TX HHS Form 6509. CLASS/DBMD Coordination of Care

The TX HHS Form 6509, CLASS/DBMD Coordination of Care, is an addendum designed to facilitate the coordination of care between a Registered Nurse (RN) and the Service Planning Team (SPT). This form helps ensure that individualized services are planned and delivered according to the unique needs of individuals with Community Living Assistance and Support Services (CLASS) or Deaf Blind with Multiple Disabilities (DBMD).

This addendum is completed at enrollment and annually thereafter, requiring the SPT to review Form 6515, Addendum E, Recommendations/Coordination of Care. The SPT must discuss any concerns, findings, or recommendations made by the RN using this form, documenting their discussion and subsequent actions taken. All members of the SPT must sign and date the form to confirm its accuracy.

The key features of this form include the required information on individual's name, date, and summary of SPT's actions taken to address concerns, findings, and recommendations. The form also highlights the responsibilities of the SPT in reviewing Form 6515 and discussing any issues with the RN. By completing this addendum, the SPT can ensure that the individual receives appropriate services and support.

• This addendum is used at enrollment and annually thereafter.
• The SPT must review Form 6515, Addendum E, Recommendations/Coordination of Care.
• All members of the SPT must sign and date the form to confirm its accuracy.