TX HHS Form 3023. Notification of Participant Rights

The TX HHS Form 3023, Notification of Participant Rights, is a crucial document for individuals participating in the Adult Mental Health (HCBS-AMH) Program. This form helps participants understand their rights and responsibilities within the program.

This form requires essential information from the participant, including their name, CARE ID number, date of birth, county of service, and legally authorized representative (LAR) details if applicable. It also provides important contact information for reporting allegations of Abuse, Neglect, and/or Exploitation (ANE), filing grievances or complaints, and requesting a Medicaid fair hearing.

The form should be completed by the participant and/or their LAR when joining the HCBS-AMH Program. This notification ensures that participants are aware of their rights and have access to necessary resources and support throughout their participation in the program.