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

The TX HHS Form 8202 is a request for technology funding for the Home and Community-Based Services - Adult Mental Health Program (HCBS-AMH) and Youth Empowerment Services Waiver Program. This form helps solve the problem of equipping providers with the necessary technology to increase the availability of remote delivery for mental health services.

The form requires the requesting contractor's name, area code and phone number, detailed request including type of equipment and number of devices, justification for the request (optional), and sustainability plan (optional). By signing below, the requester attests that the purchase(s) are for eligible items solely for the purpose of equipping providers with technology to increase remote delivery for mental health services.

This form is typically used by contractors who need funding for technology equipment or devices to support the HCBS-AMH and Youth Empowerment Services Waiver Programs. Key features include required information such as requester's details, detailed request, and justification/sustainability plan (optional). The form also emphasizes the importance of ensuring that purchases are eligible and solely for the purpose of equipping providers with technology for remote delivery.

• This form is used to request funding for technology equipment or devices.
• The requester must provide detailed information about the requested equipment or devices.
• The form requires justification or a sustainability plan (optional) for the request.