.
Suspended Benefits — The EDG is flagged to prevent the ongoing issuance of benefits until eligibility staff review the EDG.
System for Applications, Verifications, Eligibility Reports and Referral (SAVERR) — A legacy management information system that contains a database that stores individual and case information. TIERS replaces SAVERR.
System-Generated — Created by a computer system programmed with given parameters. For example, a notice is system generated when an EDG is disposed. The notice contains programmed information based on the program, type of assistance, and eligibility result. See User-Generated.
Temporary Assistance for Needy Families (TANF) – Basic — Cash assistance for families that include a dependent child and no more than one eligible adult. The EDG name must be within the required degree of relationship to the dependent child.
Temporary Assistance for Needy Families – Non-Cash (TANF-NC) — Consists of services for family planning, adult education, the prevention and treatment of substance abuse, employment services, domestic violence, and Women, Infants, and Children (WIC) nutrition.
Temporary Assistance for Needy Families Certified Child — A child who is included in a TANF grant.
Temporary Assistance for Needy Families (TANF) Redirect — Before the application process begins, HHSC staff deliver an up-front Texas Works message to TANF applicants explaining that:
- TANF is temporary and has time limits;
- there are other alternatives and options for the applicant instead of TANF benefits;
- an applicant should consider jobs and other resources (such as child support) before pursuing TANF;
- if an applicant chooses to apply for assistance, he is requesting help finding a job; and
- even if an applicant chooses not to apply for TANF, he can still apply for FMA and SNAP to support employment while working toward self-sufficiency.
Temporary Assistance for Needy Families – State Program (TANF-SP) — Cash assistance for families with a dependent child and at least two adults. Adults on the EDG must be legal parents (including a certified stepparent) to the dependent child. This includes legal parents/stepparents who are disqualified for one of the reasons listed in A-222, Who is Not Included, 4. Disqualified Members, unless that disqualification is due to not meeting citizenship requirements.
Ten-Ten-Thirteen Concept — Concept used to determine the first month when determining an overissuance claim. The individual has 10 days to report the change; the advisor has 10 days to act on the change; and the notice of adverse action expires in 13 days.
Texas Health Steps (THSteps) — A health-care program of prevention, diagnosis, and treatment for Medicaid individuals.
Texas Integrated Eligibility Redesign System (TIERS) — A computer system that:
- stores individual and case information,
- processes eligibility determinations for multiple programs based on data provided through direct input and interfaces with other systems,
- generates benefit issuance,
- assists users in monitoring and managing workload, and
- creates correspondence and reports based on system- and user-requested criteria.
Texas Workforce Commission (TWC) — TWC is the state governmental agency charged with overseeing and providing workforce development services to employers and job seekers of Texas. TWC is part of a local/state network dedicated to developing the workforce of Texas. The network is comprised of the statewide efforts of TWC along with planning and service provision by 28 local workforce boards on a regional level.
The Workforce Information System of Texas (TWIST) — TWIST is the computer system used by TWC for intake, eligibility determination, assessment, service tracking, and reporting of TWC-administered programs, such as child care, SNAP Employment and Training, Choices, and the Workforce Investment Act.
Third Party — Person or organization outside the certified household.
Third-Party Resource — A source of payment of medical expenses other than the recipient or HHSC.
Three Months Prior — The three-month period before the FMA application month. Applicants who meet eligibility requirements during any of the months in this period receive Medicaid benefits for the eligible month(s).
Time Limit — The functional area where TANF State/Federal time-limited months can be viewed. Authorized staff can correct months used in this functional area.
Timely Application or Timely Reapplication — A SNAP application submitted to HHSC no later than the 15th calendar day of the last month in the certification period.
Timely Disposed — An EDG that is disposed in accordance with program timeliness standards.
Tip Income — Income earned in addition to wages that is paid by patrons to people employed in service-related occupations (beauticians, waiters, valets, pizza delivery staff, etc.).
Trade Adjustment Assistance Act Program — A program for workers displaced by foreign workers.
Trafficking (SNAP) — Trafficking means:
- The buying, selling, stealing, or otherwise effecting an exchange of SNAP benefits issued and accessed via Electronic Benefit Transfer (EBT) cards, card numbers and personal identification numbers (PINs), or by manual voucher and signature, for cash or consideration other than eligible food, either directly, indirectly, in complicity or collusion with others, or acting alone;
- Attempting to buy, sell, steal, or otherwise effect an exchange of SNAP benefits issued and accessed via EBT cards, card numbers and PINs, or by manual voucher and signature, for cash or consideration other than eligible food, either directly, indirectly, in complicity or collusion with others, or acting alone;
- The exchange of firearms, ammunition, explosives, or controlled substances, as defined in Section 802 of Title 21, United States Code, for SNAP benefits;
- Purchasing a product with SNAP benefits that has a container requiring a return deposit with the intent of obtaining cash by discarding the product and returning the container for the deposit amount, intentionally discarding the product, and intentionally returning the container for the deposit amount;
- Purchasing a product with SNAP benefits with the intent of obtaining cash or consideration other than eligible food by reselling the product, and subsequently intentionally reselling the product purchased with SNAP benefits in exchange for cash or consideration other than eligible food; or
- Intentionally purchasing products originally purchased with SNAP benefits in exchange for cash or consideration other than eligible food.
Transitional Medical Assistance (TMA) — Medicaid coverage extended for a maximum of 12 months after denial of certain EDGs because of:
- new or increased earnings,
- loss of the 90% earned income deduction (EID), or
- declined use of the 90% EID.
Trust — Property held by one person for the benefit of another.
Type of Assistance (TOA) — The specific aid for one or more individuals in an EDG. For example, the SNAP program has two types of assistance, PA (public assistance) and NPA (non-public assistance).
Underpayment — Issuance of fewer benefits than an individual is entitled to receive.
Undocumented Alien — An alien living in the United States without the knowledge and permission of the USCIS.
Unearned Income — Payments received without performing work-related activities, including benefits from other programs.
Unreimbursed Assistance — Money paid in prior months in the form of public assistance under the Title IV-A program (that is, under the current TANF program or the former Aid to Families with Dependent Children (AFDC) program), that has not yet been recovered from collections applied to assigned arrears.
U.S. Citizenship and Immigration Services (USCIS) — The government agency that oversees lawful immigration to the U.S. In 2003, USCIS officially assumed responsibility for the immigration service functions of the federal government. The Homeland Security Act of 2002 dismantled the former Immigration and Naturalization Service (INS) and separated the former agency into three components within the Department of Homeland Security:
- USCIS provides immigrant services.
- Immigration and Customs Enforcement handles immigration enforcement.
- Customs and Border Protection is responsible for border security functions.
User-Generated — Action generated directly by an individual's computer input. For example, a user can:
- request an alert and send it to another user.
- generate manual correspondence on a case.
- generate a manual issuance of benefits outside the normal eligibility process.
User Guide — A TIERS help tool accessed by clicking on the Help icon in the upper right corner of the TIERS page. The User Guide includes information about numerous TIERS topics.
Vendor Payment — Payment made directly to the individual's creditor or person providing the service by a person or organization outside the household.
Vested Interest — A situation or circumstance to which a person has a strong personal commitment.
Vested Retirement Account — An account to which an employee makes contributions for a specified period of time as defined by the employer. The employer does not match the money contributed by the employee until the defined period of time ends.
Voluntary Quit — Leaving a job without good cause.
Waiver Counties — Those Texas counties with an unemployment rate over 10%. SNAP applicants and individuals in these counties are not subject to SNAP federal time limits because of the job market. They are still required to be registered for work with TWC and are mandatory participants if they do not meet work registration exemption requirements.
Waiver of Continued Benefits — An individual option to allow eligibility staff to process an adverse action during the individual's appeal process.
Welfare-to-Work — A federal program designed to support state and local efforts to move hard-to-employ TANF recipients into unsubsidized jobs and promote their self-sufficiency.
Wizards — A utility within TIERS that gives specific instructions to perform a particular task. Access Wizards by clicking on the Help icon in the upper right corner of the TIERS page.
Workforce Investment Act — A federal program to streamline state workforce development systems combining job training, adult education and literacy, and vocational rehabilitation. The Workforce Investment Act replaced the Job Training Partnership Act.
Wrap Up — The TIERS program page in Data Collection where EDGs are built and EDBC is run to determine the highest level of eligibility or ineligibility. See Cascade Logic, Rebuild EDG, and Run EDBC.
WTPY Citizenship Verification Resolution Period — The 95-day period an individual is allowed to provide another source of citizenship verification when the response to a WTPY citizenship verification request is returned indicating that citizenship is not verified. The 95-day period begins with the date the certification notice is generated. The period is 95 calendar days.