TX HHS Form 3041. MH Adult Uniform Assessment for Texas Resilience and Recovery

The TX HHS Form 3041, MH Adult Uniform Assessment for Texas Resilience and Recovery, is a crucial tool for healthcare professionals to assess the needs and strengths of adult patients. This form helps solve the problem of determining the appropriate level of care for individuals experiencing mental health crises or requiring ongoing treatment. Typically filled out by Licensed Professional Counselors (LPCs) or Qualified Mental Health Professionals (QMHP), this assessment is used in situations where patients require crisis intervention, initial evaluation, updates, or discharge planning.

The form requires key information such as the patient's age, ANSA Assessment Date, and Calculated Level Of Care-Recommendation (LOC-R). The Provider Recommended Deviation (LOC-D) section allows for adjustments to be made based on individual circumstances. Section 2: Authorized Level of Care (LOC-A) is completed by LMHA Utilization Management Staff, outlining the authorized level of care and any deviations from the recommended level.

Key features of this form include the ANSA Assessment Date, Calculated Level Of Care-Recommendation (LOC-R), and Provider Recommended Deviation (LOC-D). The form also includes spaces for notes and comments. It is essential to follow the instructions provided in the help file for instances when a note for reason for deviation is required. This form plays a critical role in ensuring that patients receive the appropriate level of care, and its proper completion can have a significant impact on their recovery.

• This form is used in situations where patients require crisis intervention, initial evaluation, updates, or discharge planning.
• The form requires key information such as patient age, ANSA Assessment Date, and Calculated Level Of Care-Recommendation (LOC-R).
• The Provider Recommended Deviation (LOC-D) section allows for adjustments to be made based on individual circumstances.