The CCS will submit the application or updates to the application, supporting documentation, and information obtained during the interview to the DDA Regional Office. Please enable scripts and reload this page. 2709 0 obj <> endobj Request an Intake Packet Copyright Maryland.gov. Copyright Maryland.gov. Please review COMAR 14.31.05-.07 for more information on the requirements for children's programs. All prospective providers are required to submit a completed DDA Medicaid Waiver Provider Application to the Provider Application Specialist in the Provider Resource Management Unit, and must include all supplemental information requested on the provider application checklist. (You can unsubscribe anytime), Designed, developed and hosted by cloudPWR 2023, Frequently Asked Questions on IP Contracting with DDA, DDA/HCS/AAA Individual Contractor Intake Form, A request for a copy of government-issued photo ID and Social Security Card. The State of Maryland pledges to provide constituents, businesses, customers, and stakeholders with friendly and courteous, timely and responsive, accurate and consistent, accessible and convenient, and truthful and transparent services. DDA requires that you have experience providing the services you are applying to provide and share the DDA vision for services. DDA Provider Application Help in Maryland | Start a DD Group Home in Maryland. Information on the process to become certified can be found at https://health.maryland.gov/crccp/Pages/administrators.aspx, You will also need to submit a budget to obtain a rate from the Interagency Rate Committee. Find the Maryland Dda Ohcds Form you require. 222 0 obj <> endobj endstream endobj 223 0 obj <. If you don't receive a letter, please call theRegional Office. Developmental Disabilities Administration (DDA), Washington State Department of Social and Health Services, Aging and Long-Term Support Administration (ALTSA), Facilities, Finance and Analytics Administration (FFA), Developmental Disabilities Guiding Values, 2022Developmental Disabilities Administration Caseload and Cost Report. DDA Services Become a Provider for DDA Companion Home Provider Companion Home Provider Become a Companion Home Provider! Once you have received your Maryland Medicaid provider number you will need to complete the DDA contracts and other required forms. megan.kwak@dshs.wa.gov. Please turn on JavaScript and try again. Remote Support: A new waiver service from DSHS Developmental Disabilities Administration, Employment and Community Inclusion Services, Low-Income Home Energy Assistance Program (LIHEAP) and Air Conditioning Units for DDA Clients. When you receive your application, make several copies in case you want to change information or use a rough draft for practice. Tickets are available. Unless exempt, all IPs are required to complete a basic training within 120 days of the first day they work. When center-based services are to be provided, a site visit is required. * Residential, day and supported employment services require a completed Developmental Disabilities Administration (DDA) application plus documentation of disability. The application can also be downloaded from the DDAs website, mailed to you, or you can pick one up from any of DDAs four (4) regional offices located in Central, Eastern, Southern, and Western Maryland. hWTW"I@;P After you have submitted a completed intake packet, contracts staff will send a fingerprint appointment form along with instructions on how to contact a DSHS contracted fingerprint technician. They will also determine a priority category - Crisis Resolution, Crisis Prevention, Current Request, or that services are needed in the future. %PDF-1.6 % (4A\t}`-vlwsze;37sBb#}|8aE8rB73oOSOg1Bq^5@7W;q>Y>)f`Atfy+I%n6do\K8gp9g=%];mu_zGV=Wn8Yr-d.e|^t Written description of the agencys quality assurance program developed to meet requirements in IDAPA 16.03.21.500.01-03. Review the certification checklist under Administrative/Facilities Requirements at the bottom of this page to ensure completeness of this section. You will also be able to access this hybrid event online. The letter includes information related to requesting a reconsideration and, DDA Eligibility Application Process - At A Glance, You need supports or assistance to live independently; and. +39\7VJ Step 3: Submission of Application Packet Once the application is submitted, you should receive a letter in about 5-7 business days informing you of the date your application was received. Our firm License and Cert. DDA PROVIDER APPLICATION I. By DDA Application Process Developmental Disabilities Administration Website Call the DDA office for the Region (Central, Western, Southern, or Eastern) in which you live. Future Needs means the person does have a need for services within the next three years. a Department on Disability Services - A + A Listen Waiver Application for IDD The full package is available as a PDF document: Request for a Renewal to a 1915 (c) Home and Community-Based Services Waiver The Medicaid Home and Community-Based Services (HCBS) waiver program is authorized in 1915 (c) of the Social Security Act. The process includes completing the DDA Application for Eligibility, submitting supporting documentation, an interview by a DDA representative, and a DDA determination. DDA Companion Home Provider Application (Developmental Disabilities Administration) English (Word) English (Adobe PDF) 14-550 : Job Foundation Application (Developmental Disabilities Administration) English (Word) English (Adobe PDF) 14-551 : Adult Family Homes (AFH) State Civil Penalty Reinvestment Program Grant Application . Dda Provider Application is a legal document that was released by the Maryland Department of Health - a government authority operating within Maryland.. Form Details: Released on June 2, 2022; The latest edition currently provided by the Maryland Department of Health; Ready to use and print; Open it using the online editor and begin adjusting. If you have specific requests, contact us atDDAFeedback@dshs.wa.gov. For questions about the Supported Living program, please contact: Megan Kwak,Community Residential Services All rights reserved. All current providers must seek approval from DDA and be re-enrolled as Medical Assistance Providers using new categories of service(s) and procedure codes in the . They will also determine a priority category - Crisis Resolution, Crisis Prevention, Current Request, or that services are needed in the future. You may be trying to access this site from a secured browser on the server. If needed an individual can request assistance in completing the DDA Application for Eligibility. P.O. DDA will review the application packet and will let you know the status of your application by email. The 2023-2025 DDA Strategic Plan describes our work and expected outcomes to accomplish the mission. Add the date and place your e-signature. hb``` cb/ 2g c pX;3g,b``h@ha` , You will need to have a business name. A person can complete the DDA Application for Eligibility. Documents and other materials of interest to residential providers will be posted here. GZA! How to Become an Individual Provider (IP) for a Client of the Developmental Disabilities Administration (DDA) For eligible clients of DDA who have identified a potential care giver, or for individuals who have been asked to provide personal care or respite services by a client of DDA. 04/04/2023 Informing Families - 2023 Summer Bulletin. GovDelivery Sign Up for News & Updates Information and resources for counties and providers: County Best Practices DDA Contracts Environmental Adaptation Providers Individual Providers Office of Rates Management Policy Manual Archives Residential Provider Resources Rules & Laws Forms Interested in becoming a Supported Living, Group Home or Group Training Home provider? endstream endobj startxref t+baGbj^x1z|qn;t.a]r/j,#c{)'Wc$Or=P9U=U\eM%q,:$; JI_#Gz;32K =*8l#rx(c8qsqy>K2& Be sure to fill out and sign everything according to the directions and return all required documents as soon as possible to avoid delays. Please join us as we return to an in-person conference with a Hybrid option for attendees. %PDF-1.6 % It looks like your browser does not have JavaScript enabled. Those who are required to complete the 70-hour training will also be required to become certified as a Home Care Aide through the Department of Health. %%EOF In addition to the budget sheets you will need to submit a completed Level of Intensity Score Sheet. Once certified, if you are wanting to become a Medicaid provider, complete the Medicaid provider enrollment application. The letter includes information related to requesting a reconsideration and appeal rights. United States, Certification Process for Developmental Disabilities Agencies. DDA Applicaton for Eligibility A person can complete the DDA Application for Eligibility. An official website of the United States governmentHere's how you know Official websites use .gov A .govwebsite belongs to an official government organization in the United States. The first step in becoming a DDA licensed provider is to register your business as a Maryland corporation with the Maryland State Department of Assessment and Taxation (SDAT). endstream endobj startxref Example: Yes, I would like to receive emails from Informing Families. , We do this by focusing on six areas: Self-Determination, Self-Advocacy, Supporting Families, Housing, Employment, and Assistive Technology.. If needed they will consult with a subject matter expert. :sV^.U2}D=&^VFmSb4R\2WflAArj|WRxsI*t"(h-j.,#`FzLc FNT__. Step 2:Register as an agency with the DHW's Background Check Unit to receive an ID for criminal history as all employees accessing or working with participants will need to have a criminal history clearance for your agency. Thank you for your interest in contracting with the Developmental Disabilities Administration (DDA). The DHS will only issue contracts when they have a need for services. >x?m4 ]I`, i. Join us for a screening of the film and panel discussion from 2 to 4 p.m. on Wednesday, April 19, at the Washington State Department of Labor and Industries conference area, 7273 Linderson Way SW, Tumwater. Request Certified Community Residential Service and Support Initial Application and Instructions at ccrssapplicationsrequest@dshs.wa.gov For questions about the Supported Living program, please contact: Megan Kwak, Community Residential Services (360) 764-9909 megan.kwak@dshs.wa.gov Step 3:Complete an application for Developmental Disabilities Agencies Certificateusing the DDA-RH portal link found on this page. There are some other very important steps in becoming a childrens provider. You need the support of a team to help with your services and treatment. Follow directions given by contracts staff and wait for results to be received by DDA. Applicants who pass the DDA process will be referred to the Office of Health Care Quality (OHCQ) to obtain the license. Please enable JavaScript in your browser. For questions about Companion Homes, please contact: Olga Lutysk,Community Residential Services Program Manager Applicants that fail to submit the required documentation will receive a letter from the DDS/DDA Provider Relations Specialist, requesting the information be sent to DDS/DDA within three (3) business days. Effective 7/23/17, Respite providers working less than 300 hours in a calendar year will complete 9 hours of mandatory basic training. People with developmental disabilities will have full lives in the communities of their choice where they are included, participate, and are active citizens. @IF)DE(=`QfAX,B'mcfhj)}4M 9?,\|%H= Xur! You can complete this by visitinghttps://www.idmedicaid.com/default.aspxor if you are applying to provide children's DD Medicaid services, review these instructions. 2786 0 obj <> endobj BACKGROUND INFORMATION Application is for (select one): Individual Applicant (Sole Applicant registered with SDAT proposing to render waiver services and Applicant hasno employees) Agency (An entity registered with SDAT with 1 or more employees, excluding the owner) Application is for (check all that apply): (360) 407-1518 Interested providers should review the information below and submit the DDA Provider Application along with the Provider Agreement to Conditions of Participation and Checklist. J[Q0}i$U9aEcU(W|e)i]INcU&QMoL29 `BZLh{du'Zk}AS>&o>\c(rKjPmY-i^XH^N(J4w?J2OtEfgWYZthc;XE6hKsa4&YKsTp,=CRBG$?4F~n? K4%_My+_QO+VtJP6_H3]^,5xg{vWZ=p~GE,cK? 201 W. Preston Street, Baltimore, MD 21201-2399, Developmental Disabilities Administration, Home and Community-Based Services (HCBS) final rule, Provides a coordinated service delivery system for people with developmental disabilities. DDA Intake Application Amharic DDA Intake Application French Eligibility and Intake Process for RSA Contact Email: dds-dda.intake@dc.gov Contact Phone: (202) 730-1791 Contact TTY: (202) 730-1516 Office Hours: Monday to Friday, 8:15 am to 4:45 pm Service Location: GIS Address: 250 E Street, SW City: Washington State: DC Zip: 20024 Contact Email: At that time, you will receive a call to come in to participate in a short orientation which will include reviewing DSHS and SEIU information and then signing the contract. The CCS will submit the application or updates to the application, supporting documentation, and information obtained during the interview to the DDA. Only applications submitted to that email address will be considered. You are required to submit the completed application with all required attachments. Crisis Resolution means the person is in crisis or emergency situation (for example - abuse, neglect, homeless), Crisis Prevention means the person is or will be in a health or safety crisis within the next year, Current Request means the person needs/wants services; health and safety are not the immediate issues. The 2023-2025 DDA Strategic Plandescribes our work and expected outcomes to accomplish the mission. The State of Maryland pledges to provide constituents, businesses, customers, and stakeholders with friendly and courteous, timely and responsive, accurate and consistent, accessible and convenient, and truthful and transparent services. To open an ICF/IDD home funded through the Medicaid State Plan, interested providers must contact DHCF and Department of Health, Health Regulatory and Licensing Administration (DOH/HRLA) license and certification. If the result of the check indicates no record, no further information is needed. submitted the required documentation as outlined in the Medicaid Provider Application and General Provisions of the HCBS waiver regulations. From an accredited hospital Download Brochure Apply Today! 6?i will assess all the information to determine whether the applicant meets either of the DDA eligibility categories - Developmentally Disabled or Supports Only. In order for the DDA to determine whether a person is eligible, the person or someone acting on their behalf must complete the DDA application process. JavaScript is required to use content on this page. Developmentally Disabled Eligibility means: Applicants and their representatives will receive a formal letter from the DDA stating the eligibility and priority category determinations. Check List: List of Board Members and their affiliations. hbbd``b`z$gXsuWH0'V$kbM{@ ?H2I@w `$br,F*? Please enable scripts and reload this page. 0 This web page is intended as a resource for residential providers who contract with DDA. The department will review the application form and materials to determine if the agency has met all of the regulatory requirements and has the necessary systems in place to ensure the implementation of those requirements. People with developmental disabilities and their families are valued citizens of the state of Washington. The DDA typically assigns an independent case manager referred to as a Coordinator of Community Services (CCS) to assist with the application process. ), Community Residential Training Evaluation, Residential Training Roster / Reimbursement, Training and CE Tracking Tool for Supported Living, Group Training Home,and Group Home Providers, Community Residential Services Quality Assurance Tool, Community Residential Services Quality Assurance Tool Tracker, Home Environment QA Tool and Routine Maintenance Schedule, Infection Control/Response Quality Assurance Tool, Plan Due Date Tracking tool for Supported Living, Group Home, LSR and Crisis Diversion Providers, Residential Transition Exchange of Information, Alternative Living (AL) Services Overview, Supported Living, Group Training Home, and Group Home Program Locator, AL Services Initial Training Requirements, AL Services Ongoing Training Requirements, Request Certified Community Residential Service and Support Initial Application and Instructions at. The department will notify the agency with a written decision regarding certification. Please contact unit staff for any questions or assistance.