County Indigent Health Care Program Information

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Chapter 61, Health And Safety Code,
defines the responsibilities of counties, hospital districts, and public hospitals in providing health care to eligible residents who are considered indigent.

Texas Administrative Code, Title 25, Part 1, Chapter 14 establishes the County Indigent Health Care Program (CIHCP) rules regarding program administration, determining eligibility, and providing services.

Counties that are not fully served by a public facility, i.e., a hospital district or a public hospital, are responsible for administering an indigent health care program for eligible residents of all or any portion of the county not served by a public facility.

Hospital districts and public hospitals are required to establish an application procedure and provide health care to eligible residents who reside in the hospital district's or public hospital's service area and meet the minimum resource and income limits.

The Texas Department of State Health Services (DSHS):

  • Establishes minimum eligibility standards and application, documentation, and verification procedures that are consistent with the analogous procedures used to determine eligibility in the Temporary Assistance for Needy Families (TANF)-Medicaid program and that the counties should use in determining CIHCP eligibility,

  • Defines the basic and department-established optional health care services in accordance with the TANF-Medicaid program,

  • Establishes the payment standards for basic and DSHS-established optional health care services in accordance with the TANF-Medicaid program,

  • Provides technical assistance and training to counties, hospital districts, and public hospitals,

  • Processes eligibility disputes between providers of health care assistance and governmental entities or hospital districts, and

  • Administers the state assistance fund. Counties may qualify for state assistance funds when they exceed 8% of the county’s general revenue tax levy (GRTL) for basic and DSHS-established optional health care services provided to eligible county residents.  

Spending Data

In order to receive money from the State Assistance Fund, counties are required to report their monthly Indigent Health Care expenditures to DSHS. Click here to see the annual summaries of those reports and the disbursements from the State Assistance Fund.

You may also wish to read answers to Frequently Asked Questions on our FAQ

Last updated August 07, 2012