Agency Qualified Providers
 
Existing Qualified Providers Requesting to Add/Delete Services
Submit the following documents via email to dds.providerapplications@ct.gov
 Step Description
1  Log into the eLicense system using the instructions DSAP Online Add/Remove Services Instructions.  If existing qualified provider and UserID and password are not known, please contact DDS.ProviderApplications@ct.gov
If first time logging into eLicense, then follow step #1 DSAP Online Initial Application Instructions.
2
If the services you are applying to provide moves up to a higher service category (see: Provider Minimum Qualifications), submit Executive Director’s resume.
 
Note:  If applicable, additional policies may be required to be submitted.  all required policies must be accepted and on file.  Each policy must be submitted as a separate document.

Ensure you have the following documents ready to be uploaded to the eLicense website:

  1. Executive Director's resume, if applicable
  2. Policies, if applicable.

    Most of the required policies listed in the policy grid will be electronically signed as an attestation in the eLicense system ensuring that your agency will follow the DDS policies.

    The following five policies may be required for services in the categories of Family Supports, Individualized Home Supports (IHS), Days Supports, Residential Supports and Independent Support Brokers (see the policy grid for requirements):
  • Capacity to respond to emergency situations
  • Continuity of Operations Planning (COOP)
  • Emergency Response to Individuals
  • Medication Administration
  • Quality Improvement Planning (including the self-assessment and CQIP attachments)

    Create your own policies using the templates in the policy grid.  Have the applicable documents ready to be uploaded).  Save each document with the Name of your Agency and the policy name, e.g. "ABC Agency - Continuity of Operations Planning (COOP) Policy"

c. If adding clinical behavioral supports, see Clinical Behavioral Consultant Requirements.

d. If adding Healthcare Coordination, see Healthcare Coordination Requirements

e. For other supports, see detailed service definitions on the Waiver Services page.

Instructions to Upload Documents to the eLicense website:

Logon to the eLicense website (https://www.elicense.ct.gov)using the provided information, then go to Online Services, then Upload Requested Document and follow the instructions.
User ID: [OnlineID]
Password: [OnlinePW] 
Once logged in, select ‘Upload Requested Documents’ under ‘Document Upload’. 
To upload a document:
• Have the document scanned and stored on your device
• Select the Upload 'Upload Requested Documents' link.
Select the start link and then complete the upload. 
Note: All documents must be uploaded at time of initial application, otherwise, the link to upload documents will not appear unless DDS requests additional information.  Each document must be a submitted as separate documents.
3  Interview
The clinical director will interview the clinician for Healthcare Coordination, Clinical Behavioral Supports (PBS only), Parenting Support and Peer Support.

For questions, please contact DDS.ProviderApplications@ct.gov

 

Connecticut Developmental Services

460 Capitol Avenue
Hartford Connecticut 06106