DCF: Licensing application instructions/materials

DCF Licensing Unit
Application Instructions And Materials
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We are pleased to announce that the Department has signed a Memorandum of Understanding along with the Departments of Public Health, Developmental Services, and Administrative Services regarding the creation of a Uniform Licensing Application and the operation of a web-based filing and storage system for required licensing documents.

 

We are utilizing the DAS-BIZNET system, that most of you already use, to collect and store license applications and other required licensing documentation.  This will limit the need for these forms to be submitted multiple times to different or individual state agencies.

We have implemented this uniform licensing application and online posting process for the following licenses:

 

LICENSURE APPLICATION FOR COMMUNITY BASED ENTITY

 

        Department of Public Health

  1. Private Freestanding Mental Health Day Treatment Facilities Connecticut General Statutes Sections 19a-491 and/or 19a-506
  2. Private Freestanding Mental Health Community Residence Connecticut General Statutes Sections 19a-491 and/or 19a-506
  3. Private Freestanding  Mental Health Residential Living Centers Connecticut General Statutes Sections 19a-491 and/or 19a-506
  4. Private Freestanding  Facilities for the Care or Treatment of Substance Abuse or Dependence Connecticut General Statutes Sections 19a-491 and/or 19a-506
  5. Private Freestanding Psychiatric Outpatient Clinics for Adults Connecticut General Statutes Sections 19a-491 and/or 19a-50

    Departmnent of Children and Families
  1. Extended Day Treatment Connecticut General Statutes Section 17a-147
  2. Out-Patient Psychiatric Clinic for Children  Connecticut General Statutes Section 17a-20
  3. Safe Home Connecticut General Statutes Section 17a-145
  4. Residential Treatment Connecticut General Statutes Sections 17a-145 & 17a-151
  5. Residential Education  Connecticut General Statutes Section 17a-145
  6. Group Home  Connecticut General Statutes Sections 17a-145 & 17a-151
  7. Temporary Shelter  Connecticut General Statutes Sections 17a-145 & 17a-151
  8. Child Placing Agency  Connecticut General Statutes Section 17a-150

    Department of Developmental Services
  1. Community Living Arrangement for persons with intellectual disability and/or  person with autism spectrum disorder Connecticut General Statutes Section 17a-227

For a quick look at the Uniform Licensing process visit: http://das.ct.gov/fp1.aspx?page=443

This site will provide you with a Power Point presentation and a video to walk you through the new process.  The Uniform Licensing site also contains all of the forms needed to file an application. 

 

Please feel free to speak to your DCF Licensing contacts for more information, or email DCF Licensing at: dcf.licensing@ct.gov

 

Request for Proposal Requirement: With few exceptions, DCF may only purchase services that have been requisitioned through a Request for Proposal (RFP) process.  The RFP process ensures that an open, competitive bidding process has occurred prior to DCF contracting with a provider.  If an applicant for a DCF license wishes to serve clients involved with DCF, then the applicant may need to submit a proposal in response to a published RFP.  All RFPs issued by DCF are published on a Department of Administrative Services (DAS) website.
 
 
Determination of Fiscal Viability: If the applicant has entered into a contract with DCF or another government entity, then the applicant must provide a copy of the contract in order to verify fiscal viability.  If the applicant does not have a contract with DCF or another government entity, the applicant must provide a detailed budget for the new program with a description of referral sources along with evidence of at least 4 months of funding for the new program.
 

Initial Licensing Visit: Once the applicant has submitted a completed application, the assigned Licensing staff member schedules an on-site visit to the facility/program.  The on-site activities may require more than one visit to the facility/program. The following areas will be reviewed during the on-site visit:

  1. Physical Plant: The building should be completely furnished and ready to open before an initial provisional license can be issued.  The behavioral, developmental, and medical characteristics of the children to be served must be taken into account when determining the adequacy and safety of the physical plant.
  2. Personnel Files: The personnel files of all staff listed on the DCF Staff Schedule A must be reviewed.  The files must contain:
    • the results of all background checks: DCF and State Police,
    • physicals and TB tests, (immediately prior for CCF and EDT- within 12 months prior to hire for OPCC, health statement-free from communicable disease within 12 months prior for CPA)
    • CPR training,
    • CPR and First Aid certification for at least one staff for EDT
    • completion of physical restraint training,
    • medication administration certification sufficient to cover med administration needs of the program for EDT and CCF
    • Abuse and Neglect statute sign-off (EDT and OPCC only)
    • Confidentiality statute sign-off (EDT and OPCC only)
    • Patient Rights statute sign-off (OPCC only)
    • License or certification if required for the position
    • Evidence of orientation (EDT and OPCC only)
    • Evidence of training that is in compliance with the agencys training plan
    • Evidence of clinical privileging (OPCC only)
    • Evidence of receipt of job description (EDT and OPCC only)
    • Evidence of receipt of employee grievance procedure (OPCC only)
  3. Sample Case Records: Each facility/program must prepare a sample case record which includes the required format as called for in the applicable set of regulations.
NOTE: the facility/program must have sufficient medication administration certified staff in order to ensure that all medication administration times are covered.  If the facility does not have a medication certified staff member on site, then the facility must have a plan to ensure that a medication certified staff member is on-call and can arrive at the program to administer medications as needed.
 
NOTE: facility must ensure that each shift has at least two staff on duty who are trained in physical restraint, and at least one who is trained in CPR.
 
 
Forms:
Below are links to documents necessary to apply for a license, the DCF licensing application form, and other forms required to receive licensing: