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 . hW{4k!TN )DSrB$ITD$A8S:~V}\~: @ ? {))R,'wZ{nwx(==W:1*m!9jZ-g Create a flexible, person-centered, family-oriented system of support so people can have full lives., 201 W. Preston Street, 4th FloorBaltimore, MD 21201Phone: (410) 767-5600Fax: (410) 767-5850Toll Free: (844) 253-8694. (360) 407-1518 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. 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. The following documentation is required to be uploaded with your application for it to be considered complete. Is guided by the principle that individuals with developmental disabilities have the right to direct their lives and services. People with developmental disabilities will have full lives in the communities of their choice where they are included, participate, and are active citizens. Step 3: Submission of Application Packet Please review the certification checklistfound at the bottom of this page to ensure completeness of this section. This web page is intended as a resource for residential providers who contract with DDA. Please turn on JavaScript and try again. endstream endobj 223 0 obj <. Please contact unit staff for any questions or assistance. P.O. megan.kwak@dshs.wa.gov. Once certified, if you are wanting to become a Medicaid provider, complete the Medicaid provider enrollment application. You are responsible for marketing your services. 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): Person-Centered Planning Provides a coordinated service delivery system for people with developmental disabilities Partners with people with developmental disabilities and their families to provide leadership and resources to enable these individuals in living fulfilling lives. 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. 201 W. Preston Street, Baltimore, MD 21201-2399, Developmental Disabilities Administration, Home and Community-Based Services (HCBS) final rule, https://health.maryland.gov/crccp/Pages/administrators.aspx, http://marylandpublicschools.org/programs/Pages/Special-Education/IRC/index.aspx, http://marylandpublicschools.org/programs/Pages/Special-Education/IRC/Forms.aspx. DDA requires that you have experience providing the services you are applying to provide and share the DDA vision for services. Dshs Individual Provider 2018-2023 Get the dshs individual provider application 2018 template, fill it out, eSign it, and share it in minutes. To request assistance, please contact the Regional Office. The following description and applications are available for review and completion: DDA Waiver Provider Application Review Process. An application is considered complete when all required documents are received and in compliance with rules and regulations. Please review information on the DDA website regarding the services that we provide. DSHS DDA Waiver Services: What services are available, how to find providers, and more. You will also be able to access this hybrid event online. {]Xb#1 C Companion homes are established in typical family settings. 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. 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. DDA will review the application packet and will let you know the status of your application by email. RSVP for the event by April 12. Future Needs means the person does have a need for services within the next three years. >x?m4 ]I`, i. You must have a contract with DHR to be funded for these services. endstream endobj startxref The CCS will submit the application or updates to the application, supporting documentation, and information obtained during the interview to the DDA. Information on the rate process can be found at: http://marylandpublicschools.org/programs/Pages/Special-Education/IRC/index.aspx. Documents and other materials of interest to residential providers will be posted here. Services may be long-term, intermittent, or hourly. endstream endobj startxref 04/12/23 Informing Families - Spring Newsletter, 04/10/23 2023 Community Summit -DSHS Developmental Disabilities Administration is proud to announce Community Summit 2023. 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. * Residential, day and supported employment services require a completed Developmental Disabilities Administration (DDA) application plus documentation of disability. 04/04/2023 Informing Families - 2023 Summer Bulletin. The full process is also available as a downlable PDF document. Follow directions given by contracts staff and wait for results to be received by DDA. :sV^.U2}D=&^VFmSb4R\2WflAArj|WRxsI*t"(h-j.,#`FzLc FNT__. 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). 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. You need the support of a team to help with your services and treatment. 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. 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): Secure .gov websites use HTTPS A lock( Lock A locked padlock Share sensitive information only on official, secure websites. The contract is not valid until signed by DSHS staff. 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. Please turn on JavaScript and try again. 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? For more information about our programs and services, see the 2022Developmental Disabilities Administration Caseload and Cost Report. A sample participant file that contains documents meeting the requirements of IDAPA 16.03.21.301.05.a-i. hbbd``b`z$gXsuWH0'V$kbM{@ ?H2I@w `$br,F*? 6?i 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. 2967 0 obj <>stream JavaScript is required to use content on this page. DDA providers must adhere to regulations in COMAR 10.22. Depending on the number of hours and type of service provided, all others will complete a 30 or 70 hour basic training. Once policies and procedures are approved you will be issued a license. 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 all of the information but the required forms can be found here: http://marylandpublicschools.org/programs/Pages/Special-Education/IRC/Forms.aspx. DDA Services Become a Provider for DDA Companion Home Provider Companion Home Provider Become a Companion Home Provider! A written code of ethics policy required in IDAPA16.03.21. When center-based services are to be provided, a site visit is required. Change the blanks with smart fillable fields. The Developmental Disabilities Administration is transforming lives by providing support and fostering partnerships that empower people to live the lives they want. It looks like your browser does not have JavaScript enabled. To file a complaint, click DDA-RH Portal on the right side of this page; once in the portal click on "Complaint Form," follow the directions from there. Add the date and place your e-signature. JavaScript is required to use content on this page. +39\7VJ The 2023-2025 DDA Strategic Plandescribes our work and expected outcomes to accomplish the mission. Applicants and their representatives will receive a formal letter from the DDA stating the eligibility and priority category determinations. 222 0 obj <> endobj Start a DD Group Home in DC, Maryland or Virginia. In addition to the budget sheets you will need to submit a completed Level of Intensity Score Sheet. Interested providers should review the information below and submit the DDA Provider Application along with the Provider Agreement to Conditions of Participation and Checklist. The 2023-2025 DDA Strategic Plan describes our work and expected outcomes to accomplish the mission. From an accredited hospital Download Brochure Apply Today! 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. DDA provider applicants who are referred to OHCQ for licensing will need to submit their policies and procedures to OHCQ. Please enable JavaScript in your browser. You will then receive information about login to the DDA data and billing system and will be scheduled for training in using the system. Service providers are an integral part in Transforming Lives across Washington State! Please enable scripts and reload this page. All rights reserved. 258 0 obj <>stream United States, Certification Process for Developmental Disabilities Agencies. 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. If the result of the check indicates no record, no further information is needed. Click on Done after double-checking everything. Make sure your agency is registered with the Idaho Secretary of State by visiting their website: Complete an application for Developmental Disabilities Agencies Certificateusing the DDA-RH portal link found on this page. 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 . If needed an individual can request assistance in completing the DDA Application for Eligibility. 2883 0 obj <>/Filter/FlateDecode/ID[]/Index[2786 182]/Info 2785 0 R/Length 245/Prev 938893/Root 2787 0 R/Size 2968/Type/XRef/W[1 3 1]>>stream %%EOF The DDA regional office Provider relations staff will reach out to you to schedule a time to meet with the regional office. laint, click DDA-RH Portal on the right side of this page; once in the portal click on "Complaint Form," follow the directions from there. K4%_My+_QO+VtJP6_H3]^,5xg{vWZ=p~GE,cK? You will be given instructions on how to complete this step when you come in to sign your contract. There are some other very important steps in becoming a childrens provider. Please turn on JavaScript and try again. It looks like your browser does not have JavaScript enabled. 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: dds@dc.gov Contact Phone: (202) 730-1700 Contact TTY: (202) 730-1516 Office Hours: Monday to Friday, 8:15 am to 4:45 pm The saved file and any required attachments should be attached to the email and emailed to: providerapplications.dda@maryland.gov. 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; DDA Application effective 10 01 2022 Final Version (2).pdf Person-Centered Thinking Person-centered thinking is a philosophy behind service provision that supports positive control and self-direction of people's own lives. Washington State Voter Registration for applicants age 18 or older Documents that support that you have a developmental disability, as described in DSHS Form 14-459 Eligible Conditions Specific to Age and Type of Evidence such as: Educational records Psychological records Medical records A developmental disabilities agency is a certified entity that provides center and/or home and community-based services to adults and/or children with intellectual disabilities. Thank you for your interest in contracting with the Developmental Disabilities Administration (DDA). 2889 0 obj <>stream A samplefile for a direct service provider and a supervisor that contains documents meeting the requirements in section 301.04 of thisrule. If you have specific requests, contact us atDDAFeedback@dshs.wa.gov. The Developmental Disabilities Guiding Values encompasses our vision and values for inclusive communities. Enter your email in the field below, let us know you're not a robot, and click the SIGN UP button. (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. endstream endobj startxref The application can be found on the Maryland Department of Health website. Our firm License and Cert. Submit your completed application with required attachments and the Provider Agreement to Conditions of Participation to providerapplications.dda@maryland.gov. Complete the empty areas; concerned parties names, addresses and phone numbers etc. A policy and procedure manual that contains all requirements found in IDAPA 16.03.21, https://adminrules.idaho.gov/rules/current/16/160321.pdf. 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. They will also determine a priority category - Crisis Resolution, Crisis Prevention, Current Request, or that services are needed in the future. The letter includes information related to requesting a reconsideration and appeal rights. (4A\t}`-vlwsze;37sBb#}|8aE8rB73oOSOg1Bq^5@7W;q>Y>)f`Atfy+I%n6do\K8gp9g=%];mu_zGV=Wn8Yr-d.e|^t 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. The DDA typically assigns an independent case manager referred to as a Coordinator of Community Services (CCS) to assist with the application process. 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. 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. For questions about the Group Training Home or Group Home program contact: This unit can help providers in a variety of different quality assurance areas. For questions about the Supported Living program, please contact: Megan Kwak,Community Residential Services Copyright Maryland.gov. If you have any general questions about DDA Quality Assurance, contact Lori Gianetto Bare, Residential Quality Assurance Unit Manager. hb``` cb/ 2g c pX;3g,b``h@ha` , Please enable JavaScript in your browser. ), 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. National Human Trafficking Hotline - 24/7 Confidential. Unless exempt, all IPs are required to complete a basic training within 120 days of the first day they work. 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? When you receive your application, make several copies in case you want to change information or use a rough draft for practice. Effective 7/23/17, Respite providers working less than 300 hours in a calendar year will complete 9 hours of mandatory basic training. 2786 0 obj <> endobj Be sure to fill out and sign everything according to the directions and return all required documents as soon as possible to avoid delays. DDA Provider Application Help in Maryland | Start a DD Group Home in Maryland. The DDA typically assigns an independent case manager referred to as a Coordinator of Community Services (CCS) to assist with the application process. All rights reserved. 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. For questions about Companion Homes, please contact: Olga Lutysk,Community Residential Services Program Manager hWTW"I@;P Generally children's programs are funded by the Department of Human Services (DHS). You may be trying to access this site from a secured browser on the server. Applicants who pass the DDA process will be referred to the Office of Health Care Quality (OHCQ) to obtain the license. Please enable scripts and reload this page. Request a copy of the application for services. Please review COMAR 14.31.05-.07 for more information on the requirements for children's programs. The employee file for the current administrator. You may be trying to access this site from a secured browser on the server. DDA PROVIDER APPLICATION I. People with developmental disabilities and their families are valued citizens of the state of Washington. 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. %PDF-1.6 % Individuals seeking certification of a developmental disabilities agency must complete the following: Step 1:Make sure your agency is registered with the Idaho Secretary of State by visiting their website:https://www.sos.idaho.gov/. Check List: List of Board Members and their affiliations. You may be trying to access this site from a secured browser on the server. A person can complete the DDA Application for Eligibility. If the result indicates automatic disqualification, the process ends. 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. A sample format can be found here: A copy of the proposed organizational chart or plan for staffing the agency. Please enable scripts and reload this page. 0 The CCS will submit the application or updates to the application, supporting documentation, and information obtained during the interview to the DDA Regional Office. 201 W. Preston Street, Baltimore, MD 21201-2399, Developmental Disabilities Administration, 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. Indicate the applicable DDA Regional Office where you or the agency would like to provide services in the subject line of the email. You will need to have a business name. You should also review information about the Community Pathways Waiver, the Family Supports Waiver, and the Community Supports Waiver. The department will notify the agency with a written decision regarding certification. will assess all the information to determine whether the applicant meets either of the DDA eligibility categories - Developmentally Disabled or Supports Only. hbbd```b`6g"El$/3b/ m0lspC3 e;__ w..^$]8aXM.F.A0[D2C#Z E,LJU]t,Vf`0Ju2@2Qg? Step 3: Complete an application for Developmental Disabilities Agencies Certificate using the DDA-RH portal link found on this page. JavaScript is required to use content on this page. submitted the required documentation as outlined in the Medicaid Provider Application and General Provisions of the HCBS waiver regulations. Only applications submitted to that email address will be considered. If needed they will consult with a subject matter expert. You are required to submit the completed application with all required attachments. 2709 0 obj <> endobj 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". Reviews add additional time to the process. National Human Trafficking Hotline - 24/7 Confidential. (360) 764-9909 Developmentally Disabled Eligibility means: Applicants and their representatives will receive a formal letter from the DDA stating the eligibility and priority category determinations. 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. Copyright Maryland.gov. 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 Thank you for your interest in contracting with the Developmental Disabilities Administration (DDA). To provide DDA funded services you must apply to be an approved Maryland Medicaid provider. 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). If you don't receive a letter, please call theRegional Office. 0 The process includes completing the DDA Application for Eligibility, submitting supporting documentation, an interview by a DDA representative, and a DDA determination. All rights reserved.