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
These include 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
- 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 Agency 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.
Resources
- Medicaid Transmittal
- Policy on Reportable Incidents And Investigations
- Staff Retention & Development Toolbox
- Provider Consumer Information System (PCIS2)
- National Provider Identifiers
- Standing Committee Training Now Available
- Emergency Evacuation Plan for DD Providers Memo
- Your Right to be Informed About the Most Integrated Setting
- Ask Me! FY09 Report
- Become Minority Business Enterprise (MBE) Certified
- Becoming A DDA Provider
- Training
- Regulations
- Licensing Information - Office of Health Care Quality
