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 practical tool designed to help assess the suitability of Host Home/Companion Care (HH/CC) settings for participants in the Texas Health and Human Services Commission's (HHSC) HCBS-AMH program. This form is typically used by HHSC HCBS-AMH staff during on-site assessments of provider-owned or controlled HH/CC settings where the provider is not a family member of the participants.

The assessment tool requires key information about the HH/CC setting, including street address, city and ZIP code, provider agency, and number of HCBS-AMH participants. It also evaluates specific conditions and requirements, such as lease agreements, door locks, and access to food. This form helps ensure that HH/CC settings meet program standards and provide a safe and supportive environment for participants.

The assessment tool is designed to guide the on-site evaluation process and facilitate the collection of necessary information. By completing this form, HCBS-AMH staff can identify areas that require improvement or additional support, ultimately enhancing the quality of care and services provided to participants. Some key points to note include:

• The form is used for provider-owned or controlled HH/CC settings where the provider is not a family member of the participants.
• The assessment tool evaluates specific conditions and requirements, such as lease agreements, door locks, and access to food.
• The form helps ensure that HH/CC settings meet program standards and provide a safe and supportive environment for participants.