TX HHS Form 3037.Good Faith Effort

The TX HHS Form 3037, Good Faith Effort, is a document used by HCBS-AMH Provider Agencies to demonstrate their ongoing efforts in securing critical services for individuals in the Adult Mental Health (HCBS-AMH) Program. This form helps solve the problem of identifying and justifying the clinical need for missing critical services that are essential for maintaining successful placement in the community.

The form requires HCBS-AMH Provider Agencies to list the service(s) they are unable to secure, provide justification for the clinical need, and document their provider outreach and recruitment efforts. The chart below must be completed for each missing critical service identified, with a minimum of three good faith efforts demonstrated. This information is crucial in establishing and maintaining the HCBS-AMH service array.

This form should be used by HCBS-AMH Provider Agencies when they are unable to provide critical services directly or through subcontracting. The form must be completed for each missing critical service, providing a detailed description of recruitment efforts and outcomes. By completing this form, providers can demonstrate their commitment to securing the necessary services for individuals in the Adult Mental Health (HCBS-AMH) Program.