Effective Date: 


Updated: 4/2012


This form is used when an individual receiving Home and Community-based Services (HCS) or Texas Home Living (TxHmL) services moves from one LA service area to another, but does not transfer to a new waiver contract. This form serves as the notification that an individual enrolled in one of these waiver programs is moving into an LA's service area.


The current LA service coordinator (SC) for an individual enrolled in HCS or TxHmL must complete Form 8575 before an individual moves to a different LA's service area and does not transfer to a new waiver contract.

The current LA is referred to as the sending LA and the LA where the individual will be moving to is considered the new or receiving LA.

The form and Client Assignment and Registration (CARE) System data entry will be initiated by the sending LA and completed by the receiving LA.

The individual's current SC, with the sending LA, must complete the top section of the form, and enter the individual's:

  • name,
  • CARE ID,
  • SC name,
  • SC telephone number,
  • date of move,
  • new location code,
  • new county,
  • county code,
  • program provider name, and
  • program provider component code.

The SC should contact the program provider to obtain the location code and county where the individual will be moving. The program provider must have already set up the location code in CARE. If the individual is enrolled in TxHmL or resides in his own or family's home, the generic location code is OHFH.


Sending LA

Once the SC has completed the individual's information, the sending LA representative enters the information into CARE screen L30, using the "Add" action.

The sending LA will enter into CARE:

  • date of move,
  • location and county codes,
  • name of the LA representative completing the data entry, and
  • date the entry was completed.

This information will be noted on the form, including the individual's local case number for the sending LA. Once the information has been entered into CARE, the form may be faxed to the receiving LA.

Receiving LA

If the individual has already moved, the receiving LA may complete the following CARE data entry as soon as it receives the information. If the individual has not yet moved, the receiving LA should wait until the date of the move to do the CARE data entry.

To acknowledge the transfer, the receiving LA uses the "Change" action on CARE screen L30 and enters:

  • name of the LA representative completing the data entry, and
  • date the entry was completed.

After completing CARE screen L30, CARE screen L26 is displayed. The receiving LA should confirm that the information being displayed is correct, and make any changes necessary.

Pending LA Assignment Report

An LA may access XPTR report number HC062860 (Pending LA Assignments) to determine if another LA has started this process on an individual moving into their service area.

If an LA does not complete CARE data entry as described in this document, the program provider may be unable to enter billing data in CARE. It is important that communication between the transferring and receiving LAs occurs to ensure that both LAs are aware of an individual moving from one service area to another and to share information regarding the individual's services.

Questions regarding entry of CARE screen L30 should be directed to IDD Waivers Program Enrollment/Utilization Review (PE/UR) staff.

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