Revised Consumer Directed Services Forms 1725, 1729 and 1734 for Service Provider Applicants

This notice is to inform Financial Management Services Agencies (FMSAs) that the following forms regarding qualifications for service provider applicants have been updated. FMSAs and Consumer Directed Services (CDS) employers should begin using these forms, effective immediately upon publication of this notice.

Form 1725, Criminal Conviction History and Registry Checks, was updated to clarify that an applicant for employment may not be hired by the CDS employer, and must not start providing services for payment, until the required criminal history and registry checks are completed. The applicant acknowledges they cannot provide services until the FMSA and CDS employer confirm all requirements have been met.

Form 1729, Applicant Verification for Employees, was updated to clarify that to be eligible for employment, the applicant must not have responded “Yes” to questions regarding relationship to employer, on Form 1734, Service Provider and Employer Certification of Relationship Status for CDS. 

Form 1734, Service Provider and Employer Certification of Relationship Status for CDS, was revised to document the home addresses of the applicant and the CDS employer. Both the applicant and the CDS employer must sign the form to confirm accuracy of the information provided and to acknowledge the applicant cannot be paid to provide services if they are not eligible for employment.

For questions regarding this notice, email CDS@hhs.texas.gov.