TX HHS Form 3206. Chemical Dependency Treatment Facility Closure

The TX HHS Form 3206, Chemical Dependency Treatment Facility Closure, is a crucial document that helps facilities notify the Texas Health and Human Services (HHS) of their closure. This form ensures that facilities complete necessary steps before shutting down, including returning licensure certificates, making client transfers, and storing confidential records.

The form requires facilities to provide essential information about their closure, such as facility name, headquarters address, and effective date of closure. Facilities must also indicate the type of closure, whether it is a headquarters or licensed site closure, and provide the license number if applicable. The CEO, clinical program director, or facility contact must sign and attest to completing specific steps before closing.

Key features of this form include the requirement for facilities to return licensure certificates, make client transfers and referrals, and store confidential records for six years as per Texas Administrative Code Title 26 (26 TAC) Section 564.508(h. Facilities must also pay outstanding fees in full to HHSC if applicable. The following are key points to consider:

• The form is used by chemical dependency treatment facilities that need to notify HHS of their closure.
• The facility must provide information about its name, headquarters address, and effective date of closure.
• The CEO, clinical program director, or facility contact must sign and attest to completing specific steps before closing.