TX HHS Form 3615. Request to Continue Suspension of Waiver Program Services

The TX HHS Form 3615, "Request to Continue Suspension of Waiver Program Services," is a crucial document for individuals who require waiver program services, such as Texas Home Living (TxHmL) or Home and Community-based Services (HCS). This form helps solve the problem of requesting to continue suspension of waiver program services when an individual's circumstances change.

This form requires essential information, including the individual's CARE ID, Medicaid number, date of birth, and original reason for suspending waiver program services. The service coordinator must submit written explanations and justifications, as well as review documentation at 90-day, 180-day, and 270-day intervals. If the original reason is "nursing facility," a written diagnosis and prognosis from a physician or registered nurse are also required.

The TX HHS Form 3615 should be used when an individual's circumstances change, making it necessary to continue suspending waiver program services. This form is essential for individuals who require waiver program services and need to request continued suspension due to reasons such as hospitalization, elopement, or crisis stabilization. By completing this form, service coordinators can provide the necessary documentation to support an individual's request to continue suspension of waiver program services.