TX HHS Form 1058. Request for Home and Community-based Services Crisis Diversion Slot

The Texas Health and Human Services (HHS) Form 1058, Request for Home and Community-based Services Crisis Diversion Slot, is designed to facilitate the provision of crisis diversion services for individuals with intellectual or developmental disabilities. This form serves as a crucial tool for local authorities to request these essential services, ensuring timely support for individuals in crisis.

Aimed at the Local Intellectual and Developmental Disability Authority (LIDDA) and other relevant organizations, this form collects vital information about the individual in need of crisis diversion services. The requester must provide details about their organization or advocate, as well as the person's diagnosis, reason for request, and any known diagnoses. This comprehensive data enables LIDDAs to effectively assess and address the unique needs of each individual.

The purpose of this form is to streamline the process of requesting crisis diversion services, ensuring that individuals with intellectual or developmental disabilities receive the necessary support during times of crisis. By completing Form 1058, requesters can facilitate prompt access to essential services, ultimately promoting improved outcomes and quality of life for these individuals.