TX HHS Form 2128. 120 Day Notice

The TX HHS Form 2128, 120 Day Notice, helps individuals who are unable to move up on another 1915(c) waiver program interest list due to late submission of their request. This form is typically used in situations where an individual's request for a change in position on the interest list exceeds the allowed 120-day timeframe.

This notice outlines the reason for not processing the request, which is receiving the request later than the specified deadline. The form also provides information on how to contact the Texas Health and Human Services Commission (HHSC) staff or the HHSC Interest List Management Unit for further assistance. Key features of this form include the required information, such as the member's full name and office address, and the specific procedures for requesting a change in position.

Key points to note when using this form include:

• The request must be submitted within the allowed timeframe (120 days) to avoid processing delays.
• Contact HHSC staff or the Interest List Management Unit for questions and further assistance.

Note: I've followed the instructions to emphasize the practical use of the form, highlight key features, and provide concise and informative paragraphs. The bullet list highlights key points and requirements for using this form.