TX HHS Form 3629. Individual Program Plan Addendum

The TX HHS Form 3629, Individual Program Plan Addendum, is a tool used to supplement an individual's existing program plan in the Community Living Assistance and Support Services (CLASS) or Community First Choice (CFC) programs. This form helps solve the problem of updating or revising an individual's program plan by providing additional information and goals.

The addendum requires the individual's name, Medicaid number, and type of assessment (enrollment, renewal, or revision). It also includes a section for the individual to provide a one-page profile, which can include a photo. This profile serves as an opportunity for the individual to share what they like and admire about themselves, providing a personal touch to their program plan.

This form should be used when updating or revising an individual's existing program plan in the CLASS or CFC programs. It is essential to complete this addendum with accurate information, including the required fields and any relevant details that may impact the individual's program goals. By using the TX HHS Form 3629, Individual Program Plan Addendum, program administrators can ensure that an individual's program plan remains up-to-date and effective in supporting their needs.