The community provider must accurately report the only the hours paid for Direct Support Professionals supporting persons who live in and/or receive DDA-funded services in Prince George’s County. DDS/DDA Checklist for Reviewing of Provider’s Investigation Reports for Comprehensiveness and Quality Provider Checklist June 1, 2013 2 INITIAL REVIEW RATINGS B/E M/ E E/E N/A 8. The PAS or other designated Provider Resource Management (PRM) staff use the Readiness Checklist to guide the review. The Investigator’s review of ISP/BSP/Behavioral Data Sheets was comprehensive. Department of Human Services > Division of Developmental Disabilities. Application Submittal Checklist . Application for Participation in Maryland Medical Assistance … mmcp.dhmh.maryland.gov. Roster of key personnel, their resume, and position descriptions including (as applicable): a. President/Vice President b. Basic organizational documents - Organizational chart. When DDS/DDA receives the Medicaid application and the required supplemental materials, the documentation is reviewed by the assigned Provider Application Specialist (PAS) to determine if all the required information is present. If determined eligible for paid ser… Step Two: Assessment of the person’s support needs 3. 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. 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 Community Pathways Waivers by April 30, 2018. This process continues with Provider Readiness Process - Steps 5 thru 7. 7. To find a provider, please see information for Individuals. Phone: 609.633.1482 | Toll-free: 800.832.9173. Roster of key Personnel, their resume, and position descriptions: Background checks for unlicensed Key Personnel. Effective Feb. 2018, DDA will offer a variety of community-based services and supports to eligible individuals on its waiting list and to family members of individuals enrolled. dda.cfo@maryland.gov. Step One: Intake and eligibility determination for new clients 2. LTSS Provider Upload API- Service Identifiers List Effective 3.1.2021​, Provider Upload API - User Guide Final V4.1. List of Board Members and their affiliations. Read Mayor Bowser’s Presentation on DC’s COVID-19 Situational Update: March 11. Step 2: Complete the Medicaid provider enrollment application to become a Medicaid provider. Completed and signed DDA Facility/Organization Provider Application … NUMBER. Parent Provider: Individual caring for his/her biological, step or adoptive child. Steps 3 and 4 of the DDA Medicaid Waiver Provider Application Review Process walks potential service providers through the application packet submission, checklist and pre-screening processes. Please Note: If the provider fails to contact the licensing specialist, within 12 months of being assigned a licensing specialist, the provider’s application will be closed. INITIAL CONTINUING. By-laws or similar documents regulating conduct of provider's internal affairs. Baltimore, MD 21201, Home and Community-Based Services (HCBS) final rule, Eligibility Requirements for Qualified Supports/ Services Providers, Policy – Application and Approval Processes for Qualified Supports/Services Providers in DDA’s Home and Community-Based Waivers, Instructions for Completing the DDA Provider Application - Revised 12-29-2020, DDA Provider Application - Revised 12-29-2020, Staff Training - Developmental Disabilities Services, Staff Training - Office of Children Services, Provider Agreement to Conditions of Participation, Provider Application Webinar with instructions, Developmental Disabilities Administration (DDA) Frequently Asked Questions (FAQ) about Waivers for Providers. Application Fee: $5,500; Annual Participation Fee: $1,000; Credit card payments may be made online during the application process. Provider Qualification Process: Provider Qualification Instructions; Provider Home and Community-Based Services (HCBS) Application; Provider Requirement Summary; Provider Checklist - Current Providers; Provider Checklist - New Providers; DDDS Provider Service Rates: Provider Reimbursement Methodologies and Rate Studies ; Provider Rates The provider must develop policies that are in compliance with . If an applicant does not meet any of the above criteria, then he or she is not eligible for LISS Program funding. Business license, Certificate Authority (if none, Certificate of Good Standing per state). As the introduction states, this checklist is no substitute for a full access audit and is only intended to give you an initial idea of the scale of necessary physical adjustments. services funded by the DDA. Please sign, date, and return completed form along with your application and payment to our office. You can complete this by visiting: www.idmedicaid.com 9. Undertaking Letter (refer Template No. Applicants who pass the DDA process will be referred to the Office of Health Care Quality (OHCQ) to obtain the license. Program policies & procedures for each waiver service to be provided. 4. A working agency document used to remediate challenges and deficiencies in order to create systemic improvements. MS Word. The Investigator thoroughly reviewed the target’s criminal background HCA CREDENTIAL. ORIENTATION AND SAFETY (5 hours) BASIC TRAINING. Copy of most recent audited financial statement of the organization. The PAS or other designated Provider Resource Management (PRM) staff use the Readiness Checklist to guide the review. The application packet from thecommunity provider must include an attestation to accuracy of the information provided. b. 5. Template. For COVID-19 information related to individuals served by DDD: Complete application 2. When DDS/DDA receives the Medicaid application and the required supplemental materials, the documentation is reviewed by the assigned Provider Application Specialist (PAS) to determine if all the required information is present. Application Submittal Checklist. *If a pass code box pop up, click cancel and you should be able to access the template. Application Checklist for Maryland Medical Assistance Program … Completed and signed DDA Facility/Organization Provider Application … NUMBER. Applicants will be notified when the readiness review has been completed. Submit the most recent approved Quality Assurance letter received from DDA. Payments in the form of certified check, cashier’s check, money order, or company check may be sent via mail. Description of ownership and list of major owners. For a provider who serves twenty (20) or fewer DDA clients, in lieu of CARF certification the provider may provide proof of successful employment placements. EDUCATION (CE) ONGOING CONTINUING EDUCATION (CE) Complete prior to providing care. Instructions: Please use this checklist to verify all required information is included in your application, and submit it with your application to the DDA Provider Relations Unit. 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 Community Pathways Waivers by April 30, 2018. The DDA is accepting applications from interested individuals or businesses/agencies to render services and supports to participants in its Community and Family Supports Waivers. Can be submitted later, however, that can delay the process and start of services. A completed application will include the following: Completed and signed DDA Provider Type 90 Facility/Organization Provider Application Copy of current OHCQ license, Organized Health Care Delivery System (OHCDS) certificate, or DDA authorization letter to provide services under the DDA Community Pathways Waiver
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