Revision 15-3; Effective June 25, 2015

The Texas Health and Human Services Commission (HHSC) Contract and Fiscal Compliance Monitoring Tools for the Emergency Response Program are:

• Form 3854, Contract/Program Compliance – Individual Record Evaluation (Emergency Response Services) (PDF); and
• Form 3061, Emergency Response Services Financial Errors Standard (PDF).

A provider agency should direct questions about the tools or requests for additional assistance to its contract manager.