Radiation Exposure Payments A program to compensate a person for injury or death from exposure to radiation from nuclear testing and uranium mining. Electronic Benefit Transfer (EBT) System A system HHSC staff with security access use to issue and replace Lone Star Cards. To find out if you might be eligible for Medicaid in Texas, visit yourtexasbenefits.com all eligible members receive Temporary Assistance for Needy Families (TANF) or Refugee Cash Assistance (RCA); or. Electronic Benefit Transfer (EBT) Site Coordinator An HHSC employee designated to ensure local offices comply with guidelines on security and accountability operations. Low Income Home Energy Assistance Program (LIHEAP) The federal program that funds assistance for energy costs for low-income households. This number may be found on the paperwork we gave you informing you that you are eligible for SNAP assistance. The newborn Medicaid coverage can continue through the month of the child's first birthday if the child continues to live in Texas. Benefit Issuance The functional area that supports the issuance and tracking of benefits calculated in the Eligibility Determination Benefit Calculation (EDBC) and authorized in disposition. When the term is used in the handbook, it means all the following programs combined: Emergency Medical Condition An eligibility requirement for Emergency Medicaid for nonimmigrants, undocumented aliens and certain legal permanent resident aliens. Medical Programs that follow modified adjusted gross income (MAGI) rules, except Childrens Health Insurance Program (CHIP) perinatal Only one person is certified on the EDG. You need to pass a few authentication questions. ), dentist (D.D.S. Payee A person that the Temporary Assistance for Needy Families (TANF) benefits are issued to if no one in the household qualifies or wants to be a caretaker. Rebuild EDG (Eligibility Determination Group)A button in the Wrap Up management group. Some people qualify for both Medicare and Medicaid. An example of a publicly operated community residence that is not a public institution is a county homeless shelter with a capacity of up to 16 people. Copayment Payment made directly to a provider according to a fee schedule. Lump-Sum Payment A financial settlement that often involves funds accumulated over an extended period and that is paid in a single payment. Functional Area Functions and processes that appear in the Texas Integrated Eligibility Redesign System (TIERS) Left Navigation area and represent a particular business process. A special review is conducted in Special Review mode. This includes falsifying a document or a statement, or providing false information in an interview, with the intent to commit fraud. Ten-Ten-Thirteen Concept Time periods used to determine the first month of an over-issuance claim. Its given to an elderly household member, a household member with a disability, or both, who incur medical expenses of more than $35 but less than or equal to $137. Resources Both liquid and nonliquid assets a person can convert to meet immediate needs. Unauthorized access to this site and its information assets is prohibited. The notice of adverse action expires in 13 days. Data Broker An online portal used to obtain financial and other background information about applicants and recipients. Medicaid & CHIP in . Non-Traditional Retailer A food retailer who operates in a farmer's market or as a roadside vendor. The official document indicates to and for whom the support is paid, the frequency and the amount of payment. . Falsified Statement A statement made by an individual, orally or in writing, that is not true, such as claiming to have been without worksince a certain date,when the individual was employed during that time period. Even if designed to serve up to 16 residents, the following facilities are not considered publicly operated community residences: Qualified Entity (QE) A Medicaid provider (in most instances but can also be an organization such as a school or clinic) that notifies HHSC of its election to make presumptive eligibility determinations and agrees to make presumptive eligibility determinations for pregnant women only, per HHSC policies and procedures. A request for an administrative review must be submitted in writing within 30 calendar days from the date of the hearing officer's decision. Users cannot delete system-generated correspondence. It compares an applicants statement of income against income provided by electronic data sources. 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. If you can't find it, call us at 800-777-7328. The person must be a legal parent(s) or other caretaker relative within the required degree of relationship who meets the income limits for that program. SeeCase. For example, a user can: User Guide A Texas Integrated Eligibility Redesign System (TIERS) help tool accessed by clicking on the Help icon in the upper right corner of TIERS pages. Deportation (or Removal) Withheld Deportation is being withheld under Section 243(h) of the INA, or removal is withheld under Section 241(b)(3) of the INA. This is also called a timely recertification or redetermination. Good Cause A term used to indicate that a person has an acceptable reason for not complying with a program requirement. Need help buying food because of recent disasters in your area? Based on the criteria, TIERS generates a sample list. A stripe of magnetic material, which is machine-readable and allows for the activation of point-of-sale equipment, is affixed to the back of the card at the time of manufacture. 1-877-541-7905. produces reports that meet Texas Health and Human Services Commission (HHSC), state and federal reporting requirements. ), osteopathic medical physician (D.O. This information is used in the EDBC process to build Eligibility Determination Groups (EDGs) and determine eligibility for programs and types of assistance. Type of Assistance (TOA) The specific aid for one or more people in an Eligibility Determination Group (EDG). Override A Texas Integrated Eligibility Redesign System (TIERS) procedure that allows the user to make a change to the system-determined Eligibility Determination Group (EDG) results. receives Supplemental Nutrition Assistance Program (SNAP) benefits; is physically and mentally able to work at least an average of 20 hours per week; is not a member of a SNAP Eligibility Determination Group (EDG) where a household member on the SNAP EDG is under 18; an automated eligibility determination; or. One program is the Choices program for TANF recipients, and the other is the SNAP Employment and Training (E&T) program for SNAP recipients. These are given to a SNAP household that either incurs a heating or cooling cost separate from the rent or received a Low-Income Home Energy Assistance Program (LIHEAP) payment. Supplemental Nutrition Assistance Program (SNAP) applicants and individuals in these counties are not subject to SNAP federal time limits because of the job market. In many instances, batch processing occurs overnight, when Texas Health and Human Services Commission (HHSC) offices are closed and the system is not being heavily used throughout the state. The caller must provide the head of households Social Security number (SSN) or the case number and date of birth of a household member to access information. Deductible Part of Self-Employment Tax A federal income tax deduction for self-employed people paying self-employment taxes. It provides monthly income to aged people and persons who are blind or have a disability. If the total collection is less than $75, then the amount of the collection is sent to the person . Before sharing sensitive information, make sure youre on an official government site. CHIP Perinatal Medical services to unborn children of pregnant women ineligible for Medicaid due to income or alien status. Domestic Production Activities Deduction A federal income tax deduction that a person may receive for certain qualified production activities. See Alternate Payee. Texas's EBT customer service number is 1-800-777-7328. Child A child is an adoptive, step, or natural child who is under 19. Adequate Notice A notice of adverse action that expires the same day it is sent. Sufficient Employment Job earnings, other than seasonal work such as migrant or seasonal farm work, that would result in Temporary Assistance for Needy Families (TANF) ineligibility without including the 90 percent earned income disregard . They have already gone through the eligibility determination for those programs. The marriage must not have been annulled. Family Violence An act by a member of a family or household against another member of the family or household that is: File Clearance This feature determines whether an applicant has a case record with HHSC. A mastectomy bra can provide comfort, support, and security to an individual as they become accustomed to their new normal. If there are no eligible members after cascade logic is applied, the household is ineligible for the program. Moving Expenses Federal income tax deductible expenses an active duty member of the military may claim for relocating to a new duty station. an account that contains the household's Supplemental Nutrition Assistance Program (SNAP) food benefits; an account that contains the household's Temporary Assistance for Needy Families (TANF) cash grant amount; or, Type Assistance (TA) 31, Parents and Caretaker Relatives Emergency, Type Program (TP) 32, Medically Needy with Spend Down Emergency. Standard Medical Expense A $137 deduction applied to a Supplemental Nutrition Assistance Program (SNAP) budget. Personal Responsibility Agreement (PRA) A requirement for Temporary Assistance for Needy Families (TANF) that certain people must follow the conditions of the agreement. Conditional Entrant A person granted conditional entry under Section 203(a)(7) of the INA as in effect before April 1, 1980. Advanced Authentication Personal security questions generated by third-party software to perform authentication of an applicant's identity before granting the person an account through YourTexasBenefits.com (link is external) with Case Visibility. action has been initiated on an Eligibility Determination Group (EDG) in a case (Intake, Complete Action, Change Action, Special Review, Conversion); allthe EDGs in a case are approved (Ongoing); and. The User Guide includes information about numerous TIERS topics. Qualified Hospital (QH) A Medicaid provider that notifies HHSC of its intent to make presumptive eligibility determinations and agrees to make PE determinations per HHSC policies and procedures. Authorized Representative (AR) A person or organization designated by an applicant or recipient to take the following actions on the applicants behalf: Automated Income Check Process The first step in a periodic income check (PIC). Budgeting The method used to determine eligibility and benefits for Temporary Assistance for Needy Families (TANF), Medical Programs, and the Supplemental Nutrition Assistance Program (SNAP) by calculating income and deductions. Modified Adjusted Gross Income (MAGI) Household Income The sum of every person's MAGI individual income within an applicants or recipients MAGI household composition, from which is subtracted the standard MAGI disregard. Note:This does not include anyone who otherwise qualifies as a resident of a drug and alcohol treatment center, federally subsidized housing for the elderly, a qualifying group living arrangement, a shelter for battered persons, or a shelter for the homeless. Migrant Farmworker in the Workstream Farmworkers who travel to work in agriculture or a related industry and who are presently employed away from their permanent residence or home base. request an alert and send it to another user; generate manual correspondence on a case; and. The PIN must be entered on a keypad before any electronic transaction can be processed. is not needed to process a redetermination. and Texas Human Resources Code, Title 2, Subtitle C, Chapter 32, that pays for certain medical and health care costs for people who qualify. Application A form that a person or household uses to apply for assistance. Historical Data Records of case, Eligibility Determination Groups (EDGs) and individual information. Copyright 2016-2023. Basic Utility Allowance (BUA) Deduction given to a SNAP household that has utility costs but does not qualify for the standard utility allowance (SUA). A molar pregnancy is considered a normal pregnancy that terminates early because of miscarriage or abortion. See Alternate Payee. Fair Market Value Amount of money an item would bring if sold in the current local market. These databases contain information for individuals who are currently on assistance and for individuals who have applied for or received assistance in the past. This figure represents food, clothing, housing, utilities and incidentals. The Workforce Information System of Texas (TWIST) The computer system used by the Texas Workforce Commission (TWC) for intake, eligibility determination, assessment, service tracking, and reporting of TWC-administered programs, such as child care, Supplemental Nutrition Assistance Program (SNAP), Employment and Training, Choices, and the Workforce Innovation and Opportunity Act. Medicaid Report (Form H1146) A form completed by a transitional Medicaid household in the fourth, seventh and tenth months of medical coverage to report earnings and household composition changes. A user can click the plus sign next to a functional area or sub-functional areas to display the pages available within that area. Business Day Monday through Friday from 8 a.m. to 5 p.m. local time. They are not considered inmates of a public institution. Modified Adjusted Gross Income (MAGI) Household Size The number of people in an applicants or recipients MAGI household composition, including the number of unborn children, if applicable. Be receiving disability-related assistance or benefits. In this system, patients go to their primary care physician to obtain other health services such as specialty medical care, surgery or physical therapy. If you already get SNAP benefits, you will not be eligible for Disaster SNAP. even if an applicant chooses not to apply for TANF, the person can still apply for Medical Programs and the Supplemental Nutrition Assistance Program (SNAP) to support employment while working toward self-sufficiency. Available at reasonable cost is usually defined as being available through the employer. Participation Status The designation of an Eligibility Determination Group (EDG) member as an eligible or ineligible member of the certified group. Apply online and make a Your Texas Benefitsaccount so you can start, save and go backto your online application at any time. Liquid Resources Resources that are readily negotiable, such as cash, checking or savings accounts, Electronic Benefit Transfer (EBT) cash account, savings certificates, stocks or bonds. Tax Dependent A person who expects to be claimed by someone else as a dependent on a federal income tax return for the taxable year that Medicaid or Children's Health Insurance Program (CHIP) eligibility is requested. Seecase modeandinterview mode. Citizenship and Immigration Services (USCIS). To exit from this workflow, click on Exit. A household member may be charged with an IPV even if the person has not actually received benefits to which they are not entitled. Commingled Resources Resources of a Temporary Assistance for Needy Families (TANF) or Supplemental Security Income (SSI) recipient combined with those of a non-TANF or SSI household member. Note: A licensed vocational nurse or licensed practical nurse does not meet the definition of practitioner. some eligible members receive TANF or RCA, and all other eligible members receive Supplemental Security Income (SSI), including SSI essential persons. Qualified entities that are also Breast and Cervical Cancer Services (BCCS) contractors with the DSHS may make presumptive eligibility determinations for Medicaid for Breast and Cervical Cancer (MBCC) applicants. Opportunity to Participate Providing a certified applicant with benefits, a Lone Star Card, personal identification number (PIN), and Electronic Benefit Transfer (EBT) training material. The certificate is a requirement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and is sent to denied recipients by the Texas Department of State Health Services (DSHS). Eligibility Determination Group (EDG) Members of a household whose needs, resources, income and deductions are considered in determining eligibility for benefits. ], Title 42, 1396 et seq.) Trade Adjustment Assistance Act Program (TAAP) A program for workers displaced by foreign workers. The Department of Defense Appropriations Act of 2010, PL 111-118, enacted on Dec. 19, 2009, says SIV are eligible for all benefits to the same extent and the same period as refugees. A calendar tax year is 12 consecutive months beginning Jan. 1 and ending Dec. 31.

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