Document Library and Checklists
Agency Application
Agency with Choice Assurance Form
Agency with Choice FAQs
Agency with Choice Memo
Assurance Agreement-Agency
Assurance Agreement-IHS 2 and IHS 3
Assurance Agreement-Individual Practitioner Clinical Behavioral Consultant
Assurance Agreement-Individual Practitioner Healthcare Coordination
Assurance Agreement-Remote Supports
Assurance Agreement-Subcontracted Nursing Agency
Clinical Behavioral Consultant Requirements
Connecticut Criminal History Record Request Form
Connecticut State Police website
Confidentiality and HIPAA Assurance Agreement
Criminal Background Verification Certificate for a Change in Principal of the Entity, Connecticut Administrator, Partnership or LLC
Agency with Choice Assurance Form
Agency with Choice FAQs
Agency with Choice Memo
Assurance Agreement-Agency
Assurance Agreement-IHS 2 and IHS 3
Assurance Agreement-Individual Practitioner Clinical Behavioral Consultant
Assurance Agreement-Individual Practitioner Healthcare Coordination
Assurance Agreement-Remote Supports
Assurance Agreement-Subcontracted Nursing Agency
Clinical Behavioral Consultant Requirements
Connecticut Criminal History Record Request Form
Connecticut State Police website
Confidentiality and HIPAA Assurance Agreement
Criminal Background Verification Certificate for a Change in Principal of the Entity, Connecticut Administrator, Partnership or LLC
DDS Policy and Procedures
Prevention and Reporting of Fraud, Waste and Abuse Acknowledgement of Receipt
Fraud Information Attachment A
Prevention and Reporting of Fraud, Waste and Abuse Procedure
HCBS Waiver Manual
Healthcare Coordination Requirements
Individual Practitioner Application
Parenting Support Service Requirements Checklist
Peer to Peer Support
Prevention and Reporting of Fraud, Waste and Abuse Acknowledgement of Receipt
Fraud Information Attachment A
Prevention and Reporting of Fraud, Waste and Abuse Procedure
HCBS Waiver Manual
Healthcare Coordination Requirements
Individual Practitioner Application
Parenting Support Service Requirements Checklist
Peer to Peer Support
Provider Profile Correction Form - Towns
Qualifications for Agencies to Subcontract for Nursing Services
Qualifications for Agencies to Subcontract for Nursing Services
Waiver Services Home Page
Checklists
Agency Qualified Provider Checklist
Clinical Behavioral Consultant Checklist
Healthcare Coordination Checklist
Individual Qualified Provider Checklist
Subcontracting for Nursing Supports Checklist
Clinical Behavioral Consultant Checklist
Healthcare Coordination Checklist
Individual Qualified Provider Checklist
Subcontracting for Nursing Supports Checklist
Training Materials
Provider Orientation Overview (PowerPoint Presentation)
Videos:
Review Processes
Quality Improvement - Continuous Quality Improvement Plans - Enhanced Monitoring
** Video Sign-off Sheet**
