TX HHS Form 4002. Management of Personal Funds and Payment for Support. Maintenance and Treatment

The Texas HHS Form 4002, Management of Personal Funds and Payment for Support, Maintenance and Treatment, is a crucial document that helps individuals at facilities make informed decisions about their personal funds. This form is used in situations where an individual's personal funds need to be managed, such as when they are unable to do so themselves or have an authorized representative (LAR) making decisions on their behalf.

This form requires the individual, LAR, or facility director to document how the person's personal funds will be managed. The options include self-management, management by the LAR, or management by the facility if the individual is unable to make decisions. If the facility manages the person's personal funds, all deposits and expenditures are accounted for, and a detailed accounting is provided within 72 hours of request.

The form also outlines payment responsibilities, including support, maintenance, and treatment (SMT) charges, which are determined by the Texas Health and Human Services Commission. The SMT charges are paid from the individual's personal funds if managed by the facility or by the designated person responsible for managing the funds. Key points to note include:

• The facility provides a detailed accounting of all deposits and expenditures.
• The account is maintained following Texas Health and Human Services Commission rules.
• Personal funds are returned to the individual or LAR within 30 days after discharge from the facility.