TX HHS Form 0702. Fax Cover Sheet for TxHmL and HCS

The TX HHS Form 0702, Fax Cover Sheet for TxHmL and HCS, is a crucial document that facilitates the transfer, continuation of suspension, or termination of waiver program services. This form helps solve the problem of efficiently managing changes in service provision for individuals receiving Home and Community-based Services (HCS) or Texas Home Living (TxHmL). The form is typically used by Service Coordinators, Local Authorities, and other authorized representatives to submit requests to the Texas Health and Human Services (HHS) agency.

The form requires specific information, including the date, number of pages, and fax numbers. It also specifies the types of requests that can be submitted: transfer, continuation of suspension, or termination. Each request type has its own set of required forms and documentation, such as Form 3617 for transfers and Form 3616 for terminations. The form emphasizes the importance of confidentiality and warns against unauthorized disclosure or use.

Key points to note include:

• The form is only valid after all data entry screens have been completed in the Client Assignment and Registration (CARE) System, unless specifically requested by HHSC.
• The form must be accompanied by required documentation, such as Form 3617 or Form 3608/8582, depending on the type of request.
• Confidentiality is paramount, and any unauthorized disclosure or use is strictly prohibited.