TAMENU SAVERR Inquiry Reference Guide - Texas Workforce ...

SAVERR Inquiry 

Reference Guide 

April 2009

Texas Workforce Commission 

The Automation Training Unit of the Training and Development Department would like to 

acknowledge the following persons for their support and hard work in completing the updated 

TAMENU SAVERR Inquiry Reference Guide. 

Training and Development Department 

Louis LeDoux, Training Director 

Richard Guilbeau, Training Supervisor 

Nancy Baker, Editor 

Deborah Reyes, Curriculum Developer/Training Specialist 

Deborah Cook, Curriculum Developer/Training Specialist 

Carolyn Vidrine, Curriculum Developer/Training Specialist 

Deborah Aker, Systems Support Specialist 

Workforce Data Processing 

Linda Burmeister 

TWIST Support 

Jackie Coley 

Maureen Fuentes 

Poonam Goel 

Sharon Helphenstine 

Lorraine Johnson 

Sara Sarabia 

Workforce Policy 

Loretta Robertson 

Sharon Roland 

TWC Design Services 

Miguel Hernandez IV 

HHSC Curriculum Support 

John Driggers 

Ricardo Herrera 

Don Nagel

TAMENU SAVERR Inquiry 


April 2009 

Table of Contents 

Section One: Access to TAMENU 

Introduction ............................................................................................................1-1 

Using This Reference Guide..................................................................................1-2 

Adding HHSC Session to TWC System.................................................................1-3 

Initial Sign-on to TAMENU .....................................................................................1-3 

Regular Sign-on to TAMENU.................................................................................1-7 

Exiting TAMENU..................................................................................................1-10 

Section Two: Navigating in TAMENU 

General Information about Key Functions in TAMENU..........................................2-1 

General Navigation in TAMENU ............................................................................2-2 

Screen Views.........................................................................................................2-2 

Main Menu—TDHS (HHSC) SAVERR Inquiry Menu .............................................2-4 

Definitions of Entry Fields on TDHS (HHSC) SAVERR Inquiry Menu Screen .......2-5 

Performing an Inquiry Using Name Cross Reference ............................................2-6 

Performing an Inquiry Using SSN Cross Reference ..............................................2-7 

X Ref Screen 1 Field Descriptions and Entries ......................................................2-8 

Accessing Client Screens ....................................................................................2-10 

Performing an Inquiry Using Case Number/Client Number..................................2-13 

Section Three: Detailed Field Descriptions 

General Information ...............................................................................................3-1 

Client Screens........................................................................................................3-1 

Client Screen 1—Primary ......................................................................................3-2 

Client Screen 2—Medical History ..........................................................................3-4 

Client Screen 4—Case History ..............................................................................3-6 

Client Screen 5—Alias Information ........................................................................3-7 

Client Screen A—Welfare Reform Data.................................................................3-8 

Client Screen B—Time Limited Months ...............................................................3-12 

Client Screen C—Penalty/Good Cause History ...................................................3-14 

Client Screen E—SNAP Disqualifications and Work Requirement Data..............3-16 

SNAP Case Screens............................................................................................3-19 

SNAP Case Screen 1—Primary...........................................................................3-20 

SNAP Case Screen 2—Active Client List ............................................................3-23 

SNAP Case Screen 3—Budget ...........................................................................3-24 

SNAP Case Screen 4—Miscellaneous ................................................................3-26 

SNAP Case Screen 5—Client History ..................................................................3-27 

SNAP Case Screen 6—Overpayment .................................................................3-28 

SNAP Case Screen 7—Benefit Summary ...........................................................3-29 

SNAP Case Screen 8—Benefit History................................................................3-31 

i

Section Three: Detailed Field Descriptions (continued) 

Public Assistance Case Screens .........................................................................3-33 

PA Case Screen 1—Primary ...............................................................................3-35 

PA Case Screen 2—Active Clients List................................................................3-37 

PA Case Screen 5—Client History.......................................................................3-38 

PA Case Screen 7—Benefit Summary ................................................................3-39 

PA Case Screen 8—Benefit History.....................................................................3-41 

PA Case Screen 9—Sanction Information ...........................................................3-43 

Appendix 

Request for User Access to HHSC Systems Form and Instructions................. A 

Request for User Access to HHSC Systems Example Completed Form .......... B 

HHS Enterprise Architecture & Security Management 

Security and Privacy Agreement (SPA) Form and Instructions .................. C 

HHSC Code Summary (C— 540) ................................................................... D 

HHSC and TWC County, HHSC Region, and WDA Codes .............................. E 

Medicaid Type Programs Chart (C—1116) ..................................................... F 

ii

Section One: 

Access to TAMENU

TAMENU SAVERR Inquiry Reference Guide 

TAMENU SAVERR Inquiry 


Section One: Access to TAMENU 

Introduction 

TAMENU is a set of screens that allows limited inquiry 

to the Systems for Applications of Verifications, 

Eligibility, Referral, and Reports (SAVERR) from the 

Health and Human Services Commission (HHSC), 

previously Texas Department of Human Services 

(TDHS), production mainframe computer system. The 

production mainframe computer system continues to 

reference Texas Department of Human Services 

(TDHS); therefore, this curriculum does also. The 

TAMENU allows users to access information regarding 

a partcipant‘s Temporary Assistance for Needy 

Families (TANF), Supplemental Nutrition Assistance 

Program (SNAP) (formerly known as Food Stamps), 

and Social Security status and history. Texas 

Workforce Commission (TWC) staff and their partners 

needing access must submit HHS Enterprise 

Architecture & Secuity Manangement Security and 

Privacy Agreement (EASM_SM_002 – SPA form) and 

Request for User Access to HHSC Systems for TIERS, 

TAMENU, and TVCC. A copy of these forms is 

included in the appendix. 

NOTES: Use The Workforce Information System of Texas 

(TWIST) as the primary source for HHSC (TDHS) 

information. TAMENU inquiries incur a charge for each 

inquiry. 

As of April 1, 2009 the Food Stamp Program is known as 

Supplemental Nutrition Assistance Program (SNAP). All the 

―screen views‖ continue to list SNAP as Food Stamp, Food 

Stamps, FS or F. 

April 2009_v.4.0 Access to TAMENU Page 1-1


Using This 


This guide contains three sections and an appendix. 

 

Section 1 provides access to TAMENU information 

about how to appropriately sign on and sign off the 

system. 

 

 

 

Section 2 provides General Instructions on how to 

access information using client name, social 

security number, case number, and client number. 

Section 3 provides detailed field descriptions by 

type of screen. 

The appendix includes the SPA and Request for 

User Access Forms; HHSC Code Summary; HHSC 

and TWC County, HHSC Region, and WDA Codes; 

and Medicaid Type Programs Chart. 

Section 3 references HHSC Code Summary. This 

Code Summary is a Desk Reference and references 

Section C-540 of the Texas Works Handbook. 

This HHSC Code Summary references TANF and 

SNAP Codes related to TWC‘ s limited TAMENU 

Inquiry use. 

Page 1-2 Access to TAMENU April 2009_v.4.0


Adding HHSC 

Session to TWC 

System 

Check with your supervisor or system administrator for 

instructions in setting up and accessing the HHSC 

Session (TAMENU) on your computer. 

As of January 28, 2008, 

Host/IP Address = 147.80.2.51 

Port = 1029 

NOTE: The TAMENU screen displays in a Windows format. 

Windows features are not available to users. Do not use 

the mouse to navigate this screen! Using the mouse causes 

the system to FREEZE. Use the TAB key to move the 

cursor from field to field. Use the mouse to print a screen. 

Initial Sign-on to 

TAMENU 

On January 28, 2008 and after, the Online Terminal 

Security (OTS) screen appears. 



Initial Sign-on to Type your existing IRIS userid (SSN) on the 


―ENTER USERID‖ line. 

(continued) 

TAB to the PASSWORD field. 

NOTE: Use the TAB key. Do not hit the ENTER key, 

because this transmits your user id with a null password 

to the system, and your violation counter increments in 

the system. If you do hit the ENTER key, start over and 

enter your userid again. 

 

Type your existing four-character IRIS password 

and ―1+23‖ on the ―PASSWORD‖ line. 

For example: If your password is ―BEAR,‖ the initial 

OTS password is ―BEAR1+23.‖ 

 

Type your new eight-character password on the 

―NEWPASSWORD‖ line, and transmit (press 

ENTER). 

NOTE: Users are required to enter a new password the 

first time they sign on after the system change. Once the 

change is made, the new password becomes your 

password at the next sign-on. If you do not enter a new 

password the first time you sign on, a message displays 

―Password Longevity Has Expired—Please Re-enter.‖ 

After completing the initial new password change, you do 

not need to fill in the ―NEWPASSWORD‖ field if you are 

not changing your password. 



Initial Sign-on to Additional password information: 


(continued) The system requires at least eight characters but 

no more than 12 characters. 

 

 

 

The password is not case sensitive. 

Some special characters that are not allowed in 

OTS password are ‗ ‗ (space), ―, #, ^, @, ], [, ‗,‘ 

(comma), \, _, or the cent sign. 

Users are required to change their passwords every 

90 days. 

After successful sign-on, the screen shown on the 

following page displays. 

 

Transmit (press ENTER) which displays a blank 

screen. 



 

Type TAMENU for TAMENU Inquiry or TVCC for 

Child Care Inquiry and Transmit (press ENTER). If 

accessing TAMENU, the TDHS (HHSC) SAVERR 

INQUIRY MENU page displays. (See example on 

next page.) 

NOTE: This guide does not include Child Care Inquiry 

information. 


Regular Sign-on 

to TAMENU 


The next time you sign-on to TAMENU after you 

changed your password successfully, the following 

screen appears: 



Regular Sign-on Type your existing IRIS userid (SSN) on the 

to TAMENU 

―ENTER USERID‖ line. 

(continued) 

TAB to the PASSWORD field. 

NOTE: Use the TAB key. Do not hit the ENTER key, 

because this transmits your user id with a null password 

to the system, and your violation counter increments in 

the system. If you do hit the ENTER key, start over and 

enter your userid again. 

 

Type your new eight-character password on the 

―NEWPASSWORD‖ line, and transmit (press 

ENTER). 

After successfully signing on, the following screen 

displays 

 

Transmit (press ENTER) which displays a blank 

screen. 



 

Type TAMENU for TAMENU Inquiry or TVCC for 

Child Care Inquiry and Transmit (press ENTER). If 

accessing TAMENU, the TDHS (HHSC) SAVERR 

INQUIRY MENU page displays. (See example 

below.) 

NOTE: This guide does not include Child Care Inquiry 

information. 



Exiting TAMENU 

To exit or end the TAMENU session: 

 

 

 

Press F12 or F15 = Shift F3. The screen clears and 

the cursor is positioned in the upper left corner. 

Type SINOF1 and press ENTER. 

Message displays ―Sign-off is Complete.‖ 

SINOF1 

***SIGN OFF COMPLETE** 

 

Click File on the Menu Bar, and click EXIT, 

Or 

 

 

 

Click the ―X‖ at the top right corner of the screen. 

The following question appears ―Do you want to 

disconnect session HHSC MAINFRAME?‖ 

Click Yes. This action closes the connection to the 

mainframe and returns you to Windows. 

NOTE: Close BOTH the TAMENU application with SINOF1 

and end connection to the HHSC MAINFRAME. 


Section Two: 

Navigating in TAMENU


Section Two: Navigating in TAMENU 

General 

Information 

about Key 

Functions in 


TAMENU may respond differently for various connections 

and operating systems. Some systems may use the 

Function keys with the Ctrl key. For example, if F3 

does not work, try Ctrl F3. 

 

Cursor Movement — Move the cursor with the arrow 

keys or the tab key. If you are working through a 

Windows application, do not use the MOUSE except 

to print, or the system freezes. You must keep the 

cursor behind all entered information; otherwise, the 

computer cannot read the complete information. 

 

 

 

If System Freezes — Press Alt, Ctrl, Delete at the 

same time; select Task Manager>end task, sign-on to 

TAMENU again. 

Page/Menu 

ARROW keys move right, left, up, and down 

TAB moves from field to field 

SHIFT-TAB moves backwards from field to field 

F3 moves to the previous menu (TDHS SAVERR 

INQUIRY MENU) 

F5 moves to the next page of the displayed Sub- 

Screen (e.g., more persons on case and additional 

payment or benefit history screens) 

F6 moves to the previous page of the displayed 

Sub-Screen 

F7 clears the Menu screen 

F9 moves lower screen up 

F12 exits the menu 

F15 (Shift F3) sign-off complete. 

PRINT — Shift-Print Screen or Ctrl-P prints the 

screen. 

If you are working inside a Windows application, a print 

icon or a print function is available in the File Menu. The 

Print Screen button on the keyboard provides a graphic 

copy of the screen that you paste into other applications 

and then print. 

April 2009_v.4.0 Navigating in TAMENU Page 2-1


General 

Navigation in 


TAMENU has three types of screens: 

1. Client Screens provide general client information and 

history. 

2. SNAP (formerly known as Food Stamp--FS) Screens 

provide specific SNAP case information. 

3. Public Assistance (PA) Screens provide specific 

TANF/Medicaid case information. 

These instructions navigate sequentially through each 

type of screen. You can navigate from one type of 

screen to another, or go directly to the screens you use 

most. The directions and prompts on each screen are 

useful. 

Screen Views 

The viewing screen is split into two separate screens. 

1. The top part of the screen is a primary screen or X- 

Reference Screen (X-Ref meaning Cross-Reference). 

2. The bottom half of the screen is a display screen 

(view only). 

To move the Primary — Screen 1 up from the bottom to 

the top: 

 

 

 

Enter the page number to view in the display 

(bottom) part. 

This number can be two through eight, depending on 

the available screens indicated at the top right corner 

of Screen 1. 

Put an ―X‖. This moves the bottom primary screen to 

the top. 

EXAMPLE: Client Screen 1— Primary is at the bottom 

of the viewing screen, and you want to move it to the 

top. Enter 2X in the KEY:__ field to move the Primary 

Screen up to the top and display the second screen at 

the bottom. 

Page 2-2 Navigating in TAMENU April 2009_v.4.0


Screen Views 

(continued) 

See the example below. 

KEY _2X_ ENTER C (CLIENT)OR CASE LETTERS P, S, OR F ALONG WITH LINE # 

X-REF SCREEN 1 SSN= 432-XX-74XX PAGE 1 

CLIENT NO NAME BIRTH DT S R CNTY PA(P) SSI(S) FS(F) 

1 506674XXX BEE,MARIA ANN 10/08/964 F 3 015 X X 

2 

3 

4 

5 

6 

7 

8 

PA CASE SCREEN 1 - PRIMARY 

PAGE 1 

CASE 063719XX ACTIVE CAT 02 TP 01 BP BJN 086-04-C-04 MC 281-2 CNTY 015 

CASE NAME BEE,MARIA ANN DATE FILE 06/16/06 SEQ 18 PRINTED 11/17/07 

CERT DATE 06/25/06 LAST FORM 1000-A/B 

GN/PAY/RP GRANT EFF 03/01/07 REVIEW I ACTION 138 

MAIL ADDR 133 KAY ST 3MO PRIOR FORM EFF DT 01/01/08 

APT 115 

END DATE 

SAN ANTONIO TX 78213 HOLD CD/DT 8 02/06 PERIODIC RV DT 01/18/08 

TEMP ADDR N EBT PAW 013228XXX GRANT 293 APP INC 

TIERS FLAG 

The screen below shows the Primary Screen moved to 

the top and displays PA Case Screen 2 on the display 

or bottom window. 

NOTE: If the case is in TIERS, a ―T‖ appears under PA (P) 

or SNAP (FS--F) in upper right in the above screen rather 

than a ―X‖. As of April 1, 2009 the Food Stamp Program is 

known as Supplemental Nutrition Assistance Program 

(SNAP). The ―screen views‖ continue to list it as FS or F. 

PA CASE SCREEN 1 - PRIMARY PAGE 1 

CASE 063719XXX ACTIVE CAT 02 TP 01 BP BJN 086-04-C-04 MC 281-2 CNTY 015 





APT 115 

END DATE 



TIERS FLAG 

PA CASE SCREEN 2-ACTIVE CLIENTS LIST ENTER"C"& LINE# FOR CLIENT PAGE 01 

CASE 063719XXX ACTIVE CAT 02 TP 01 BP BJN 086-04-C-04MC 281-2CNTY 015 

PL CLIENT NO NAME BIRTH DT SR SIG W SSN 

C1 1A 506674XXX BEE,MARIA ANN 10/08/964 F3 8 M 432-XX-74XX 

C2 1B 506855XXX BEE,ELIZA 05/07/996 F3 5 A 464-XX-69XX 

C3 1C 508323XXX BEE,BOB 12/16/997 M3 5 A 463-XX-87XX 



C4 1D 510631XXX BEE,BRAD 09/15/003 M3 5 A 628-XX-63XX 

Main Menu— 

TDHS (HHSC) 

SAVERR Inquiry 

Menu 

After you complete the sign-on, the TDHS (HHSC) 

SAVERR Inquiry Menu screen displays. 

The screen has two sections, an upper input area, and a 

bottom listing the types of screens available for each 

type program. 

The TDHS (HHSC) SAVERR Inquiry Menu screen also 

displays instructions for function keys (F keys at the top 

on the keyboard). 

12/10/07 TDHS SAVERR INQUIRY MENU 15:35:57 

1) NAME XREF: TYPE _ NAME (L,F MI) _____________________ 

SEX _ COUNTY ___ BIRTH DATE ______ 

2) SSN XREF: TYPE _ SSN ___ __ ____ 

3) CASE/CLIENT: TYPE _ CASE/CLIENT # _________ SCREEN # _ 

TYPE MEANING SCREENS AVAILABLE 

A APPLICATION 1 

C CLIENT 1, 2, 4, 5, A, B, C, D, E & T 

F SNAP (Food Stamp) CASE 1 - 8 

P PUBLIC ASSISTANCE CASE 1, 2, 5, 7, 8 & 9 

S SOCIAL SECURITY CASE (SDX) 1 & 3 

F7 - REFRESH MENU F12 - EXIT MENU F15 - SIGN OFF 

You can perform an inquiry three different ways: 

1. name cross-reference 

2. Social Security number cross-reference 

3. Case/Client type number. 



Definitions of The following information provides the entry fields on the 

Entry Fields on TDHS (HHSC) SAVERR Inquiry Menu screen: 

TDHS (HHSC) 

SAVERR Inquiry Type—required entry on all three inquiry types 

Menu Screen 

A — HHSC application; requests information on 

applications filed at HHSC. This can include 

SNAP, TANF, or Medicaid application numbers 

C — HHSC client; requests information on the 

specific client 

F — SNAP (formerly known as Food Stamps) 

case; requests information specifically on the 

SNAP case 

P — Public Assistance case; requests information 

specifically on the PA case (An individual client 

may have more than one PA case.) 

S — Social Security case; requests information 

specifically on the Social Security Administration 

records available to HHSC. This may include SSI, 

RSDI, and Medicare information. 

 

 

 

 

 

Name — name of the HHSC client in a format of last 

name, first name, middle initial. If more than one 

client has this same name, narrow the search by 

entering other identifying information such as sex, 

birth date, county. This avoids having all clients with 

the name listed in the results. This is required if you 

are searching by name cross reference. 

Sex — restricts the search to a specific gender, male 

or female; not a required field 

County — three-digit number designating a specific 

county in Texas. This restricts the search to an HHSC 

case located in a specific county; not a required field 

Birthdate — specific date of birth of a client in the 

format of MMDDYY year entry is three digits; not a 

required field 

SSN — the nine-digit Social Security number 

assigned to the client; required entry if searching by 

SSN 



Definitions of Case/Client # — unique nine-digit number assigned 

Entry Fields on to each HHSC case. It usually begins with zero. This 

TDHS (HHSC) 

number must match the Type entry for Case/Client 

SAVERR Inquiry search 

Menu Screen 

(continued) Screen # — enter the specific screen number for the 

the Type entered for Case/Client; list of screens 

available appears in the bottom right corner; not a 

required entry 

NOTE: Detailed information on Client and Case screen 

displays is provided in Section 3 of this guide. 

Performing an 

Inquiry Using 

Name Cross 

Reference 

Performing an inquiry using the Name cross reference is 

the first option on the TDHS (HHSC) SAVERR INQUIRY 

MENU. 

You must verify that the spelling of the name is correct. 

You can display any case type screen by entering the 

appropriate TYPE entry. 

To view information from TDHS (HHSC) based on the 

name, from the TDHS (HHSC) SAVERR INQUIRY 

MENU screen: 

 

 

 

 

Press TAB until the cursor displays in the field 

labeled 1) NAME X-REF: TYPE _. 

Enter a TYPE depending on the type of case the 

client has. 

Enter the client’s name as indicated in his or her 

records; the more complete the name entered, the 

more narrow the search. Format of the name is last 

name(comma)first name(space)middle initial. 

Enter the gender, county number, and date of birth. 

These are not required entries, but the additional 

entries narrow the search. 



Performing an 


Name Cross 


(continued) 

 

Press ENTER. 

If more than one case meets the search criteria for the 

entries you made, a list of all cases displays as a result 

of the search. 


1) NAME XREF: TYPE C NAME (L,F MI) BEE,MARIA A___ 

SEX f COUNTY 015 BIRTH DATE 100864 

2) SSN XREF: TYPE __ SSN ___ __ ____ 




C CLIENT 1, 2, 4, 5, A, B, C, E 

F SNAP (FOOD STAMP) 1 - 8 




If no match is found, a message displays at the bottom 

of the screen that no information is available. 

Performing an 


SSN Cross 


Performing an inquiry using the SSN cross reference is 

the second of three ways to access the information from 

TDHS (HHSC). 

You must verify that the SSN is correct. 

To perform an inquiry using the customer Social 

Security number: 

 

 

 

At the Main Menu TDHS (HHSC) SAVERR INQUIRY 

MENU, press TAB until the cursor displays in 2) SSN 

X-REF: TYPE _. 

Enter C in the TYPE field. 

Enter the client’s SSN (the ―XX‖ used here for 

purposes of confidentiality). 



Performing an 


SSN Cross 


(continued) 

The screen below provides an example of the entries on 

the TDHS (HHSC) SAVERR INQUIRY MENU screen 

when performing a search using the SSN cross 

reference (SSN XREF). 




2) SSN XREF: TYPE C SSN 432 XX 74XX 




C CLIENT 1, 2, 4, 5, A, B, C, D, E 

F SNAP (FOOD STAMP) 1 - 8 




 

Press ENTER to display the X- Ref (Reference) 

Screen 1. 

X Ref Screen 1 

Field 

Descriptions 

and Entries 

X- Ref Screen 1 is ―view only‖ and provides general 

information about the client. It displays when you 

perform an inquiry using the client’s SSN. 

KEY __ ENTER C (CLIENT)OR CASE LETTERS P, S, OR F ALONG WITH LINE # 




2 

3 

4 

5 

6 



X Ref Screen 1 

Field 

Descriptions 

and Entries 

(continued) 

The X-Ref Screen 1 provides the following information: 

 

KEY — this is the only entry field on this screen 

C — to access client information 

P — to access PA case information 

S — to access Social Security case information 

F — to access SNAP case information 

 

 

 

 

 

 

 

SSN—Social Security number of the client 

Client No.— client number assigned by HHSC 

Name — name of the client 

Birth Dt — date of birth of the client 

S — client gender 

M — male 

F — female 

R — race of the client 

1 — white 

2 — black 

3 — Hispanic 

4 — American Indian or Alaskan Native 

5 — Asian or Pacific Islander (includes 

Indochinese) 

6 — computer entered code indicating 

inappropriate or omitted code 

Cnty — county code of residence (three-digit) 

NOTE: County codes designated by HHSC are 

different than county codes designated by TWC. See 

HHSC county codes in the appendix. 

 

PA (P) — X in column means the client has an 

existing PA case. The case may be active or denied. 



X Ref Screen 1 SSI (S) — X in column means the client has an 

Field 

existing SSI case. The case may be active or denied. 

Descriptions 

and Entries FS (F) — X in column means the client has an 

(continued) 

existing SNAP case. The case may be active or 

denied. 

Accessing Client 

Screens 

TWC and partners using client search have four client 

screens and four sub-screens available. 

The four client screens available to TWC and partners 

are: 

 

 

 

 

Client Screen 1 — Primary – general client and case 

information 

Client Screen 2 — Medical History 

Client Screen 4 — Case History 

Client Screen 5 — Alias Information 

The four sub screens available to TWC and partners 

are: 

 

 

 

 

Client Screen A — Welfare Reform Data 

Client Screen B — Time Limited Months 

Client Screen C — Penalty/Good Cause History 

Client Screen E — SNAP (formerly known as FS) 

Disqualification and Work Requirement. 

To access the Client screen from the X-Ref Screen 1: 

 

 

Type C plus the line number of the client in the KEY 

field. 

Press ENTER. 




Screens 

(continued) 

KEY _C1_ ENTER C (CLIENT)OR CASE LETTERS P, S, OR F ALONG WITH LINE # 




2 

3 

4 

5 

6 

7 

8 

The client screen, Client Screen 1 – Primary, appears 

at the bottom of the X-Ref Screen 1. 

KEY __ ENTER C (CLIENT)OR CASE LETTERS P, S, OR F ALONG WITH LINE # 




2 

3 

4 

5 

6 

7 

8 

CLIENT SCREEN 1 - ENTER 'C' & LINE # SCREENS= 1,2,4,A,B,C,E PAGE 01 

CLIENT NUM 506674XXX NAME BEE,MARIA ANN BD 10/08/964 SF R3 CNTY 015 

CASE-NUM TC S S-I-G W CLI-CERT SSN 432-XX-74XX * ALIAS 

C1 013228XXX 4 1 A 3 05/06/06 

C2 063719XXX 1 1 8 M 06/25/06 COV TP OPEN CLOSE SD 

C3 069104XXX 1 1 8 M 11/17/07 02R 29 01/01/07 

C4 02R 01 03/01/06 12/31/06 

C5 02R 07 11/01/05 02/28/06 

C6 02R 01 12/01/04 10/31/05 

TW FLAG LTC FLAG 

To access Client Screen 2 — Medical History: 

 

 

Type 2X in the KEY field. 

Press ENTER. 




Screens 

(continued) 

This action moves the Primary screen to the top and 

displays Client Screen 2 at the bottom. 

KEY _2X_ ENTER C (CLIENT)OR CASE LETTERS P, S, OR F ALONG WITH LINE # 




2 

3 

4 

5 

6 




C1 013228XXX 4 1 A 3 05/06/06 


C3 069104XXX 1 1 8 M 11/17/07 02R 01 01/01/07 

C4 02R 01 03/01/06 12/31/06 

C5 02R 07 11/01/05 02/28/06 

C6 02R 01 12/01/04 10/31/05 


Client Screen 2 displays at the bottom of Client Screen 

1. 

KEY __ 




C1 013228XXX 4 1 A 3 05/06/06 


C3 069104XXX 1 1 8 M 11/17/07 02R 01 01/01/07 

C4 02R 01 03/01/06 12/31/06 

C5 02R 07 11/01/05 02/28/06 

C6 02R 01 12/01/04 10/31/05 


CLIENT SCREEN 2 - MEDICAL HISTORY PAGE 01 


COV TP OPEN CLOSE SD COV TP OPEN CLOSE SD 

02R 01 01/01/07 02R 41 03/01/98 07/31/98 

02R 01 03/01/06 12/31/06 

02R 07 11/01/05 02/28/06 

02R 01 12/01/04 10/31/05 

02R 37 09/01/01 01/31/02 

02R 01 05/01/00 08/31/00 

02R 01 08/01/99 01/31/00 





Performing an 


Case Number/ 

Client Number 

You can access information from the HHSC (TDHS) 

systems either by case or client numbers. 

The following PA case screens are available to TWC: 

 

 

 

 

 

 

PA Case Screen 1 — Primary 

PA Case Screen 2 — Active Clients List 

PA Case Screen 5 — Client History 

PA Case Screen 7 — Benefit Summary 

PA Case Screen 8 — Benefit History 

PA Case Screen 9 — Sanction Information. 

To obtain PA (TANF) case information, from the TDHS 

(HHSC) SAVERR Inquiry Menu: 

 

 

 

 

Enter TAB until the cursor is on the field labeled 

3) CASE/CLIENT: TYPE _. 

Enter P for a PA (TANF) Case in the TYPE field. 

Enter the client’s PA (TANF) CASE Number. (The 

―XXX‖ should be numbers; X’s used here for 

confidentiality). 

Press ENTER. 

Refer to the sample screen on the following page. 



Performing an 


Case Number/ 

Client Number 

(continued) 





3) CASE/CLIENT: TYPE P CASE/CLIENT # 063719XXX SCREEN # _ 



C CLIENT 1, 2, 4, 5, A, B, C, D, E 

F SNAP (FOOD STAMP) CASE 1 - 8 



F7 - REFRESH MENU F12 – EXIT MENU F15 – SIGN OFF 

The PA Case Screen 1 — Primary displays. 

KEY _2_ 


PAGE 1 






APT 115 END DATE 



TIERS FLAG 



Performing an To access PA Case Screen 2 — Active Clients: 


Case Number/ Enter 2 in the KEY field. 

Client Number 

(continued) Press ENTER. 

KEY _2_ 


PAGE 1 






APT 115 END DATE 



TIERS FLAG 

The PA Case Screen 2 — Active Clients displays below 

the PA Case Screen 1 — Primary. 

KEY __ 







APT 115 

END DATE 



TIERS FLAG 




C1 1A 506674XXX BEE,MARIA ANN 10/08/964 F3 8 M 432-XX-7499 

C2 1B 506855XXX BEE,ELIZA 05/07/996 F3 5 A 464-XX-6930 

C3 1C 508323XXX BEE,BOB 12/16/997 M3 5 A 463-XX-8715 

C4 1D 510631XXX BEE,BRAD 09/15/003 M3 5 A 628-XX-6310 

You can display any PA Case Screen (2, 5, 7, 8, or 9) 

with available case information by entering the screen 

number in the KEY Field, such as in the previous 

example. 



Performing an To view SNAP case information, from the TDHS (HHSC) 

Inquiry Using SAVERR INQUIRY MENU: 

Case Number/ 

Client Number Enter TAB until the cursor displays in the field labeled 

(continued) 

3) CASE/CLIENT: TYPE_. 

 

 

 

Enter F for a SNAP (formerly known as Food Stamp) 

Case in the TYPE field. 

Enter the client’s SNAP CASE Number. (The ―XXX‖ 

should be numbers; X’s used here for confidentiality.) 

Press ENTER. 





3) CASE/CLIENT: TYPE F CASE/CLIENT # 013228XXX SCREEN # _ 



C CLIENT 1, 2, 4, 5, A, B, C, D, E 




F7 - REFRESH MENU F12 – EXIT MENU F15 - SIGN OFF 

The SNAP (Food Stamp) Case Screen 1 — Primary 

displays. 

KEY _ 

SNAP ( FS) CASE SCREEN 1 - PRIMARY 

PAGE 1 

CASE 013228XXX ACTIVE CAT 06 AID TYPE 3 BJN 086-04-C-04 MC 281-2CNTY 015 

CASE NAME BEE,MARIA ANN ORIG CERT 05/01/06 SEQ 63 PRINTED 11/18/07 


AUTH REP LAST ATP 02/08 REVIEW M 

MAIL ADDR 133 KAY ST MOS CERT 06 FORM EFF DT 01/01/08 

APT 115 PERSONS 04 

SAN ANTONIO TX PLAN C SSI 

ZIP78213 EBT PA# 063719XXX 

HOLD CODE 0 DT 09/06 APP NO A13228XXX 

CASH 0.00 STAMPS 454 ACTION CD DT TIERS FLAG 



Performing an To access SNAP (Food Stamp) Case Screen 2 — 

Inquiry Using Active Clients Lists: 

Case Number/ 

Client Number Enter 2 in the KEY field. 

(continued) 

Press ENTER. 

KEY _2 

SNAP ( FS) CASE SCREEN 1 - PRIMARY PAGE 1 

CASE 013228XXX ACTIVE CAT 06 AID TYPE 3 BJN 086-04-C-04 MC 281-2CNTY 015 



AUTH REP LAST ATP 02/08 REVIEW M 







The SNAP (FS) Case Screen 2 — Active Clients Lists 

displays below the SNAP (FS) Case Screen 1 — 

Primary. 

KEY __ 

SNAP ( FS) CASE SCREEN 1 - PRIMARY PAGE 1 

CASE 013228XXX ACTIVE CAT 06 AID TYPE 3 BJN 086-04-C-04MC 281-2CNTY 015 



AUTH REP LAST ATP 02/08 REVIEW C 

MAIL ADDR133 KAY ST MOS CERT 06 FORM EFF DT 01/01/08 



ZIP 78213 EBT PA# 063719XXX 


CASH 0.00 STAMPS 454 ACTION CD DT 

SNAP CASE SCREEN 2-ACTIVE CLIENTS LIST ENTER"C"& LINE #FOR CLIENTPAGE 01 

CASE 013228XXX ACTIVE CAT 06 AID TYPE 3 BJN 086-04-C-04 MC 281-2 

CNTY 015 

PL CLIENT NO NAME BIRTH DT SR SIG SSN 

C1 1A 506674XXX BEE,MARIA ANN 10/08/964 F3 A 472-XX-7460 

C2 1B 506855XXX BEE,ELIZA 05/07/996 F3 463-XX-6900 

C3 1C 508323XXX BEE,BOB 12/16/997 M3 465-XX-8715 

C4 1D 510631XXX BEE,BRAD 09/15/003 M3 626-XX-6354 



Performing an 


Case Number/ 

Client Number 

(continued) 

You can display any SNAP (FS) Case Screen (2, 3, 4, 5, 

6, 7, or 8) with available case information by entering the 

screen number in the KEY field such as in the previous 

example. 

To view information from TDHS (HHSC) based on the 

client number, from the TDHS (HHSC) SAVERR 

INQUIRY MENU screen: 

 

 

 

 

Press Tab until the cursor displays in the field labeled 

3) CASE/CLIENT: TYPE_. 

Enter a C in the TYPE field. 

Enter the client’s CLIENT Number. (The ―XXX‖ 

should be numbers; X’s used here for confidentiality). 

Press ENTER. 





3) CASE/CLIENT: TYPE C CASE/CLIENT # 506674XXX SCREEN # _ 



C CLIENT 1, 2, 4, 5, A, B, C, D, E 




F7 - REFRESH MENU F12 – EXIT MENU F15 - SIGN OFF 



Performing an 


Case Number/ 

Client Number 

(continued) 

Client Screen 1 — Primary displays. 

KEY _ 




C1 013228XXX 4 1 A 3 05/06/06 


C3 069104XXX 1 1 8 M 11/17/07 02R 29 01/01/06 

C4 02R 01 03/01/06 12/31/06 

C5 02R 07 11/01/05 02/29/06 

C6 02R 01 12/01/04 10/31/05 


To access Client Screen A — Welfare Reform Data: 

 

 

Enter A in the KEY field. 

Press ENTER. 

KEY A 



CASE-NUM TC S S-I-G W CLI-CERT SSN 432-XX-7499 * ALIAS 

C1 013228XXX 4 1 A 3 05/06/06 


C3 069104XXX 1 1 8 M 11/17/07 02R 29 01/01/06 

C4 02R 01 03/01/06 12/31/06 

C5 02R 07 11/01/05 02/29/06 

C6 02R 01 12/01/04 10/31/05 




Performing an Client Screen A — Welfare Reform Data displays 

Inquiry Using below Client Screen 1. 

Case Number/ 

Client Number 

(continued) 

KEY __ 

CLIENT SCREEN 1 - ENTER 'C' & LINE # SCREENS= 1,2,4,A,B,C PAGE 01 

CLIENT NUM 519274XXX NAME DAY,SALLY E BD 07/31/979 SF R2 CNTY 015 


C1 066092XXX 4 1 A 3 09/07/07 


C3 02R 01 09/01/07 

C4 02R 01 10/01/06 01/31/07 

C5 

C6 


CLIENT SCREEN A - WELFARE REFORM DATA PAGE 01 


PILOT INDICATOR X SL/TIER 5 TIER REASON 

IDA INDICATOR TARGET GRP 1 TL MONTHS USED 05 

FINGERPRINT CODE Y VOLUNTEER N TL FREEZE OUT END DT 

CARETKR EX END DT 06/2004 18 MONTH FLAG Y WORK HISTORY 00 

OT LAST INELIG MO RA FLAG Y LITERACY LEVEL 11 

PARENTING SKILLS LITERACY ASSESS DT 01/2005 

JOBS CASE STATUS O NOTIFICATION EFF DT 10/2006 

JOBS CLOSE DT 

You can display any Client Screen (2, 4, 5, A, B, C, or E) 

with available Client information by entering the screen 

number in the KEY Field such as in the previous 

example. 


Section Three: 

Detailed Field Descriptions


Section Three: Detailed Field Descriptions 

General 

Information 

This section of the reference guide provides you with 

detailed field descriptions of screens that are available 

to TWC and partners through the TDHS (HHSC) 

SAVERR Inquiry Menu. 

Three different type screens and several sub-screens 

are available to staff who are granted permission to 

access this system. The screens are: 

 

 

 

Client screens 

SNAP (formerly known as Food Stamp) Case 

screens 

Public Assistance (PA) Case screens. 

NOTE: As of April 1, 2009 the Food Stamp Program is 

known as Supplemental Nutrition Assistance Program 

(SNAP). All the ―screen views‖ continue to list SNAP as 

Food Stamp, Food Stamps, FS or F. 

Client Screens 

Four different Client screens are available. Each 

screen provides different information. The screens are: 

 

 

 

 

Client Screen 1 — Primary 

Client Screen 2 — Medical History 

Client Screen 4 — Case History 

Client Screen 5 — Alias Information 

Four sub-screens are available: 

 

 

 

 

Client Screen A — Welfare Reform Data 

Client Screen B — Time Limited Months 


Client Screen E — SNAP (FS) Disqualification and 

Work Requirement 

April 2008_v.4.0 Detailed Field Descriptions Page 3-1


Client Screens 

(continued) 

Notice that the screens are not sequential. The other 

Client screens in the series are not available to TWC 

and partners. 

The first line of all Client screens provides the same 

information, which is the: 

 

 

 

screen number 

screen title 

page number. 

The second line of all Client screens also provides the 

same information: 

 

 

 

CLIENT NUM — client number composed of nine 

digits, beginning with a number one through five, 

assigned to each certified person in the TDHS 

(HHSC) SAVERR system 

NAME — client’s name 

BD — client’s birth date (MM/DD/YYY) 

S — client’s gender (See HHSC Code Summary C- 

540, Page D-1) 

 

 

R — client’s self-declared race (See HHSC Code 

Summary C-540, Page D-1) 

CNTY — the client’s county of residence (see 

County Codes in Appendix E) 

Client Screen 1 

—Primary 

Client Screen 1 — Primary provides general 

information about the case. 

Lines 1 and 2 fields are described in the Client Screen 

section above. 

Page 3-2 Detailed Field Descriptions April 2009_v.4.0



—Primary 

(continued) 

KEY _C2_ 

CLIENT SCREEN 1 --- ENTER 'C' & LINE # SCREENS= 1,2,4,A,B,C,E PAGE 

01 



C1 013228XXX 4 1 A 3 05/06/06 


C3 069104XXX 1 1 8 M 11/17/07 02R 01 01/01/07 

C4 02R 01 03/01/06 12/31/06 

C5 02R 07 11/01/05 02/29/06 

C6 02R 01 12/01/04 10/31/05 


The specific field descriptions for Client Screen 1 — 

Primary are: 

 

 

 

 

CLIENT NUM — client number composed of nine 

digits, beginning with a number from one through 

five, assigned to each certified person in the TDHS 

(HHSC) SAVERR system 

CASE NUM — case number composed of nine 

digits assigned to specific program case. The 

number usually starts with a zero. 

TC — type case codes: 

1 — TANF 

2 — Aged and Disabled 

3 — SSI 

4 — SNAP (formerly known as Food Stamps) 

5 — Refugee Assistance 

S — case status codes: 

1 — active 

2 — denied 

3 — suspended 

4 — hold 




—Primary 

(continued) 

 

 

 

 

 

 

 

 

 

 

 

 

S-I-G — client’s Status-in-Group code (See HHSC 

Code Summary C-540, Page D-2) 

W — client’s applicable work code (See HHSC 


CLI-CERT — date client was certified 

SSN — client’s Social Security number — an 

asterisk indicates that the Social Security 

Administration has verified the SSN. 

ALIAS — Y indicates that a Client Screen 5 exists 

COV — Medicaid coverage code composed of the 

two-digit assistance category and a third character: 

H — hold 

R — regular 

L — lock-in 

I — institutional care. 

TP — Type Program (See HHSC Code Summary 

C-540, Page D-4) 

OPEN — date Medicaid coverage began 

CLOSE — date Medicaid coverage ended 

SD — spend-down indicator (some clients are 

allowed to deplete their resources in order to be 

eligible for Medicaid) 

TW FLAG — Texas Works- ―T‖ indicates client 

moved to TIERS 

LTC FLAG — Long Term Care - ―T‖ indicates client 

moved to TIERS 


—Medical 

History 

Client Screen 2 — Medical History provides 

information on the client’s history of Medicaid coverage. 

The Client Screen section above describes Lines 1 

and 2 fields. 



Client Screen 2 Client Screen 2 — Medical History displays in the 

—Medical lower half of the screen below Client Screen 1 — 

History 

Primary. 

(continued) 

KEY __ 

CLIENT SCREEN 1 --- ENTER 'C' & LINE # SCREENS= 1,2,4,A,B,C,E PAGE 01 



C1 013228XXX 4 1 A 3 05/06/06 


C3 069104XXX 1 1 8 M 11/17/07 02R 01 01/01/07 

C4 02R 01 03/01/06 12/31/06 

C5 02R 07 11/01/05 02/28/06 

C6 02R 01 12/01/04 10/31/05 


CLIENT SCREEN 2 --- MEDICAL HISTORY PAGE 01 


COV TP OPEN CLOSE SD COV TP OPEN CLOSE SD 

02R 01 01/01/07 02R 41 03/01/01 07/31/01 

02R 01 03/01/06 12/31/06 

02R 07 11/01/05 02/29/06 

02R 01 12/01/04 10/31/05 

02R 37 09/01/03 01/31/04 

02R 41 05/01/02 08/31/03 

02R 01 08/01/01 01/31/02 


Medical History are: 

 

COV — Medicaid coverage code composed of the 

two-digit assistance category and a third character 

plus 

H — hold 

R — regular 

L — lock-in 

I — institutional care. 

TP — type program (See HHSC Code Summary C- 

540, Page D-4) 

 

 

 

OPEN — date Medicaid coverage began 

CLOSE — date Medicaid coverage ended (if blank, 

coverage continues) 

SD — spend-down indicator (some clients are 

allowed to deplete their resources in order to be 

eligible for Medicaid). 




—Case History 

Client Screen 4 — Case History provides information 

on the different case groups a client has been 

considered as a member. 

The client may have been an eligible member or 

ineligible member of a group. As long as the client’s 

name appears as a group member, the case number 

appears in this list of information. 


and 2 fields. 

Client Screen 4 — Case History displays in the lower 

half of the screen below Client Screen 1 — Primary. 

KEY __ 




C1 013228XXX 4 1 A 3 05/06/06 


C3 069104XXX 1 1 8 M 11/17/07 02R 01 01/01/07 

C4 02R 01 03/01/06 12/31/06 

C5 02R 07 11/01/05 02/28/06 

C6 02R 01 12/01/04 10/31/05 


CLIENT SCREEN 4 -CASE HISTORY (ENTER LETTER BESIDE CASE # DESIRED) PAGE 01 


CASE NUM TC S S-I-G ADD-DATE DROP-DT CASE NUM TC S S-I-G ADD-DATE DROP-DT 

A 063719XXX 1 1 8 06/25/06 11/17/06 H 015316XXX 1 2 9 12/22/04 02/19/05 

B 063719XXX 1 4 8 06/25/06 12/22/06 I 012023XXX 1 2 8 04/29/03 01/14/04 

C 012023XXX 1 2 0 01/22/05 06/22/06 J 012973XXX 1 2 9 07/18/02 08/18/02 


Case History are: 

 

TC — type case codes: 

1 — TANF 

2 — Aged and Disabled 

3 — SSI 

4 — SNAP (formerly known as Food Stamps) 

5 — Refugee Assistance. 



Client Screen 4 S — case status codes 

—Case History 1 — active 

(continued) 

2 — denied 

3 — suspended 

4 — hold. 

 

 

 

S-I-G — client’s Status-in-Group code (See HHSC 


ADD-DATE — date client was certified/added to 

the case 

DROP-DT — date the client was removed/dropped 

from the case. 


—Alias 

Information 

Client Screen 5 — Alias Information provides 

information on any alias the client may have used to 

receive a benefit or service from TDHS (HHSC). 


and 2 fields. 

Client Screen 5 — Alias Information displays in the 

lower half of the screen below Client Screen 1 — 

Primary. 

KEY __ 

CLIENT SCREEN 1 - ENTER 'C' & LINE # SCREENS= 1,2,4,5,A,C PAGE 01 

CLIENT NUM 503175XXX NAME BOYD,LISA BD 08/16/981 SF R2 CNTY 015 


C1 008333XXX 1 1 8 G 06/16/07 

C2 COV TP OPEN CLOSE SD 

C3 02R 07 10/01/07 

C4 02R 01 06/01/06 09/30/07 

C5 02R 01 12/01/04 05/31/05 

C6 02P 40 06/01/03 08/31/04 


CLIENT SCREEN 5 - ALIAS INFORMATION PAGE 01 

CLIENT NUM 503175XXX NAME BOYD,LISA BD 08/16/981 SF R2 CNTY 015 

ALIAS NUM 503140XXX TYPE C ALIAS NUM TYPE 

MERGE DATE 11/05/96 CASE MERGE DATE CASE 

ERR MERGE FROM TO ERR MERGE FROM TO 

ALIAS NUM TYPE ALIAS NUM TYPE 

MERGE DATE CASE MERGE DATE CASE 

ERR MERGE FROM TO ERR MERGE FROM TO 




—Alias 

Information 

(continued) 


Alias Information are: 

 

ALIAS NUM — a client number, Social Security 

number, Social Security claim number, or Railroad 

Retirement number at one time associated with the 

client 

 

TYPE — alias number types are: 

C — client number 

H — Social Security Claim number or Railroad 

Retirement number 

S — Social Security number 

MERGE DATE — 

if TYPE C, date the TDHS (HHSC) computer 

processed a merge transaction 

if TYPE S or H, process date of the TANF or 

SNAP transaction that removed the alias 

number 

 

 

 

CASE — if the code is H or S, case number of the 

SDX (SSI) case in which a different Social Security 

number, Social Security claim number, or Railroad 

Retirement number was reported 

ERR MERGE DATE — if a merge transaction was 

done in error, the date the TDHS (HHSC) computer 

processed the erroneous merge is listed; cannot 

appear with a merge date 

TO — date the TDHS (HHSC) computer processed 

a separate transaction to resolve the erroneous 

merge 

Client Screen A Client Screen A — Welfare Reform Data provides 

—Welfare 

information on requirements for welfare reform policy 

Reform Data that was implemented in 1996. 

Lines 1 and 2 fields are described in the Client Screen 

section above. 



Client Screen A 

—Welfare 

Reform Data 

(continued) 

Client Screen A — Welfare Reform Data displays in 

the lower half of the screen below Client Screen 1 — 

Primary. 

KEY __ 




C1 066092XXX 4 1 A 3 09/07/07 


C3 02R 01 09/01/07 

C4 02R 01 10/01/05 01/31/06 

C5 

C6 


CLIENT SCREEN A - WELFARE REFORM DATA PAGE 01 


PILOT INDICATOR SL/TIER 5 TIER REASON 

IDA INDICATOR TARGET GRP 1 TL MONTHS USED 05 

FINGERPRINT CODE Y VOLUNTEER N TL FREEZE OUT END DT 

CARETKR EX END DT 08/2007 18 MONTH FLAG Y WORK HISTORY 00 

OT LAST INELIG MO RA FLAG Y LITERACY LEVEL 11 

PARENTING SKILLS LITERACY ASSESS DT 09/2007 

JOBS CASE STATUS O NOTIFICATION EFF DT 09/2007 

JOBS CLOSE DT 

The specific field descriptions for Client Screen A — 

Welfare Reform Data are: 

 

PILOT INDICATOR — this code relates to Time 

Limits policy. It may include one of the following 

codes (no longer applicable): 

C — client in RA (Responsibility Agreement) 

Control Group 

E — client in RA Pilot Experimental Group 

R — client in RA Experimental Group (Non- 

Choices Area) 

S — client in RA Control Group (Non-Choices 

Area) 

L — client in TL (Time Limited) Control Group 

T — client in TL Experimental Group 



Client Screen A 

—Welfare 

Reform Data 

(continued) 

 

 

 

 

 

 

 

 

 

X — client/household was in TL or RA Control 

Group Area but later moved to Experimental Group 

Area or Experimental Group Client moved into a 

Control Group household. The Pilot Indicator is 

changed to X for everyone in the household and 

Time Limits or Responsibility Agreement now apply. 

IDA INDICATOR — Individual Development 

Account Indicator 

FINGERPRINT CODE — Finger Imaging Code, e.g. 

Y - finger images have been taken (See HHSC 


CARETKR EX END DT — Caretaker Exemption 

End Date (MM/YYYY); the last date the client is 

eligible for an exemption due to caring for a child 

OT LAST INELIG MO — one-time TANF Last 

Ineligibility Month (MM/YYYY); the last month of 

TANF ineligibility due to application of the one-time 

TANF policy 

PARENTING SKILLS — Codes: 

R — advisor referred the client to Parenting 

Skills course 

J — client completed Parenting Skills through 

the Choices (formerly JOBS) program 

C — client completed Parenting Skills course 

JOBS CASE STATUS — Choices codes are: 

O — open 

C — closed 

JOBS CLOSE DT — effective date (MM/YYYY) the 

Choices (formerly JOBS) case closed to services 

SL/TIER 

SL — Service Level — four JOBS service levels 

were used for the JOBS program before WorkFirst 

began. Codes ranged from one to four. Tier Levels 

replaced codes. 



Client Screen A TIER- Tier Level. Time Limit Tier Codes replace 

—Welfare 

the SL codes: 

Reform Data - Tier 5 — 12 months 

(continued) - Tier 6 — 24 months 

- Tier 7 — 36 months 

- Tier 8 — Unknown (set by SAVERR if tier 

data has not yet been received). 

 

 

 

 

 

 

TARGET GRP — Target Groups are federal and 

state categorizations of types of clients used to 

obtain enhanced funding. The codes range from 

one to nine. 

VOLUNTEER — client volunteered for Choices 

services during the eligibility interview: 

Y — Yes, qualify 

N — No. 

18-MONTH FLAG — client gets 18 months of 

Transitional Medicaid coverage as a volunteer for 

Choices while exempt. 

Y - Yes, qualify 

BLANK - does not qualify. 

RA FLAG — a signal that the caretaker and second 

parent have signed the Personal Responsibility 

Agreement (PRA): 

Y — client has signed the PRA 

P — client has signed the PRA but is no longer 

a TANF recipient. 

TIER REASON — Codes: 

J — Choices staff changed a tier due to 

functional literacy assessment 

R — reset or re-determination; tier level 

changed by Advisor. 

TL MONTHS USED — Time Limited Months Used 

(two-digit number) — number of months counted 

towards the client’s state time limit. The maximum 

amount of months in this field is the number of 

months allowed in the client’s tier. 



Client Screen A TL FREEZE OUT END DT — Time Limit Freeze 

—Welfare 

Out End Date (MM/YYYY) the five years after the 

Reform Data 

client reaches the Federal time limit 

(continued) 

WORK HISTORY — two-digit number representing 

the number of months the client worked during a 

24-month work history period 

 

 

 

LITERACY LEVEL — two-digit number 

representing the functional grade level. The 

possible range of digits is 01 to 13 (13= post high 

school). 

LITERACY ASSESS DT — Literacy Assessment 

Date (MM/YYYY) - date on which the functional 

literacy level determined by the Choices specialist 

NOTIFICATION EFF DT — Notification Effective 

Date (MM/YYYY) — the month after the client 

notified of Choices participation. This is the date 

the state time limit clock starts ―ticking.‖ 

Client Screen B 

—Time Limited 

Months 

Client Screen B — Time Limited Months provides 

information about the specific months that have been 

counted toward a client’s time limit. 


and 2 fields. Line 1 also indicates the maximum 

number of months to count toward the time limit for 

this specific client. 



Client Screen B Client Screen B — Time Limited Months displays in 

—Time Limited the lower half of the screen below Client Screen 1 — 

Months 

Primary. 

(continued) 

KEY __ 




C1 066092XXX 4 1 A 3 09/07/07 


C3 02R 01 09/01/07 

C4 02R 01 10/01/05 01/31/07 

C5 

C6 


CLIENT SCREEN B -TIME LIMITED MONTHS TIER MONTHS MAX 12 

CLIENT NUM 519274XXX NAME DAY,SALLY E BD 07/31/979 SF R 

PAGE 01 

CNTY 015 

BENEFIT 

MONTH 

12/2007 

11/2007 

09/2007 

BENEFIT 

MONTH 

BENEFIT 

MONTH 

BENEFIT 

MONTH 

BENEFIT 

MONTH 

BENEFIT 

MONTH 

The specific field descriptions for Client Screen B — 

Time Limited Months are: 

 

TIER MONTHS MAX — indicates the maximum 

number of state time limit months a client can 

receive TANF benefits. Inquiry uses the value in the 

SL/TIER field to determine this number. The 

following table shows the formula: 

If the SL/Tier field 

is…. 

The Tier Months Max 

field displays 

5 12 

6 24 

7 36 

 

Benefit Month — MM/YYYY displays the history 

of the State Time Limited months used. Use this 

screen to check the accuracy of the number of 

TANF months used. 



Client Screen B 

—Time Limited 

Months 

(continued) 

Client Screen C 

—Penalty/ 

Good Cause 

History 

The maximum number of months the Benefit Month 

screen displays is 36. The screen is blank if there 

are no months used towards the state time limit. 


gives you with the type and the start and end dates of 

any penalty assessed against the client or any good 

cause granted the client. 


and 2 fields. 


displays in the lower half of the screen below Client 

Screen 1 — Primary. 

KEY __ 




C1 066092XXX 4 1 A 3 09/07/07 


C3 02R 01 09/01/07 

C4 02R 01 10/01/05 01/31/07 

C5 

C6 


CLIENT SCREEN C - PENALTY/GOOD CAUSE HISTORY PAGE 01 

CLIENT NUM 519274XXX NAME DAY,SALLY E BD 07/31/979 SF R CNTY 015 

TYPE START END TYPE START END TYPE START END 

F 12/2007 



Client Screen C The specific field descriptions for Client Screen C — 

—Penalty/ 

Penalty/Good Cause History are: 

Good Cause 

History TYPE — for Codes. See table below for codes. 

(continued) 

If a penalty is imposed, the 

following codes are displayed 

Requested by Choices 

Staff/Imposed by HHSC Texas 

Works Staff 

Choices Penalty Codes, 

indicating whether it is the first, 

second, or third time or more that 

the client failed to comply: 

If good cause is 

granted, the following 

codes are displayed 

Determined by Choices 

staff 

HHSC (TDHS) code: 

F – first month non-cooperation 

5 

S – second month noncooperation 

5 

T – forfeit month(s) of noncooperation 

5 

Determined and imposed by 

HHSC Texas Works staff: 

Non-Choices Penalty Codes: 

C – Child Support 

V – Voluntary Quit 

Determined and Imposed 

by HHSC Texas Works 

staff: 

Non-Choices Good 

Cause Codes: 

No Good Cause code 

exists 

E – Texas Health Steps 6 

G – Immunization 

1 alternate schedule 

2 medical 

3 religious beliefs 

4 control or grace period 

A – School Attendance 


exists 

P – Parenting Skills 7 

D – Drugs/Alcohol 


exists 



Client Screen E 

— SNAP (FS) 

Disqualifications 

and 

Work 

Requirement 

Data 

Client Screen E — SNAP (formerly known as Food 

Stamps-FS) Disqualifications and Work 

Requirement Data gives you with information about 

the SNAP disqualifications imposed on the specific 

client named on the Primary Screen. It also provides 

information about the SNAP work requirements of the 

specific client. 


and 2 fields. 

Client Screen E — SNAP (FS) Disqualifications and 

Work Requirement Data displays in the lower half of 

the screen below Client Screen 1 — Primary. 

KEY __ 

CLIENT SCREEN 1 - ENTER 'C' & LINE # SCREENS= 1,4,A,E,T PAGE 01 

CLIENT NUM 525571XXX NAME JONES,SALLY BD 10/08/964 SF R3 CNTY 015 


C1 

C2 COV TP OPEN CLOSE SD 

C3 

C4 

C5 

C6 


CLIENT SCREEN E-FS DISQUALIFICATIONS AND WORK REQUIREMENT DATA PAGE 01 

CLIENT NUM 525571XXX NAME JONES,SALLY BD 10/08/964 S F R 3 CNTY 015 

DISQUALIFICATIONS: 

WORK REQUIREMENT: 

FUGITIVE WORK REQUIREMENT END DATE 08/2008 

INELIG ALIEN (DOC) 

INELIG ALIEN (UNDOC) 

ELIGIBILITY MONTHS: 

SSN REQUIREMENT 1 09/2005 

DRUG CONVICTION 2 05/2007 

Y E&T/VOL QUIT 

LAST CHANGED BY P 

S E&T/VOL QUIT COUNTER LAST CHANGED ON 06/01/2007 



Client Screen E 

— SNAP (FS) 

Disqualifications 

and 

Work 

Requirement 

Data 

(continued) 

The specific field descriptions for Client Screen E — 

SNAP (FS) Disqualification and Work Requirement 

Data are: 

 

DISQUALIFICATIONS — (See HHSC Code C-540, 

Page D-8): 

B — ineligible alien without BCIS document 

C — ineligible alien with BCIS document 

D — felony drug conviction 

F — first offense failure to comply with 

Employment Services Program (ESP) 

requirements (Employment and 

Training/voluntary quit/reducing hours to less 

than 30) 

J — fugitive 

N — failure to meet Social Security number 

requirement 

S — second offense failure to comply with ESP 

requirements 

T — third or subsequent offense failure to comply 

with ESP requirements 

W — failure to comply with the 18-50 SNAP work 

requirement. 

 

 

E&T/VOL QUIT — Flag indicating that a client has 

been disqualified from a SNAP case because of 

non-compliance with the employment and training 

program: 

Y — currently disqualified 

N — previously disqualified, but is no longer 

disqualified 

Blank — not currently or previously disqualified. 

E&T/VOL QUIT COUNTER — the client’s offense 

count: 

F — first E&T/voluntary quit offense 

S — second E&T/voluntary quit offense 

T — third and subsequent E&T/voluntary quit 

offense 

Blank — no E&T/voluntary quit offense record. 



Client Screen E LAST CHANGED BY — type of process by which 

— SNAP (FS) the last update to the SNAP (FS) client 

Disqualifi- 

disqualification record was made: 

cations and 

A — change was made by the Add process 

Work 

F — change was made by the Force Change 

Requirement 

process 

Data 

M — change was made by the Merge process 

(continued) 

S — change was made by the Separate process 

P — change was made by the Plucker process 

C — change was made by the Conversion 

process. 

 

 

 

 

LAST CHANGED ON — last date an update was 

made to the SNAP (FS) client disqualification 

record. 

WORK REQUIREMENT — flag indicating that a 

client eighteen to fifty years of age who has been 

receiving SNAP is disqualified from a SNAP (FS) 

case. This happens when, for three months within a 

36-month period, the client’s average weekly work 

hours fall below 20 hours: 

Y — currently disqualified 

N — previously disqualified but is no longer 

disqualified 

Blank — not currently or previously disqualified. 

WORK REQUIREMENT END DATE — the date a 

client’s 36 months of 18-50 SNAP work requirement 

ends. 

ELIGIBILITY MONTHS: 

1 — first month a client worked less than twenty 

hours per week and received SNAP (FS) 

benefits 

2 — second month a client worked less than 

twenty hours per week and received SNAP (FS) 

benefits 

3 — third month a client worked less than twenty 

hours per week and received SNAP (FS) 

benefits 

4 — fourth month a client worked less than 

twenty hours per week and received SNAP (FS) 

benefits. 



SNAP (formerly 

known as Food 

Stamp) Case 

Screens 

Eight different SNAP (formerly known as Food Stamp) 

Screens are available, and each screen provides 

different information. The screens are: 

 

SNAP (FS) Case Screen 1 — Primary 

 

 

 

 

 

 

 

SNAP (FS) Case Screen 2 — Active Clients List 

SNAP (FS) Case Screen 3 — Budget 

SNAP (FS) Case Screen 4 — Miscellaneous 

SNAP (FS) Case Screen 5 — Client History 

SNAP (FS) Case Screen 6 — Overpayment 

SNAP (FS) Case Screen 7 — Benefit Summary 

SNAP (FS) Case Screen 8 — Benefit History 

The first two lines of each SNAP (FS) Case Screen 

provides identical information: 

 

 

 

screen number 

screen title 

page number. 

The second line of all SNAP (FS) Case Screens also 

provides the same information: 

 

 

 

Case — nine digit case number, which usually 

begins with zero. 

Case Status: 

active 

denied 

suspended 

hold. 

CAT — category of assistance (See HHSC Code 

Summary C-540, Page D-1). 



SNAP (formerly AID TYPE — type of SNAP household (See HHSC 

known as Food Code Summary C-540, Page D-4) 

Stamp) Case 

Screens BJN — TDHS (HHSC) caseworker’s budgeted job 

(continued) 

number 

 

 

MC — advisor’s mail code 

CNTY — client’s county of residence (see County 

Codes in Appendix E) 


known as FS) 

Case Screen 1— 

Primary 

SNAP (FS) Case Screen 1 — Primary provides 

general information about the SNAP case. 

The SNAP (FS) Case Screen section above provides 

Lines 1 and 2 field descriptions. 

KEY __ 

SNAP (FS) CASE SCREEN 1 --- PRIMARY 

PAGE 

1 











The specific field descriptions for SNAP (FS) Case 

Screen 1 — Primary are: 

 

 

 

 

CASE NAME — name of the head of household 

AUTH REP — name of the authorized 

representative allowed to use the EBT account to 

buy food for the household 

MAIL ADDR — mailing address of the client 

CASH — always zero; household allotments are 

adjusted for income 






known as FS) 


Primary 

(continued) 

 

 

STAMPS — amount of allotment the client’s 

household is entitled to 

ORIG CERT — date of the earliest certification for 

a continuous period of eligibility 

SEQ — sequence number of the Form 1000-B 

eligibility document 

 

 

 

 

 

 

 

 

 

 

PRINTED — date the latest Form 1000-A/B was 

processed 

CERT DATE — effective date of the most recent 

certification or re-certification for the case 

LAST ATP — date (MM/YY) that this case will 

receive its last Electronic Benefits Transfer (EBT) 

allotment in the current certification period 

REVIEW — type of case review reported on the last 

Form 1000-B (See HHSC Code Summary C-540, 

Page D-4) 

MOS CERT — number of months certified 

FORM EFF DT — effective date of the latest Form 

1000-B eligibility document 

PERSONS — number of persons in the household 

eligible to receive SNAP 

PLAN — documentation shown if the household is 

subject to income eligibility test or shelter deduction 

SSI — ―X‖ indicates that every member of the 

household receives SSI; no entry indicates that at 

least one person in the household does not receive 

SSI 

EBT — SNAP cases in Texas are on Electronic 

Benefits Transfer (EBT) 



SNAP (formerly PA # — case number of a related TANF case if 

known as FS) 

applicable. This data is not always current. 


Primary HOLD CODE — code indicating the benefits have 

(continued) 

been placed on hold (withheld) or released. (See 

HHSC Code Summary C-540, Page D-6) 

 

 

 

 

 

DT — MM/YY the hold or release became effective 

APP NO — application number from the most 

recent NOA, Notice of Application 

ACTION CD — entry indicates the case is denied. 

(See HHSC Code Summary C-540, Page D-6) 

DT — date the case denied 

TIERS FLAG — ―T‖ indicates case moved to TIERS 



SNAP (FS) Case 

Screen 2— 

Active Client 

List 

SNAP (FS) Case Screen 2 — Active Client List 

provides a list of all persons who are considered SNAP 

household members. 



SNAP (FS) Case Screen 2 — Active Client List 

displays in the lower half of the screen below SNAP 

(FS) Case Screen 1 — Primary. 

KEY __ 


PAGE 

1 





MAIL ADDR133 KAY ST MOS CERT 06 FORM EFF DT 01/01/08 



ZIP 78213 EBT PA# 063719XXX 



FSCASE SCREEN 2-ACTIVE CLIENTS LIST ENTER"C"& LINE #FOR CLIENT PAGE 01 

CASE 013228XXX ACTIVE CAT 06 AID TYPE 3 BJN 086-04-C-04 MC 281-2 CNTY 

015 

PL CLIENT NO NAME BIRTH DT SR SIG SSN 

C1 1A 506674XXX BEE,MARIA ANN 10/08/964 F3 A 472-XX-74XX 

C2 1B 506855XXX BEE,ELIZA 05/07/996 F3 463-XX-69XX 

C3 1C 508323XXX BEE,BOB 12/16/997 M3 465-XX-87XX 

C4 1D 510631XXX BEE,BRAD 09/15/003 M3 626-XX-63XX 



SNAP (FS) Case The specific field descriptions for SNAP (FS) Case 

Screen 2— 

Screen 2 — Active Client List are: 

Active Client 

List PL — page and line number of the client on the 

(continued) 

Form 1000-A/B 

 

 

 

 

 

 

CLIENT NO — a nine-digit number beginning with a 

number one through five that is each client’s unique 

identifier in the SAVERR system 


BIRTH DT — MM/DD/YYY of client’s birth 

SR — client’s declared gender and race 

SIG — client’s status in group (e.g., A for head of 

household). (See HHSC Code Summary C-540, 

Page D-2) 

SSN — client’s Social Security number. 


Screen 3— 

Budget 

SNAP (FS) Case Screen 3 — Budget provides an 

overview of the SNAP household budget used to 

determine eligibility for SNAP benefits. 


field descriptions of Lines 1 and 2. 




Screen 3— 

Budget 

(continued) 

SNAP (FS) Case Screen 3 — Budget displays in the 

lower half of the screen below SNAP (FS) Case 


KEY __ 

SNAP (FS) CASE SCREEN 1 --- PRIMARY PAGE 1 








ZIP 78213 EBT PA# 063719XXX 



FS CASE SCREEN 3 --- BUDGET 


EARNED DEDUC AGI 5.00 

RSDI FARM DED EXEC SHELTER 168.50 

ITEM53 

PASS CD 

SSI PASS XMPT NET INCOME 

RR 

OTHER 139.00 SHELTER 171.00 

UTIL CD 1 

T INC 139.00 MED COST 


Screen 3 — Budget are: 

 

 

 

 

 

 

 

EARNED — amount of gross earned income of the 

household 

RSDI — amount of social security benefits received 

ITEM 53 — amount of veterans benefits, pensions, 

and/or unemployment compensation received (See 


SSI — amount of supplemental security income 

received 

RR — amount of railroad retirement income 

received 

OTHER — amount of miscellaneous income 

received 

T INC — total income 





SNAP (FS) Case DEDUC — amount of total deductions 

Screen 3— 

Budget FARM DEDUC — amount of farm deductions 

(continued) 

SHELTER — household shelter deductions 

 

 

 

 

 

UTILITY CD — utility code (See HHSC Code 


MED COST — amount of medical cost deduction 

AGI — household’s adjusted gross income 

EXEC SHELTER — excess shelter allowance 

NET INCOME — amount of SNAP is based on the 

net income and household size. 


Screen 4— 

Miscellaneous 

SNAP (FS) Case Screen 4 — Miscellaneous gives 

you information on child support income and the 

amount of the child support disregard. 



SNAP (FS) Case Screen 4 — Miscellaneous displays 

in the lower half of the screen below SNAP (FS) Case 


KEY __ 

SNAP (FS) CASE SCREEN 1 — PRIMARY PAGE 1 






APT 110E PERSONS 04 


ZIP 78213 EBT PA# 063719XXX 



SNAP (FS) CASE SCREEN 4 — MISCELLANEOUS 


-------- ATTORNEY GENERAL CHILD SUPPORT --------- 

MO/YR CD REC'D BUDGET MO/YR CD REC'D BUDGET TDL: 10016XXX 

07/06 A 50.00 50.00 

RES ADDR DB01 




Screen 4— 

Screen 4 — Miscellaneous are: 

Miscellaneous 

(continued) MO/YR — month and year of child support 

disregard payment 

 

 

 

 

CD — code describes the amount displayed in the 

BUDGET field: 

A — amount entered from Attorney General 

information 

N — previous disregard payment amount has 

been replaced with an amount of zero (based 

on Attorney General information) 

P — amount entered by the worker 

H — disregard payment amount previously 

reported by the Attorney General has been 

replaced by the advisor 

REC’D — actual disregard amount paid to the 

client(s) in the MO/YR shown 

BUDGET — anticipated amount of child support 

disregard budgeted to determine benefits received 

in the MO/YR shown 

TDL — Texas driver’s license of the head of 

household 


Screen 5—Client 

History 

SNAP (FS) Case Screen 5 — Client History gives 

you a listing of all persons, by client number, who have 

been associated with the specific SNAP case 

indicated. 

Lines 1 and 2 field descriptions are provided in the 

SNAP (FS) Case Screen section above. 




Screen 5—Client 

History 

(continued) 

SNAP (FS) Case Screen 5 — Client History displays 



KEY __ 


PAGE 

1 





MAIL ADDR 133 KAY MOS CERT 06 FORM EFF DT 01/01/08 


SAN ANTONIO TX PLAN C SSI 

ZIP 78213 EBT PA# 063719XXX 



FSCASE SCREEN5-CLIENT HISTORY ENTER LETTER/NUMBER BESIDE CLIENT#PAGE 01 


CLIENT NO CLIENT NO CLIENT NO CLIENT NO CLIENT NO CLIENT NO 

A1 504212XXX 

A2 518870XXX 

To view a client screen, enter the line reference 

number (e.g., A1, A2, B7, C4) that corresponds to the 

client in the KEY:__ field on the primary screen. 

The body of the screen lists up to six columns of client 

numbers (CLIENT NO) of any client who had a prior 

affiliation with this case. 

The most recent client number affiliated with the case 

is the last entry. 


Screen 6— 

Overpayment 

The SNAP (FS) Case Screen 6 — Overpayment 

screen reflects information about benefit overpayments 

that TDHS (HHSC) has taken action to recover. 






Screen 6— 

Overpayment 

(continued) 

The sample screen indicates that the household’s 

offense resulted in a $909 overpayment. As a result, 

TDHS (HHSC) reduced benefits for twelve months, 

beginning January 2007, until the entire $909 in 

benefits was recovered. The overpayment was 

considered a client error that was not fraudulent. 

SNAP (FS) Case Screen 6 — Overpayment displays 



KEY 

SNAP (FS) CASE SCREEN 1 — PRIMARY PAGE 1 





MAIL ADDR 133 KAY MOS CERT 06 FORM EFF DT 01/01/08 



ZIP 78213 EBT PA# 063719XXX 



SNAP (FS) CASE SCREEN 6 — OVERPAYMENT SCREEN PAGE 01 

CASE 013228XXX ACTIVE CAT 06 AID TYPE 3 BJN 086-04-C-04 MC 278-8 CNTY 

015 

STATUS FRAUD: CLIENT: CTIVE 10% AGENCY 

BEG/END MONTH/YEAR 01/07 12/07 

MOS WH / START DT 12 1/07 

OVERPAYMENT AMT 909.00 

RESTITUTION PD TO DT 400.00 

RECOUPMENT PD TO DT 509.00 

CLAIM BALANCE 0.00 

LAST AMOUNT COLLECTED 100.00 

 

STATUS — Information listed under the category of 

Fraud, Client, and/or Agency refers to who caused 

the overpayment. 


Screen 7— 

Benefit 

Summary 

SNAP (FS) Case Screen 7 — Benefit Summary gives 

you information on the date, amount, type and value of 

SNAP benefits received by the household. 





SNAP (FS)Case 

Screen 7— 

Benefit 

Summary 

(continued) 

SNAP (FS) Case Screen 7 — Benefit Summary 



KEY __ 


PAGE 

1 


CASE NAME BEE,MARIA ANN ORIG CERT 05/01/06 SEQ 63 PRINTED11/18/07 






ZIP 78213 EBT PA# 063719XXX 



SNAP (FS) CASE SCREEN 7 --- BENEFIT SUMMARY 

PAGE 

1 

CASE 013228XXX CAT 06 AID TYPE 3 BJN 086-04-C-04 CNTY 015 

CASE NAME BEE,MARIA ANN 

ISSUED USED ISSUED USED 

DATE # VALUE #PERS TYPE # VALUE DATE # VALUE #PERS TYPE # VALUE 

01/08 1 454 4 A 1 454 07/07 1 445 4 A 1 445 

02/07 1 445 4 A 1 445 08/07 1 445 4 A 1 445 

03/07 1 445 4 A 1 445 09/07 1 445 4 A 1 445 

04/07 1 445 4 A 1 445 10/07 1 454 4 A 1 454 

05/07 1 445 4 A 1 445 11/07 1 454 4 A 1 454 

06/07 1 445 4 A 1 445 12/07 1 454 4 A 1 454 


Screen 7 — Benefit Summary are: 

 

 

 

 

ISSUED — SNAP allotment for the household for 

that month 

USED — value of the SNAP used from the 

household’s food account for that month 

DATE — issue date (MM/YY) of the SNAP 

Electronic Benefit Transfer (EBT) allotment 

# — number of EBT issued to the household for the 

indicated month 





SNAP (FS) Case # PERS — number of persons in the household 

Screen 7— 

Benefit VALUE under Issued — amount of EBT issued 

Summary 

(continued) TYPE — type of issuance, i.e., A for initial benefit, 

E for initial expedited benefits, L for restoring full 

benefits for a past month (See HHSC Code 


 

 

# — number of EBTs transferred into the 

household’s EBT account for that month 

VALUE under Used — amount of EBT used 


Screen 8— 

Benefit History 


provides specific information about the SNAP benefits 

received by the household. 






KEY __ 


PAGE 

1 








ZIP 78213 EBT PA# 063719XXX 



SNAP (FS) SCREEN 8 - BENEFIT HISTORY 

PAGE 1 

CASE 013228XXX CAT 06 AID TYPE 3 BJN 086-04-C-04 CNTY 015 


BENEFIT# IS/CAN TYP VAL RECP PRS AID CTY ISSUE-DT EFF 

RW2436X M A 454 0 4 3 015 01/01/08 01/08 

RQ9821X M A 454 0 4 3 015 12/01/07 12/07 

RL6676X M A 454 0 4 3 015 11/01/07 11/07 

RG0838X M A 454 0 4 3 015 10/01/07 10/07 

RA9167X M A 445 0 4 3 015 09/01/07 09/07 

QV7045X M A 445 0 4 3 015 08/01/07 08/07 

QQ5490X M A 445 0 4 3 015 07/01/07 07/07 




Screen 8— 

Screen 8 —Benefit History are: 

Benefit History 

(continued) BENEFIT # — also called the Electronic Benefit 

Number; the identifying number for the individual 

EBT deposit 

 

 

 

 

 

 

 

 

 

IS/CAN — how the SNAP benefits were issued 

(See HHSC Code Summary C-540, 

Page D-6): 

S — reporting Administrative Terminal 

Application (ATA) issuance 

E — requesting issuance or timely reporting 

benefits issued via the ATA 

N — requesting cancellation of benefits 

TYP — type of SNAP benefits issued (See HHSC 


VAL — total value of SNAP issued 

RECP — recoupment amount 

PRS — number of persons in the household 

AID — type of SNAP household 

CTY — county code 

ISSUE DT — date the benefits were issued 

EFF — date (MM/YY) the benefits are available in 

the EBT account. 



Public 

Assistance Case 

Screens 

Six different Public Assistance (PA) Case Screens 

are available; each screen providing different 

information. 

 

 

 

 

 

 

PA Case Screen 1 — Primary 

PA Case Screen 2 — Active Clients List 

PA Case Screen 5 — Client History 

PA Case Screen 7 — Benefit Summary 

PA Case Screen 8 — Benefit History 

PA Case Screen 9 — Sanction Information 



Public 

The first line of each PA Case screen provides the 

Assistance Case same information: 

Screens 

(continued) screen number 

 

 

screen title 

page number. 

The second line of all PA Case screens also provides 

the same information: 

 

 

 

 

 

 

Case — nine-digit case number beginning with zero 

Case Status: 

active 

denied 

hold. 

CAT — the category of assistance: 

1 — age 

2 — TANF recipient 

3 — blind 

4 — disabled 

5 — refugee. 

TP — type of TANF program that the client is 

applying for/receiving, and whether the client is 

named on the grant (See HHSC Code Summary C- 

540, Page D-4): 

01 — the client is named on the grant; money 

grant and Medicaid 

07 or 37 — 12 or 18 months of Medical 

Assistance only 

61 — TANF-UP cash and medical assistance 

other PA programs in the medical programs list 

in the appendix. 

BP — Medicaid Only (MAO) code indicating living 

arrangement. 

BJN — advisor’s budgeted job number. 



Public MC — advisor’s mail code. 

Assistance Case 

Screens CNTY — client’s county of residence. 

(continued) 

PA Case Screen 

1—Primary 

PA CASE SCREEN 1 — Primary gives you general 

information about the Public Assistance Case. 

Lines 1 and 2 field description are provided in the PA 

Case Screen section above. 

KEY __ 


CASE 063719XXX ACTIVE CAT 02 TP 01 BP BJN 086-04-C-04 MC 281-2CNTY 015 





APT 115 

END DATE 

SAN ANTONIO TX78213 HOLD CD/DT 8 02/06 PERIODIC RV DT 01/18/08 


TIERS FLAG 

The specific field descriptions for PA Case Screen 1 

— Primary are: 

 

 

 

 

 

CASE NAME — name of the caretaker 

GN/PAY/RP — name of guardian, payee or 

representative (if different from case name) allowed 

to receive/utilize the TANF grant on the family’s 

behalf 

MAIL ADDR — client’s mailing address 

TEMP ADDR — temporary address 

Y — yes 

N — no 

DATE FILE — date the client filed for benefits that 

were subsequently granted 

SEQ — sequence number of the Form 1000-B 

eligibility document 




1—Primary 

(continued) 

 

 

 

 

 

 

 

 

 

 

 

PRINTED — LAST FORM 1000-A/B — date the 

latest Form 1000-A/B eligibility document was 

processed 

CERT DATE — effective date of the most recent 

certification or re-certification for the case 

GRANT EFF — effective date of the grant 

REVIEW — type of the case review reported on the 

last Form 1000-B. (See HHSC Code Summary C- 

540, Page D-4) 

C — complete review 

I — incomplete review 

N — non-review activity (case maintenance) 

ACTION — code representing the action taken on 

the case (See HHSC Code Summary C-540, Page 

D-6) 

3 MO PRIOR — number of unduplicated months of 

Medicaid coverage granted under the three-months 

prior provision; the remaining characters indicate 

the date (MM/YY) of the application for three 

months prior coverage. 

FORM EFF DATE — date the case action was, is, 

or will be effective 

END DATE — date Medicaid coverage ends 

HOLD CD/DT — hold/release code indicating the 

reason benefits are held/released on an active case 

(See HHSC Code Summary C-540, Page D-6) 

PERIODIC RV DT — date the case is due for a 

periodic review (about six months from the printed 

date) 

PAW — number of an associated SNAP case 



PA Case Screen GRANT — whole dollar amount of the TANF grant 

1—Primary 

(continued) APP INC — applied income amount a Medical 

Assistance Only (MAO) recipient must pay, from his 

or her own income, toward institutional or nursing 

care costs 

 

TIERS FLAG — ―T‖ indicates case moved to TIERS 


2—Active 

Clients List 

PA Case Screen 2 — Active Clients Lists gives you 

information about who is included in the PA group. 

Lines 1 and 2 field descriptions are provided in the PA 


PA Case Screen 2 — Active Clients List displays in 

the lower half of the screen below PA Case Screen 1 

— Primary. 

KEY __ 

PA CASE SCREEN 1 --- PRIMARY 

PAGE 

1 






APT 115 

END DATE 



TIERS FLAG 




C1 1A 506674XXX BEE,MARIA ANN 10/08/964 F3 0G E J 432-XX-74XX 

C2 1B 506855XXX BEE,ELIZA 05/07/996 F3 5 A 464-XX-69XX 

C3 1C 508323XXX BEE,BOB 12/16/997 M3 5 A 463-XX-87XX 

C4 1D 510631XXX BEE,BRAD 09/15/903 M3 5 A 628-XX-63XX 


— Active Clients List are: 

 

 

PL — page and line number of the client on the 

Form 1000-A/B 

CLIENT NO — nine-digit number beginning with a 

number one to five that is each client’s unique 







2—Active 

Clients List 

(continued) 

 

 

 

 

 


BIRTH DT — client’s date of birth as MM/DD/YYY 

SR — client’s declared gender and race (See 


SIG — client’s status in group (See HHSC Code 


E — a prior code that no longer means anything; 

still shows up on some cases 


— Active Clients List are: 

 

 

 

 

 

 

 

PL — page and line number of the client on the 

Form 1000-A/B 

CLIENT NO — nine-digit number beginning with a 

number one to five that is each client’s unique 



BIRTH DT — client’s date of birth as MM/DD/YYY 

SR — client’s declared gender and race (See 


W — client’s work registration eligibility code (See 


SSN — client’s Social Security number 


5—Client 

History 

PA Case Screen 5 — Client History gives you 

information about any client who had a prior affiliation 

with the specific case named in the search. 





PA Case Screen PA Case Screen 5 — Client History displays in the 

5—Client History lower half of the screen below PA Case Screen 1 — 

(continued) Primary. 

KEY __ 


PAGE 

1 


CASE NAME MAYS,JANE DATE FILE 06/05/07 SEQ 04 PRINTED 09/08/07 



MAIL ADDR 534 KERRY 3MO PRIOR FORM EFF DT 10/01/07 

END DATE 08/07 

SAN ANTONIO TX 78233 HOLD CD/DT 

PERIODIC RV DT 

TEMP ADDR N PAW 066400XXX GRANT 000 APP INC 

TIERS FLAG 

PA CASE SCREEN 5-CLIENT HISTORY ENTER LETTER/# BESIDE CLIENT# PAGE 01 


CLIENT NO CLIENT NO CLIENT NO CLIENT NO CLIENT NO CLIENT NO 

A1 502180XXX 

A2 503175XXX 

A3 505868XXX 

A4 502180XXX 

A5 500434XXX 

The body of the screen lists up to six columns of client 

numbers (CLIENT NO) of any client who had a prior 

affiliation with this case. The most recent client number 

affiliated with the case is the last entry. 


7—Benefit 

Summary 

PA Case Screen 7 — Benefit Summary provides 

information on the date and amount of benefits 

received by the client. 





PA Case Screen PA Case Screen 7 — Benefit Summary displays in 

7—Benefit the lower half of the screen below PA Case Screen 1 

Summary 

— Primary. 

(continued) 

KEY __ 


PAGE 

1 






APT 115 

END DATE 



TIERS FLAG 

PA CASE SCREEN 7 --- BENEFIT SUMMARY 

PAGE 

1 

CASE 063719XXX CAT 02 BJN 086-04-C-04 CNTY 015 

CASE NAME BEE,MARIA ANN PURGED WRT AMT 00000 

ISSUED 

ISSUED 

DATE NO AMOUNT CD DATE NO AMOUNT CD 

01/08 1 0293 07/07 1 0272 

02/07 1 0272 08/07 1 0272 

03/07 1 0272 09/07 1 0272 

04/07 1 0272 10/07 1 0293 

05/07 1 0272 11/07 1 0293 

06/07 1 0272 12/07 1 0293 


— Benefit Summary are: 

 

 

 

 

CASE NAME — usually the caretaker of the 

children 

PURGED WRT AMOUNT — total dollar amount of 

all benefit amounts purged. The Benefit History 

Screen may have up to three years of benefit 

history on three pages; older benefit amounts are 

purged and included in this total. 

DATE — months 01-12 are always listed. If benefit 

activity occurs for a given month, the year is 

entered by that month; if no benefit amount is 

issued, the year field is blank. 

NO — number of benefit allotments issued for the 

month 





PA Case Screen AMOUNT — total of all benefit amounts issued for 

7—Benefit 

the month 

Summary 

(continued) CD — indicates whether there was a deduction 

from the benefit amount: 

R — a recoupment from the benefit amount 

Blank — indicates there were no deductions 


8—Benefit 

History 

PA Case Screen 8 — Benefit History provides 

specific information about the PA benefits received by 

the household. 



PA Case Screen 8 — Benefit History displays in the 

lower half of the screen below PA Case Screen 1 — 

Primary. 

KEY __ 


PAGE 

1 

CASE 063719XXX ACTIVE CAT 02 TP 01 BP BJN 086-04-C-04MC 281-2 CNTY 015 





APT 115 

END DATE 



TIERS FLAG 

PA CASE SCREEN 8 --- BENEFIT HISTORY 

PAGE 

01 


CASE NAME AGUAYO,MARIA MARGARITA PURGED WRT AMT 00000 

BENEFIT NO EFF DT ISSUE DT TYPE AUTH A-CH RECP BEN AMT STATUS 

AB21453XX 01/08 01/01/08 1 1-03 $000 $293 A 

AB20586XX 12/07 12/01/07 1 1-03 $000 $293 A 

AB19273XX 11/07 11/01/07 1 1-03 $000 $293 A 

AB17910XX 10/07 10/01/07 1 1-03 $000 $293 A 

AB16571XX 09/07 09/01/07 1 1-03 $000 $272 A 

AB14672XX 08/07 08/01/07 1 1-03 $000 $272 A 

AB14672XX 07/07 07/01/07 1 1-03 $000 $272 A 



PA Case Screen The specific field descriptions for PA Case Screen 8 

8—Benefit 

— Benefit History are as follows: 

History 

(continued) CASE NAME — usually the caretaker of the 

children 

 

 

 

 

 

 

 

 

 

 

PURGED WRT AMT — total dollar amount of all 

benefits purged. The Benefit History Screen may 

have up to three years of benefit history on three 

pages; older benefits are purged and included in 

this total. 

BENEFIT NO — assigned number for the individual 

benefit issuance 

EFF DT — month and year the benefits were 

authorized 

ISSUE DT — month, day, and year the benefit was 

issued 

TYPE — type of benefit requested 

AUTH — type of retroactive benefits (See HHSC 


A-CH — (Adult and Children) 

Heading A — number of adults whose needs are 

included in the benefit. 

Heading CH — number of children whose needs 

are included in the benefit 

RECP — amount of money withheld from the 

benefit for recoupment 

BEN AMT — amount of the benefit after deductions 

(including any recoupments and/or penalty) 

STATUS — status of the benefit. Most frequently 

used code A — EBT benefit issued. 




9—Sanction 

Information 

PA Case Screen 9 — Sanction Information gives 

you information on any sanction that has been placed 

on any member of the PA group. 



PA Case Screen 9 — Sanction Information displays 

in the lower half of the screen below PA Case Screen 

1 — Primary. 

KEY __ 


PAGE 

1 





MAIL ADDR 133 KAY 3MO PRIOR FORM EFF DT 01/01/08 

APT 115 

END DATE 



TIERS FLAG 

PA CASE SCREEN 9 --- SANCTION INFORMATION 

PAGE 

01 



EFF DT BENEFIT TYPE SNCT-1 SNCT-2 SNCT-3 

01/08 1 $000 $000 $000 

12/07 1 $000 $000 $000 

11/07 1 $000 $000 $000 

10/07 1 $000 $000 $000 

09/07 1 $000 $000 $000 

08/07 1 $000 $000 $000 

07/07 1 $000 $000 $000 


— Sanction Information are: 

 

 

 

CASE NAME — usually the caretaker of the 

children 

EFF DT — month and year of the penalty/sanction 

BENEFIT TYPE — code indicates type of benefit 

issued. 1 — Full month’s amount (See HHSC Code 






PA Case Screen SNCT-1 — amount of first penalty/sanction 

9—Sanction 

Information SNCT-2 — amount of a second penalty/sanction 

(continued) 

SNCT-3 — amount of a third penalty/sanction 

 

000 — no penalty/sanction 

NOTE: As of September 2003, SNCT-1, SNCT-2, and 

SNCT-3 amounts are no longer applicable. See 

additional codes listed under Client Screen 

Penalty/Good Cause History. 


Appendix A: 

Request for User Access to HHSC 

Systems Form and Instructions

Request for User Access to HHSC Systems 

Please Note: We cannot accept forms with corrections or modifications, including strikethroughs, "write-overs," and/or correction fluid. 

Section 1: Type of request ‐‐ Please mark only one box: 

ADD/MODIFY: Add New SAVERR/TIERS User or Modify an Existing User's Access 

DELETE: Delete a SAVERR/TIERS User Completely 

Section 2: User Identifying Information ‐‐ Please type or print clearly: 

User's Name: 

Social Security Number: 

Agency: 

TWC: 

WDA: 

Specify Board #_ 

Work Email Address: 

Phone Number: 

(Include area code and extension, if any) 

Section 3: HHSC Systems Access Requested ‐‐ A signed and dated HHSC Security and Privacy Agreement must 

be submitted for all requests for new user access to SAVERR/TIERS systems: 

Please specify access by checking "Allow" or "Deny" for the three SAVERR/TIERS resources: 

ALLOW DENY HHSC Application Name 

SAVERR TAMENU Inquiry (Transaction Code TAMENU) 

TIERS TWC Inquiry 

SAVERR Client Eligibility Inquiry (Transaction Code TVCC) 

Section 4: Signatures ‐‐ Please add the appropriate signatures. If the user is an internal TWC employee, then 

only the user's supervisor needs to sign: 

_______________________________ _________ ___________________________________ ___________ 

User's Supervisor's Signature Date WDA TWIST Administrator's Signature Date 

Section 5: Contact Information ‐‐ Please email (scan), fax, or mail completed forms to: 

Mail to: 

Or: 

SAVERR ‐ TIERS ACCESS 

TWC DATA PROCESSING, ROOM 0307 

Email: saverr.tiersaccess@twc.state.tx.us 

101 E. 15th Street 

Austin, TX 78758 

Fax: (512) 463‐6394 

Section 6: TWC Security Coordinator Use Only: 

TAMENU Initial Password: 

________________________________________________ ___________ 

TWC Security Coordinator Signature 

Date 

Comments:


10/1/2008 

INSTRUCTIONS 

When to Complete the Request for User Access to HHSC 

Systems (HHSC System Access Form.doc): 

1. To add new user’s access you must complete this form 

along with the HHS Enterprise Architecture & Security 

Management Security and Privacy Agreement (SPA) Form 

EASM_SM_002 (HHSC SPA Form TWC.xls) to obtain 

access to the Texas Health and Human Services 

Commission (HHSC) systems. 

2. To modify or delete an existing users access. 

 

 

When a user is deleted from any HHSC system for 

non-use* their current HHSC Access Request and 

Security and Privacy Agreement (SPA) form are no 

longer valid. According to HHSC policy, being deleted 

for non-use requires that new forms be submitted. Resubmitting 

current forms is unacceptable because 

according to HHSC policy, forms submitted for the 

purpose of requesting access to HHSC systems 

cannot be older than 30 days from today’s date. 

*HHSC deletes users who have not logged in to their 

system in 90 days. If you have access to HHSC 

SAVERR and TIERS systems you must log into both 

systems within 90 days to retain access. 

Required Approvals: 

1. The user’s supervisor must approve his/her access to the 

requested HHSC system. This approval indicates that the 

access is job-related. 

2. If you are employed by a TWC WDA the TWIST System 

Administrator must also approve it. This approval indicates 

that the user has completed and signed all of the relevant 

security agreements, and that he/she has met any 

additional requirements of interagency data access 

agreements. 

6. Email Address: enter the user’s work place e-mail 

address. Provide e-mail address to HHSC when requesting 

access to TIERS or to reset password. 

7. Phone Number: enter the user work place phone number. 

HHSC Accesses 

8. Access can be granted to the following HHSC Systems: 

 

 

 

SAVERR TAMENU Inquiry 


SAVERR Client Eligibility Inquiry – Child Care 

9. Access to HHSC systems can be added, modified or 

deleted: 

 

 

 

Enter the letter “A” in the applicable column and rows 

to add new access to the designated HHSC system(s). 

Enter the letter “M” in the applicable column and rows 

to modify existing access to the designated HHSC 

system(s). 

Enter the letter the letter “D” in the applicable column 

and rows to delete existing access to the designated 

HHSC system(s). 

10. Signatures: If the request is from a TWC WDA the user’s 

supervisor and the WDA TWIST System Administrator must 

both sign the completed HHSC Access Request form. If the 

request is from a TWC employee only the user’s supervisor 

is required to sign the HHSC Access Request form. 

11. Submit completed and signed form(s) to the appropriate 

TWC Security Coordinator via scanned e-mail, fax or mail. 

How to complete the Request for Access to HHSC Systems 

1. Action: Mark the appropriate check box to indicate the 

action being requested. 

 

 

 

Add New User Access – Add access to selected 

HHSC systems for a new user or a prior user who has 

lost access due to lack of use for 90 days. 

Modify Existing User Access – Modify access for 

existing HHSC system users (i.e. name change, etc.) 

Delete Existing User Access – Delete access for 

employees who have moved to another job function 

and no longer need access to do their job or for 

individual whose employment is terminated. 

Identifying Information 

2. User Name: Enter in the user’s name. 

3. SSN: Enter in the user’s Social Security Number. 

4. Local Office #: Enter the user’s local office number. 

5. Agency: Mark the appropriate check box to indicate the 

agency the user is employed by. 

 

 

If the user is working for the WDA, enter the WDA 

local office number also. 

If the user is working for some Other agency or a 

contractor, enter the agency or contractor’s name also. 

HHSC Access Request Instructions.doc

Appendix B: 

Request for User Access to HHSC 

Systems 

Example Completed Form

EXAMPLE COMPLETED FORM 

Request for User Access to HHSC Systems 


10/26/2006 (Revised 10/24/2008) 

ACTION: X Add New User Access Modify Existing User Access Delete User Access 

TWC WDA - email (scan), fax, or mail to: 

SAVERR - TIERS Access 


TWC Data Processing, Room 0307 

101 E. 15th Street Fax Number: (512) 463-6394 


TWC State Office - email, (scan), fax, or mail to: 

User Name 

SAVERR - TIERS Access 


TWC Data Processing, Room 0307 

101 E. 15th Street Fax Number: (512) 463-6394 


User Identifying Information 

SSN 

Smith, John 999-19-9999 

1020 

Agency 

Email Address 

Phone Number 

TWC 

WDA X (Specify #) 12 

Local Office No. 

john.smith@twc.state.tx.us (999)555-5555 

HHSC Systems Access Requested 

A signed and dated HHSC Security and Privacy Agreement (SPA Form) must be on file for all requests for new user 

access to HHSC systems 

Add Modify Delete 

Transaction 

HHSC Application Name 

TPSM4 Designation 

(A) (M) (D) 

Code 

X SAVERR TAMENU Inquiry TAMENU ATTY GEN Child Support 

X 


X SAVERR Client Eligibility Inquiry TVCC Child Care TVCC 

User's Supervisor's Signature Date WDA TWIST System Administrator's Signature Date 

TAMENU Initial Password 

TWC Security Coordinator Use Only 

Comments 

TIERS Initial Password 

TWC Security Coordinator Signature 

Date

Appendix C: 

HHS Enterprise Architecture & Security 

Management Security and Privacy 

Agreement (SPA) — 

EASM_SM_002 – SPA Form and 

Instructions

User ID: 

HHS Enterprise Architecture & Security Management 

Employee ID Number 

SECURITY AND PRIVACY AGREEMENT (SPA) FORM 

COMPLETED FORM IS TO BE SIGNED, MAILED TO, AND RETAINED BY HHS ENTERPRISE SECURITY MANAGEMENT 

Date of Birth: (mm/dd) 

User Name: 

Work Email: 

Facility Name/Department: TWC Employee OR TWC WDA 

Check ONE box below: 

The purpose of this agreement is to help you understand your duties regarding confidential information. 

EMPLOYEE of TWC I am a full-time or part-time employee of TWC, with TWC sponsored access to HHSC Systems, and to 

what this agreement refers to as "confidential information." (EXCLUDES Volunteers, Contractors, and other users NOT on TWC 

payrolls) 

Other (TWC WDA) I am a full-time or part-time with TWC sponsored access to HHSC Systems and to what this agreement 

refers to as "confidential information." 

Confidential information includes patient/client identifying information, patient/client medical information, or any information (patient or 

otherwise) that is classified confidential by federal or state law. You may have access to some or all of this confidential information 

through a computer system or through your associated activities with HHS Systems. 

Confidential information is valuable and sensitive and is protected by law and by HHS policies. The intent of these laws and policies is to 

assure that confidential information will remain confidential - that is, that it will be used only as necessary to accomplish the organization's 

mission. As a user of HHS systems, you are required to conduct yourself in conformance to applicable laws and HHS policies governing 

confidential information. Your principle obligations in this area are outlined below. You are required to read and to abide by these principles. 

The violation of any of these duties will subject you to discipline which might include, but is not limited to, termination of access privileges, 

termination of employment, and/or legal liability. 

You understand that you will have access to and are not to divulge confidential information which may include, but is not limited to, 

information relating to: 

+ Patient/client (such as records, conversations, admittance information, diagnosis, prognosis, treatment plan, financial information, 

etc). 

+ ANY INFORMATION by which the identity of a client can be determined, either directly OR indirectly. 

+ Employees, contractors, volunteers (such as home addresses, home phone numbers, social security numbers, etc). 

+ HHS information (such as financial information, internal reports, memos, contracts, peer review information, communications, 

proprietary computer software, etc.). 

+ Third party information (such as vendor information, etc). 

Accordingly, as a condition of and in consideration of your access to confidential information, you promise that: 

1. You will use confidential information only as needed to perform legitimate duties. This means, among other things, that: 

+ You will only access confidential information for which you have a need to know; and 

+ You will not in any way divulge, copy, release, sell, loan, review, alter, or destroy any confidential information except as properly 

authorized within the scope of your activities; and 

+ You will not misuse confidential information or carelessly handle confidential information. 

2. You will safeguard and will not disclose your password or any other authorization you have that allows you to access confidential 

information, except as permitted by law. 

3. You accept responsibility for all activities undertaken making use of your User ID/password and other authorization. 

4. You will report activities by any other individual or entity that you suspect may compromise the confidentiality, integrity or availability of 

confidential information. Reports are made in good faith about suspect activities and will be held in confidence to the extent permitted 

by law, including the name of the individual reporting the activities. 

5. You understand that your obligations under this Agreement will continue after termination of your association with HHS or HHS 

applications. 

6. You understand that your privileges hereunder are subject to periodic review, revision, and if appropriate, renewal. 

7. You understand that you have no right or ownership interest in any confidential information referred to in this Agreement. HHS may 

revoke your access code or other authorized access to confidential information. 

8. You will, at all times, safeguard and retain the confidentiality, integrity and availability of confidential information. 

9. You understand that your failure to comply with this Agreement may also result in the loss of access privileges to HHS applications. 

User's Signature User's Printed Name Date Signed (mm/dd/yyyy) 

By completing this form, you are providing the requested information to HHS Enterprise Architecture and Security Management in order to gain access to secured 

systems. This information will not be shared in any manner or for any reason not permitted by the laws of the State of Texas. You may, in writing, request copies 

of this information at any time and may request that any information in error be corrected. 

EASM_SM_002 - Security and Privacy Agreement (SPA) Revised 10/1/2006


10/1/2006 

INSTRUCTIONS 

When to Complete the HSC Security and Privacy Agreement 

(SPA) - Form HHS Enterprise Architecture and Security 

Management SPA (HHS SPA Form TWC.xls): 

1. To add new user’s access you must complete this form 

along with the Request for User Access to HHSC Systems 

(HHSC Systems Access Form.doc) to obtain access to the 

Texas Health and Human Services Commission (HHSC) 

systems. 

 

 

When a user is deleted from any HHSC system for 

non-use* their current HHSC Access Request (HHSC 

Access Req.doc) and Security and Privacy Agreement 

(SPA) form (HHSC SPA Form TWC.xls) are no longer 

valid. According to HHSC policy, being deleted for 

non-use requires that new forms be submitted. Resubmitting 

current forms is unacceptable because 

according to HHSC policy, forms submitted for the 

purpose of requesting access to HHSC systems 

cannot be older than 30 days from today’s date. 

*HHSC deletes users who have not logged in to their 

system in 90 days. If you have access to HHSC 

SAVERR and TIERS systems you must log into both 

systems within 90 days to retain access. 

Required Approvals: 

1. The user’s supervisor must approve his/her access to the 

requested HHSC system by completing and signing the 

Request for User Access to HHSC Systems. This approval 

indicates that the access is job-related. 

5. Purpose: the user must read and agree to comply with all 

of the Security and Privacy information provided in this 

section. 

6. Check ONE Box Below: Mark the appropriate check box 

to indicate who the user is employed by. 

 

 

If the user is a TWC Employee, mark the TWC 

Employee check box. 

If the user is working for a TWC WDA, mark the Other 

(TWC WDA) check box. 

7. User Signature: The user must read and sign this form, 

acknowledging agreement to comply with all aspects of 

HHS Enterprise Architecture & Security Management, 

Security and Privacy Agreement (SPA). 

8. Users Printed Name: enter the users printed name. 

9. Date Signed: enter the date the user signed the form. 

10. Submit completed and signed form(s) to the appropriate 

TWC Security Coordinator via scanned e-mail, fax or mail. 

The following Forms must be submitted together when 

requesting new user access. 

HHS Security and Privacy Agreement (HSC SPA Form 

TWC.xls) 

Request for User Access to HHSC Systems (HHSC 

Systems Access Form.doc) 

2. If you are employed by a TWC WDA the TWIST System 

Administrator must also approve it. This approval indicates 

that the user has completed and signed all of the relevant 

security agreements, and that he/she has met any 

additional requirements of interagency data access 

agreements. 

How to complete the HHS Security and Privacy Agreement 

Action: Only complete the required fields listed below, all other 

fields are reserved for HHSC internal use. 

Identifying Information 

1. Date of Birth: Enter user birth month and day (mm/dd). 

2. User Name: Enter in the user’s name (Last, First, Middle 

Initial). 

3. Work Email: enter the user’s work place e-mail address. 

Provide e-mail address to HHSC when requesting access 

to TIERS or to reset password. 

4. Facility Name/Department: Mark the appropriate check 

box to indicate who the user is employed by. 

 

 

 

If the user is working for the WDA, mark the TWC 

WDA check box. 

If the user is a TWC Employee, mark the TWC 

Employee check box. 

If the user is working for some Other agency or a 

contractor, enter the agency or contractor’s name also. 

Security and Privacy Acknowledgement 

HHSC SPA TWC Instructions.doc 

EASM_SM_002 – Security and Privacy Agreement (SPA)

Appendix D: 

HHSC Code Summary (C — 540)

Appendix D: HHSC Code Summary (C — 540) Revision Number: 08-4 

Effective date: October, 2008 

TANF and SNAP (formerly known as Food Stamps) — Revised for TWC use (04/09) 

Category 

TANF 

SNAP 

2 — TANF 6 — Public Assistance (PA) SNAP Case 

5 — Refugee Cash Assistance (RCA) 8 — Refugee, PA SNAP 

9 — Non-PA SNAP Case 

Sex 

TANF and SNAP 

M — Male 

F — Female 

Race 

TANF and SNAP 

1 — White 

2 — Black 

3 — Hispanic 

4 — American Indian or Alaskan Native 

5 — Asian or Pacific Islander (includes Indochinese) 

6 — Computer entered code indicating inappropriate or omitted code 

Education/Service Code 

TANF and SNAP 

1 — First Grade 9 — Ninth Grade 

2 — Second Grade A — Tenth Grade 

3 — Third Grade B — Eleventh Grade 

4 — Fourth Grade C — High School Graduate/completed general 

equivalency diploma 

5 — Fifth Grade E — Attending college or completed some college but 

has not graduated from a four-year college 

6 — Sixth Grade F — Graduate of a four-year college 

7 — Seventh Grade N — No formal education 

8 — Eighth Grade 

04/09 D-1

Status in Group (SIG) 

TANF — Primary Codes 

TANF — Secondary Codes 

2 — Disqualified/ineligible child or second parent G — Reached end of Time Limits 

3 — Noncertified child: Identifies the only deprived H — Eligible Refugee 

child of the certified caretaker/second parent; If child 

receives: SSI — 3, Foster Care Payments — 3F, 

Adoption Assistance payments — 3A 

5 — Certified Child I — Ineligible Child 

7 — Second Parent K — Child of a Minor Child 

8 — Caretaker L — Minor Parent with a Dependent Child 

9 — Payee M — Eligible Only for Three Months Prior Medical 

Assistance 

0 — Case Name Only N — Ineligible for Retroactive Medical Assistance and 

Current Assistance 

P — Private Health Insurance 

Q — Proof of THSteps Screening 

R — HHSC Employee 

S — Alien with Acceptable Alien Status 

T — Ineligible Alien 

U — Ineligible – No Citizenship Proof 

V — Living in Nursing Home 

W — Disqualified Child 

X — Deceased 

Y — Disqualified Second Parent 

Z — Migrant 

SNAP — Head of Household Codes 

A — Household head 

G — Household head is nonmember 

GK — Head of household disqualified for a reason 

other than intentional program violation (IPV) 

GT — Head of household is disqualified for 

intentional program violation (IPV) 

SNAP — Other Codes 

B — Student 

C — Able Bodied Adult without Dependent (ABAWD) 

not meeting 18-50 work requirement 

D — ABAWD meeting 18-50 work requirement 

F — Resident of drug and alcohol treatment/group living 

arrangements facility 

H — Eligible Refugee 

K — Disqualified for a reason other than intentional 

program violation (IPV) 

M — Migrant, out of work stream 

R — HHSC Employee 

S — Eligible Alien (not a refugee) 

T — Disqualified for Intentional Program Violation (IPV) 

U — Seasonal Farm Worker 

W — Migrant, in work stream 

D-2 04/09

Employment Services/Work Registration 

TANF 

Codes 

Explanation 

A Child (SIG 5 or 5L) 

B Caretaker or second parent, age 18 or younger attending school 

C Caring for an ill or disabled child in the household, even if the child is not a member of the 

certified group 

E Unable to work due to a disability expected to last more than 180 days 

F 60 years of age or older 

G Caring for a child (SIG 2, 3, or 5) under age 1 

H Presence required in home due to illness or incapacity of another adult household member and 

the disability is expected to last more than 180 days 

J Not subject to participation – not a certified TANF client 

K Pending during appeal of denial or disqualification 

M Mandatory registrant 

N Employment Hardship Exemptions 

P Mandatory registrant employed or self-employed at least 30 or more hours per week, and 

earnings of at least $700 per month 

Q Severe Personal Hardship Exemption 

R Caring for child under age 1 who is not listed on the case 

T Pregnant and unable to work 

U A single grandparent age 50 or over caring for a child under age three 

V An SSI recipient parent 

W Identifies a client who non-complies with the Choices program 

X A parent who has exhausted state time limits 

Y A parent who is disqualified due to third party resource (TPR) requirements, Social Security 

number requirements, intentional program violation, failure to report a child’s absence, being a 

fugitive, having a felony drug conviction, failure to cooperate with Quality Control or 

noncompliance with the unmarried minor parent domicile requirement 

SNAP 

Codes 

Explanation 

A Child age 16 years of age or child age 16 or 17 who attends school at least half-time, or is not 

the head of household 

D Three to nine-months pregnant 

E Physically or mentally unfit for employment 

F 60 years of age or older 

G Caring for a child under age six 

H Presence in home required for care of an incapacitated person 

J Person in drug addiction or alcoholic treatment and rehabilitation program 

N Receiving or applying for unemployment compensation 

P Employed or self-employed 30 hours or more a week 

Q Client resides in a Choices county and is mandatory or has volunteered for TANF employment 

services 

R Registered again, after previously serving the E&T noncompliance penalty period 

S Student exemption (age 18 or older/in a training program) 

T Disqualified household member or nonmember head of household 

U Primary wage earner failed to comply with SNAP employment services 

2 Registered, employed less than 30 hours a week 

3 Registered, not working 

4 Registered, job attached (temporarily laid off) 

5 Registration postponed, expedited service 

04/09 D-3

Type Income 

TANF and SNAP 

A — Veteran's Administration (VA) benefits 

C — Unemployment Insurance benefits 

P — Pension benefits (other than RSDI, SSI, VA, or Rail Road) 

M — Combination of unemployment benefits with benefits from a pension, VA, or both 

W — Combined income from VA and a pension 

Type Program 

TANF 

01 — Cash and medical assistance 

04 — Medical Assistance Only – Deceased 

07 — 12 or 18 months medical assistance only 

11 — Three months prior medical assistance only not currently eligible 

20 — Medical assistance only – Child Support 

37 — 12 or 18 months medical assistance only 

61 — TANF-SP (State Program) cash and medical assistance (Two-Parent) 

71 — OTTANF – One parent household 

72 — OTTANF – Two parent household 

Type of Review 

TANF and SNAP 

C — Complete review 

I — Incomplete review 

N — Non-review activity (case maintenance) 

AID 

SNAP 

1 — NPA (Non-Public Assistance) Only 

2 — NPA Mixed (Mixed household with TANF-Public Assistance and Non-Public Assistance) 

3 — TANF-PA 

5 — Refugee, PA 

D-4 04/09

Disqualification Code (Intentional Program Violation) 

SNAP 

1 st digit T — Administrative disqualification for offense which occurred prior to September 22, 1996 

S — Administrative disqualification for offense which occurred on or after September 22, 1996, 

or disqualification for conviction due to trafficking 

C — Court-ordered disqualification 

M — Disqualification due to receipt of multiple benefits in one month. 

2 nd digit 1 — 1st disqualification 

2 — 2nd disqualification 

3 — 3rd disqualification 

4 — permanent disqualification for trafficking in SNAP benefits or program access devices of 

$500 or more. 

3 rd — 6 th digit MMYY — last month of disqualification 

PERM — disqualification permanent 

Util (Utility Expense Code) 

SNAP 

Code 

Description 

1 Household claiming the Standard Utility Allowance. 

2 Household claiming telephone standard only, or telephone standard plus actual utilities. 

3 Household claiming actual utility costs only (even if some members are disqualified). 

4 Household without utility costs 

5 Two households live together and share the standard utility allowance. 

6 Households claiming the standard utility allowance with member(s) disqualified for not meeting 

the citizenship, 18-50 work, and and/or SSN requirements. 

7 All other proration situations. A combination of households described in Codes 5, 6, B, and C, 

a prorated telephone standard, and all other situations in which the utility allowance is prorated 

(such as a proration involving three or more households, or more than one disqualified 

member). 

8 Household claiming the homeless shelter standard 

9 Household claiming the homeless shelter standard with one member who is disqualified for not 

meeting the citizenship, 18-50 work and/or SSN requirements 

A Households claiming the basic utility allowance 

B Two households live together and share the basic utility allowance. 

C Households claiming the basic utility allowance with member(s) disqualified for not meeting the 

citizenship, 18-50 work, and/or SSN requirement. 

Codes 1, 2, 3, 4, 5, 7, A, and B are allowed for household containing member(s) disqualified for an intentional 

program violation, felony drug conviction, E&T non-compliance, and/or being a fugitive. Codes 3, 4, 6, 7, 9, and 

C are allowed for households containing member(s) disqualified for not meeting the citizenship requirement, 

18-50 work requirement, or SSN requirement. Also, these codes are allowed for household containing 

member(s) disqualified for an intentional program violation, felony drug conviction, E&T non-compliance, and/or 

being a fugitive and member(s) disqualified for citizenship, 18-50 work requirement, and/or SSN requirements. 

Note: Utility, homeless, and telephone standards, if used, are prorated for these kinds of disqualifications. 

04/09 D-5

Action Codes 

SNAP 

See C-221, Denial Codes in http://www.dads.state.tx.us/handbooks/TexasWorks/. 

TANF 

See C-200 for Codes in http://www.dads.state.tx.us/handbooks/TexasWorks/. 

Type of Warrant Requested 

TANF 

SNAP 

1 — Full month’s amount S — Reporting Administrative Terminal Application 

(ATA) issuance untimely 

2 — Additional amount for a month E — Requesting issuance or timely reporting benefits 

issued via the Administrative Terminal Application (ATA) 

N — Requesting cancellation of benefits 

Code/Hold Date 

TANF — Advisor Hold Codes 

SNAP 

1 — Unable to locate 2 — Hold benefits 

2 — Guardianship pending A — Form H1000-B has fatal error not cleared by cutoff 

3 — New payee pending Z — Dormant EBT account (state office use) 

4 — Notice of adverse action to lower benefits that 

expires between cutoff and the end of the month 

5 — Notice of adverse action expires between cutoff 

and end of month (case denial or transfer to TP 07 

or TP 20) 

State Office Hold Codes 

A — Hold, Form H1000-B has fatal error not cleared 

by cutoff 

C — Form H3087 returned, moved 

D — Form H3087 returned, deceased 

E — Form H3087 returned, unclaimed 

F — Warrant Undeliverable and returned by post 

office 

G — Warrant undeliverable because client is 

deceased 

H — TANF case has SIG 5 member age 19 or over 

L — State time limit expiring and SAVERR cannot 

rebudget TANF 

J — Warrant charged back 

R — SDX hold 

Z — Dormant EBT account 

3 — RCA case has a member who entered the 

United States eight months ago 

6 — TANF case pending denial or transfer to TP 20 

Advisor Release Codes 

8 — Release benefits as originally authorized 

9 — Release benefits as originally authorized using 

the new address 

0 — Release future benefits. 

SNAP – Release Code 

0 — Do not hold future benefits. 

D-6 04/09

Type of Issuance 

TANF — Reason for Authorization of 

Benefits 

9 — Action Code 090, simultaneous open and 

close 

B — Change in both household composition and 

money reflected in the budget 

F — Additional benefits issued due to penalty 

imposed in error 

H — Change in household composition 

M — Change in money reflected in the budget 

O — Retroactive and/or current month's benefit 

when releasing a case from hold with release Code 

0 or 7 

P — Budgeting process requires different payment 

month benefits 

R — (State office use only) Identifies on the history 

file benefits produced when release Code 8 or 9 is 

used to release a case from hold 

T — Transfer from TP 07, 20, 29, or 37 to TP 01/ 61 

SNAP — Full Regular On-going Benefits or 

Their Replacements 

A — Initial benefit (regular ongoing benefit) 

E — Initial expedited benefit issued 

H — Priority benefits issued to meet hearing officer 

decision timeliness 

L — Restoring benefits for a past month 

1 — Initial expedited benefits issued through 

Administrative Terminal Application (ATA) 

2 — Priority benefits issued through SAVERR or 

Administrative Terminal Application (ATA) to meet 

timeliness 

3 — Initial priority benefits issued through Administrative 

Terminal Application (ATA) 

4 — Historical Information: CCDMI mailed out of state 

as a result of converting EBT benefits to coupons (state 

office use only). No longer in use effective April 1, 2004. 

5 — Historical Information: Benefits replaced in EBT 

account when CCDMI was returned (state office use 

only). No longer in use effective April 1, 2004. 

Additional Benefits for a Month 

C — Supplemental benefits. Use when providing 

benefits in addition to initial benefits for the current 

month, or following month if submitting request for 

benefits after cutoff. 

D — Restoration benefits. Use when restoring partial 

benefits for a past month. 

F — Supplemental or restoration benefits. Use when 

providing additional benefits for a month in which the 

household has already received one issuance coded C 

and/or D. 

P — Restore an erroneously expunged EBT benefit. 

Destroyed Food 

T — Replacement of destroyed food, which was 

purchased with SNAP benefits 

Advisor Enter Cancellation 

G — Use to cancel EBT benefit because the household 

has moved out of state 

04/09 D-7

Finger Image Code 

TANF and SNAP — Enrollment or Exemption Code 

Y — If all available images have been taken 

Z — If one image has been taken 

A — Appeal pending (TANF related) 

B — Low quality image/physically unable to image/equipment failure 

C — Certified out of office or unable to come to office 

D — Undue burden for disabled client 

E — Undue burden for elderly client 

F — Disqualified (SNAP only) 

SNAP Disqualification 

B — ineligible alien without BCIS document 

C — ineligible aliens with BCIS document 

D — felony drug conviction 

F — first offense failure to comply with ESP requirements (E&T /voluntary quit/reducing work hours to less than 

30 ) 

J — fugitive 

N — failure to meet SSN requirement 

S — second offense failure to comply with ESP requirements 

T — third or subsequent offense failure to comply with ESP requirements 

W — failure to comply with the 18-50 work requirement 

Remove — end a disqualification or change a time limit benefit code 

1 — delete the first countable month 

2 — delete the second countable month 

3 — delete the third countable month 

4 — delete the fourth countable month (first month of second three month period) 

B — end the ineligible alien (undoc) disqualification 

C — end the ineligible alien (doc) disqualification 

F — end the first offense SNAP ESP disqualification 

J — end the fugitive disqualification 

L — subtract one offense from the ESP offense counter 

N — end of the SSN disqualification 

S — end the second offense SNAP ESP disqualification 

T — end the third offense SNAP ESP disqualification 

W — end the 18 - 50 work requirement disqualification 

Countable Month Code 

SNAP 

1 — benefit authorized for the first month of the initial three-month period 

2 — benefit authorized for the second month of the initial three-month period 

3 — benefit authorized for the third month of the initial three-month period 

4 — benefit authorized for the first month of the second three-month period 

D-8 04/09

Additional Codes 

TANF Benefit History Codes — Read benefit history codes on inquiry from right to left. The most recent 

code/action appears on the far left. 

A — Mailed warrant/EBT benefit issued 

C — Warrant held 

D — Warrant or EBT issuance cancelled 

E — Warrant charged back 

P — Warrant paid by state treasure 

R — Warrant returned 

S — Warrant stop payment in effect 

L — Warrant stop payment lifted 

Y — Duplicate EBT benefit or warrant issued 

Z — Duplicate warrant returned 

04/09 D-9

D-10 04/09

Appendix E: 

HHSC and TWC County, HHSC Region, 

and WDA Codes

Appendix E: HHSC and TWC County, HHSC Region, and WDA Codes 

Name 

HHS TWC HHS WDA Name HHS TWC HHS WDA Name HHS TWC HHS WDA 

Cty Cty Reg 

Cty Cty Reg 

Cty Cty Reg 

A Comal 046 091 08 20 Gray 090 179 01 1 

Anderson 001 001 04 8 Comanche 047 093 02 9 Grayson 091 181 03 25 

Andrews 002 003 09 11 Concho 048 095 09 12 Gregg 092 183 04 8 

Angelina 003 005 05 17 Cooke 049 097 03 25 Grimes 093 185 07 16 

Aransas 004 007 11 22 Coryell 050 099 07 26 Guadalupe 094 187 08 20 

Archer 

Armstrong 

005 

006 

009 

011 

02 

01 

3 

1 

Cottle 

Crane 

051 

052 

101 

103 

02 

09 

3 

11 

H 

Hale 095 189 01 2 

Atascosa 007 013 08 20 Crockett 053 105 09 12 Hall 096 191 01 1 

Austin 008 015 06 28 Crosby 054 107 01 2 Hamilton 097 193 07 26 

B Culberson 055 109 10 10 Hansford 098 195 01 1 

Bailey 009 017 01 2 D Hardeman 099 197 02 3 

Bandera 

Bastrop 

010 

011 

019 

021 

08 

07 

20 

15 

Dallam 

Dallas 

056 

057 

111 

113 

01 

03 

1 

6 

Hardin 

Harris 

100 

101 

199 

201 

05 

06 

18 

28 

Baylor 012 023 02 3 Dawson 058 115 09 11 Harrison 102 203 04 8 

Bee 013 025 11 22 Deaf Smith 059 117 01 1 Hartley 103 205 01 1 

Bell 014 027 07 26 Delta 060 119 04 7 Haskell 104 207 02 9 

Bexar 015 029 08 20 Denton 061 121 03 4 Hays 105 209 07 15 

Blanco 016 031 07 15 DeWitt 062 123 08 19 Hemphill 106 211 01 1 

Borden 017 033 09 11 Dickens 063 125 01 2 Henderson 107 213 04 8 

Bosque 018 035 07 13 Dimmit 064 127 08 27 Hidalgo 108 215 11 23 

Bowie 019 037 04 7 Donley 065 129 01 1 Hill 109 217 07 13 

Brazoria 

Brazos 

020 

021 

039 

041 

06 

07 

28 

16 

Duval 

E 

066 131 11 22 Hockley 

Hood 

110 

111 

219 

221 

01 

03 

2 

4 

Brewster 022 043 10 10 Eastland 067 133 02 9 Hopkins 112 223 04 7 

Briscoe 023 045 01 1 Ector 068 135 09 11 Houston 113 225 05 17 

Brooks 024 047 11 22 Edwards 069 137 08 27 Howard 114 227 09 11 

Brown 025 049 02 9 Ellis 070 139 03 4 Hudspeth 115 229 10 10 

Burleson 026 051 07 16 El Paso 071 141 10 10 Hunt 116 231 03 4 

Burnet 027 053 07 15 Erath 072 143 03 4 Hutchinson 117 233 01 1 

C F I 

Caldwell 028 055 07 15 Falls 073 145 07 13 Irion 118 235 09 12 

Calhoun 029 057 08 19 Fannin 074 147 03 25 J 

Callahan 

Cameron 

030 

031 

059 

061 

02 

11 

9 

24 

Fayette 

Fisher 

075 

076 

149 

151 

07 

02 

15 

9 

Jack 

Jackson 

119 

120 

237 

239 

02 

08 

3 

19 

Camp 032 063 04 8 Floyd 077 153 01 2 Jasper 121 241 05 17 

Carson 033 065 01 1 Foard 078 155 02 3 Jeff Davis 122 243 10 10 

Cass 034 067 04 7 Fort Bend 079 157 06 28 Jefferson 123 245 05 18 

Castro 

Chambers 

035 

036 

069 

071 

01 

06 

1 

28 

Franklin 

Freestone 

080 

081 

159 

161 

04 

07 

7 

13 

Jim Hogg 

Jim Wells 

124 

125 

247 

249 

11 

11 

21 

22 

Cherokee 037 073 04 8 Frio 082 163 08 20 Johnson 126 251 03 4 

Childress 038 075 01 1 G Jones 127 253 02 9 

Clay 039 077 02 3 Gaines 083 165 09 11 K 

Cochran 040 079 01 2 Galveston 084 167 06 28 Karnes 128 255 08 20 

Coke 041 081 09 12 Garza 085 169 01 2 Kaufman 129 257 03 4 

Coleman 042 083 02 9 Gillespie 086 171 08 20 Kendall 130 259 08 20 

Collin 043 085 03 4 Glasscock 087 173 09 11 Kenedy 131 261 11 22 

Collingsworth 044 087 01 1 Goliad 088 175 08 19 Kent 132 263 02 9 

Colorado 045 089 06 28 Gonzales 089 177 08 19 

HHS Cty = Health and Human Services Commission (HHSC) County Codes 

TWC Cty = Texas Workforce Commission County Codes 

HHS Reg = HHSC Region Codes 

WDA = Workforce Development Area Codes 

08/08 E-1

Name 

HHS 

Cty 

TWC 

Cty 

HHS 

Reg 

WDA Name HHS 

Cty 

Kerr 133 265 08 20 Nolan 177 353 02 9 T 

Kimble 134 267 09 12 Nueces 178 355 11 22 Tarrant 220 439 03 5 

King 135 269 01 2 O Taylor 221 441 02 9 

Kinney 136 271 08 27 Ochiltree 179 357 01 1 Terrell 222 443 09 11 

Kleberg 137 273 11 22 Oldham 180 359 01 1 Terry 223 445 01 2 

Knox 138 275 02 9 Orange 181 361 05 18 Throckmorton 224 447 02 9 

L P Titus 225 449 04 7 

Lamar 139 277 04 7 Palo Pinto 182 363 03 4 Tom Green 226 451 09 12 

Lamb 140 279 01 2 Panola 183 365 04 8 Travis 227 453 07 14 

Lampasas 141 281 07 26 Parker 184 367 03 4 Trinity 228 455 05 17 

LaSalle 142 283 08 27 Parmer 185 369 01 1 Tyler 229 457 05 17 

Lavaca 143 285 08 19 Pecos 186 371 09 11 U 

Lee 144 287 07 15 Polk 187 373 05 17 Upshur 230 459 04 8 

Leon 145 289 07 16 Potter 188 375 01 1 Upton 231 461 09 11 

Liberty 146 291 06 28 Presidio 189 377 10 10 Uvalde 232 463 08 27 

Limestone 147 293 07 13 R V 

Lipscomb 148 295 01 1 Rains 190 379 04 8 Val Verde 233 465 08 27 

Live Oak 149 297 11 22 Randall 191 381 01 1 Van Zandt 234 467 04 8 

Llano 150 299 07 15 Reagan 192 383 09 12 Victoria 235 469 08 19 

Loving 151 301 09 11 Real 193 385 08 27 W 

Lubbock 152 303 01 2 Red River 194 387 04 7 Walker 236 471 06 28 

Lynn 153 305 01 2 Reeves 195 389 09 11 Waller 237 473 06 28 

M Refugio 196 391 11 22 Ward 238 475 09 11 

Madison 154 313 07 16 Roberts 197 393 01 1 Washington 239 477 07 16 

Marion 155 315 04 8 Robertson 198 395 07 16 Webb 240 479 11 21 

Martin 156 317 09 11 Rockwall 199 397 03 4 Wharton 241 481 06 28 

Mason 157 319 09 12 Runnels 200 399 02 9 Wheeler 242 483 01 1 

Matagorda 158 321 06 28 Rusk 201 401 04 8 Wichita 243 485 02 3 

Maverick 159 323 08 27 S Wilbarger 244 487 02 3 

McCulloch 160 307 09 12 Sabine 202 403 05 17 Willacy 245 489 11 23 

McLennan 161 309 07 13 

San 

Augustine 

203 405 05 17 Williamson 246 491 07 15 

McMullen 162 311 11 22 San Jacinto 204 407 05 17 Wilson 247 493 08 20 

Medina 163 325 08 20 San Patricio 205 409 11 22 Winkler 248 495 09 11 

Menard 164 327 09 12 San Saba 206 411 07 26 Wise 249 497 03 4 

Midland 165 329 09 11 Schleicher 207 413 09 12 Wood 250 499 04 8 

Milam 166 331 07 26 Scurry 208 415 02 9 Y 

Mills 167 333 07 26 Shackelford 209 417 02 9 Yoakum 251 501 01 2 

Mitchell 168 335 02 9 Shelby 210 419 05 17 Young 252 503 02 3 

Montague 169 337 02 3 Sherman 211 421 01 1 Z 

Montgomery 170 339 06 28 Smith 212 423 04 8 Zapata 253 505 11 21 

Moore 171 341 01 1 Somervell 213 425 03 4 Zavala 254 507 08 27 

Morris 172 343 04 7 Starr 214 427 11 23 

Motley 173 345 01 2 Stephens 215 429 02 9 

N Sterling 216 431 09 12 

TWC 

Cty 

HHS 

Reg 

Nacogdoches 174 347 05 17 Stonewall 217 433 02 9 

Navarro 175 349 03 4 Sutton 218 435 09 12 

Newton 176 351 05 17 Swisher 219 437 01 1 

HHS Cty = Health and Human Services Commission (HHSC) County Codes 

TWC Cty = Texas Workforce Commission County Codes 

HHS Reg = HHSC Region Codes 

WDA = Workforce Development Area Codes 

E-2 08/08 

WD 

A 

Name 

HHS 

Cty 

TWC 

Cty 

HHS 

Reg 

WDA

Appendix F: 

Medicaid Type Programs Chart 

(C—1116)

APPENDIX F: Medicaid Type Programs (C — 1116) 

TANF, Medical Programs and Refugee 

All programs listed below are Category 2 unless noted otherwise. 

Type 

Description 

Program 

01 money grant and Medicaid for caretakers and deprived children with income below TANF 

recognizable needs 

04 medical assistance only – deceased 

07 twelve months transitional Medicaid resulting from increase in earnings or combined increase 

in earnings and child support 

09 medical coverage for foster care youths age 18 – 21 who have aged out of foster care 

11 three months prior Medicaid – not currently eligible 

20 four months post Medicaid resulting from child support 

29 12 Months post Medicaid following end of state time limited TANF 

30 ineligible alien with an emergency condition 

37 twelve months transitional Medicaid coverage resulting from loss of 90% earned income 

disregard 

40 pregnant women 

WHP Women's Health Program (WHP) for women age 18-44 with income below 185% FPIL. This 

program is not processed in SAVERR. WHP is processed in TIERS as a type of assistance 41. 

42 presumptively eligible pregnant woman 

43 children under age one with income below 185% FPIL 

44 children age 6 – 19 with income below 100% FPIL 

45 children to age one born to Medicaid eligible mother 

47 children ineligible for TANF, TANF-SP, or the age-appropriate medical program due to 

stepparent or grandparent's applied income, or stepparent's income when included on the 

case 

48 children age 1 – 5 with income below 133% FPIL 

51 State Office Data Integrity type program used to fund medical expenses when an erroneous 

Form H1027-A is issued to a client who does not have medicaid coverage. 

55 Medically Needy Program – Medicaid for caretakers of Medicaid children with income 

below TANF Recognizable Needs, or pregnant women and children who are ineligible 

for any other type program and have medical expenses that spend down their income 

to below the MNIL. 

Breast and Cervical Cancer Control Program (BCCCP) – Medicaid coverage for women 

who are screened and diagnosed by the Texas Department of State Health Services as 

needing treatment for breast or cervical cancer. 

Refugee Medical Assistance (Category 5) 

61 TANF State Program (TANF-SP) – two parent household eligible for money grant and Medicaid 

with income below TANF recognized needs 

71 One Time TANF (OT-TANF) – one parent household cash grant only, no Medicaid 

72 One Time TANF (OT-TANF) – two parent household cash grant only, no Medicaid 

08/08 F-1

Protective and Regulatory Services (Category 2) 

Type Program 

Description 

08 TANF foster care 

09 non – TANF (MAO) foster care 

10 state paid foster care 

15 state paid adoption assistance 

21 IV-E adoption assistance 

Aged and Disabled (Categories 1, 3 and 4) 

All programs listed below can be a Category 1, 3 or 4 unless otherwise noted. 

Note: Some of the Medicaid groups may also be eligible for Medicare Savings if they are Medicare. 

Type 

Description 

Program 

03 RSDI COLA Disregard Programs – most TP 03s are considered eligible based on the 1977 

Pickle Amendment 

11 SSI, two months prior or three months prior, as appropriate 

12 manually certified SSI (processed by SSA) 

13 SSI (processed by SSA) 

14 Institutional Medicaid – Institutional settings could be in a Medicare skilled nursing facility, 

Medicaid nursing facility, state school, ICF/MR facility or an institute for mental disease (IMD). 

TP 14 can also be 1915(c) home/community based waivers. This TP uses a special income 

limit currently set at 300% of SSI FBR. TP (BP 13) SIG code F14 is used for the Program of All 

Inclusive Care for the Elderly (PACE), which is a Medicaid state optional program. Exception: 

Clients with coverage code T are receiving primary home care but not Medicaid under 

community attendant services (CAS) based on the federal provisions under 1929(b). 

18 Disabled Adult Children (DAC) – Clients (at least age 18) who were denied SSI due to 

entitlement to, or an increase in, their Social Security Disabled Adult Children Benefits and are 

eligible for Medicaid to ensure continued coverage. 

19 SSI Denied Kids - Medicaid for children denied SSI cash assistance due to more restrictive 

disability criteria under welfare reform. They continue to receive Medicaid under the prewelfare 

reform definition of disability until age 18 and are eligible for 3 months prior rather 

than 2 months prior. 

22 Widows/Widowers - Early age widows/widowers, disabled widows/widowers or surviving 

divorced spouses age 50 - 65 and ineligible for Medicare (Categories 3 or 4) who were denied 

SSI due to an increase in their RSDI widow/widower benefits. They are eligible for Medicaid 

under TP 22 until they reach age 65 or become eligible for Medicare, whichever occurs first. 

23 Medicare Savings Program - Specified Low-Income Medicare Benefits (SLMB) or Qualifying 

Individuals-1 (QI-1)) 

24 Medicare Savings Program – Qualified Medicare Beneficiary (QMB) 

25 Qualified Disabled and Working Individuals (QDWI) – A special Medicare savings program that 

pays Part A Medicare premiums for certain working individuals under age 65 who are disabled 

and are no longer eligible for free Part A because of earnings. 

30 Emergency medical for an undocumented alien 

MBI 

MBI is not processed in SAVERR; it is processed using TIERS as TP 87. MBI was implemented 

in September 2006 for people with disabilities who work. Clients must pay a share of the 

Medicaid premium to be eligible for Medicaid. 

Revision Number: 07-3 

Effective date: July 1, 2007 

F-2 08/08

TAMENU SAVERR Inquiry Reference Guide - Texas Workforce ...

Create successful ePaper yourself

Delete template?

Save as template?