TX HHS Form 3044. Home and Community Based Services Adult Mental Health (HCBS-AMH) Settings Checklist

The TX HHS Form 3044, "Home and Community Based Services Adult Mental Health (HCBS-AMH) Settings Checklist," is a tool used to assess the suitability of home settings for providing adult mental health services. This biennial report helps identify any concerns or heightened scrutiny requirements for HCBS-AMH participants.

This form requires provider information, including street address, city, state, and ZIP code, as well as type of setting, such as supervised living, assisted living, or Type A or B facilities. Providers must also indicate if their setting meets the 4:1 ratio of residents to staff and whether it is located in an isolated remote or rural area.

The form's walk-through section allows for a comprehensive assessment of the home setting, including integration with the community and safety considerations. This section evaluates factors such as door locks, participant mobility, and environmental adaptations. The checklist helps identify potential issues and provides guidance and feedback to providers to ensure compliance with HCBS-AMH requirements.