TX HHS Form H2060-A. Addendum to Form H2060

The Addendum to Form H2060, TX HHS Form H2060-A, is a supplementary document that helps track additional personal assistance services (PAS) hours not identified on the primary form. This addendum is typically used in situations where an individual requires more PAS hours than initially recorded on Form H2060.

This addendum requires identifying information such as applicant/member name, Medicaid ID number, and date completed. It also includes a needs assessment questionnaire and task/hour guide to help service coordinators and health professionals accurately record additional PAS hours. The form allows for the tracking of various tasks, including purchased delegated nursing tasks and health maintenance activities.

The Addendum to Form H2060-A is used by service coordinators, health professionals, and individuals receiving personal assistance services to document and manage their care plans. Key features include the recording of additional PAS hours, tasks, and activities, as well as space for comments. By using this addendum, users can ensure that all necessary information is captured and tracked, facilitating effective care planning and coordination.

• This form is used to track additional personal assistance services (PAS) hours not identified on Form H2060.
• The addendum requires identifying information such as applicant/member name, Medicaid ID number, and date completed.