TX HHS Form 1041. Refusal of PASRR Mental Illness Specialized Services

The TX HHS Form 1041, Refusal of PASRR Mental Illness Specialized Services, is a crucial document for individuals who have been admitted to a nursing facility and are in need of mental illness specialized services. This form helps solve the problem of ensuring that individuals receive the necessary support and services to improve their quality of life and community participation.

This form is typically used in situations where an individual has been offered PASRR Mental Illness Specialized Services, but has declined or does not wish to participate at this time. The form requires the individual's name, contact information, and a statement acknowledging that they have visited with a Local Mental Health Authority (LMHA) or Local Behavioral Health Authority (LBHA) provider and discussed their options. The individual must also indicate that they do not want to receive additional information at this time.

The form outlines the responsibilities of the LMHA/LBHA, including offering to discuss PASRR MI specialized services with the individual every month for three months, and providing an annual meeting where the services may be offered again. The individual can request specialized services at any time by contacting the LMHA/LBHA provider listed on the form. Key points to note include:

• The individual's right to refuse PASRR MI specialized services
• The LMHA/LBHA's responsibility to offer additional information and services every month for three months
• The annual meeting where PASRR MI specialized services may be offered again
• The individual's ability to request specialized services at any time