TX HHS Form 1045. Request for Extension of Enrollment Offer Due Date

The TX HHS Form 1045 is a request for extension of enrollment offer due date, specifically designed for individuals seeking Home and Community-based Services (HCS) or Texas Home Living (TxHmL) through the Local Intellectual and Developmental Disability Authority (LIDDA). This form is issued by the Texas Health and Human Services (HHS), making it a crucial document for those requiring assistance with intellectual and developmental disabilities.

The purpose of this form is to provide individuals with a means to request an extension of their enrollment offer due date, ensuring they have sufficient time to complete necessary activities. The form consists of three sections: LIDDA Information, Person's Information, and Enrollment Activities. These sections gather essential details about the individual, including their current living situation, Medicaid status, and previous program participation.

This form is intended for individuals seeking services from HCS or TxHmL, as well as those who have already begun the enrollment process. By completing this form, individuals can request an extension of their enrollment offer due date, allowing them to complete necessary activities without facing a deadline. The TX HHS Form 1045 is an essential tool for those navigating the complex process of seeking services and support from LIDDA.