TX HHS Form 3708. Regulatory Services NF. ALF and ICF/IID Amelioration Request

The TX HHS Form 3708, "Regulatory Services NF. ALF and ICF/IID Amelioration Request", is a document used to request amelioration for non-compliance issues in Adult Foster Care (ALF) and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID). This form helps facilities address specific problems or violations by providing a structured process for submitting a plan to correct the issue.

The form consists of two main sections: Facility Information and Legal Entity, Owner, or License Holder Information. The first section requires facility-specific details such as name, ID number, inspection exit date, administrator's contact information, and area codes for phone and fax numbers. The second section collects information about the legal entity, owner, or license holder, including their name, contact person's name, phone and fax numbers, and disclosure information on funding plans.

This form should be used when a facility needs to request amelioration due to non-compliance with regulations. Amelioration is only offered if the same or similar violation does not occur more than once in a two-year period, or if it does not occur more than three times in a two-year period. The form's instructions emphasize the importance of providing detailed information on funding plans and ensuring that proposed solutions are feasible.