Individual Practitioners
Steps to Become a New 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.
Qualified providers must meet the standards established in the DDS Home and Community Based Services Waiver (HCBS). Be sure to review the following documents:
Providers who already submitted an application in the past and were instructed to submit documents using the DDS.QPAPenrollment@ct.gov mailbox, should submit documents to DDS.ProviderApplications@ct.gov Otherwise, new providers should follow the instructions below:
Steps to Apply to Become a New Qualified Provider
| Step | Description |
| 1 | Log into the eLicense system using the instructions DSIP Online Initial Application Instructions |
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2
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Ensure you have the documents listed in the Individual Qualified Provider Checklist ready to be uploaded to the eLicense website. 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] Once logged in, select ‘Upload Requested Documents’ under ‘Document Upload’. To upload a document:
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| 3 |
Background Check and Verification of Credentials:
New private providers applying to become a DDS qualified provider are required to complete a Connecticut State Police criminal background check.
IMPORTANT: YOU MUST PRINT THE COMPLETED SERVICE CODE FORM CONTAINING THE TRACKING NUMBER AND BAR CODE AND BRING IT TO THE CONNECTICUT STATE POLICE TO CONDUCT THE FINGERPRINTING PROCESS/CRIMINAL BACKGROUND CHECK. Some local police departments offer fingerprinting services (they can electronically submit the fingerprinting or may hand you the hard copy of the fingerprinting cards to bring them to the State Police).
Please review CCHRS-Pre-Enrollment-User-Manual
Contact DDS.ProviderApplications@ct.gov for the SERVICE CODE. Fingerprinting is by appointment only. See Connecticut State Police website: State-Police-Bureau-of-Identification
BE SURE TO ENTER A VALID EMAIL ADDRESS WHEN COMPLETING THE PRE-ENROLLMENT. Reports will also be electronically sent to DDS.
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| 4 |
Interview Once all documents have been accepted, DDS will schedule an interview. |
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5
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Nurse Orientation Training (for Healthcare Coordination and Subcontractor for Nursing Supports only)
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