SECTION 31.22. Recipient Eligibility Requirements

(a) An individual shall be eligible to receive services when the individual receives local agency approval after meeting all of the following requirements.

(1) Be determined categorically eligible.

(A) If a woman, be pregnant or not more than six months postpartum if not breastfeeding or within one year postpartum if breastfeeding; or

(B) If a child, be under age five.

(2) Physically reside within the State.

(A) The applicant shall provide documentation of residency within the local agency's approved service area.

(i) The following documents shall be accepted as documentation of residency: utility bill; credit card bill; rent receipt; rental agreement; business letter from an office other than the local agency; other bills; letter from the person the applicant lives with accompanied by documentation of that person's address; voter registration card; property tax receipt; documentation by a third party such as the staff of a church, social service agency, legal-aid society, school, or a public health official, nurse, doctor, or elected public official; homeless facility documentation; or documentation of adjunctive income eligibility.

(ii) If none of the documents referenced in this section exists, an applicant may provide a map indicating where the applicant lives.

(iii) A homeless individual may complete a WIC Program affidavit stating he or she is homeless or is the parent, caretaker, or guardian of a homeless applicant.

(B) If residency has been documented for another family member within the 60-day period prior to application, that documentation shall be sufficient for meeting the residency requirement.

(3) Meet the income requirements as follows:

(A) Income guidelines shall not exceed 185% of the federal poverty income guidelines.

(B) Applicants shall provide documentation of the amount of current income received by each member of the family or separate economic unit within a family at each certification and subsequent certification as authorized by federal WIC regulations at 7 CFR §246.7.

(C) Acceptable documentation of income are: check stubs stating current earnings; United States Internal Revenue Service form W-2 if less than 90 days old at the time of application and if reflective of current income; a signed statement from the employer; completion of WIC Program affidavit allowed in specific circumstances such as for homeless or those with no income; completion of WIC Program affidavit for self-employed individuals with no business accounting records or who are paid in cash and whose employer will not provide documentation of income; bankbook, if reflective of current income; current federal tax records; income receipt book or other accounting records if self-employed; foster child placement letter; other documentation which the local agency requests to use and which has been approved by the state agency; and the placement letter from the welfare agency legally responsible for a foster child.

(i) Only one document no more than 60 days old which accurately reflects the applicant's income from each source is required, unless the applicant only receives such documentation annually, such as a Social Security Award letter.

(ii) Instream migrant farmworkers and their families are required to provide documentation of meeting the income requirements only once every 12 months.

(D) Certain applicants shall be deemed adjunctively income eligible as follows.

(i) Applicants who are fully eligible to receive Food Stamps benefits or who are fully eligible or presumptively eligible to receive Temporary Assistance to Needy Families benefits or Medicaid benefits.

(ii) Applicants who are members of families in which one other member is fully eligible or presumptively eligible to receive Temporary Assistance to Needy Families benefits.

(iii) Applicants who are members of families in which a pregnant woman or infant is fully eligible or presumptively eligible to receive Medicaid benefits.

(iv) Applicants shall provide documentation from one of the following categories as proof of their status as adjunctively income eligible:

(I) The applicant shall provide written documentation from the other benefit program which shows current eligibility in the benefit program at the time of application to the WIC Program.

(II) The applicant may grant permission for the local agency to conduct a phone or computer on-line verification from the benefit program on behalf of the client when the local agency has the capability to do so.

(v) Applicants eligible to receive Food Stamp benefits shall provide documentation that the applicant himself or herself is fully eligible to receive such benefits.

(vi) Applicants applying as adjunctively income eligible based on receipt of Food Stamps by a family member as head of household shall provide documentation that the person named as head of household for Food Stamps purposes is a member of the applicant's family and is fully eligible to receive such benefits.

(vii) Applicants eligible to receive Temporary Assistance to Needy Families or Medicaid shall provide documentation that the applicant himself or herself is fully or presumptively eligible to receive such benefits.

(viii) Applicants applying as adjunctively income eligible based on a family member's eligibility to receive Temporary Assistance to Needy Families or Medicaid shall provide documentation of the family member's receipt of such benefits and that the recipient is a member of the applicant's family.

(ix) Applicants eligible for adjunctive income eligibility shall verbally declare their total gross family income or net income if self-employed.

(E) Income eligibility shall be based on the total income of the family.

(F) When determining an applicant's income eligibility for WIC Program services, the local agency shall determine the size of the applicant's family as follows:

(i) All family members shall be counted except for individuals who qualify as a member of a separate economic unit.

(I) A pregnant woman shall be counted as more than one person according to the number of children she expects to give birth to. If she is expecting one child, she shall be counted as two individuals; if she is expecting twins, she shall be counted as three individuals and so on.

(II) A foster child shall be considered a separate family of one.

(ii) Persons temporarily absent from the family may be counted if the following circumstances exist:

(I) other members still consider the family to be the principal residence of the absent member;

(II) the absence does not exceed six months;

(III) the absence is for a purpose such as school, training, employment, hospitalization, or institutionalization; and

(IV) the absent member continues to exercise customary family responsibilities such as income, planning, or physical care.

(G) Some individuals may qualify as a separate economic unit as an exception if the unit has an adequate source of income and usually purchases and prepares food separately from other persons who live in the same dwelling or the unit intends after certification to purchase and prepare food separately from other persons who live in the same dwelling. The following shall not be certified as a separate economic unit:

(i) minor children who live with their parent or parents;

(ii) a child under age 18 who lives with family members who serve as managing conservators and provide more than half of the child's support, and the family members state that the child is under parental control;

(iii) spouses; or

(iv) two people who live together and represent themselves to the community as husband and wife.

(H) Individuals who have been determined eligible for WIC Program services are not required to report changes in income during certification periods.

(i) The local agency has no responsibility to monitor the continued income eligibility of the participant during the certification period.

(ii) If the local agency becomes aware of changes in income during a certification period, the participant shall be reassessed for income eligibility under the rules for determining income eligibility.

(4) Have one or more nutritional risk conditions as defined by the United States Department of Agriculture's national nutritional risk codes and conditions, nutritional risk priorities, and nutritional risk priority system.

(A) At subsequent certification, if there is a possibility of regression in nutritional status without WIC nutrition education and supplemental foods, an applicant may be determined at nutrition risk for regression by the competent professional authority.

(B) Regression shall be used only at a subsequent certification and only when no other risk condition can be determined.

(C) Applicants may be certified for regression for one certification period only.

(5) Be physically present at the initial WIC Program certification and the subsequent certification:

(A) Exceptions may be granted in limited circumstances if approved by the competent professional authority as follows.

(i) Newborn infants may be certified without being physically present if all required documentation is available, the local agency has elected to implement this practice, and the infant is physically presented to the local agency by the time the infant is six weeks of age.

(ii) An applicant or parent, caretaker, or guardian of an applicant who is an individual with a disability may be certified without being physically present because he or she is unable to be physically present because of his or her disability.

(I) Disability conditions which meet this standard are a medical condition that necessitates the use of medical equipment that is not easily transportable; a medical condition that requires confinement to bed rest; or a serious illness that may be exacerbated by coming into the local agency.

(II) A verbal declaration by the applicant or parent, caretaker, or guardian of the applicant that the applicant has a disability and cannot be physically present is sufficient to request the exception.

(iii) An infant, other than a newborn infant, or child may be certified without being physically present if being physically present would present an unreasonable barrier and the infant or child has documented ongoing health care from a health care provider other than the WIC local agency.

(iv) An infant, other than a newborn infant, or child may be certified without being physically present if the infant or child was physically present at a WIC Program certification or subsequent certification within the one-year period which ended on the date the infant or child was last certified or subsequently certified and the infant or child is under the care of one or more working parents, caretakers, or guardians who verbally declare that their working status presents a barrier to bringing the infant or child to the WIC local agency.

(B) Exemptions may be granted for one certification period, or for an extended period of time if the competent professional authority approves the extended period of time.

(6) Provide documentation of identification:

(A) The following documents shall be accepted as documentation of identification: birth certificate; hospital records, including a "crib" card, hospital wrist band, or discharge papers; baptismal certificate; marriage license; drivers license; WIC Family Identification Card; immunization card; school identification card; employment identification card; military identification card; official identification card with picture; passport or immigration records; letter from Medicaid, Food Stamps, Temporary Assistance to Needy Families, or the Supplemental Security Income Programs; indigent health care identification card; paycheck stub with imprinted name; voter registration card; identification card from another WIC local agency; Social Security card; housing or rental lease; loan papers from a bank or finance company; or property tax receipt.

(B) Each local agency may designate additional documents which shall be accepted as documentation of identification with the approval of the state agency.

(b) Citizenship is not a requirement for eligibility.

Source Note: The provisions of this §31.22 adopted to be effective August 5, 2001, 26 TexReg 5642; amended to be effective June 4, 2006, 31 TexReg 4428