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You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
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| Download | Number | Name | Effective Date |
|---|---|---|---|
|
PPP-1122A | Limited English Proficiency (LEP) Poster (English) | 08/01/2020 |
|
PPP-1063A-S | HIPAA Privacy Complaints (Spanish) | 05/01/2018 |
|
PPP-1063A | HIPAA Privacy Complaints (English) | 05/01/2018 |
|
POX-248A- Swahili | Americans with Disabilities Act Grievance Notice - Lobby (Swahili) | 07/01/2020 |
|
POX-248A- Kinyarwanda | Americans with Disabilities Act Grievance Notice - Lobby (Kinyarwanda) | 07/01/2020 |
|
POX-248A- Arabic | Americans with Disabilities Act Grievance Notice - Lobby (Arabic) | 07/01/2020 |
|
POX-248-S | Aviso sobre la Ley de Estadounidenses con Discapacidades | 07/01/2020 |
|
POX-248 -Arabic | Americans with Disabilities Act Notice (Arabic) | 07/01/2020 |
|
POX-248 - Swahili | Americans with Disabilities Act Notice (Swahili) | 07/01/2020 |
|
POX-248 - kinyarwanda | Americans with Disabilities Act Notice (Kinyarwanda) | 07/01/2020 |
| Download | Number | Name | Effective Date |
|---|---|---|---|
|
DDD-2172A | Authorization of Disclosure of Confidential Substance Use Disorder (SUD) Record Information | 02/01/2023 |
|
DDD-2171A | Accounting Disclosures Tracking | 02/01/2023 |
|
DDD-2153A | Likely Eligibility Tool (LET) | 03/01/2023 |
|
DDD-2149A | Authorization to Release Records | 08/01/2022 |
|
DDD-2121A-S | Person-Centered Service Plan Supplement to the Individualized Family Service Plan (Spanish) | 03/01/2024 |
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DDD-2121A | Person-Centered Service Plan Supplement to the Individualized Family Service Plan (English) | 03/01/2024 |
|
DDD-2114A-S | Application for Redetermination of Eligibility at Age 18 (Spanish) | 09/01/2023 |
|
DDD-2114A | Application for Redetermination of Eligibility at Age 18 (English) | 09/01/2023 |
|
DDD-2113A-S | DDD-EVV Member Contingency / IP Model Back-up Plan (Spanish) | 01/01/2022 |
|
DDD-2113A | DDD-EVV Member Contingency / IP Model Back-up Plan (English) | 01/01/2022 |