TX HHS Form 6509. CLASS/DBMD Coordination of Care

TX HHS Form 6509, CLASS/DBMD Coordination of Care, is an addendum used to ensure coordination of care between a Registered Nurse (RN) and the Service Planning Team (SPT). This form helps facilitate consideration of appropriate services for an individual's unique needs according to issues identified by the RN.

This addendum should be completed at enrollment and annually thereafter. The SPT must review Form 6515, Addendum E, Recommendations/Coordination of Care, discuss any concerns or findings with the RN, and document subsequent actions required. All members of the SPT must sign and date to confirm the accuracy of the information in this form.

The key features of this form include the individual's name, date, and a summary of the SPT's actions taken to address concerns, findings, and recommendations. The form also requires signatures from various team members, including the individual, their Legally Authorized Representative, Case Manager, Program Director, and RN.