How to Complete Texas HCS Forms for Home and Community-Based Services

The Texas Home and Community-based Services program runs on a defined set of HCS forms published by the Texas Health and Human Services Commission, and the four that drive enrollment and service authorization are Form 3608 (Individual Plan of Care), Form 8578 (ID/RC Assessment), Form 8665 (Person-Directed Plan), and Form 8584 (Nursing Comprehensive Assessment). Blank forms are free to download from the HHSC website; completed forms are transmitted to the state through the TMHP Long-Term Care Online Portal by the program provider or Local Intellectual and Developmental Disability Authority (LIDDA).

Where to Download HCS Forms

Every official HCS form lives on the HCS Forms page of the Texas Health and Human Services website, organized by form number, with instructions and a downloadable PDF for each.¹ You do not need an account to download blanks. The numbering is grouped: the 1000 series includes the nursing tasks screening tool and review reports, the 3000 series holds the Individual Plan of Care, and the 8000 series contains the ID/RC assessment, person-directed plan, and nursing comprehensive assessment.

Submitting a completed form is a different step. HCS submissions go through the TMHP Long-Term Care Online Portal, which program providers and LIDDAs use to transmit data electronically.²

The Core HCS Forms

Dozens of forms exist, but a short list carries most of the work. Errors in Medicaid numbers, diagnostic codes, or service-unit math on any of these can delay or block authorization.

Form 3608, Individual Plan of Care (IPC) — HCS and CFC. Authorizes every service the participant will receive and totals the annual cost, which must sit within the individual’s approved cost ceiling.³
Form 8578, ID/RC Assessment. Documents diagnosis, IQ, adaptive behavior, and behavioral status. Scoring assigns the Level of Care and Level of Need that drive the reimbursement rate.⁴
Form 8665, Person-Directed Plan (PDP). Captures the individual’s goals, preferred outcomes, people in their life, and how each service connects to what matters to them. The PDP sets the content of the IPC.⁵
Form 8584, Nursing Comprehensive Assessment. A registered nurse’s documentation of the individual’s health history, current status, and needs.⁶
Form 8665-ID, Individual Data. Companion to Form 8665 for identifying data that rarely changes.⁷

Other commonly used forms include Form 1572 (Nursing Tasks Screening Tool), Form 1592 (RN Delegation Checklist), Form 2125 (Implementation Plan), Form 1740 (Service Backup Plan), and Form 8583 (Contact Information). The full list is on the HCS Forms page.¹

Completing Form 3608 (Individual Plan of Care)

Form 3608 translates a participant’s person-directed plan into authorized, billable Medicaid services. It must be filled out before IPC data is entered into the HHSC data system. An IPC is valid for 365 days (366 in a leap year); a new one is completed at initial enrollment and at each annual renewal.³

Identifying Information

Page 1 asks for the individual’s full name, Medicaid number, date of birth, age, and address, along with the IPC begin date, end date, and effective date. The effective date depends on the situation. For an initial enrollment or annual renewal, it matches the IPC begin date. For a transfer, it is the day the individual begins receiving services from the new provider. For a revision triggered by a PDP change, it must fall on or after the date of the IPC meeting.

You also enter the currently authorized Level of Need, the program provider’s name, four-digit vendor number, and contract number. If a Financial Management Services Agency is involved for consumer-directed services, its vendor and contract numbers go in the same section. Mark the residential type (host home/companion care, residential support services, or supervised living), enter the location code assigned by the program provider, and identify the county of service. Then check the IPC type — initial enrollment, renewal, transfer, or revision — that describes why the form is being completed.

Services and Cost

The body of the form lists every HCS and CFC service authorized, the number of units per year, and the cost per unit. Combined annual costs across all services must stay within the individual’s authorized cost ceiling. A separate section documents non-HCS supports — family-provided help or other community resources — so the plan reflects the individual’s full care picture, not just what Medicaid funds.

You also record who will deliver each service, where it will be delivered, and projected start and completion dates. Two portal rules affect how the form can be entered: service units of less than one unit will not transmit, and a renewal or transfer-at-renewal cannot be submitted more than 60 days before the end of the current IPC period.²

Completing Form 8578 (ID/RC Assessment)

Form 8578 establishes whether a person has an intellectual disability or qualifying related condition and assigns the Level of Care and Level of Need. It can be completed by a registered nurse, licensed vocational nurse, Qualified Intellectual Disability Professional (QIDP), case manager, LIDDA service coordinator, or HCS provider representative, depending on the program.⁴

Diagnostic and Clinical Items

The form captures primary diagnosis, ICD code and version, onset date, and any secondary medical or psychiatric diagnoses. IQ scores go into Item 29, with the name of the testing instrument used in Item 68. Adaptive behavior level, the instrument used, and the assessment date fill Items 30, 69, and 70.

For HCS participants, Inventory for Client and Agency Planning (ICAP) data is the piece that drives funding. Broad Independence (Item 31), General Maladaptive (Item 32), and the ICAP Service Level (Item 33) map directly to the Level of Need:⁸

LON 1: ICAP service level 7, 8, or 9
LON 5: ICAP service level 4, 5, or 6
LON 8: ICAP service level 2 or 3
LON 6: ICAP service level 1

The LON determines the reimbursement rate the program provider receives for certain HCS services, so an inaccurate ICAP score has a direct financial impact.

Behavioral, Nursing, and Day Service Items

Items 34 through 38 capture behavioral status: whether the individual has a behavior program, and whether self-injurious, seriously disruptive, aggressive, or sexually aggressive behaviors are present. Nursing service frequency goes in Items 39 and 40. Day or employment service details fill Items 41 through 46. Item 47 covers ambulation.

Submission Rules Specific to 8578

For HCS participants, the LIDDA or provider enters Form 8578 data into the TMHP portal. If you are requesting a behavioral, medical, or initial LON 9 increase, supporting documentation justifying the increase must be submitted to HHSC within seven calendar days of the electronic transmission.⁴ The Inactivate and Correct functions on the 8578 Purpose Code 2 and the initial enrollment IPC are restricted to HHSC staff. Providers cannot self-correct these submissions and must contact HHSC to fix errors.²

Completing Form 8665 (Person-Directed Plan)

The PDP is an ongoing process rather than a one-time event. The LIDDA service coordinator convenes and facilitates the PDP meeting, and the individual must be involved in every aspect. The service coordinator asks the individual or their legally authorized representative (LAR) whether they want to invite the HCS provider and anyone else.⁷

Form 8665 has four main pages. Pages 1 through 3 cover identifying information, the discovery methods used to learn about the individual’s preferences, important background information, a list of people in the individual’s life, the frequency of service coordination, any non-HCS services, and additional comments. Page 4 is the Action Plan, which identifies each service to be provided, the individual’s preferences for how services are delivered, whether a backup plan is necessary, and why each service matters to and for the individual.

Because the PDP drives the IPC, services listed on Form 3608 should trace directly back to goals and preferences in the PDP. A service on the IPC with no connection to anything the individual or LAR identified during planning is likely to generate questions from HHSC during review. The governing rules are in 26 Texas Administrative Code, Chapters 262 and 263.⁵

Completing Form 8584 (Nursing Comprehensive Assessment)

Form 8584 documents a registered nurse’s assessment of the individual’s physical and psychological health, covering health history, current health status, and current health needs.⁶ The results feed the nursing service frequency on Form 8578 and inform whether nursing tasks can be delegated to non-licensed staff.

Providers are not required to use the state’s exact form. They may use their own assessment tool as long as it contains every required element in Form 8584, per 26 Texas Administrative Code Section 262.8.⁹

Submitting Forms Through the TMHP Portal

Most HCS form submissions happen electronically through the TMHP Long-Term Care Online Portal. Providers and LIDDAs use the system to enter IPC data, transmit ID/RC assessments, update provider locations, and manage individual movement forms.² Step-by-step guides for each form type are available through the TMHP Learning Management System.

Practical rules that affect what the portal will accept:

Renewal timing. A renewal or transfer-at-renewal cannot be submitted earlier than 60 days before the current IPC period ends.
Minimum units. The system will not accept service entries with less than one unit.
Individual Movement forms. A Local Authority reassignment form can be submitted with an effective date up to 15 days in the future.
Provider Location Updates. Providers can correct or inactivate a submitted PLU form when they identify an error.
Corrections to initial forms. The Inactivate and Correct buttons on the 8578 Purpose Code 2 and initial enrollment IPC are available only to HHSC staff; providers must contact HHSC to make changes.

Alongside the TMHP portal, the state maintains the Client Assignment and Registration (CARE) system, a separate application that stores demographic, diagnostic, assessment, residential, service assignment, and other data for all HHS clients served through mental health and intellectual and developmental disability service areas.¹⁰ The LIDDA enters service coordinator assignments into the HHSC data system and updates them as changes occur.¹¹

Electronic Visit Verification

Certain in-home HCS services also require Electronic Visit Verification. Under the federal 21st Century Cures Act, EVV must electronically document the type of service, the individual receiving it, the date, the location, the provider delivering it, and the start and end times.¹² Program providers may use an HHSC-approved proprietary EVV system or an EVV vendor system. HHSC publishes HCS- and TxHmL-specific best-practices documents to help providers avoid EVV claim mismatches at billing.

A Note on Getting Into the Program

Filling out HCS forms is a provider and LIDDA task that happens after a person is being enrolled. Someone seeking to join the program does not start by submitting forms. Texas operates an interest list because qualified applicants exceed available funding slots, and placement is handled by contacting your Local Intellectual and Developmental Disability Authority.¹³ Applicants are placed first-come, first-served, and the LIDDA or a state office contacts the person when their name reaches the top. Eligibility requires an ICF/IID Level of Care VIII, an approved plan of care, and Medicaid eligibility under the special income limit, with a service begin date within 30 days of certification.¹⁴ The 2026 Medicaid waiver income limit in Texas is $2,982 per month for a single applicant. Once enrollment begins, the LIDDA assigns a service coordinator who becomes the individual’s primary point of contact and who is responsible for walking the person and their representative through the paperwork described above.¹¹

1
Texas Health and Human Services. HCS Forms
2
Texas Medicaid & Healthcare Partnership. Updated LTC Online Portal User Guides for HCS and TxHmL Waiver Programs Now Available
3
Texas Health and Human Services. Form 3608, Individual Plan of Care (IPC) HCS and CFC
4
Texas Health and Human Services. Form 8578, Intellectual Disability or Related Conditions – ID/RC Assessment
5
Texas Health and Human Services. Form 8665, Person-Directed Plan
6
Texas Health and Human Services. Form 8584, Nursing Comprehensive Assessment
7
Texas Health and Human Services. 4000, Person-Directed Plan
8
Texas Health and Human Services. 5000, Level of Care and Level of Need
9
Legal Information Institute. 26 Texas Administrative Code 262.8 – Comprehensive Nursing Assessment
10
Texas Health and Human Services. Client Assignment and Registration System
11
Texas Health and Human Services. 2000, Service Coordination
12
Texas Health and Human Services. Electronic Visit Verification (EVV)
13
Texas Health and Human Services. Interest List Reduction
14
Texas Health and Human Services. A-3300, Home and Community-Based Services Waiver Programs