TX HHS Form 2749. Submitting an Application Packet for a Treatment Decision

TX HHS Form 2749, "Submitting an Application Packet for a Treatment Decision," helps individuals or their surrogates request treatment decisions from the Texas Health and Human Services (HHS) Consent Committee. This form is used in situations where medical treatment is required, but the individual lacks capacity to provide informed consent.

The application packet requires submission of several forms, including Form 2700, "Application for a Treatment Decision by a Surrogate," and certification of need forms depending on the type of treatment decision requested. Additionally, supporting documentation such as lab work, EKG, and chest x-ray results must be included. For psychoactive medication or highly restrictive procedure requests, specific requirements include a written statement from the prescribing physician, cumulative medication history, and social history.

Key features of this form include the requirement for separate applications and certifications of need when submitting multiple treatment decisions. The form also emphasizes the importance of documenting previous attempts at less restrictive behavioral alternatives and their results. By completing Form 2749, individuals or their surrogates can request treatment decisions that align with their needs and goals.

• Used to request treatment decisions from the Texas HHS Consent Committee
• Requires submission of multiple forms and supporting documentation
• Specific requirements for psychoactive medication or highly restrictive procedure requests
• Emphasizes documenting previous attempts at less restrictive behavioral alternatives