Social Security

TX HHS Form 3021. Consent for Eligibility Determination and Enrollment

TX HHS Form 3021. Consent for Eligibility Determination and Enrollment

The TX HHS Form 3021, Consent for Eligibility Determination and Enrollment, is a crucial document that helps individuals determine their eligibility for the Home and Community Based Services-Adult Mental Health (HCBS-AMH) program. This program provides support services designed to help adults with mental health conditions live in their chosen community.

TX HHS Form 3022. Provider Selection

TX HHS Form 3022. Provider Selection

The Texas Health and Human Services (HHS) Form 3022, Provider Selection, is a crucial document for individuals seeking Adult Mental Health (HCBS-AMH) services. This form helps solve the problem of selecting a provider agency (PA) or recovery management (RM) entity that best suits an individual's needs. Typically, this form is completed by HCBS-AMH participants and/or their legally authorized representatives (LARs).

TX HHS Form 3023. Notification of Participant Rights

TX HHS Form 3023. Notification of Participant Rights

The TX HHS Form 3023, Notification of Participant Rights, is a crucial document that helps individuals participating in the Adult Mental Health (HCBS-AMH) Program understand their rights and responsibilities. This form is typically completed by participants or their legally authorized representatives (LARs) to acknowledge receipt of important information about their program participation.

TX HHS Form 3024. Respite Relative Provider

TX HHS Form 3024. Respite Relative Provider

The TX HHS Form 3024, Respite Relative Provider, is a crucial document that helps solve the problem of providing respite services to adult mental health participants. This form is used in situations where a relative of the participant other than the natural or adoptive parents or legally authorized representative (LAR) provides respite services. The form is typically completed by the respite provider (relative) and requires specific information such as individual name, CARE ID number, date of birth, county of service, and LAR name if applicable.

TX HHS Form 3026. Random Sample Review of Nursing On-call and/or Deceased Individual Required Submission of Documentation

TX HHS Form 3026. Random Sample Review of Nursing On-call and/or Deceased Individual Required Submission of Documentation

The TX HHS Form 3026 is a crucial document for Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICFs/IID) to submit in response to a random sample review. This form helps ensure that ICFs/IID facilities maintain accurate records of their nursing staff and provide necessary documentation for the health and well-being of individuals under their care.

TX HHS Form 3028. Hemophilia Assistance Program (HAP) Provider Enrollment

TX HHS Form 3028. Hemophilia Assistance Program (HAP) Provider Enrollment

The TX HHS Form 3028, Hemophilia Assistance Program (HAP) Provider Enrollment, is a crucial document for healthcare providers seeking to participate in the Texas Hemophilia Assistance Program. This form facilitates the enrollment process by gathering essential information about the provider's facility, business structure, and contact details.

TX HHS Form 1032. Residential Care Copayment Worksheet

TX HHS Form 1032. Residential Care Copayment Worksheet

The Residential Care Copayment Worksheet (TX HHS Form 1032) is a practical tool designed to help individuals calculate their copayment amounts for residential care services. This form is typically used in situations where an individual requires long-term care services, such as assisted living or nursing home facilities, and needs to determine their monthly copayment amount.

TX HHS Form 1035. PASRR Consent for Use of Audio-Only and Audio-Visual Communication

TX HHS Form 1035. PASRR Consent for Use of Audio-Only and Audio-Visual Communication

The TX HHS Form 1035, PASRR Consent for Use of Audio-Only and Audio-Visual Communication, is a crucial document that helps solve the problem of facilitating communication between healthcare professionals and individuals receiving specialized services. This form is typically used in situations where in-person visits are not feasible or practical, such as during preadmission screening and resident review (PASRR) assessments.

TX HHS Form 1038. Consent for the Use of Audio-Only or Audio-Visual Communication

TX HHS Form 1038. Consent for the Use of Audio-Only or Audio-Visual Communication

The TX HHS Form 1038, Consent for the Use of Audio-Only or Audio-Visual Communication, is a crucial document that facilitates communication between individuals with intellectual and developmental disabilities (LIDDA) and their service coordinators. This form helps solve the problem of ensuring that LIDDA clients provide consent for audio-only or audio-visual communication during service coordination visits.