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 develop a personalized plan for receiving Community Living Assistance and Support Services (CLASS) or Community First Choice (CFC) services. This form should be used when an individual requires assistance with daily living activities, such as healthcare, personal care, or homemaker services.

The form requires the following information: LOC Effective Date, IPC Effective Period, Enrolled from Code, and Type of Service. It also includes sections for estimating annual costs and specifying service categories. The form is designed to help individuals, caregivers, or authorized representatives create a comprehensive plan that outlines the necessary services and support required to maintain their independence.

This form is particularly useful in scenarios where an individual requires ongoing support with daily living activities, such as those with disabilities, chronic illnesses, or aging populations. By using this form, individuals can ensure they receive the appropriate services and support to meet their unique needs and improve their overall quality of life.