11/2019
Page 17
H1010
Application for benefits
Texas Health and Human Services Commission
Legal
Information
Section U
Legal information
Your Right to be Treated Fairly
This institution is prohibited from discriminating on the
basis of race, color, national origin, disability, age, sex
and in some cases religion or political beliefs.
The U.S. Department of Agriculture also prohibits
discrimination based on race, color, national origin, sex,
religious creed, disability, age, political beliefs or
reprisal or retaliation for prior civil rights activity in any
program or activity conducted or funded by USDA.
Persons with disabilities who require alternative means
of communication for program information (e.g. Braille,
large print, audiotape, American Sign Language, etc.),
should contact the Agency (State or local) where they
applied for benefits. Individuals who are deaf, hard of
hearing or have speech disabilities may contact USDA
through the Federal Relay Service at (800) 877-8339.
Additionally, program information may be made
available in languages other than English.
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Social Security number:
Medicaid and Temporary Assistance for
Needy Families
To file a complaint of discrimination regarding a
program receiving Federal financial assistance through
the U.S. Department of Health and Human Services
(HHS), write: HHS Director, Office for Civil Rights,
Room 515-F, 200 Independence Avenue, S.W.,
Washington, D.C. 20201 or call (202) 619-0403 (voice)
or (800) 537-7697 (TTY).
This institution is an equal opportunity provider.
You also can file a complaint with the Texas Health and
Human Services Commission, Civil Rights Office.
Email HHSCivilRightsOffice@hhsc.state.tx.us, call
1-888-388-6332, fax (512) 438-5885, or write Texas
Health and Human Services Commission, Civil Rights
Office, 701 W. 51st St., MC W206, Austin, Texas
78751.
Citizenship and Immigration Status
You can get benefits for your children who are U.S.
citizens or legal immigrants even if you are not a U.S.
citizen or a legal immigrant. You do not have to give
your citizenship or immigration status to get benefits for
your children. You only have to give the citizenship or
immigration status of people who want benefits. If you
are not a U.S. citizen or a legal immigrant, the only
benefits you might be able to get are emergency
Medicaid services. Getting long-term care (Medicaid for
the Elderly and People with Disabilities) or cash help
(TANF) could affect your immigration status and your
chances of getting a Permanent Resident Card (green
card). Getting other benefits will not affect your
immigration status and your chances of getting a
Permanent Resident Card. You might want to talk to an
agency that helps immigrants with legal questions
before you apply. If you are a refugee or have been
given asylum, getting benefits will not affect your
chances of getting a Permanent Resident Card or
becoming a citizen.
Social Security Numbers
You only need to give the Social Security numbers
(SSNs) for people who want benefits. Giving or
applying for an SSN is voluntary; however, anyone who
doesn’t apply for an SSN or doesn’t give an SSN can’t
get benefits. If you don’t have an SSN, we can help you
apply for one if you are a U.S. citizen or a legal
immigrant. You must be a U.S. citizen or a legal
immigrant to get an SSN. You can get benefits for your
children if they have an SSN and you don’t. We will not
give SSNs to the Bureau of Immigration and Customs
Enforcement. We will use SSNs to check the amount of
money you get (income), if you can get benefits, and
the amount of benefits you can get. (7 C.F.R 273.6 for
food benefits; 45 C.F.R 205.52 for TANF; and 42 C.F.R
435.910 for health care.)
Supplemental Nutrition Assistance
Program (SNAP)
To file a program complaint of discrimination, complete
the USDA Program Discrimination Complaint Form,
(AD-3027), found online at:
http://www.ascr.usda.gov/complaint_filing_cust.html,
and at any USDA office, or write a letter addressed to
USDA and provide in the letter all of the information
requested in the form. To request a copy of the
complaint form, call (866) 632-9992. Submit your
completed form or letter to USDA by:
(1) mail: U.S. Department of Agriculture
Office of the Assistant Secretary
for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410
(2) fax: (202) 690-7442; or
(3) email: program.intake@usda.gov
For any other information dealing with Supplemental
Nutrition Assistance Program (SNAP) issues, persons
should either contact the
USDA SNAP Hotline Number at (800) 221-5689, which
is also in Spanish or call the State Information/Hotline
Numbers (click the link for a listing of hotline numbers by
State); found online at:
http://www.fns.usda.gov/snap/contact_info/hotlines.htm.