GUIDANCE AND TOOLS

• Avoiding Service Gaps
• Claiming for Support Coordination Services for Individuals Enrolled in SP or CCP-FFS
• Electronic Signature (E-Signature) Use in iRecord
• Electronic Signature (E-Signature) Frequently Asked Questions
• Email Validation Process: SC Training (11/28/2018)
• Entering Supported Employment–Individual Employment Support Services Into the ISP
• EVV Checkbox Quick Reference Guide
• EVV Checkbox Communication to Support Coordination Agencies
• EVV Guidance for Support Coordination Agencies
• Communication Protocol
• Community Care Program (CCP) Frequently Asked Questions
• Guidance on Waiver Program Transitions
• Independent Living Discussion Tool
• ISP Plan Reviews: Guidance for SCAs
• Quick Reference Guide to Mandated Trainings for SDEs
• SCA Policies & Procedures Guidebook
• Seeking Out Support (SOS) Form
• Tips for Preparing an ICM Referral
• Transitioning Individuals from Institutional Settings
• Transportation Services in Fee for Service
• ISP Signature Page Frequently Asked Questions

GUARDIANSHIP

• Guardianship Referral Form
• Instruction for Guardianship Referrals
• Request for Guardianship Need Recommendation

 

INCIDENT REPORTING

• DDD Incident Reporting Documents and Forms

 

PLAN DEVELOPMENT AND MONITORING

• Addressing Enhanced Needs Form
• Continuation of Prevocational Training Justification Form
• DDD Mental Health Pre-Screening Checklist
• DVRS Referral Guidelines
• Employment Determination Form – (F3)
• Employment Non-Referral Form to DVRS or CBVI – (F6)
• Employment Forms Instruction Guide – F3 & F6
• HIPAA Form Approved for Use by SC Agencies
• ISP Review Checklist for Support Coordination Supervisors
• ISP Revision and Notification Form
• ISP Worksheet for Day Hab Providers
• ISP Worksheet for Residential Providers
• Medicaid Eligibility Troubleshooting Form
• Participant Enrollment Agreement- English
• Participant Enrollment Agreement-Spanish
• Participant Rights and Responsibilities-English
• Participant Rights and Responsibilities-Spanish
• Support Coordinator Face to Face Visit Declination Form
• Support Coordinator Monitoring Tool – Monthly
• Support Coordinator Monitoring Tool - Quarterly and Annual
• Support Coordinator Monitoring Tool – Work Instructions

REQUEST FORMS

• AT/EM Evaluation Request Form
• AT/EM/VM Purchase Request Form
• Community Care Program Waiting List Request Form
• Community Transitions Unit Case Transfer Form
• Enhanced Reasonable and Customary Wage Request
• Goods and Services Request Form Instructions
• Goods and Services Request Form
• Human Rights Committee Referral Form
• ICD-10 Diagnosis Change Request Form
• ICF/ID Referral Form
• Individual Supports Request Form
• Intensive Case Management (ICM) Referral
• Retirement Request Form
• Retroactive Change Request Process
• Retroactive Change Request Form
• Single Passenger Rate Transportation Request Form
• Supported Employment Funding Request Form
• Voluntary discharge from Division Services

DDD RESOURCE TEAM REFERRAL FORMS

• BCBA Consultation Form
• RN Consultation Form
• Speech Pathology Consultation Form

RESIDENTIAL PLACEMENT FORMS

• Residential Referral Coversheet
• Residential Referral Coversheet Instructions
• Residential Provider Response Form
• Residential Placement Offer Form
• Pre-placement Transition Plan

• Interim Policy Guide to Support Coordination
• Support Coordinator's Guide to Unusual Incident Reporting
• Conflict-Free Policy (Revised 1/2022)

To become a Division-approved Support Coordination Agency, a provider must complete and submit the Combined Application to Become a Medicaid/DDD Approved Provider (Combined Application) found on the Provider Portal page of the Division's website.

Prior to submitting the Combined Application, agencies interested in providing Division-funded Support Coordination services must

• Review the Division's revised Conflict-Free Policy (Revised 1/2022)
• Review the Support Coordinator's Guide to Unusual Incident Reporting
• Submit an Agency Letter of Interest and an Agency Conflict-Free Policy (both on agency letterhead ) to the Provider Helpdesk: DDD.ProviderHelpdesk@dhs.nj.gov