TX HHS Form 1067. Offer of Home and Community-based Services (HCS) Program

The TX HHS Form 1067, Offer of Home and Community-based Services (HCS) Program, helps individuals with intellectual or developmental disabilities access long-term care services. This form is used in situations where funding is available to offer the HCS program, which provides life-long support for changing needs.

This form notifies the individual that funding is available and outlines the required response. The individual must respond to the Local Intellectual and Developmental Disability Authority (LIDDA) within 30 calendar days after the date of this form or the offer may be withdrawn. Key features include the provision of 20 services, such as professional therapies, residential assistance, and respite nursing, which supplement natural supports or other programs.

The individual must contact the LIDDA staff using the information provided to respond to the offer. Failure to respond within the required timeframe will result in removal from the interest list and withdrawal of the offer. Declining the offer will also remove the individual's name from the interest list, stopping any General Revenue-funded services similar to HCS services. The form includes instructions for reinstating one's name on the interest list if desired.

• This form is used when funding is available to offer the Home and Community-based Services (HCS) Program.
• The individual must respond within 30 calendar days or the offer may be withdrawn.
• The HCS program provides life-long support for changing needs, supplementing natural supports or other programs.