The TX HHS Form 2110-A, Community Care Intake Nursing Facility Diversion Slot Screening, is a practical tool designed to help identify individuals who require nursing facility diversion slots. This form is typically used in situations where an individual's caregiver is no longer able to provide care, or when the individual experiences a sudden occurrence of a major illness/physical trauma and lacks a caregiver.
The TX HHS Form 2111, Interest List Notification, helps individuals who are requesting Long Term Services and Supports to notify the Texas Health and Human Services Commission (HHSC) of their interest in various programs. This form is typically used by applicants who need assistance with daily living activities or have disabilities that require specialized care.
The TX HHS Form 2113, Community Services Interest List Registration and Follow-Up, is a crucial tool for individuals seeking community services and support. This form helps solve the problem of identifying eligible individuals who require assistance with daily living activities, healthcare, or other essential services. Typically filled out by individuals, caregivers, or service providers, this form serves as a registration and follow-up mechanism to ensure that those in need receive the necessary support.
The TX HHS Form 2115, Conflict of Interest Notification, is a crucial document that helps resolve potential conflicts of interest in various situations. Typically filled out by providers, provider employees, or applicants, this form ensures transparency and accountability within the Texas Health and Human Services (HHS) system.
The Residential Care, Adult Foster Care or Assisted Living Contribution Acknowledgement Form 2119 is a crucial document that helps individuals continue their eligibility for these services through the Texas Health and Human Services Commission (HHSC). This form is typically used in situations where an individual requires residential care, adult foster care, or assisted living services.
The TX HHS Form 2122, Service Delivery Log with Written Narrative/Written Summary, is a practical tool for tracking and documenting the delivery of services. This form helps solve the problem of keeping accurate records of service provision, ensuring that important details are captured and easily accessible.
The TX HHS Form 2123, Adaptive Aid/Minor Home Modification Request for Prior Approval, is a crucial document that helps individuals with disabilities or special needs obtain necessary modifications to their homes. This form is typically filled out by the individual themselves, or on their behalf by a program provider, to request prior approval for adaptive aids or minor home modifications.
The Supported Home Living or Community Support Transportation Log (TX HHS Form 2124) is a practical tool designed to track transportation services provided to individuals in need of support. This form helps solve the problem of documenting transportation services and ensuring that necessary information is recorded for future reference.
The TX HHS Form 2125, HCS, TxHmL, and CFC Implementation Plan is a crucial document for healthcare providers and service coordinators to develop personalized care plans for individuals with complex needs. This form helps solve the problem of ensuring that person-centered care is implemented effectively, taking into account individual preferences and goals.
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.
