Section 278.5 - Income Eligibility(a) Applicants with household income at or below the Texas median income level are eligible without a copayment requirement.(b) Applicants with income at or above 105% of the Texas median income level must contribute to the cost of services in the IH/FSP.(c) SSI recipients who are determined to have a disability are categorically eligible and are exempt from the copayment requirement.(d) Copayments are determined according to the State Median Income (SMI) for the federal fiscal year. A client whose income is at or below the SMI for his household size has no copayment. A client whose income is at or greater than 105% of the SMI will be assessed a copayment. The copayment begins at 10% of the cost of the items/services and increases in 10% increments until 100% of the cost of items/services is reached, at which point the client is ineligible. The copayment is assessed as follows: Attached Graphic
(e) Applicants must provide to the caseworker all required documentation of earned or unearned income or both. This income is considered in determining financial eligibility. The following income is exempt from income eligibility calculation: (1) Proceeds of either a commercial or an informal loan for which repayment is required with or without interest. To claim exemption of the proceeds of a loan, a client must prove that he acknowledges an obligation to repay and that some plan for repayment exists. If these can be verified, no written contract is required.(2) Payments from the Agent Orange Settlement Fund or any other fund established in the settlement of the Agent Orange Product liability litigation (Public Law 101-239).(3) Any payment received under the Radiation Exposure Compensation Act (Public Law 101-246).(4) Value of any housing assistance paid on a house under the United States Housing Act of 1937, the National Housing Act, §101 of the Housing and Urban Development Act of 1965, or Title V of the Housing Act of 1949 as authorized by Public Law 94-347.(5) Payment from any source made to individuals because of their status as victims of Nazi persecution (Public Law 103-286).(f) An applicant 18 or older who lives with a spouse or relatives has the household income considered only if he was reported as a dependent on the personal income tax return form or if he filed a joint tax return with his spouse.(g) An applicant who has earned income at or below the limits listed in IRS Publication 17 must sign a statement reporting the amount of earned income, unless he filed a personal income tax return claiming a refund for federal withholding. If he files this type of a tax return, he must present it to the caseworker as documentation of earned income.(h) Upon request from the caseworker, the applicant or his responsible party must furnish the documentation or verification needed to determine eligibility within 10 days of the interview. If the applicant fails to provide the information requested, the caseworker notifies the applicant in writing, specifying the information that is needed and advising that failure to furnish the information could result in denial of the application. If the applicant has not furnished the information and is not making a good faith effort to obtain the information, the caseworker denies the application at the end of the 45-day application processing period.(i) Consumers must notify the caseworker within 10 calendar days of a change in their circumstances that were considered in determining their eligibility or copayment amount.26 Tex. Admin. Code § 278.5
Transferred from 40 TAC § 48.2703 Texas Register, Volume 49, Number 23, June 7, 2024, TexReg 4061, eff. 6/28/2024