TX HHS Form 2111. Interest List Notification

The Texas Health and Human Services (HHS) has placed your name on an interest list for various long-term services and supports programs. This notification is a result of your request for these programs, which includes Adult Foster Care, Emergency Response Services, Residential Care Program, Client Managed Personal Assistance Services, Family Care, Special Services to Persons with Disabilities, Day Activity and Health Services, Home Delivered Meals, STAR + PLUS Waiver, and In-Home Family Support Program.

The interest list notification serves as a reminder that it is essential to report any changes in your contact information, such as address and telephone number, to the HHS office immediately. Additionally, HHSC staff will attempt to contact you annually to confirm your continued interest in these programs. Failure to respond may result in removal from the interest list.

This notification also authorizes the sharing of your name and phone number with your local Area Agency on Aging (AAA) for potential home delivered meals or attendant services. If you do not wish to share this information, you must notify the HHS office within seven calendar days by calling or writing to the provided phone number and address. A list of other HHSC programs is attached, providing specific information on how to request additional details.