TX HHS Form 2128. 120 Day Notice

The TX HHS Form 2128, 120 Day Notice, is a crucial document that helps individuals navigate the process of requesting a change in their position on an interest list for a Medically Dependent Children Program. This form serves as a formal notice to inform applicants that their request has been denied due to being submitted late.

This form requires specific information, including the applicant's full name and address, as well as the date of notice and office contact details. The key section highlighted in this document is the notification of denial, which explains the reason for the rejection and provides alternative options for the applicant to consider. Common scenarios of use include cases where applicants have missed the 120-day deadline or need to request a change in their position on the interest list.

The TX HHS Form 2128, 120 Day Notice, is an essential tool for individuals seeking to move up on another 1915(c) waiver program interest list. By understanding this form's purpose and requirements, applicants can effectively navigate the process and make informed decisions about their next steps. For more information or assistance, please contact the Texas Health and Human Services Commission (HHSC) staff at the phone number provided.