The TX HHS Form H1706, Good Cause Recommendation and Family Violence Exemption, is a crucial document that helps address domestic violence as a barrier to cooperating with child support or providing other information. This form is typically used by domestic violence specialists who have interviewed individuals regarding their experiences with domestic violence.
The TX HHS Form H1701, Child Support, TANF Foster Care, and TANF/Medicaid Case Information Exchange, is a crucial tool for facilitating communication between parties involved in child support cases. This form helps resolve issues related to absent parents' responsibilities towards their children, ensuring that necessary information is shared and actions are taken accordingly.
The TX HHS Form H1700-A1, Certification of Completion/Delivery of STAR+PLUS HCBS Program Items/Services, is a crucial document that helps ensure the satisfactory completion of healthcare services for individuals enrolled in the STAR+PLUS Home and Community-Based Services (HCBS) program. This form is typically used by Member Representatives or caregivers to certify the delivery of specific program items/services, such as adaptive aids, emergency response services, or minor home modifications.
The Individual Service Plan Signature Page (Form H1700-3) is a crucial document that helps solve the problem of ensuring individuals receive necessary services to meet their assessed medical, functional, and cognitive needs. This form is typically used in situations where an individual requires Home and Community-Based Services (HCBS) through the STAR+PLUS program. The applicant or member, along with their authorized representative or service coordinator, fills out this form to acknowledge review of the waiver services and accept a person-centered service plan.
The Individual Service Plan Addendum (Form H1700-2) is a crucial document for individuals receiving services under the STAR+PLUS Home and Community-Based Services (HCBS) program in Texas. This form helps to identify necessary services and benefits for applicants or members, ensuring that their unique needs are met.
The STAR+PLUS HCBS Program Individual Service Plan Form H1700-1 is a crucial document for individuals entering the Texas Health and Human Services (HHS) program. This form helps solve the problem of creating a personalized plan for each participant's healthcare needs, outlining their goals, services, and budget.
The Treatment Verification Form H1551, issued by Texas Health and Human Services (HHS), is a crucial document for individuals receiving Medicaid benefits for breast and cervical cancer treatment. This form helps verify the patient's medical needs to determine continued eligibility for services.
Form H1299 is used by the Texas Health and Human Services Commission (HHSC) to collect detailed information about a joint bank account held by an applicant or recipient of public assistance. The form helps determine whether funds in a jointly held account should be counted as a financial resource when evaluating eligibility for benefits.
Form H1252 is a Texas Health and Human Services Commission (HHSC) document used to formally designate specific resources as burial funds for Medicaid eligibility purposes. By completing this form, a client or responsible party confirms that certain life insurance policies, financial accounts, or other resources are set aside exclusively for burial expenses and should be treated as exempt assets under Medicaid rules.
Form H1239, titled “Request for Verification of Bank Accounts”, is an official document used by the Texas Health and Human Services Commission (HHSC) to verify financial information for individuals being evaluated for medical assistance programs. The form allows HHSC to confirm the existence, type, and balances of bank accounts and other financial assets held by an applicant.
