TX HHS Form 8202. HCBS-AMH Program and YES Waiver Program Request for Technology Funding

The TX HHS Form 8202, "HCBS-AMH Program and YES Waiver Program Request for Technology Funding," is a crucial document that helps solve the problem of requesting technology funding for mental health services. This form should be used by contractors seeking to equip providers with the necessary technology to increase remote delivery availability for mental health services in the Home and Community-Based Services (HCBS) Adult Mental Health (AMH) Program or Youth Empowerment Services (YES) Waiver Program.

The form requires essential information, including the date of request, requesting contractor's name, area code, and phone number. The detailed request section should include the type of equipment and number of devices needed to support remote delivery. Additionally, contractors may provide justification for their request and a sustainability plan, if applicable.

This form serves as an official attestation that the requested technology purchases are eligible items intended solely for equipping providers with the necessary tools to increase remote mental health service availability. The approving staff signature date is also required for internal use only. By completing this form, contractors can efficiently request technology funding and support the delivery of essential mental health services in Texas.