TX HHS Form 3024. Respite Relative Provider

The TX HHS Form 3024, Respite Relative Provider, is a crucial document that helps solve the problem of providing respite services to adult mental health participants. This form is used in situations where a relative of the participant other than the natural or adoptive parents or legally authorized representative (LAR) provides respite services. The form is typically completed by the respite provider (relative) and requires specific information such as individual name, CARE ID number, date of birth, county of service, and LAR name if applicable.

The form outlines key features that are essential for providing respite services. These include meeting required qualifications, being documented on the Individual Recovery Plan (IRP) as a respite provider, and providing services in accordance with an active IRP. The form also emphasizes the importance of obtaining signatures from the individual or LAR after the provision of respite services, indicating the date(s), time, duration, and total units provided.

Key points to note when using this form include:

• The HCBS-AMH relative respite provider may only submit a claim for one unit of service per calendar day.
• The form must be completed by the respite provider (relative) and signed by the individual or LAR after the provision of respite services.
• The reporting period is from the first day of the month through the last day of the month.