County Indigent Health Care Program

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The County Indigent Heath Care Program (CIHCP) provides health care services to eligible residents through the counties, hospital districts and public hospitals in Texas.  

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.

NOTE TO CLIENTS: Applications for the County Indigent Health Care Program must be filed at your local office.

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Find your local office  Handbook
Information Pamphlet  Forms and Instructions
Eligibility Criteria Training Opportunities
Basic and Optional Health Care Services  Payment Rate Information

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Frequently Asked Questions

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.  

Report on Intergovernmental Transfers by County Indigent Health Care Programs  - December 2014


Texas Department of State Health Services
Community Health Services
Primary Care Group MC- 2831
PO Box 149347
Austin, TX 78714-9347
Phone: (512) 776-7796
Fax: (512) 776-7203
Email: County Indigent Health Care Program

Last updated April 09, 2015