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Effective Date: 
11/2018

Documents

Instructions

Updated: 11/2018

Purpose

The purpose of the Home and Community Based Services Adult Mental Health (HCBS-AMH) program is to provide supports designed to help individuals live in the community of their choice. If enrolled in the program, the individual, or their legally authorized representative (LAR), will choose a recovery manager and provider agency that will work to create an individual recovery plan. This individual recovery plan focuses on the goals identified and on building strengths and supports needed for continued life and recovery in the community. 
The recovery manager will assist the individual in gaining access to needed services and other resources, making informed choices according to needs and preferences, resolving issues impeding recovery, and developing strategies/resources to promote recovery.

In addition to the supports that the recovery manager provides, the HCBS–AMH program has services designed to support long term recovery. There is no time limit on services; they are available as long as the need exists and the individual continues to meet diagnostic criteria.

When to Prepare

The consenting adult and/or LAR completes and signs Form 3021 to permit Texas Health and Human Services Commission (HHSC) staff or designees to administer Form 3020, Uniform Assessment, to the person named on Form 3021. The data will be used by HHSC to determine eligibility for the HCBS-AMH program. HHSC or its designees will speak with members of the interdisciplinary team (IDT) and access protected health information (PHI) to complete the UA. All PHI provided to HHSC will be retained pursuant to the Health Insurance Portability and Accountability Act (HIPAA) and state law. 

Instructions

The individual or LAR signs Form 3021 to represent the named individual's agreement to participate in the Uniform Assessment to determine eligibility for the HCBS-AMH program. Upon confirmation of eligibility for the HCBS-AMH program, the named individual agrees to enroll in the program. The HCBS-AMH program is explained to the named individual, including: 

• the specific services offered by the provider agency; 
• the role of the recovery manager; 
• what an individual recovery plan and person centered recovery plan entails; 
• living arrangements that meet home and community-based setting requirements; and
• that consent to participate in the HCBS-AMH Uniform Assessment may be withdrawn at any time.  


Privacy Notification

With few exceptions, you have the right to request and be informed about information that the state of Texas collects about you. You are entitled to receive and review the information upon request. You also have the right to ask the state agency to correct any information that is determined to be incorrect. (Reference: Government Code, Section 552.021, 552.023, 559.003 and 559.004).