Texas Health and Human Services
SAH 21-1, Appendix II
On-Site Security Review
Local/Benefit Office Address: Review Date:
EBT Site Coordinator: Last Review:
EBT Site Coordinator Backup: Reviewer:
Program Manager: Review Months:
Office Security Procedures
[Reference in brackets] Yes No N/A If no, explanation or comments
1. Did the local benefit office follow Electronic Benefit
Transfer (EBT) procedures, including regional
procedures?
2. Was the Local Office Security Plan (LOSP) updated
to reflect current staff and permissions?
3. Were EBT permissions for staff listed on the LOSP
consistent with the level of access of their assigned
position in EBT?
4. Was there a current contingency plan and location
for EBT issuance in the LOSP?
5. Are staff aware of special procedures for home-visit
advisors who handle Lone Star cards and are they
being followed? [Form H1172, EBT Card, PIN and
Data Entry Request, and Form H1173, EBT Card
Issuance and PIN Self-Selection/Issuance Log,
Instructions, Texas Works Handbook (TWH) B-233]
6. Were special EBT Issuance procedures for home-
visits followed? [Form H1172 and Form H1173
Instructions, TWH B-233]
7. Were separation of duties for ordering, receiving,
storing, issuing and accounting for Lone Star Cards
followed?