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 modifications to their living space under the YES waiver program. This form helps solve the problem of ensuring that participants' homes are safe and accessible by facilitating minor home modifications.

The form typically requires information from the participant, including their name, comprehensive waiver provider, wraparound facilitator, and wraparound supervisor. Additionally, it asks for property information, such as whether the participant leases their living space and obtains approval from the landlord if necessary. The requested service section outlines the description and cost of the proposed modification, as well as the reason for referral to the YES waiver program.

This form is used in situations where participants require minor home modifications to ensure their safety and accessibility. Key features include required information such as participant details and property information, as well as conditions like obtaining approval from landlords if necessary. By completing this form, participants can initiate the process of modifying their living space to better meet their needs.

• This form is used for individuals seeking minor home modifications under the YES waiver program.
• The form requires participant information, property details, and requested service descriptions.
• Obtaining approval from landlords may be necessary if participants lease their living space.