TX HHS Form 3088. Request for State Assistance Funds (90 Percent)

The TX HHS Form 3088, "Request for State Assistance Funds (90 Percent)", is a crucial document used to request reimbursement from the State Assistance Fund for health care services provided under the County Indigent Health Care Program. This form should be completed by counties that have paid for health care services and wish to receive 90% of their spending reimbursed.

The form requires key information, including the state assistance request number, county name, county vendor ID number, and amount requested (which is 90% of the county's spending). The payee must also acknowledge that they will repay any funds paid in error and agree to the state's authority to collect such funds. The form must be submitted by the end of August 31, 2020.

This form is essential for counties participating in the County Indigent Health Care Program (Chapter 61, Health and Safety Code) to receive reimbursement for health care services provided. By completing this form, counties can ensure that they receive the necessary funds to continue providing vital health care services to their residents.