TX HHS Form 2813. Youth Empowerment Services (YES) Waiver Minor Home Modification (MHM) Request

The TX HHS Form 2813, "Youth Empowerment Services (YES) Waiver Minor Home Modification (MHM) Request", is a crucial document for individuals seeking to modify their living space under the YES Waiver program. This form helps solve the problem of requesting minor home modifications that are necessary for a participant's well-being and quality of life.

The form requires essential information, including participant details such as name, wraparound provider organization, and comprehensive waiver provider. Additionally, it asks about property information, specifically whether the participant leases their living space, and if so, obtains approval from the landlord. The requested service section outlines the description and cost of the proposed modification, along with the reason for referral to the YES Waiver program.

This form should be used when a participant in the YES Waiver program requires minor home modifications to ensure their continued participation and success. The conditions explicitly mentioned include obtaining approval from the property owner if the participant leases their living space. By completing this form, participants can request the necessary modifications to create a more suitable environment for their needs.