Case Manager In-Home and Family Support Program Handbook

Form Updates

Date

No. and Title

Change
May 16, 2013 Form 2305, Practitioner Recommendation for Items and Services, and Instructions Changes the name of the form, adds the individual’s date of birth, case manager’s fax number and a pre-printed statement for over-the-counter pain relief medications. Removes Part II, Prescribed Medications, and the list of services that can be purchased with In-Home and Family Support Program funds.
February 15, 2013 Form 2110, Community Care Intake, and Instructions Removes "N/A for STAR+PLUS Area" from the bottom of Page 1 of the form and from the instructions. Adds STAR+PLUS Waiver (SPW) to the instructions in the "Purpose" section and in the "Describe this individual's need for other help" section.
January 25, 2013 Form 2356, Individual Program Participant Agreement, and Instructions Informs the applicant/individual that he must use any other available resources from federal, state or local resources before accessing the In-Home and Family Support Program. Deletes a reference to old policy for “capital expenditures”.
December 27, 2012 Form 2307-I/2307-IS, IHFSP Individual Rights and Responsibilities, and Instructions Changes the title (previously IHFSP Consumer Rights and Responsibilities), incorporates new policy for annual reviews and corrects person first respectful language.
December 20, 2012 Form 2065-E/Form 2065-ES, Notification of In-Home and Family Support Program Benefits, and Instructions Changes the wording regarding ineligibility from "after" to "effective." On Page 2, Statement of Rights, changes "request a hearing within 12 days" to "request a hearing before the effective date shown on Page 1." Removes mention of "Capital grant." Adds instructions for entering the individual's name and number on Page 2 and changes the definition of Date.
December 17, 2012 Form 1015, Fair Hearing Exception Letter, and Form 1015-S (Spanish) Adds a letter for DADS staff to send to an applicant or individual when a fair hearing exception request is forwarded to the Health and Human Services Commission (HHSC) for review.
October 16, 2012 Form 2110, Community Care Intake, and Instructions Changes SAVERR to Texas Integrated Eligibility Redesign System (TIERS) and changes client to individual. Adds a section to the nursing facility diversion question. Adds nursing tasks to describe the individual’s need for help. Moves the question regarding intellectual disability and intellectual developmental disability, and deletes the statement, "If Yes and if the applicant is requesting In-Home Family and Support, refer to MHMR IHFSP."
October 15, 2012 Form 4800-D, DADS Fair Hearing Request Summary, and Instructions
  • Revises the form to add a "Yes" box in Section 6.
  • Revises the instructions to reflect STAR+PLUS policy changes regarding the HHSC Centralized Representation Unit, and the MCO table is updated in Section 2-F.
September 21, 2012 Form 2113, Community Services Interest List Registration and Follow-Up, and Instructions Changes ICF/MR to ICF/IID, changes consumer to individual, and changes "the case" to "follow-up" in the instructions.
August 24, 2012 Form 2356, Individual Program Participation Agreement, Instructions only Updates information from CSPO 11-12-013.
August 24, 2012 Form 2364, Disabilities Screening Instrument, Instructions only Adds new policy for reviewing this form if the annual recertification is completed by telephone.
August 15, 2012 Form 2121, Long Term Services and Supports (English/Spanish), and Instructions Simplifies the program descriptions.
August 10, 2012 Form H1746-A, MEPD Referral Cover Sheet, Instructions Only Adds detailed instructions for DADS case managers and providers, and corrects the fax number.
August 9, 2012 Form 2354, Learning Your Responsibilities as an Employer, Instructions only Replaces reference to Form 2352, Notification of Certification/Recertification, with Form 2065-E, Notification of In-Home and Family Support Program Benefits.
July 19, 2012 Form 2351, Application for Assistance, and Instructions Removes that the applicant must live in Texas for six months. Deletes the question asking if an applicant has applied for services at MHMR. Moves Section 5 to Section 3 and renumbers other sections.
June 26, 2012 Form 2306, Service Plan (IHFSP), and Instructions Removes the date of birth field and the requirement for a supervisor's signature. Changes "consumer" to "individual."
May 2, 2012 Form H1746-A, MEPD Referral Cover Sheet, and Instructions Updates the form and revises the instructions so that applications get to the right place or get registered in the system.
May 2, 2012 Form H1746-B, Batch Cover Sheet, Instructions Only Revises the instructions so that applications get to the right place or get registered in the system.
March 12, 2012 Form 2121, Long Term Services and Supports (English/Spanish), and Instructions Updates the form and instructions with consideration to people first respectful language.
March 1, 2012 Form 2371, Financial Worksheet, and Instructions Changes title and removes "Other CCAD Services" from Section 1 to coincide with CSPO 10-09-003, effective Sept. 28, 2010.