The Long-Term Care Partnership (LTCP) Resource Worksheet, Form H0057, is a practical tool designed to help individuals determine their eligibility for long-term care benefits. This form is typically used in situations where an individual is applying for or receiving LTCP benefits, such as when seeking assistance with daily living activities or healthcare services.
The TX HHS Form H0056, Notice of Opportunity to Designate Countable Resources, is a crucial document for individuals who have a Long-Term Care Partnership (LTCP) disregard balance. This form helps solve the problem of designating countable resources that can be used to meet long-term care expenses. Typically, this form is filled out by individuals who are eligible for LTCP benefits and need to designate specific resources to offset their long-term care costs.
The TX HHS Form H0055, Verification of Long-Term Care Insurance Policies, is a crucial document that helps determine eligibility for assistance. This form is typically filled out by an Eligibility Specialist from the Texas Health and Human Services (HHS) to verify the status of a long-term care insurance policy.
The Medicaid Buy-In Eligibility Notice (Form H0054) is a crucial document that helps individuals determine their eligibility for the Medicaid Buy-In program. This form is typically used in situations where an individual's premium payment has been received, making them eligible for coverage. The notice outlines the requirements and responsibilities necessary to maintain eligibility.
The Medicaid Buy-In Potential Eligibility Notice (Form H0053) is a crucial document that helps individuals determine their eligibility for Medicaid coverage. This form is typically filled out by individuals who are considering purchasing Medicaid coverage through the Medicaid Buy-In program.
Form 8618 is an official training log used by the State Long-Term Care Ombudsman Program to document completion of initial certification requirements for ombudsman trainees. The form tracks mandatory classroom instruction, self-study, and in-facility training hours to verify that a trainee meets state and federal standards before being certified to perform ombudsman duties.
Form 8708, Criminal History Disclosure, is an official Texas Health and Human Services (HHS) document used to collect detailed criminal background information from individuals applying for, working in, or volunteering with certain state-regulated programs and facilities. The form is a mandatory part of the background check process and helps HHS determine whether a person is eligible to work or serve in sensitive roles involving vulnerable populations.
Form 8619 is a confidential case record used within the State Long-Term Care Ombudsman Program. It serves as the official internal document for recording, tracking, and resolving complaints related to long-term care facilities, including nursing facilities and assisted living facilities. The form documents the lifecycle of an ombudsman case, from intake through investigation and final disposition.
Form 8615 is an official service documentation form used in Texas for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) programs. It serves as a detailed delivery log for Individualized Skills and Socialization services provided both on-site and off-site. The form is designed to document when, where, and how services were delivered, who provided them, and which specific skill areas were addressed for each individual.
Form 8647 (June 2025) is a structured assessment tool used by Local Intellectual and Developmental Disability Authorities (LIDDAs) in Texas. Its purpose is to evaluate the level of service coordination a person needs across several key life domains: rights and legal status, physical health, emotional and behavioral health, and independent living skills. While the form looks straightforward, it plays a critical role in determining the type and intensity of support a person receives — which means accurate, thoughtful completion is essential.
