TX HHS Form 8206. Service Area Change Request

The TX HHS Form 8206, Service Area Change Request, is a crucial document for providers of adult mental health services in Texas. This form helps solve the problem of requesting changes to an existing service area, which may require a contract amendment.

This form requires key information such as the current service area(s), proposed expansion or removal of service areas, and resources currently available in the proposed area(s). Important sections include the request for expansion, where providers must list all proposed local mental health authorities (LMHAs) and local behavioral health authorities (LBHAs), as well as individual rural counties. The form also includes a section for removing service areas, which requires information on the number of participants served in the area(s) and efforts made to fulfill contractual obligations.

This form is typically used by providers who need to adjust their service areas due to changes in their organization or the needs of their clients. It is essential that all required information is provided, including updated exhibits from the original OE packet, to ensure a smooth submission process. The form's instructions indicate that it should be submitted to [email protected].