TX HHS Form H6516. Community First Choice Assessment

The Community First Choice Assessment Form H6516 is designed to help individuals with disabilities or impairments determine their level of support needed for personal assistance services (PAS). This form is typically used in situations where an individual requires assistance with daily activities due to a physical or mental impairment. The assessment helps identify the type and amount of support required, ensuring that individuals receive the necessary care and accommodations.

The form consists of two sections: Individual's Information and Type of Assessment, and Needs Assessment Questionnaire and Task and Hour Guide. The latter section includes a scoring system to determine the level of support needed for PAS, with options ranging from 0 (no functional impairment) to 4 (total functional impairment). Additionally, the form provides guidelines for calculating PAS times, including specific tasks and subtasks that may require assistance.

Key features of this form include the requirement to score the individual's level of support needed based on a standardized scale. The assessment also highlights the importance of considering an individual's specific circumstances when determining the type and amount of support required. Supervisory approval is necessary for any PAS minutes outside these guidelines, ensuring that individuals receive the appropriate level of care.

• The Community First Choice Assessment Form H6516 is used to determine the level of support needed for personal assistance services (PAS) in situations where an individual requires assistance with daily activities due to a physical or mental impairment.