If the services you are providing are community based and not provided through a specific location (Community Based Supports or Supported Employment, for example), apply for an NPI for the main location (administrative office). Application packets must be submitted to[emailprotected] no later than 14 days prior to clinic date requested. You will need to submit the following information to complete the Qualified Vendor application: 3. Learn More . DDD can accept your application packet in one of three ways: If you would like to speak to an Eligibility Specialist in person, they are available at the below locationsduring the hours listed*. Contact Us (Note: The age of the person is taken in to consideration when identifying significant limitations in daily life skills.). Having this information in hand prior to arriving in Arizona and starting the process will reduce delays in eligibility determination. The person needs assistance from a mechanical device like a wheelchair or a walker to move from place to place. Hence, you need to go through the stringent process if you wish to become a qualified DDD provider. Review Service requirements before selecting services (for those you intend to provide). Prior to submitting the Combined Application, agencies interested in providing Day Habilitation services must apply for and receive Provisional Day Habilitation Certification. Applicants may choose to provide care to a child or adult, male or female. It also provides support to family members and other caregivers. Contact your school or the district office to get a copy of an IEP (Individual Education Plan) and MET (Multi-Disciplinary Team Report)/Psychoeducational. The Division has identified and is actively recruiting for the following services that are needed statewide: Please contact Network Development & Recruitment for more information. Great for: Therapeutic Foster Care. The characteristics of your desired placement will be thoroughly discussed during the application process. Yes. The services are based on age and specific eligibility based on federal requirements and referral/application processes. Overview HSL is a locally owned and operated real estate development and management company that has been headquartered in Tucson, Arizona for almost 50 ye Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. Services include room and board, habilitation, providing appropriate personal care and supervision. Vendors need to apply for and submit their Federal Employment Identify Number (FEIN). Our current incentive program is as follows: Thank you for your interest in the Family Partners Developmental Home Programs. The physician shall submit a report to the Department documenting the diagnosis of cerebral palsy and include available medical records supporting the diagnosis. You must use the FULL Application for Determination of Eligibility* if either: You may use the SHORT Application for Determination of Eligibility* if either: The completed Application for Determination of Eligibility, including all signed forms and supporting documentation, can be submitted in person, by mail, or by email. You may view the appropriate policies, and their attachments, by clicking on the links below: Recruitment and Application to Become a Provider of Developmental Disability Services, 02-701; Recruitment and Application to become a Provider of Behavioral Health Services . A psychiatrist, neurologist, licensed psychologist, or developmental pediatrician who has expertise in diagnosing autism shall make an autism diagnosis. To become a RSA provider requires interested individuals and businesses to complete forms and undergo a rigorous review and approval process. Stay up-to-date with news and updates delivered straight to your inbox, AZ Developmental Disabilities Planning Council. Every respite provider must be approved by Family Partners prior to providing services. Your Partner for a Stronger Arizona. Can you help me get copies of my records? Created by Rocket Media. This includes documentation that you: To meet the functional criteria for a developmental disability, you must provide documentation that you have a chronic physical and/or intellectual disability that began before you were 22 years old, is expected to be lifelong, and limits your ability to care for yourself and live on your own. Direct Care Worker Training and Testing Program AHCCCS has instituted training and testing requirements for Direct Care Workers (DCW) who provide direct care services (Attendant Care, Personal Care and Homemaker) to Arizona Long Term Care System (ALTCS) members residing in their own home. The Office of System Support and Standards conducts compliance reviews of licensed and unlicensed waiver-funded settings and licensed intermediate care facilities. Services include room and board, habilitation, providing appropriate personal care and supervision. Family Partners will not deduct payroll taxes, and the developmental home reimbursement is tax-free. Be registered as a provider with the Arizona Health Care Cost Containment System Administration (AHCCCS) and become certified as a Home and Community Based Services (HCBS) provider with the DES/DDD Office of Licensing, Certification, and Regulation (OLCR). Please submit public comments electronically using the RFQVA Public Comment Submission form. For provider relations or billing information: DDDCustomerService-Providers@azdes.gov or 1-844-770-9500 For information on Curriculum: dddstatewidetraining@azdes.gov or 1-480-223-7410 Abuse, Neglect & Exploitation Prevention (Training Materials and Information) Article 9 New Instructor Clinics To meet the functional criteria for a developmental disability, you must provide documentation that you have a chronic physical and/or intellectual disability that began before you were 22 years old, is expected to be lifelong, and limits your ability to care for yourself and live on your own. Find information about their respite voucher program. You can email the completed application and all required documentation to. Re-determination is the process when the Division of Developmental Disabilities (DDD) looks at the information we have about you or your child and decides if you or your child continues to be eligible or need DDD services. Call 888-737-7494. night blindness means a driver . A new, Qualified Vendor Agreement (QVA) has been developed with input from stakeholders including Qualified Vendors, members, families and other organizations. Division of Developmental Disabilities Home and Community Based Directory This website allows members and their families to search for member services by HCBS Providers that are in the HCBS Qualified Provider network -- . Licensed Physician, such as a Family Physician or Neonatologist, Pediatrician including Developmental Pediatrician, Spina Bifida with Arnold Chiari Malformation, Chromosomal Abnormalities with high risk for Intellectual Disability, Post-Natal Traumatic Brain Injury (such as Shaken Baby Syndrome or near drowning), Disorders due to drugs or alcohol (Such as Fetal Alcohol Syndrome). During the re-determination process, you or your child will continue to receive supports and services. Join the Vituity Team. This training covers the requirements and responsibilities of instructors that teach the rights of individuals with developmental disabilities and is available for all Qualified Vendor Agency Trainers in order to become certified as an Article 9 instructor. The ArizonaDivision of Developmental Disabilities(DDD) now offers a new way to support families who need Habilitation and Attendant Care services for their child. All adults in the household must submit to a background check through the Department of Public Safety and Adult Protective Services, All adults in the household must submit a Physicians Statement, You must be able to meet the needs of the children or adults placed in your home, All adults must submit to all other medical testing that may be required by your physician or Family Partners, You must submit immunization records for each child in the home, You must have income or resources to meet the financial needs of the family and show proof of income and other resources, You must participate in the interview process when completing your home study, You must have reliable transportation and current insurance and registration, You must provide releases of information to conduct all background checks, Provide a furnished bedroom (there are certain restrictions on sharing bedrooms), Ensure all health and nutritional needs are met, Include the individual in all family activities and routines, Protect the individual from harm and exploitation, Assist the individual in developing and fostering personal relationships, Provide an opportunity for the individual to pursue their own religious beliefs, Provide transportation to meet their educational, medical, habilitation, employment, therapeutic, and social needs, Assist the individual with day to day concerns in regards to school, work, friends, and family, Provide positive reinforcement and encouragement, Prepare for and participate in IEP, IFSP, and ISP meetings and carry out assignments from the meetings, Complete required paperwork in a timely fashion, Ensure that all of the individuals rights are respected and that they are treated fairly and humanely, Advocate for what is in the best interest of the individual, The decision to become a licensed Developmental Home provider should be carefully thought out. A developmental assessment, provided by a medical professional or school evaluator trained in childhood development, can be used to identify a developmental delay that could lead to a developmental disability. Prospective vendor agency completes and submits an application both electronically and in hard copy. Parents can make tuition payments, purchase educational items, and pay for other education-related expenses directly through the ClassWallet Marketplace. NOTE: to be processed, your completed form must identify Arizona Department of Economic Security as the State Agencyand list 220 as the Agency number. AHCCCS 801 E Jefferson St Phoenix, AZ 85034 Find Us On Google Maps. You can drop off the completed application and all required documentation at any DDD office statewide. Our employees are our highest priority! Crisis Response System. 6. Additionally, all necessary information and training for potential respite providers are offered through Family Partners. RFQVA DDD-710000 Amendment 9, Effective August 15, 2022. The individuals placed in developmental homes come from a wide range of disabilities, medical conditions, and / or behavioral issues. Call Availity at 1-800-282-4548 Monday-Friday, 8 a.m. to 8 p.m. (excluding holidays). Offices are closed on state service holidays. This training covers the requirements and responsibilities of instructors that teach emergency physical intervention techniques that meet the terms and conditions as emergency measures in Article 9 and is available for all Qualified Vendor Agency trainers preparing to be certified as Prevention & Support instructors. Arizona 8-Hour Caregiver Training Course. Division Contracts Administration Unit, Network Unit, and Finance Unit reviewthe submitted application. Download current list of Certified Article 9 Instructors. The DBHDD Provider Enrollment Process is guided by specific DBHDD policies. A family member or other interested person can assist an individual in completing DDD's Application for Eligibility, but cannot apply on the individual's behalf. Some people prefer to wait to apply until they are 19 or 20, since services are not actually available until age 21 or older.