1520 Obtaining Certified Birth Certificates and Printing Birth Records Screenshots
CPS March 2021
Access to DSHS Vital Statistics TxEVER System
A CPS foster care eligibility specialist has access to the Department of State Health Service’s (DSHS) Vital Statistics TxEVER system, which allows the eligibility specialist to verify birth information and order certified birth certificates for children in DFPS conservatorship who were born in Texas.
Obtain Birth Certificate from Family Members or Guardian When Possible
A child’s caseworker always attempts to obtain a birth certificate from the child’s parents, relatives, or guardian instead of requesting a copy of the birth certificate through the BVS TxEVER system. If a child’s caseworker obtains a copy of the birth certificate, he or she submits it to the eligibility specialist. This copy serves as documentation of a child’s birth and citizenship or immigration status for the Foster Care Assistance Application.
Use Screenshot of Birth Record if Birth Certificate Is Unavailable
If the child’s caseworker cannot obtain a copy of the birth certificate, the caseworker asks the eligibility specialist for a printed screenshot of the birth record from the TxEVER system. The eligibility specialist then does the following:
- Uses the printed birth verification as verification of the child’s birth and citizenship or immigration status for the Foster Care Assistance Application.
- Sends a copy of the printed screenshot to the child’s worker.
Use Printed Screenshot of Birth Record if Birth Certificate Is Not Required
In other circumstances requiring birth information, but not requiring a certified copy of a birth certificate, the child’s caseworker uses a printed screenshot of the birth record from the TxEVER system. It is no longer necessary to obtain a certified birth certificate when registering a child for school. The child’s caseworker can instead use a printed screenshot of the birth verification from the TxEVER system.
Request Certified Birth Certificate Only Under Certain Circumstances
Certified birth certificates may be requested only in the following situations:
- It is necessary when applying for a Social Security number if one has never been obtained; otherwise the Social Security Administration can confirm the SSN of a child in DFPS managing conservatorship.
- It is necessary when applying for Supplemental Security Income (SSI) or other federal benefits for the child.
- It is necessary when applying for a Texas driver license or Texas Identification Card for the child to help prepare youth who may be aging out of care.
- Parental rights are terminated and the child becomes eligible for adoption (see 1521.1 Requesting Birth Certificates for Children Born in Texas).
- To resolve credit report discrepancy for youth ages 14 or older to comply with CPS Handbook policy (see 6453 Consumer Credit Reports).
- Other situations in which the recipient requires a certified copy.
See 1521 Requesting Certified Birth Certificates for procedures for requesting certified birth certificates for children born in Texas, out of state or internationally.
1521 Requesting Certified Birth Certificates
1521.1 Requesting Birth Certificates for Children Born in Texas
CPS March 2021
The CPS worker may request a certified birth certificate for a child in DPFS conservatorship born in Texas under the circumstances stated in 1520 Obtaining Certified Birth Certificates and Printing Birth Records Screenshots. The caseworker completes and submits Form 1745 Birth Certificate Request for Children in DFPS Conservatorship to the foster care eligibility specialist, except when a birth certificate is needed for adoption purposes. The eligibility specialist orders the birth certificate through the DSHS Vital Statistics TxEVER system and sends it to the caseworker when received.
1521.2 Requesting Birth Certificates for Children Born in Texas for Adoption Purposes
CPS March 2021
When parental rights have been terminated, CPS may order a birth certificate through the Department of State Health Service’s (DSHS) Vital Statistics unit in order to facilitate the child’s adoption. Designated regional staff submits requests to state office via the DFPS BVS/Adoption Requests mailbox. State office orders the birth certificate from the Vital Statistics unit.
CPS staff follows the step below to request a certified birth certificates for adoption purposes:
- The regional designee submits an e-mail request to the DFPS BVS/Adoption Requests mailbox that includes the items below:
- The child’s name and PID number in the subject line.
- The template below with the child’s information for each birth certificate request. If certificates are needed for siblings a separate template must be completed for each child but they can be on the same e-mail.
- Child’s name
- Child’s date of birth
- Gender
- Place of birth (city or town/county/state)
- Full name of father and cause number for termination order
- Full maiden name of mother and cause number for termination order
- A copy of the child’s termination orders as an attachment. The orders must state that the parental rights have been terminated for both parents and the managing conservatorship of the child is with DFPS. If siblings have the same mother but different fathers, a copy of each order terminating a father’s rights must be included. Please underline the language that states parental rights have been terminated.
- Once the request has been received, state office staff does the following:
- Submits the request to the Vital Statistics unit within three business days.
- Sends the designee an e-mail to confirm that the request was received and processed.
- Forwards the birth certificate from the Vital Statistics unit to the designee who made the initial request.
- Sends the designee an e-mail informing them that the certificate is being sent.
If the designee does not receive a confirmation from state office that the request was received and processed within three business days, the designee should send a follow up e-mail (with the original request attached) to the DFPS BVS/Adoption Requests mailbox.
1521.3 Requesting Out-of-State Birth Certificates
CPS March 2021
A CPS caseworker initiates the ordering of certified copies of out-of-state birth certificates for children in DFPS conservatorship by following the steps described below. Each region has designated eligibility specialists who are able to order birth certificates through an online process with VitalChek.
Through VitalChek, designated eligibility staff are able to request certified copies of birth certificates for children in DFPS conservatorship born in the 49 states (excluding Texas); Washington, D.C.; and the following U.S. commonwealths and territories:
- American Samoa
- Guam
- Puerto Rico
- Virgin Islands
Steps for Ordering Out-of-State Birth Certificates
The child’s caseworker or designee completes the following:
- Complete Form 1745 Birth Certificate Request for Children In DFPS Conservatorship. The form must be completely filled in. The form will be returned to the requestor if incomplete.
- Create a scanned or electronic copy of the signed court order stating DFPS has temporary or permanent managing conservatorship of the child. Copies of signed court orders are acceptable as long as they have not been altered or written on by anyone other than the court.
- Submit the completed Form 1745 and scanned or electronic file court orders to the regional e-mail box for out-of-state birth certificate requests (for example, DFPS Region 01 Out of State Birth Certificates). If the orders are not attached to the e-mail, the request cannot be processed and will be returned to the requestor.
Once the request has been received, the eligibility specialist does the following:
- Processes the request through the VitalChek online website.
- Sends the requestor a confirmation email that the request has been received and processed.
Once the birth certificate is received, the designated eligibility specialist does the following:
- Forwards the birth certificate to the requestor.
- Sends the requestor an e-mail indicating that the birth certificate has being sent.
1521.4 Requesting International Birth Certificates
CPS March 2021
Regional foster care eligibility specialists cannot order birth certificates for international births. To order a foreign birth certificate, CPS caseworkers refer to instructions in the International and Immigration Issues Resource Guide.
1521.5 Request Reimbursement if Personal Funds Must Be Used to Obtain Certificate
CPS March 2021
Though the preferred method for obtaining a birth certificate is through the regional eligibility specialist, a CPS caseworker or designee (such as a unit administrative assistant) may need to use personal funds to purchase a certified birth certificate from the Department of State Health Services or from an out-of-state agency.
To request reimbursement for the purchase of a certified birth certificate, the CPS worker:
- Completes a Form 4116 State of Texas Purchase Voucher.
- Enters his or her name, address (home or office), and Social Security number as the vendor number.
- Ensures the forms have the worker and supervisor’s signatures;
- Includes the receipt of purchase.
- Submits the completed form and receipt to the CPS budget analyst at state office mail code E-669.
Forms may not be e-mailed to budget analysts. If an employee is not in the same office as the supervisor, he or she may fax the form to the supervisor for his or her signature. An employee may submit more than one family per voucher as long as he or she differentiates between families and dates of purchase.
1530 Foster Care Assistance Eligibility Requirements for Children and Youth Who Are in DFPS Conservatorship
CPS March 2021
There are three types of foster care assistance for children in DFPS conservatorship. Each child qualifies for only one of the following types of foster care assistance:
Type of Assistance |
Benefits Provided |
Must Meet Applicable Requirements in the Following Policies: |
|---|---|---|
Title IV-E foster care |
|
1531.1 General Eligibility Requirements for Title IV-E and State-Paid Foster Care 1532 Additional Eligibility Requirements for Title IV-E Foster Care |
State-paid (Non-Title IV-E) foster care |
|
1531.1 General Eligibility Requirements for Title IV-E and State-Paid Foster Care 1534 Additional Eligibility Requirements for State-Paid Foster Care |
Medical Assistance Only (MAO) |
Medicaid or equivalent benefits to children in DFPS conservatorship who are not otherwise eligible for IV-E or state-paid foster care |
1531 General Foster Care Assistance Eligibility Requirements
1531.1 General Eligibility Requirements for Title IV-E and State-Paid Foster Care
CPS March 2021
Every child who is eligible for Title IV-E or state-paid foster care assistance must meet the requirements in 40 TAC §700.316, described in the sections below. Each requirement must be verified by the eligibility specialist.
In addition to the general requirements listed in the above-referenced state code, the following must also be true:
- Children eligible for Title IV-E must meet the requirements of 1532 Additional Eligibility Requirements for Title IV-E Foster Care.
- Children eligible for state-paid care must meet the requirements of 1534 Additional Eligibility Requirements for State-Paid Foster Care.
- Children eligible for MAO must meet the requirements of 1535.1 Medicaid Eligibility Types.
1531.11 Responsibility for Placement and Care
CPS March 2021
The child or youth must be under the placement and care responsibility of DFPS, which is met if any of the following are true:
- The child is placed in DFPS’s managing conservatorship according to a written court order issued under Title 5 of the Texas Family Code.
- DFPS takes possession of a child under Texas Family Code Chapter 262;. Foster care eligibility staff confer with the CPS Federal and State Support division for clarification of whether DFPS obtained responsibility for placement and care of a child and if DFPS is able to pay for a placement through IMPACT.
- The child lives with his or her minor parent, and the minor parent is in DFPS’s conservatorship, so long as the minor parent and the child reside in the same foster home or child care institution.
- The young adult was in DFPS’s conservatorship on the day before turning 18, has signed a voluntary Extended Foster Care Agreement, and meets all of the eligibility requirements in 40 TAC §700.346 (relating to Extended Foster Care).
- The child lives with a parent who is receiving extended foster care assistance. In some instances, the parent may be required to apply for Medicaid on the child’s behalf under 40 TAC §700.346.
1531.12 Age
CPS March 2021
When a child first comes into foster care, the child must be under the age of 18 and the eligibility specialist must verify the child’s age by reviewing the child’s birth certificate, hospital certificate, or one of the other items in subsection B of Appendix 1530-F: Categorical Requirements for AFDC. If none of these is available at the time application is made, the caseworker may chose the Evaluative Conclusion option on the Foster Care Assistance Application in IMPACT and document on the application why he or she chose the option. The Evaluative Conclusion must be based on one of the following sources:
- A document containing the child’s date of birth (medical, insurance, or school record) that was created before the date of removal.
- A credible person with knowledge of the family’s history who can provide either the child’s date of birth or current age.
- Any other reasonable basis to indicate that the child meets applicable age requirements.
See the Evaluative Conclusion section 1532.2 Citizenship or Immigration Status for further instruction.
1531.13 Placement Facility
CPS March 2021
Except in circumstances described in 1537 Foster Care Payments During Absences From Foster Care Placements, the child must be receiving care in a placement for which the following are true:
- Placement meets the definition of foster family home or child-care institution as those terms are defined by 42 USC §672(c).
- Placement is approved by DFPS.
DFPS does not contract for foster care services with any public child care institutions with more than 25 beds. Children are not eligible for either Title IV-E or state-paid assistance while placed in such settings.
1531.14 Social Security Number
CPS March 2021
If eligible, the child must have, or must have applied for, a Social Security number. See 1511 Applying for Foster Care Assistance for guidance on obtaining a Social Security number for a child who has never been issued a number by the Social Security Administration. Social Security numbers are obtained for all children except undocumented children. Once undocumented children receive their Legal Permanent Residency, a Social Security number is obtained for them.
1531.15 Young Adults and DADS
CPS March 2021
A young adult is eligible for continued foster care maintenance payments subject to the provisions at 40 TAC §700.316(c) if the following are true:
- The young adult was previously in DFPS’s conservatorship the day before turning 18.
- The young adult is under guardianship of the Department of Aging and Disability Services (DADS) on or after turning 18.
1531.2 General Eligibility Requirements for MAO Foster Care
CPS March 2021
Every child who is eligible for MAO foster care must meet the following general requirements, as verified by the eligibility specialist:
- Responsibility for Placement and Care – The child or youth must be under the placement and care responsibility of DFPS, as described in 1531.11 Responsibility for Placement and Care.
- Age – The child or youth must be under the age of 18, using the verification methods described in 1531.12 Age.
In addition to the general requirements above, children in DFPS conservatorship who are eligible for MAO foster care must also meet the requirements in 1535.1 Medicaid Eligibility Types.
1532 Additional Eligibility Requirements for Title IV-E Foster Care
CPS March 2021
Besides the general eligibility requirements specified in 40 TAC §700.316(c)(relating to general eligibility requirements for foster care assistance), a child must meet the requirements below to qualify for Title IV-E foster care.
1532.1 Judicial Determinations
CPS March 2021
The following judicial determinations must be made in the manner described below:
Best Interest of the Child
At the time a child is first removed from the home, regardless of whether it is an emergency removal subject to ex parte proceeding or removal pursuant to an adversary hearing with prior notice, the first court ruling that sanctions the removal must contain the judicial determination of either of the following:
- Continuation in the home would be contrary to the welfare of the child.
- Placement in foster care would be in the best interest of the child.
Reasonable Efforts to Prevent Removal
Not later than 60 days following the initial removal, a judicial determination must be made that says, when considering the child’s health and safety, the state made reasonable efforts to do any of the following:
- Prevent or eliminate the need for removal and make it possible for a child to return safely to the child’s home.
- Does not need to make reasonable efforts because of aggravated circumstances, as defined in the Texas Family Code §262.2015, or because a parent has previously had parental rights involuntarily terminated with respect to a sibling.
- Has not or cannot make reasonable efforts due to the circumstances regarding the child’s safety and protection.
Time Frame for Title IV-E Eligibility
Title IV-E eligibility starts on the first day of placement in the month in which a court order finds the following to be true:
- Remaining in the home would be contrary to the welfare of the child.
- DFPS made reasonable efforts to prevent removal.
Example
A child is removed from the home on October 30. On November 1, the court finds that remaining in the home is contrary to the welfare of the child and that DFPS made reasonable efforts to prevent the child’s removal from the home. Title IV-E eligibility begins on November 1. The child is not Title IV-E eligible for October 30-31 and must be assigned state-paid eligibility for those days.
Reasonable Effort to Finalize a Permanency Plan
Additional judicial determinations must be made regarding permanency planning. At least once during every 12-month period that the child remains in foster care, a court must make a determination that the agency has made reasonable efforts to finalize the child’s permanency plan. This period starts with the date of the court-ordered removal.
If the court does not find that DFPS has made reasonable efforts to finalize the child’s permanency plan, the child’s Title IV-E eligibility ends on the last day of the month in which the finding is due.
The child will not regain Title IV-E eligibility until the court finds subsequently that DFPS has made reasonable efforts to finalize a permanency plan for the child. In this case the child’s Title IV-E eligibility resumes on the first day of the month in which the finding is made.
Requirements for All Judicial Determinations
All required judicial determinations must be explicitly documented and made on a case-by-case basis as stated in the court order. It is not acceptable for a court order to merely reference state law in support of a required judicial determination.
Affidavits and Nunc pro tunc orders cannot be used as documentation to verify that the required judicial determinations were made (nunc pro tunc refers to a ruling that retroactively corrects an earlier court ruling). Nunc pro tunc orders may be used only to make technical corrections unrelated to the judicial determination requirements. The only acceptable alternative documentation of judicial determinations, absent language in a court order, is a transcript of the court proceedings.
1532.2 Citizenship or Immigration Status
CPS March 2021
In order to receive Title IV-E payments (foster care maintenance or adoption assistance), the child must be a citizen of the United States or a qualified alien as defined in 8 USC §1641. If a child does not meet the U.S. citizenship or qualified alien status requirement in the month of the removal, the child cannot subsequently become IV-E eligible if they later obtain U.S. citizenship or a qualifying alien immigration status. In addition, the Title IV-E state plan requires states to have procedures to verify the citizenship or immigration status of foster care children.
Verification
The eligibility specialist must review the foster care application and supporting documentation to verify the child’s U.S. citizenship or qualified alien status.
Staff verifies U.S. citizenship with either of the following:
- U.S. certificate of birth.
- A Texas Department of State Health Services Vital Statics birth record printout for children born in Texas.
Note: If a child is born out of state, staff submits a request to order the birth certificate through the VitalChek website through his or her regional foster care eligibility specialist/VitalChek liaison
When a birth certificate or the child’s birth record cannot be located in the BVS data base, staff uses the documents listed in Appendix 1000-2: Additional Acceptable U.S. Citizenship Verification Documents in descending order to confirm citizenship.
Staff verifies qualified alien status with a:
- Permanent Resident Card (I-551).
- Form I-94 Arrival/Departure Document, which is issued when the child is granted asylum. The Form I-94 should have a stamp showing that asylum was granted under Section 208 of the Immigration and Nationality Act (INA).
- Form I-94 Arrival/Departure Document for refugees admitted under section 207 of the Immigration and Nationality Act (INA).
- Form I-94 Arrival/departure card with a stamp showing parole at any time as a Cuban/Haitian Entrant.
If the child possesses other U.S. immigration documentation besides the above documents, staff contacts the Federal/State Support Unit or his or her regional Immigration Specialist for a determination on the child’s immigration status.
Evaluative Conclusion
The caseworker may choose the Evaluative Conclusion option on the Foster Care Assistance Application in IMPACT to determine that a child is a U.S. citizen. The caseworker must document on the application the reason for using this option based on either of the following criteria:
- A document proving the child’s birth in the U.S. (medical, insurance, or school record) that was created before the date of removal.
- A credible person with knowledge of the family’s history who states that the child was born in the U.S.
If an Evaluative Conclusion is used for U.S. citizenship, the eligibility specialist certifies the child’s foster care assistance for six months. When recording the child’s initial eligibility determination in IMPACT, the eligibility specialist sets the review date to six months from the eligibility start date. At the six-month review, the eligibility specialist must verify that the agency has obtained a U.S. birth certificate or other documentation of U.S. citizenship.
For the six-month review, the eligibility specialist takes the following steps:
- If documentation verifying the child’s U.S. citizenship status is found, the child’s citizenship and eligibility status remain unchanged.
- If no documentation is received verifying the child’s U.S. citizenship status, or if it has been established that the child is not a U.S. citizen, the eligibility specialist does the following:
- Changes the child’s eligibility status to state-paid eligible effective to the initial eligibility start date.
- Changes the child’s citizenship status in IMPACT to Undetermined Status.
- Notifies the caseworker of the citizenship status change.
1532.3 Social Security Number
CPS March 2021
If eligible, the child must have, or must have applied for, a Social Security number. See 1511 Applying for Foster Care Assistance for guidance on obtaining a Social Security number for a child who has never been issued a number by the Social Security Administration.
1532.4 Valid Removal from the Home
CPS March 2021
A child is eligible for Title IV-E assistance only if the child is the subject of a valid removal from the home.
Both of the following must occur for a removal to be valid:
- The court makes a finding that remaining in the home is “contrary to the welfare” of the child.
- The court’s “contrary to the welfare” finding coincides with DFPS’s action to physically take the child from the home.
If DFPS does not physically remove the child from the home by the end of the next business day following the day the court makes the “contrary to the welfare” finding, the following occurs:
- The child is not eligible for Title IV-E assistance.
- The child remains ineligible for Title IV-E assistance for the entire foster care episode. A foster care episode is the time period from when the court legally orders the child’s removal to when the court dismisses the conservatorship case.
- The foster care eligibility specialist denies the child’s application for Title IV-E assistance.
Exceptions to Standard Time Frame
Extenuating circumstances may prevent DFPS from physically removing the child from the home by the end of the next business day after the day the court makes the “contrary to the welfare” finding. For example, the child may be missing because the child has run away or the parent has taken the child.
In some cases, the court may order an alternative time frame for DFPS to physically remove the child from the home.
In these situations, foster care eligibility staff members consult with the Federal and State Support division.
1532.5 Aid to Families with Dependent Children (AFDC) Requirements
CPS March 2021
The child must meet the AFDC eligibility requirements that were in effect in the AFDC state plan on July 16, 1996. To meet those requirements, the child must have been a needy child under the following circumstances:
- In the home from which the court judicially (legally) removed the child.
- During the month in which DFPS filed the petition for removal.
See Appendix 1530-F: Categorical Requirements for AFDC.
1533 Requirements When IV-E Children Are in a Non-IV-E Placement
1533.1 Trial Home Visits / Monitored Returns
CPS March 2021
When a child is in a trial home visit or monitored return, the child is not eligible to receive either IV-E or state-paid foster maintenance payments. This is because the child is now living with the person who is responsible for the child’s financial support. The child can be reinstated for IV-E foster care payments without a new foster care application if the following are true:
- The reunification fails.
- DFPS retains responsibility for care and placement of the child (the original removal order is still in effect).
A trial visit or monitored return can last for only six months unless the court issues an order to extend the trial home placement beyond that time frame. A new foster care application must be processed based on current circumstances in the home if either of the following are true:
- DFPS conservatorship has been dismissed.
- The child stayed in the placement longer than six months without the court continuing the placement.
In these circumstances the child will more than likely not meet Title IV-E requirements and instead will be eligible to be paid by the state-paid.
Eligibility Staff Actions
If the child returns to foster care within the 6-month period or the court-ordered time frame, the eligibility specialist reinstates the child’s previous foster care eligibility.
If the child returns to foster care after the 6 month-period or the court-ordered time frame, the child’s Title IV-E eligibility must be re-established through a new Foster Care Application. In this case the eligibility specialist does the following:
- Asks the CPS caseworker to take the following actions:
- Complete and submit to the specialist a new Foster Care Application in IMPACT, reflecting the situation in the home from where the monitored return occurred in the month the child returned to foster care.
- Send the specialist the court order that moves or transfers the child into a different placement.
- Reviews the court order for the required Title IV-E judicial determinations described in 1532.4 Valid Removal from the Home.
- Processes the submitted Foster Care Application in IMPACT and answers the questions regarding the Title IV-E judicial determinations accordingly.
- Adds the appropriate eligibility for child in IMPACT.
1533.2 Placements Outside the Scope of Foster Care
CPS March 2021
When a child returns to a paid foster care placement from a non-paid placement, the child retains Title IV-E eligibility as long as the original court order pertaining to the child’s removal is still in effect. The foster care eligibility specialist reinstates the child’s Title IV-E foster care eligibility without completing a foster care application or review.
Examples of such non-paid placements include the following:
- Kinship or relative placements.
- Adoptive placements.
- Jails or facilities that are primarily for the detention of children.
- Medical or psychiatric hospitals.
The exceptions are for children returning to foster care from a monitored return as described in the previous section and youth in Extended Foster Care as described in 10424 Temporary Absences From Extended Foster Care.
1534 Additional Eligibility Requirements for State-Paid Foster Care
CPS March 2021
Besides the requirements in 1530 Foster Care Assistance Eligibility Requirements for Children and Youth Who Are in DFPS Conservatorship, a child must meet the following criteria to be eligible for state-paid foster care.
A child is eligible for non-IV-E foster care if all of the following are true:
- He or she is not eligible for Title IV-E foster care assistance.
- He or she meets requirements in 40 TAC §700.316.
- He or she is placed by DPFS in a foster home or other residential child-care facility, or in a comparable residential facility in another state.
In addition to the above criteria, the child must also meet one of the following criteria:
- He or she is the subject of a suit DFPS has initiated and for which DFPS has been named as conservator.
- He or she is a child for whom DFPS has the duty of care, control, and custody after taking possession of the child in an emergency.
General revenue funds are used for children who are not U.S. citizens or qualified aliens as defined by federal law.
1535 Medical Coverage for Children in Foster Care
CPS March 2021
If the placement is a setting that is eligible to receive Medicaid, DFPS provides medical coverage to the following people:
- Children who are in DFPS’s managing conservatorship.
- Young adults in the Extended Foster Care Program.
Any child who is in the managing conservatorship of DFPS is certified as having at least Medical Assistance Only (MAO). The certification is effective until DFPS’s legal responsibility is terminated. This includes children absent from their placements without authorization or in unauthorized placements.
Situations may arise in which it would be in the best interest of the child to discontinue foster care Medicaid in order to provide a child in DFPS conservatorship with another type of Medicaid coverage. This might be needed to facilitate a placement or to provide the child access to other medical services. In these situations, it is necessary for the CPS state office division administrator of the Federal/State Support Division to give approval before terminating the Medicaid benefits of any child in DFPS conservatorship.
1535.1 Medicaid Eligibility Types
CPS March 2021
Children and young adults who receive aid and assistance under Title IV-E of the state plan are eligible for federally funded Medicaid. On the Eligibility Summary page in IMPACT, the eligibility specialist chooses Regular as the Medicaid Eligibility Type for all children with an Actual Eligibility type of Title IV-E.
The eligibility specialist selects Regular as the Medicaid Eligibility Type if the child or young adult meets the following criteria:
- He or she is not categorically eligible for Title IV-E Medicaid.
- He or she is a U.S. Citizen or a qualified alien and any of the following criteria apply:
- He or she is younger than age 18 and has been placed in the managing conservatorship of DFPS by the county or district court as a result of a finding of abuse or neglect by DFPS.
- He or she is younger than age 21 and DFPS assumes financial responsibility for him or her in whole or part. He or she is cared for in a foster home or other residential child-care facility licensed by DFPS or a public or private child-placing agency.
- He or she is younger than age 21 and in the Extended Foster Care Program and in a supervised independent living (SIL) setting.
For all other children and young adults, the eligibility specialists selects State-paid as the Medicaid Eligibility Type.
1535.2 Medical Assistance Only (MAO) Auto-Eligibility
CPS March 2021
Medical Assistance Only (MAO) Auto-Eligibility establishes an MAO-type of Medicaid in TIERS before DFPS determines the actual foster care assistance eligibility.
The IMPACT case management system creates an MAO Auto-Eligibility Event when the following are true:
- A child has an open SUB-REG or SUB-C-PB stage in IMPACT.
- A child does not have an open foster care or adoption assistance type of eligibility in IMPACT.
- A caseworker enters a child’s placement in IMPACT.
If the system does not generate MAO Auto Eligibility, Medicaid will not be added until the foster care eligibility specialist processes a Foster Care Assistance Application.
When the application is processed, MAO Auto Eligibility ends and the correct eligibility type is entered in IMPACT based on the eligibility determination
1535.3 MAO Coverage for Children Placed in Kinship, Relative, or Own Home Placement
CPS March 2021
Foster care eligibility specialists must certify children for Medical Assistance Only (MAO) coverage when children meet the following criteria:
- The child leaves foster care, but remains in the conservatorship of DFPS.
- The child returns to his or her own home, relatives, or kinship placement.
Application for and Determination of Eligibility for Foster Care Assistance
When a child is placed in the conservatorship of DFPS, the following actions occur:
- The CPS worker assigned to a child’s case must complete a Foster Care Assistance Application.
- A foster care eligibility specialist assigns MAO eligibility.
Caregivers May Apply for TANF When MAO Is Active
The application and determination are required regardless of whether the relative or kinship caregiver is applying for Temporary Assistance for Needy Families (TANF) or kinship care payment. The relative or kinship caregiver may apply for TANF payments even if an MAO-type Medicaid is active for the child.
Basis for and Duration of MAO Eligibility
If a child in DFPS conservatorship is placed directly with a relative or kinship caregiver, the foster care eligibility specialist assigns MAO eligibility using the Foster Care Assistance Application submitted by the child’s assigned CPS worker. This eligibility remains open until a court terminates DFPS responsibility as conservator. The foster care eligibility specialist follows the procedures for determining eligibility that apply to all children in DFPS conservatorship.
1535.4 MAO Coverage for Children in Adoptive Placements
CPS March 2021
Children in adoptive placements may or may not qualify for adoption assistance, which includes Medicaid.
For children in adoptive placements and in the managing conservatorship of DFPS who do not qualify for adoption assistance, DFPS must continue to provide Medical Assistance Only (MAO) coverage until the child qualifies for adoption assistance or until DFPS legal responsibility for the child ends.
Transferring Foster Care to Adoption MAO Coverage
On the effective date of the adoptive placement, the following actions occur:
- The foster care eligibility specialist end-dates the child’s foster care eligibility.
- The adoption assistance eligibility specialist opens the child’s Medical Assistance Only (MAO) eligibility in the child’s adoption stage effective the first day of the month following the adoptive placement.
1535.5 MAO Coverage for Children in Texas Juvenile Justice Department (TJJD) Placements
CPS March 2021
Terminating Medical Assistance Only (MAO) Eligibility
When a child is placed in TJJD or a juvenile detention facility administered by the county juvenile probation department, the foster care eligibility specialist must end the child’s MAO eligibility in IMPACT. This is required because these placements are considered to be secured settings.
Reinstating MAO Eligibility
The child’s eligibility may be reinstated when he or she is released from the TJJD detention facility and placed back into CPS foster care or a kinship placement, provided DFPS continues as managing conservator.
1536 Eligibility in Medical Facilities Before Placement
CPS March 2021
A child in a medical facility is eligible for Medical Assistance Only (MAO) if the following are true
- The child meets the general eligibility requirements specified in Texas Administrative Code §700.316(b).
- DFPS plans to place the child outside the home in a residential child-care facility or relative placement as soon as the child leaves the medical facility.
DFPS must proceed with the planned placement unless the court changes the order or some other event occurs that clearly precludes making the placement.
The child’s eligibility for foster care assistance begins on the date DFPS takes possession of the child as stated in Texas Family Code Chapter 262.
In certain situations, when a child is in the hospital, he or she may be eligible for Medicaid before entering DFPS conservatorship. These cases must be referred to the CPS Federal and State Support Division for review on a case-by-case basis. Request for approval will be submitted to HHSC by the Federal and State Support division.
1537 Foster Care Payments During Absences From Foster Care Placements
CPS March 2021
During a temporary absence Title IV-E payments can only be made to a foster care placement for the entire month if both of the following are true:
- The child is only absent from the placement for 14 days or less.
- The child returns to the same foster care provider at the end of the temporary absence.
The Role of the DFPS Eligibility Specialist
The caseworker’s supervisor notifies the foster care eligibility specialist when an approved temporary absence situation exceeds 14 days. The eligibility specialist monitors the situation until the end of the temporary absence and updates the child’s Title IV-E eligibility status as described below.
- If the temporary absence period was 14 days or less and the child returned to the same foster care provider, the specialist continues the child’s eligibility as Title IV-E through the entire month.
- If the temporary absence period was more than 14 days and the child was returned to the same foster care provider, the specialist changes the following:
- The child’s selected eligibility to state-paid eligible effective the 15th day of the temporary absence.
- The child’s selected eligibility back to Title IV-E, effective the date when the child is placed back with the same foster care provider.
- If the child was not returned to the same foster care provider at the end of the temporary absence, DFPS cannot use Title IV-E funds to pay the provider during the temporary absence. Instead, DFPS uses state-paid funds to pay the provider from the beginning of the temporary absence through the date the child is discharged from the provider’s care. To ensure that state-paid funds are used for that period, the specialist does the following:
- Changes the child’s selected eligibility to state-paid effective the first day of the temporary absence.
- Ends the child’s state-paid eligibility effective the date of discharge from the foster care provider.
- When applicable, adds Medical Assistance Only (MAO) eligibility for the period between the discharge and the subsequent paid foster care placement.
- Changes the child’s selected eligibility back to Title IV-E effective the date of placement with the subsequent paid foster care placement.
See:
4280 Temporary Absence from Paid Placement
1538 Medicaid Benefits for Foster Care Children Placed in Texas From Other States
CPS March 2021
When a child who is eligible for Title IV-E is placed in Texas from another state and the sending state continues to pay for the child’s foster care with Title IV-E funds and the following processes are true:
- DFPS provides the child’s Medicaid benefits.
- The sending state provides DFPS with information about the child’s eligibility to receive Medicaid benefits through Title IV-E.
Authorizing Medicaid Benefits
The foster care eligibility specialist records the child’s eligibility as Medical Assistance Only (MAO) in the IMPACT case management system. The effective date of the child’s Medicaid coverage is the earliest date that both of the following are true for the child:
- He or she is eligible for Title IV-E payments for foster care while placed in Texas.
- He or she is not receiving Medicaid from another state.
Every 12 months, the eligibility specialist confirms whether the child is still eligible for DFPS foster care Medicaid by verifying with the caseworker that the sending state continues to make Title IV-E foster care payments to the child’s caregiver.
If the child continues to be eligible, the foster care eligibility specialist records a new eligibility date for the child in IMPACT. An IMPACT review of the child’s foster care is not needed to recertify children for continued Medicaid eligibility.
For More Information
See 4520 Placing Children From Another State in Texas for more information about what to do when a public agency in another state requests that a child who is abused or neglected be placed into foster care in Texas.
1539 Medicaid Benefits for Foster Care Children Placed Out of State
CPS March 2021
Title IV-E Foster Care Payments
When a child in DFPS conservatorship who is eligible for Title IV-E is placed in another state and DFPS continues to pay for the child’s foster care with Title IV-E funds the following are true:
- The receiving state becomes responsible for providing the child’s Medicaid benefits.
- DFPS provides the receiving state with information about the child’s eligibility to receive Medicaid through Title IV-E.
After the receiving state approves the child’s placement and the child has been placed, the following steps are taken to arrange for the receiving state to provide the child’s Medicaid coverage:
- The caseworker completes the Interstate Compact Placement Status Report (Form ICPC 100-B) in IMPACT no later than seven business days after the child is placed.
- The caseworker submits Form 100-B to his or her supervisor for approval.
- After the supervisor approves Form 100-B, it is assigned by the caseworker through IMPACT to the regional ICPC coordinator and then to the Texas Interstate Compact Office (TICO).
- TICO prints out Form ICPC 100-B from IMPACT and sends it to the receiving state’s Interstate Compact for the Placement of Children (ICPC) office.
- The caseworker notifies the foster care eligibility specialist that the child has been placed and that the receiving state will be providing Medicaid coverage.
- The eligibility specialist changes the child’s Medicaid type to None in IMPACT, which allows DFPS to continue making Title IV-E payments to the child’s caregiver but ends the child’s DFPS foster care Medicaid.
No Title IV-E Foster Care Payments
When Title IV-E payments will not be made while a child in DFPS conservatorship is placed in another state, DFPS continues to provide both Medicaid benefits and foster care payments, as applicable.
DFPS will continue to provide Medicaid for children placed in another state until the child receives Medicaid from the receiving state. The Medicaid is based on Texas Medicaid rates, and the medical provider must apply and be approved as a Texas Medicaid provider. The caregiver may need to apply for Medicaid on behalf of the child in the receiving state. Some states will not approve Medicaid if the child is in the custody of another state.
State-Paid Foster Care
If DFPS is paying for the foster care of a child who is eligible for state-paid care, the foster care eligibility specialist records the child’s selected eligibility as State-Paid in IMPACT.
MAO Foster Care
If DFPS is not making foster care payments, the foster care eligibility specialist changes the child’s selected eligibility to Medical Assistance Only (MAO)in IMPACT. This applies to children who are eligible for both Title IV-E and state-paid care.
Ending the Child’s Eligibility
The eligibility specialist ends the child’s eligibility for DFPS foster care Medicaid or equivalent coverage in IMPACT only if either of the following occur:
- The specialist is later notified that the child is receiving Medicaid in the receiving state.
- The legal responsibility of DFPS is terminated.