TX HHS Form 3038. Childrens Autism Program Family Cost Share Attestation Worksheet

The TX HHS Form 3038, Children's Autism Program Family Cost Share Attestation Worksheet, is a crucial tool for determining the cost share of families seeking services under the Texas Health and Human Services (HHS) Children's Autism Program. This form helps solve the problem of accurately calculating the family's annual income and deductions to determine their cost share.

The form requires families to provide information on their gross income, including wages, alimony, and other forms of income, as well as allowable deductions such as medical expenses not covered by insurance. The form also includes sections for child and other income types, as well as a section for the family's parent or guardian to attest that the information provided is correct.

This form should be used when a family seeks services under the Texas HHS Children's Autism Program and needs to determine their cost share. It is essential to complete this form accurately, as it will impact the family's financial responsibility for program services. The form must be signed by the parent or guardian attesting that the information provided is correct.