TX HHS Form 1046. Request for HCS Adult NF Transition Slot

The Texas Health and Human Services (HHS) issues Form 1046, Request for HCS Adult NF Transition Slot, to facilitate the transition of adults with intellectual or developmental disabilities from nursing facilities (NFs) to community settings. This form is designed for individuals who meet specific criteria, including being at least 21 years old, currently residing in an NF, and expressing a desire to live in a community setting.

The purpose of this form is to request a transition slot for adults with intellectual or developmental disabilities who are eligible for Home and Community-Based Services (HCS) waiver programs. The form requires information about the individual's current waiver services, as well as LIDDA (Local Intellectual and Developmental Disability Authority) determination that the person meets the necessary criteria. Once completed, the form should be scanned and submitted via secure email to [email protected] with a subject line of "Request for HCS Adult NF Transition Slot."

This form is intended for use by individuals who are seeking to transition from an NF to a community setting, as well as professionals involved in the process. HHSC staff should review and complete the form, including the reviewer's signature and date, to recommend the individual for an HCS Adult NF Transition Slot.