DDS: Application Information on How to Become a Qualified Provider

Application Information on How to Become a Qualified Provider



Thank you for your interest in becoming a qualified provider.  The Department of Developmental Services (DDS) is committed to quality services and supports for the individuals we serve.  Qualified providers are essential to accomplish our goal of delivering quality services.  The links below provide useful information for those seeking to become qualified.

Qualified providers must meet the standards established in the DDS Home and Community Based Services Waiver (HCBS) or the Autism Waiver.  All providers must be incorporated in the United States and Connecticut.  Click here to view the HCBS Waiver Manual and DDS Policy and Procedures.

The Division of Autism Spectrum Disorders is now managed by the Department of Social Services (DSS).  The Qualified Provider Application process for Autism services is transitioning to DSS.
 
Currently, if you select Autism services on either the Agency Application or the Individual Practitioner Application, an email notification will direct you to contact
DDS.Autism@ct.gov for additional instructions.

To reduce wait time, email DDS.Autism@ct.gov directly for instructions on how to apply for Autism services.

NEW As of April 13, 2017, new private providers applying to become a DDS qualified provider are required to complete a Connecticut State Police criminal background check.  This applies to the Principal of the entity, Connecticut Administrator, any managing partners/owners and Individual Practitioners once all application documents have been accepted.
  • The Principal of the entity, Connecticut Administrator, any managing partners/owners and Individual Practitioners must be fingerprinted.

  • The background check must be completed by the Connecticut State Police and the report must be submitted to DDS (dds.qpapenrollment@ct.gov) showing any findings/no findings.  The Criminal Conviction History Record must be searched using Fingerprints.
Out of state providers may utilize their state agency for the criminal background check and fingerprinting process.  All reports must be submitted to DDS (dds.qpapenrollment@ct.gov) showing any findings/no findings.

Connecticut Criminal History Record Request Form http://www.ct.gov/despp/lib/despp/reports_and_records/dps-846-c.pdf


Get Help

For Intellectual Disability Services, contact dds.providerapplications@ct.gov
For Autism Specific Services, contact dds.autism@ct.gov

New Providers Apply Here

 Agency

Individual Practitioner

If applying as an Agency, submit the following:
  1. Resume(s) for the Principal of the Entity and CT Administrator, if applicable, and Executive Management Team must be submitted via email to dds.qpapenrollment@ct.gov

  2. If applying for Clinical Behavioral Supports or Healthcare Coordination, email the required documents listed in Clinical Behavioral Consultant Checklist or Healthcare Coordination Checklist to dds.qpapenrollment@ct.gov
If DDS determines an agency meets minimum qualifications for the services they are applying to provide, an email notification will be sent with detailed requirements.  These include:
  1. The remaining application documents: Agency Qualified Provider Checklist which must be submitted via email to dds.qpapenrollment@ct.gov  Please use the policy templates located in the Policy Requirements document Policy Requirements Based on Support Level


  2. The related policy documents outlined in the email notification sent to the agency.  The policies must be submitted via email to dds.qpappolicies@ct.gov.
A provider may move to a Purchase of Service (POS) contract when DDS revenue for qualified services reach $200,000.  For more information on the similarities and differences providing services through Individual Budgets and POS Contract, review the following document: Similarities and  Differences in services through Ind Budgets and POS Contract
If applying as an Individual Practitioner, submit the following:
  1. For Clinical Behavioral Supports and Healthcare Coordination, submit all the required documents on the checklist: Individual Qualified Provider Checklist. For Peer Support, submit all the required documents on the checklist: Individual Qualified Provider Checklist Peer.  All documents must be submitted via email to dds.qpapenrollment@ct.gov.




























 
Already a Qualified Provider?
  1. If you are already a Qualified Provider and would like to add Clinical Behavioral Support Services or add a clinician to provide Clinical Behavioral Support, submit all the required documents on the Clinical Behavioral Consultant Requirements Checklist to the appropriate contact in the Get Help section below.

  2. If you are already a Qualified Provider and would like to add Healthcare Coordination Services or add a clinician to provide Healthcare Coordination, submit all the required documents on the Healthcare Coordination Requirements Checklist Checklist to the appropriate contact in the Get Help section below.

  3. If you are already a Qualified Provider and would like to add Parenting Support Services or add a Parenting Support Provider to provide Parenting Support, submit all the required documents on the Parenting Support Requirements Checklist to the appropriate contact in the Get Help section below.

  4. If you are already a Qualified Provider and would like to add/delete services for:

    a.  Autism Specific Services: submit Application to Amend Services-Autism to the Autism Specific Services contact in the Get Help section below.

    b.  Intellectual Disability Services: submit Application to Amend Services-IDS to the Intellectual Disability Services contact in the Get Help section below.

  5. If the services you are applying to provide moves up to a higher service category, then submit a summary of how you meet the minimum qualifications to the appropriate contact in the Get Help section below (see: Provider Minimum Qualifications-IDS or Provider Minimum Qualifications-Autism)    (Note: It would be helpful to include a resume as well)

  6. Agencies who DDS determines meet minimum qualifications for the additional services they are applying to provide will be asked to submit the remaining required policies and any revisions to existing policies that may apply (see: Policy Requirements Based on Support Level-Autism or Policy Requirements Based on Support Level-IDS). Submit all documents to the appropriate contact in the Get Help section below.
Important Resources




For Intellectual Disability Services, contact dds.providerapplications@ct.gov
For Autism Specific Services, contact dds.autism@ct.gov





Content Last Modified on 4/13/2017 1:03:38 PM