TX HHS Form 2064. Eligibility Worksheet

The TX HHS Form 2064, Eligibility Worksheet, is an essential tool for determining eligibility for Community Care for Aged and Disabled (CCAD) services. Issued by the Texas Health and Human Services (HHS), this form helps assessors evaluate applicants' age, need, and financial criteria to authorize service(s). The worksheet provides a structured approach to evaluating eligibility, ensuring accurate and efficient processing.

The Form 2064 guides users through a series of questions and calculations to determine categorical eligibility, income eligibility, or financial ineligibility. It also includes spaces for recording excess resources and income, as well as referral information for Alternative Assistance Arrangements (AAA). The form's sections are designed to facilitate the verification process, ensuring that applicants' needs are accurately assessed and services are authorized accordingly.

This comprehensive worksheet is a crucial component of the CCAD application process. By using the Form 2064, assessors can confidently determine eligibility for CCSE services, while also providing essential information on rights and responsibilities to applicants. The form's clear structure and logical flow make it an invaluable resource for HHS staff, ensuring that applications are processed efficiently and accurately.