TX HHS Form 2101. Authorization for Community Care Services

The TX HHS Form 2101, Authorization for Community Care Services, is a crucial document that enables individuals to authorize community care services for their personal needs. This form helps solve the problem of securing necessary support services for daily living activities, such as bathing, feeding, and grooming, by providing a standardized authorization process.

The form requires essential information from the individual seeking services, including name, date, contract number, and provider address. It also outlines specific service items that can be authorized, with options ranging from personal assistance services like bathing and toileting to meal preparation and shopping. The form emphasizes the importance of case management, with space for authorizing agents, case managers, and nurse contacts.

This form is typically used in situations where individuals require community care services to maintain their independence and quality of life. Key features include required information fields, specific service items, and designated spaces for case manager and agency contact information. By completing this form, authorized agencies can initiate services and ensure that necessary support is provided to individuals who need it most.

• The TX HHS Form 2101 is used to authorize community care services for personal assistance needs.
• The form requires essential information from the individual seeking services.
• It outlines specific service items that can be authorized, including personal assistance services and meal preparation.
• The form emphasizes case management with designated spaces for authorizing agents, case managers, and nurse contacts.