TX HHS Form 5831. Community-based Programs Access and Eligibility Services Contract Application Packet Checklist. Regionally Enrolled

The TX HHS Form 5831, Community-based Programs Access and Eligibility Services Contract Application Packet Checklist, is a crucial document for entities seeking to establish a contract with the Texas Health and Human Services Commission (HHSC) for community-based programs. This form serves as a checklist to ensure that all required forms and documents are submitted during the contract application process.

The form outlines specific requirements for entities applying for a provisional contract, including submission of designated forms and documents. Key features include the need to download required HHSC forms from the Texas Health and Human Services (HHS) Internet forms website, unless an exception is requested and approved. Failure to submit all required forms and documents may delay the application process or result in denial.

Applicants should carefully review the instructions for each form before completing it, as errors and omissions can delay the application process. It's essential to retain copies of submitted forms and not send original business documents. The following forms are required: Ferm 2031, Form 3681, Form 3834, Form 3691, Form $871, Form 5871-S, and others.

• This form is intended for contract applicants and HHSC staff to ensure all required forms and documents are submitted during the contract application process.
• Entities applying for a provisional contract with HHSC must submit all forms listed in Section 1 unless otherwise indicated.