Texas Health and Human Services

The TX HHS Form 3019, Infant Sleep Exception/Health Care Professional Recommendation, is a crucial document that helps solve the problem of ensuring compliance with Texas child care minimum standards for infants who require alternative sleep positions or restrictive devices due to medical reasons. The form is typically used in situations where a health care professional determines that an infant's medical condition necessitates a deviation from standard sleeping practices.

The Uniform Assessment Form 3020 is a crucial tool for Medicaid providers to assess the mental health needs of adults in Texas. This form helps solve the problem of ensuring that individuals receive appropriate care and services by providing a standardized assessment process.

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.

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).

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.

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.

The TX HHS Form 3025, Individual Safety Plan, is a practical tool designed to help individuals at risk of abuse or harm identify potential dangers and develop strategies to minimize those risks. This form is typically used in situations where an individual may be vulnerable to abuse, such as in adult mental health settings.

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.

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.

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.