TX HHS Form 3023. Notification of Participant Rights

The TX HHS Form 3023, Notification of Participant Rights, is a crucial document that helps individuals participating in the Adult Mental Health (HCBS-AMH) Program understand their rights and responsibilities. This form is typically completed by participants or their legally authorized representatives (LARs) to acknowledge receipt of important information about their program participation.

This notification form outlines key aspects of participant rights, including the ability to report allegations of abuse, neglect, and exploitation (ANE), file grievances or complaints, and request a Medicaid fair hearing. The document also provides contact information for relevant agencies, such as the Department of Family and Protective Services and the Texas Health and Human Commission's Consumer Services and Rights Protection.

The TX HHS Form 3023 is an essential tool for ensuring that participants in the HCBS-AMH Program are informed about their rights and responsibilities. By completing this form, individuals can take advantage of the protections and services offered by the program. Key points to note include:

• Reporting allegations of ANE: 1-800-252-5400 or www.txabusehotline.org
• Filing grievances or complaints: 1-800-252-8154 or mail to HHSC Office of Consumer Services and Rights Protection
• Requesting a Medicaid fair hearing: 1-800-252-8154 or mail to HHSC Office of Consumer Services and Rights Protection