Texas Health and Human Services

The TX HHS Form 3605, "HCS Parent or Legally Authorized Representative (LAR) Contact Information for Individuals Under 22 Years of Age," is a crucial document that helps ensure timely communication between parents or legally authorized representatives (LARs) and the Texas Health and Human Services Commission (HHSC). This form is used in situations where individuals under the age of 22 are receiving supervised living or residential support through the Home and Community-based Services (HCS) Program.

The Individual Plan of Care (IPC) Form 3608 is a crucial document for individuals receiving Home and Community-based Services (HCS) and Community First Choice (CFC) services in Texas. This form helps facilitate person-centered planning by outlining the individual's care goals, needs, and services. It is typically completed by the service coordinator or provider, with input from the individual and their caregivers.

The TX HHS Form 3611, Involuntary Termination of Consumer Directed Services IPC Cover Sheet, is a crucial document for resolving situations where the health or welfare of an individual is at risk. This form helps address immediate concerns by facilitating the involuntary termination of consumer-directed services (CDS) and outlining necessary steps to ensure the individual's well-being.

The TX HHS Form 3612 Transfer Process Checklist is a crucial document that facilitates the transfer of services for individuals in Texas Health and Human Services (HHS) programs. This form helps solve the problem of ensuring a smooth transition between service providers, allowing individuals to choose their preferred provider or Financial Management Services Agency (FMSA). The form is typically used when an individual or legally authorized representative (LAR) desires a transfer, and the service coordinator (SC) must begin the process within three days.

The TX HHS Form 3613, Provider Investigation Report with Fax Cover Sheet, is a crucial tool for home health, hospice, and personal assistance services providers in Texas. This form helps resolve complaints and incidents related to these services by providing a standardized framework for reporting and investigating issues.

The TX HHS Form 3613-A is a report that helps investigate incidents or complaints in skilled nursing facilities (SNF), nursing facilities (NFs), intermediate care facilities for individuals with an intellectual disability or related conditions (ICF/IIDs), assisted living facilities (ALFs), day and activity health services facilities (DAHS) including Individualized Skills and Socialization (ISS) providers, and prescribed pediatric extended care centers (PPECCs). This form is used to document incidents and track progress in resolving issues.

The TX HHS Form 3615, "Request to Continue Suspension of Waiver Program Services," is a crucial document for individuals who require waiver program services, such as Texas Home Living (TxHmL) or Home and Community-based Services (HCS). This form helps solve the problem of requesting continued suspension of these services when an individual's circumstances change.

The TX HHS Form 3616 is a request for termination of services provided by Home and Community-based Services (HCS) or Texas Home Living (TxHmL) Waiver Provider. This form helps solve the problem of ending enrollment in these waiver programs when an individual's circumstances change, making it necessary to terminate their participation.

The TX HHS Form 3617, Request for Transfer of Waiver Program Services, is a crucial document that helps individuals with intellectual and developmental disabilities (I/DD) transfer their waiver program services to a new provider. This form is typically used in situations where an individual needs to change their service provider due to various reasons such as relocation or dissatisfaction with the current provider.

The Resident Transaction Notice (TX HHS Form 3618) is a crucial document that helps track and record resident transactions in various healthcare settings. This form is typically filled out by administrators or authorized personnel in hospitals, nursing facilities, hospices, and other long-term care institutions to provide essential information about patient admissions, discharges, and transfers.