Developmental Disabilities Administration (for pda/handhelds)

Information, Forms, And Resources For DDA Providers

Individuals receiving funding from the DDA can request a change (i.e. increase, decrease, addition or deletion) in services at any time as noted in DDA’s Eligibility for and Access to Community Services for Individuals with Developmental Disabilities (COMAR 10.22.12.11 D) - click here for further information

 All forms marked with with are in PDF. (The freely available Adobe Acrobat reader is required to view and print PDF files).

Please Note: To download/save any file to your hard drive, right click on the link and click on save target as... from the drop down menu to save the file to your hard drive.

Forms

• Misc. Forms and Documents For Providers
  CMS 1500, funding plans, application forms, monthly contribution to room and board and cost of care, and vacancy data
• Cost Reports and Wage Survey
• Rates And Invoices
• Provider Agreement And Procurement Exemption Forms
• New Directions Forms
• Application Forms For Services
• Absence Day Policy - FAQ
• Supports Intensity Scale (SIS) FAQ
• Medical Day Referral Form
  for Resource/Service Coordinators
• Medical Day Care Referral
  Process Statement
• Medical Day Care Service Eligibility
  Criteria
• Medical Day Care Transmittal #68

• Disaster Readiness Planning Template
• Provider Information Request Sheet
  In order to be listed or change the information about your agency on the DDA Web site, please complete this form. Mail the form along with a cover letter (on agency letterhead) asking DDA to include your information on the Web site. Please address the cover letter to Mr. Pete deFries, Assistant Director Operations, at DDA HQ (201 W. Preston Street, Fourth Floor, Baltimore, MD 21201).
  The cover letter must be signed by the Executive Director.

Memos to Providers

• Memo - Monitoring and Follow up of People who are at risk of choking
• Utilization reviews for FISS, IFC, and Innovation Services - January 2012
• Changes in DDA fiscal practices - November 2011
• Discharge requests - April 2011
• Submission to Federal form 990
• Request for Service Change

Resources

• "Ask Me!" Survey Report 2011
• Medicaid Transmittal
• Staff Retention & Development Toolbox
• Provider Consumer Information System (PCIS2)
• National Provider Identifiers
• Policy On Reportable Incidents
• Standing Committee Training Now Available
  • PowerPoint
  • PDF
• Emergency Evacuation Plan for Providers
  Memo
• Your Right to be Informed
  About the Most Integrated Setting
• Become Minority Business Enterprise (MBE) Certified
• Becoming A DDA Provider
• Training
• Regulations
• COMAR 10.22
• Licensing Information - Office of Health Care Quality