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This version of the form is not currently in use and is provided for reference only. Download this version of
Form 1058
for the current year.
Form 1058 Request for Home and Community-Based Services Crisis Diversion Slot - Texas
What Is Form 1058?
This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 1058?
A: Form 1058 is a request for Home and Community-Based Services Crisis Diversion Slot in Texas.
Q: What is the purpose of Form 1058?
A: The purpose of Form 1058 is to request a Crisis Diversion Slot for home and community-based services in Texas.
Q: Who can use Form 1058?
A: Form 1058 can be used by individuals who need crisis diversion services in Texas.
Q: How do I fill out Form 1058?
A: You need to provide your personal information and details about your crisis situation on the form.
Q: What happens after submitting Form 1058?
A: After submitting Form 1058, your request will be reviewed, and if approved, you may be assigned a Crisis Diversion Slot.
Q: What are Home and Community-Based Services?
A: Home and Community-Based Services (HCBS) are services provided to individuals who require assistance to live in the community instead of an institution.
Q: What is a Crisis Diversion Slot?
A: A Crisis Diversion Slot is a temporary placement in a home or community-based service program to help individuals during a crisis.
Q: Is there a cost for Home and Community-Based Services?
A: The cost for Home and Community-Based Services may vary based on your income and eligibility.
Q: How long does it take to get a Crisis Diversion Slot?
A: The time to get a Crisis Diversion Slot can vary based on availability and the urgency of your crisis.
Form Details:
- Released on February 1, 2018;
- The latest edition provided by the Texas Health and Human Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form 1058 by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.
Download Form 1058 Request for Home and Community-Based Services Crisis Diversion Slot - Texas
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