The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise.

1. (1) Applicant--A person seeking assistance under the Medicaid for Transitioning Foster Care Youth Program (MTFCY) who:

   1. (A) has never received Medicaid and is not currently receiving Medicaid; or
   2. (B) previously received Medicaid but subsequently was denied and reapplies for Medicaid.
2. (2) Authorized representative--A person whom a budget group authorizes to apply for Medicaid benefits on behalf of a certified group but who is not included in the certified group.
3. (3) CFR--Code of Federal Regulations.
4. (4) Child--Any household member under 19 years of age.
5. (5) Countable income--The receipt of cash or its equivalent, either earned or unearned, that a person may directly or indirectly use to meet basic needs (such as food, clothing, and shelter), including TANF cash payments.
6. (6) Earned income--Compensation received from employment or job training, including military and flight pay, allowances for housing and food, and receipts from self-employment (but not receipts from ownership of property involving less than 20 hours of work per week, which are unearned income).
7. (7) Eligible group--A category of people who are eligible for MTFCY. In other Medicaid programs, an eligible group may be called a coverage group.
8. (8) Fair market value--The amount of money an item would bring if sold in the current local market.
9. (9) Federal Poverty Income Limit (FPIL)--The household income guidelines issued annually and published in the Federal Register by the U.S. Department of Health and Human Services. Percentages of these guidelines are used to determine income eligibility for MTFCY and certain other public assistance programs. In other programs, the FPIL may be referred to as the Federal Poverty Level or the Federal Poverty Guidelines.
10. (10) Medicaid--A state and federal cooperative program, authorized under Title XIX of the Social Security Act and the Texas Human Resources Code, that pays for certain medical and health care costs for people who qualify. Also known as the medical assistance program.
11. (11) Person acting responsibly--A person, other than a provider, who may apply for Medicaid on behalf of an individual who is incompetent or incapacitated if the person is determined by the Texas Health and Human Services Commission (HHSC) to be acting responsibly on behalf of the applicant.
12. (12) Recipient--A person receiving MTFCY services, including a person who is renewing eligibility for MTFCY.

13. (13) Resources--Cash (or its equivalent) and property that is convertible to cash (or its equivalent). Resources include:

    1. (A) cash from income that is not obligated in the month of receipt; and
    2. (B) lump sum payments that may be received intermittently and no more often than once annually.
14. (14) Retroactive coverage--Payment for Medicaid-reimbursable medical services received up to three months before the month of application.
15. (15) Texas Works Handbook--An HHSC manual containing policies and procedures used to determine eligibility for SNAP food benefits, TANF, and Medicaid programs for children and families. The Texas Works Handbook is found on the Internet at www.hhsc.state.tx.us/Programs/Programs.shtml#handbooks.
16. (16) Unearned income--Payments received without performing work-related activities, including benefits from other programs.
17. (17) U.S.C.--United States Code.

Source Note:The provisions of this §366.603 adopted to be effective June 9, 2010, 35 TexReg 4661.