By DDA Application Process Developmental Disabilities Administration Website Call the DDA office for the Region (Central, Western, Southern, or Eastern) in which you live. After the initial request for assistance or the application has been received, a DDA representative will contact you to schedule an interview and review the information. Is guided by the principle that individuals with developmental disabilities have the right to direct their lives and services. 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. 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): It is important for you to keep the DDA updated on any changes in your circumstances or contact information including phone numbers, addresses, and caretakers. 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. will assess all the information to determine whether the applicant meets either of the DDA eligibility categories - Developmentally Disabled or Supports Only. Please contact unit staff for any questions or assistance. Please review information on the DDA website regarding the services that we provide. How do I become licensed to provide services to people with developmental disabilities? %PDF-1.6 % 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? , We do this by focusing on six areas: Self-Determination, Self-Advocacy, Supporting Families, Housing, Employment, and Assistive Technology.. DDA requires that you have experience providing the services you are applying to provide and share the DDA vision for services. 241 0 obj <>/Filter/FlateDecode/ID[<2414CF6C61C62F4791FEB0FCEDD5844A>]/Index[222 37]/Info 221 0 R/Length 93/Prev 98777/Root 223 0 R/Size 259/Type/XRef/W[1 2 1]>>stream The Developmental Disabilities Administration strives to develop and implement public policies that will promote individual worth, self-respect, and dignity such that each individual is valued as a contributing member of the community. You may be trying to access this site from a secured browser on the server. The DDA Regional Office will assess all the information to determine whether the applicant meets either of the DDA eligibility categories - Developmentally Disabled or Supports Only. Indicate the applicable DDA Regional Office where you or the agency would like to provide services in the subject line of the email. DDA PROVIDER APPLICATION I. Click here for a listing of local DDA offices. 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. Once you have received your Maryland Medicaid provider number you will need to complete the DDA contracts and other required forms. Information on the rate process can be found at: http://marylandpublicschools.org/programs/Pages/Special-Education/IRC/index.aspx. endstream endobj startxref 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. Once you are licensed you will need to have a certified Program Administrator. endstream endobj startxref This web page is intended as a resource for residential providers who contract with DDA. Add the date and place your e-signature. The DDS/DDA Provider Relations Specialist or designated staff reviews the application to determine whether an applicant submitted the required documentation as outlined in the Medicaid Provider Application and General Provisions of the HCBS waiver regulations. Provider Qualifications Licensed Practical Nurse or Registered Nurse acting within the scope of the standards of nursing conduct per Chapter 246-700 WAC Contracted with DDA to provide the service Sample Contract 1789XP: DDA Nursing Services - Statement of Work The DDA typically assigns an independent case manager referred to as a Coordinator of Community Services (CCS) to assist with the application process. The 2023-2025 DDA Strategic Plan describes our work and expected outcomes to accomplish the mission. Our firm License and Cert. DDA Provider Application Help in Maryland | Start a DD Group Home in Maryland. Frequently Asked Questions on IP Contracting with DDA. JavaScript is required to use content on this page. A written code of ethics policy required in IDAPA16.03.21. @IF)DE(=`QfAX,B'mcfhj)}4M 9?,\|%H= Xur! Step 3:Complete an application for Developmental Disabilities Agencies Certificateusing the DDA-RH portal link found on this page. GZA! 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. You are required to submit the completed application with all required attachments. 0 2889 0 obj <>stream Effective 7/23/17, Respite providers working less than 300 hours in a calendar year will complete 9 hours of mandatory basic training. Call our office at 410-543-6790 for general information, on how to obtain an application or apply for services. 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. submitted the required documentation as outlined in the Medicaid Provider Application and General Provisions of the HCBS waiver regulations. hbbd```b`6g"El$/3b/ m0lspC3 e;__ w..^$]8aXM.F.A0[D2C#Z E,LJU]t,Vf`0Ju2@2Qg? You will need to have a business name. The DHS will only issue contracts when they have a need for services. Please turn on JavaScript and try again. You must have a contract with DHR to be funded for these services. Interested providers should review the information below and submit the DDA Provider Application along with the Provider Agreement to Conditions of Participation and Checklist. Companion homes are established in typical family settings. Please enable JavaScript in your browser. 2829 0 obj <>/Filter/FlateDecode/ID[<7486B1C82E6F17469EE512D82C806907>]/Index[2709 181]/Info 2708 0 R/Length 234/Prev 807377/Root 2710 0 R/Size 2890/Type/XRef/W[1 3 1]>>stream 0 Example: Yes, I would like to receive emails from Informing Families. 2967 0 obj <>stream 04/12/23 Informing Families - Spring Newsletter, 04/10/23 2023 Community Summit -DSHS Developmental Disabilities Administration is proud to announce Community Summit 2023. t+baGbj^x1z|qn;t.a]r/j,#c{)'Wc$Or=P9U=U\eM%q,:$; JI_#Gz;32K =*8l#rx(c8qsqy>K2& Unless exempt, all IPs are required to complete S & O after they have completed the contract process (DSHS has signed their contract) and before beginning to work for a client of DDA. Please review COMAR 14.31.05-.07 for more information on the requirements for children's programs. There are some other very important steps in becoming a childrens provider. 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. If you are interested in becoming a contracted provider, please call your localDDAoffice and ask for the contracts department: Developmental Disabilities Administration Contracts, Washington State Department of Social and Health Services, Aging and Long-Term Support Administration (ALTSA), Developmental Disabilities Administration (DDA), Facilities, Finance and Analytics Administration (FFA). It looks like your browser does not have JavaScript enabled. 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. For more information, visitwww.communitysymmit.ws, 04/04/23 Get your tickets to our premiere of "UNSEEN: How We're Failing Parent Caregivers & Why It Matters". Service providers are an integral part in Transforming Lives across Washington State! Copyright Maryland.gov. The application can be found on the Maryland Department of Health website. They will also determine a priority category - Crisis Resolution, Crisis Prevention, Current Request, or that services are needed in the future. RSVP for the event by April 12. For questions about Companion Homes, please contact: Olga Lutysk,Community Residential Services Program Manager Please enable scripts and reload this page. Show details How it works Open the wa dshs dda and follow the instructions Easily sign the dshs individual provider with your finger Send filled & signed dshs intake form or save Once certified as a developmental disabilities agency, you will be required to submit a request for request for renewal of certification 90 days before the certificate expires. * Residential, day and supported employment services require a completed Developmental Disabilities Administration (DDA) application plus documentation of disability. The Developmental Disabilities Administration is transforming lives by providing support and fostering partnerships that empower people to live the lives they want. 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 . The Developmental Disabilities Administration is transforming lives by providing support and fostering partnerships that empower people to live the lives they want. National Human Trafficking Hotline - 24/7 Confidential. DDA also requires that you have a board of directors so you will want to begin to form your board. Thank you for your interest in contracting with the Developmental Disabilities Administration (DDA). Step 3: Submission of Application Packet You will also be able to access this hybrid event online. Request a copy of the application for services. National Human Trafficking Hotline - 24/7 Confidential. 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. Change the blanks with smart fillable fields. (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. %%EOF %%EOF The saved file and any required attachments should be attached to the email and emailed to: [email protected]. DDA providers must adhere to regulations in COMAR 10.22. 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? Please enable JavaScript in your browser. Dshs Individual Provider 2018-2023 Get the dshs individual provider application 2018 template, fill it out, eSign it, and share it in minutes. Thank you for your interest in contracting with the Developmental Disabilities Administration (DDA). 0 If the result indicates automatic disqualification, the process ends. The process includes completing the DDA Application for Eligibility, submitting supporting documentation, an interview by a DDA representative, and a DDA determination. An application is considered complete when all required documents are received and in compliance with rules and regulations. How to Become a Provider of Services Funded in Whole or in Part by DDA Application Review Process Waiver Service Description Vendor Identification Form Attachment (s): Vendor Identification Form - 68.4 KB (docx) Contact Email: [email protected] Contact Phone: (202) 730-1700 Contact TTY: (202) 730-1516 Office Hours: Monday to Friday, 8:15 am to 4:45 pm A sample format can be found here: A copy of the proposed organizational chart or plan for staffing the agency. {]Xb#1 C If you don't receive a letter, please call theRegional Office. United States, Certification Process for Developmental Disabilities Agencies. The following documentation is required to be uploaded with your application for it to be considered complete. The CCS will submit the application or updates to the application, supporting documentation, and information obtained during the interview to the DDA Regional Office. Only applications submitted to that email address will be considered. (4A\t}`-vlwsze;37sBb#}|8aE8rB73oOSOg1Bq^5@7W;q>Y>)f`Atfy+I%n6do\K8gp9g=%];mu_zGV=Wn8Yr-d.e|^t The following documentation is required to be uploaded with your application for it to be considered complete. To provide DDA funded services you must apply to be an approved Maryland Medicaid provider. (360) 407-1518 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; When center-based services are to be provided, a site visit is required. Partners with people with developmental disabilities and their families to provide leadership and resources to enable these individuals in living fulfilling lives. If needed an individual can request assistance in completing the DDA Application for Eligibility. All rights reserved. DDA Services Become a Provider for DDA Companion Home Provider Companion Home Provider Become a Companion Home Provider! JavaScript is required to use content on this page. Parent personal care providers will complete a 7 hour training. Please review all of the information but the required forms can be found here: http://marylandpublicschools.org/programs/Pages/Special-Education/IRC/Forms.aspx. o9`.=0 $%pH3@ D) The process includes completing the DDA Application for Eligibility, submitting supporting documentation, an interview by a DDA representative, and a DDA determination. All new providers are required to submit a completed DDA Medicaid Waiver Provider Application and submit the required supporting documentation in the form of policies and procedures, licensure and/or certification that demonstrates the provider agency's compliance with the specific rules for each of the waiver services the provider agency is . DDA will review the application packet and will let you know the status of your application by email. JavaScript is required to use content on this page. The following documentation is required to be uploaded with your application for it to be considered complete. All rights reserved. ), 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. DDA PROVIDER APPLICATION I. If you have any general questions about DDA Quality Assurance, contact Lori Gianetto Bare, Residential Quality Assurance Unit Manager. 2786 0 obj <> endobj Check List: List of Board Members and their affiliations. Applicants and their representatives will receive a formal letter from the DDA stating the eligibility and priority category determinations. If the result indicates a review is required, contracts staff will request professional references and will send you the required paperwork. 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. You will be given instructions on how to complete this step when you come in to sign your contract.

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