TX HHS Form 8496. HCBS-AMH Program On-Site Settings Assessment Tool

The TX HHS Form 8496, HCBS-AMH Program On-Site Settings Assessment Tool, is a crucial document used by the Texas Health and Human Services Commission (HHSC) HCBS-AMH program staff to conduct on-site assessments of Host Home/Companion Care (HH/CC) settings. This form helps ensure that provider-owned or controlled HH/CC settings meet specific requirements for participants receiving services.

The assessment tool is designed for situations where the HH/CC provider is not a family member of the individuals receiving services. The form requires important information, including the street address, city and ZIP code, and provider agency details. Additionally, it asks about key setting requirements, such as lease agreements, door locking mechanisms, and access to food at any time.

This form should be used by HCBS-AMH program staff when conducting on-site assessments of HH/CC settings that are provider-owned or controlled. The tool helps identify areas for improvement and ensures compliance with necessary standards. With the TX HHS Form 8496, HCBS-AMH Program On-Site Settings Assessment Tool, program staff can effectively evaluate and improve the quality of care provided to participants in these settings.