TX HHS Form 1720. Appointment of a Designated Representative

The Texas Health and Human Services (HHS) Form 1720, "Appointment of a Designated Representative," is used by employers to designate an individual to make decisions on behalf of a person receiving consumer-directed services. This form is essential for ensuring the proper authorization and management of services.

This document outlines the requirements for appointing a designated representative (DR) who is not a relative, including obtaining information needed to request a criminal conviction check with the Department of Public Safety. The DR must also acknowledge permission for the financial management services agency (FMSA) to obtain this check. Additionally, the form ensures that the appointed DR meets eligibility requirements outlined in Texas Health and Safety Code Section 250.006(a) and (b).

The Form 1720 is a crucial tool for employers seeking to appoint a non-relative designated representative. By using this form, employers can ensure compliance with Department of Public Services rules and regulations, as outlined in the Texas Administrative Code Chapter 26, Consumer Directed Services (CDS), Section 264.205. This form is an essential part of the consumer-directed services process and helps to facilitate efficient and effective service delivery.