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Revised Consumer Directed Services Forms 1720 and 1722

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This notice is to inform Financial Management Services Agencies (FMSAs) and Consumer Directed Services (CDS) employers that forms 1720 and 1722, including their instructions, have been updated. FMSAs and CDS employers should begin using the updated forms effective immediately upon publication of this notice.

Form 1720, Appointment of a Designated Representative, was updated to include a list of tasks CDS employers frequently appoint their Designated Representatives (DRs) to perform. The CDS employer may check any or all of the checkboxes in the list and describe additional tasks appointed to the DR in the open textbox where indicated.

The selection list on Form 1720 includes the option to appoint the DR to assist with using Electronic Visit Verification (EVV) for programs and services as required under the Federal 21st Century Cures Act and the Texas Government Code. As required by TAC §41.305, Appointment of a Designated Representative, FMSAs must collect and maintain Form 1720 for CDS employers who choose to appoint a DR.

Form 1722, Employer's Selection for Electronic Visit Verification Responsibilities, was updated to remove the checkbox where the CDS employer indicated their DR would perform the required EVV responsibilities. The checkbox is now included on Form 1720.

For questions regarding this notice, please contact EVV@hhs.texas.gov or CDS@hhs.texas.gov.