TX HHS Form 1057. Habilitation Service Plan HSP

The TX HHS Form 1057, Habilitation Service Plan (HSP), is a crucial document issued by the Texas Health and Human Services (HHS) for individuals with intellectual and developmental disabilities. The form serves as a comprehensive plan outlining habilitation services to be provided to the individual while residing in a nursing facility (NF). The purpose of this form is to ensure that the individual receives necessary support and coordination to achieve their goals and outcomes.

The HSP is designed for use by Local Intellectual and Developmental Disabilities Authorities (LIDDA) and requires information about the individual, including their name, CARE ID, Medicaid number, and habilitation service plan date. The form also includes sections for listing discovery processes and participants used to gather information about the individual, as well as a section for recording changes made to the HSP during the plan year. This document is essential for ensuring that individuals with intellectual and developmental disabilities receive the necessary support and services to lead fulfilling lives.

The Habilitation Coordination Plan outlined in Section 4 of the form ensures that the individual receives regular face-to-face meetings with a habilitation coordinator (HC) to monitor progress toward achieving goals and outcomes. The HC will also coordinate specialized services provided to the individual, including NF Preadmission Screening and Resident Review (PASRR) support activities. This plan is critical for ensuring that individuals receive the necessary support and coordination to achieve their goals and live independently in a nursing facility setting.