TX HHS Form 3621. CLASS or CFC Individual Plan of Care

The TX HHS Form 3621, CLASS or CFC Individual Plan of Care, is a crucial document that helps individuals with disabilities develop a personalized plan for receiving community-based services. This form is typically used in situations where an individual requires ongoing support to maintain their independence and quality of life.

This form outlines the necessary information for creating a comprehensive plan, including the effective date, enrolled from code, direct services agency, and estimated annual cost. The document also highlights key features such as the type of backup plan and service category. Additionally, it includes space for recording specific therapies, such as massage therapy or recreational therapy.

This form is essential for individuals with disabilities to receive the necessary support and services to maintain their independence. By filling out this form, individuals can ensure that they receive the right level of care and support to meet their unique needs. Key points to note include:

• The effective date and period of the plan
• The type of backup plan and service category
• The estimated annual cost of services
• The specific therapies required, such as massage therapy or recreational therapy