TX HHS Form H2060. Needs Assessment Questionnaire and Task/Hour Guide

The TX HHS Form H2060, Needs Assessment Questionnaire and Task/Hour Guide, is a practical tool designed to help individuals with impairments assess their daily living needs. This comprehensive form is typically used in situations where an individual requires assistance with daily activities, such as bathing, dressing, feeding, and grooming.

The questionnaire portion of the form asks a series of questions about the individual's ability to perform various tasks, including transferring, walking, cleaning, laundry, meal preparation, shopping, and medication management. The Task/Hour Guide provides a framework for calculating the total hours needed to complete these tasks, taking into account factors such as assistance with companions or caregivers.

Key features of this form include required information on impairment, assessment date, and Medicaid ID number, as well as conditions that affect daily living, such as balance issues and difficulties with opening jars. The form also includes follow-up questions to assess the individual's mental health and overall well-being. By using this form, individuals can gain a better understanding of their needs and develop a plan for receiving necessary support.

• This form is used by individuals who require assistance with daily living activities due to impairments.
• The questionnaire assesses the individual's ability to perform various tasks, including personal care, household chores, and meal preparation.
• The Task/Hour Guide provides a framework for calculating the total hours needed to complete these tasks, taking into account factors such as assistance with companions or caregivers.