The Admit and Discharge form, HCBS 105, is used to admit and discharge individuals into and from the Home and Community Based Services waiver program. It is to be completed by the OSDP Counselor at the time of the initial certification into the program, at each re-certification and anytime there is a change in the individual's status.
See Resource Guide for the 105 form and detailed instructions on completing the form.
32 Miss. Code. R. 1-12.7