Initial Survey Request for HCSSAs in Texas
This document outlines the requirements for Home and Community Support Services Agencies to request an initial survey within six months of receiving their initial license. It provides detailed instructions for compliance and necessary documentation. Stay informed about your responsibilities to maintain your agency's licensure.
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How do I fill this out?
To fill out this document, ensure that you have gathered all required information regarding client admissions and services rendered. Carefully follow the guidelines outlined in the applicable Texas Administrative Code. Completing the HHSC Form 2020 accurately will facilitate your request for an initial survey.

How to fill out the Initial Survey Request for HCSSAs in Texas?
1
Gather the required client admission information.
2
Complete HHSC Form 2020 with accurate details.
3
Ensure all necessary documents are ready for submission.
4
Make sure you have the minimum required client count.
5
Submit your request to the designated survey office.
Who needs the Initial Survey Request for HCSSAs in Texas?
1
Newly licensed Home and Community Support Services Agencies need this form to comply with state regulations.
2
Managers of HCSSAs require this document to properly request an initial survey.
3
Healthcare administrators must submit this form to ensure proper licensing checks.
4
Compliance officers use this document to maintain agency standings.
5
Legal advisors for HCSSAs need this form to advise clients on regulatory compliance.
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What are the instructions for submitting this form?
To submit this form, you must complete HHSC Form 2020 and ensure it contains all the required client information and agency policies. You may submit the filled form via email to LTCRpolicy@hhs.texas.gov or by mailing it to P.O. Box 13247, Austin, Texas 78711-3247. Ensure your submission is made within the six-month window to avoid delays or penalties.
What are the important dates for this form in 2024 and 2025?
Keep track of important dates relevant to the initial survey request process. Ensure that your initial survey request is submitted within six months of your initial license effective date. Mark your calendar for key compliance deadlines to avoid enforcement actions.

What is the purpose of this form?
The purpose of this form is to facilitate the process of requesting an initial survey for Home and Community Support Services Agencies. It serves to remind HCSSAs of their responsibilities under Texas law regarding licensure and compliance. By completing this form, agencies can ensure they meet regulatory requirements essential for maintaining their operational license.

Tell me about this form and its components and fields line-by-line.

- 1. Agency Name: The official name of the Home and Community Support Services Agency.
- 2. Client List: A comprehensive list of clients receiving services.
- 3. Service Categories: Categories of services the agency is licensed to provide.
- 4. Request Submission Date: The date on which the initial survey request is being submitted.
What happens if I fail to submit this form?
Failing to submit this form may lead to serious consequences such as license revocation or denial of license renewal.
- License Revocation: The agency might lose its operational license if the survey request is not submitted on time.
- Legal Repercussions: There may be legal actions taken against the agency for non-compliance.
- Increased Scrutiny: Failure to comply can result in increased scrutiny from regulatory bodies.
How do I know when to use this form?

- 1. Post-License Application: After receiving your initial license, submit this form promptly.
- 2. Client Admission Compliance: If your agency has admitted clients, this form is required.
- 3. Regulatory Compliance: To support compliance with Texas Administrative Code requirements.
Frequently Asked Questions
What is the purpose of this document?
The document is meant to guide newly licensed HCSSAs in requesting their initial survey for compliance.
How do I obtain the required information?
You should collect client admission details and services rendered before filling out the form.
Can I edit this document online?
Yes, you can easily edit this PDF using our platform before downloading it.
Is there a deadline for submitting this form?
Yes, you must submit your request within six months of your license effective date.
How do I access the HHSC Form 2020?
You can find and download HHSC Form 2020 from the Texas Health and Human Services website.
What happens if I miss the submission deadline?
Failing to submit on time may lead to enforcement actions, including license revocation.
What information is needed on the form?
You will need details about client services and compliance documentation.
Can I share this document digitally?
Yes, you can easily share your edited PDF through email or social media with our sharing tools.
What measures should I take if I'm unsure about the form?
Reach out to the Policy and Rules Section for guidance and clarification.
Are there contact details for questions regarding the form?
You can contact the Policy and Rules Section at LTCRpolicy@hhs.texas.gov.
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