Determine Eligibility

For early intervention services, children age birth to three must have a significant delay in one or more developmental areas or an established condition that could lead to a developmental disability.  To make a referral for a child, please email AzEIP Central Referral Line (Encircle Families formerly Raising Special Kids) or call toll-free at (888) 592-0140. Once a child has been made eligible for AzEIP, with the family’s consent, DDD eligibility will be determined.

To qualify for Division of Developmental Disabilities services, a person aged 6 years to adulthood must

• Voluntarily apply,
• Be an Arizona resident, and
• Be diagnosed with a qualifying developmental disability which developed before the age of 18 and is likely to continue indefinitely, and
• Also have significant limitations in daily life skills related to the disability (see the following Daily Life Skills and Substantial Functional Limitations section).

Qualifying Diagnosis Requirements

Cerebral Palsy

A licensed physician with expertise in diagnosing neurological disorders, such as a neurologist, or specialist in rehabilitation medicine, shall diagnose cerebral palsy. The physician shall submit a report to the Department documenting the diagnosis of cerebral palsy and include available medical records supporting the diagnosis.

Epilepsy

A physician specializing in neurology shall diagnose epilepsy.

1. The physician specializing in neurology shall submit a report to the Department documenting the active diagnosis of epilepsy and include the following:
   • Electroencephalogram (EEG) report; 
   • A description of the nature and frequency of the seizures, including current anti-seizure medication; and 
   • Confirmation of the ongoing nature of the disorder. 
2. If the records of a neurological evaluation cannot be obtained or a diagnosis is not made by a physician specializing in neurology, the Division Medical Director shall review the available medical records to confirm a diagnosis of epilepsy.

Autism Spectrum Disorder

A psychiatrist, neurologist, licensed psychologist, or developmental pediatrician who has expertise in diagnosing autism shall make an autism diagnosis. A pediatrician who has completed specialized training approved by the Department in the diagnosis of autism may also make an autism diagnosis. The psychiatrist, neurologist, licensed psychologist, developmental pediatrician, or pediatrician with specialized training shall submit a diagnostic report regarding the individual documenting the presence of diagnostic criteria for autism, including the presence of the required number of symptoms of autism based on current guidelines established by the American Psychiatric Association.

Intellectual (Cognitive) Disabilities

A licensed psychologist trained to perform psychological evaluations utilizing standardized, culturally appropriate, and psychometrically sound measures shall diagnose cognitive/intellectual disability by considering the following:

• Other mental disorders identified in current guidelines established by the American Psychiatric Association, including Schizophrenia, Bipolar Disorder, Attention Deficit Hyperactivity Disorder, and Substance Abuse;
• Significant disorders related to language or language differences;
• Physical factors, including sensory impairments, motor impairments, acute illness, chronic illness, and chronic pain;
• Testing performed during an acute inpatient hospitalization;
• Educational or environmental deprivation; and
• Psychosocial factors.

Down Syndrome

1. A Licensed Primary Care Physician, Developmental Pediatrician, Neonatologist, or Clinical Geneticist shall diagnose Down Syndrome.
2. The physician shall submit the diagnostic prenatal or postnatal genetic testing results and a report to the Department documenting how the practitioner came to the diagnosis based on the diagnostic prenatal or postnatal genetic testing.

Daily Life Skills and Substantial Functional Limitations

In addition to being diagnosed with at least one developmental disability, the person must show significant limitations in daily life skills due to their qualifying diagnosis in three (3) of the following. (Note: The age of the person is taken in to consideration when identifying significant limitations in daily life skills.)

Receptive and Expressive Language

• Cannot communicate with others.
• Cannot communicate effectively without the assistance of others or a mechanical device.

Learning

The person cannot participate in age appropriate learning without assistance.

Self-Direction

• The person needs assistance with making decisions that affect their well being.
• Does not have safety awareness skills.
• Needs help with personal finances.

Self-Care

• Needs significant help with bathing, toileting, tooth brushing, dressing and grooming (taking care of themselves).
• Or the time to complete self-care activities takes so long it affects attendance or success in school, employment or other activities of daily living.

Mobility

• Fine and motor skills are impaired.
• The person needs assistance from a mechanical device like a wheelchair or a walker to move from place to place.
• The time it takes for the person to move takes so long that it affects keeping a job or completing activities of daily living.

Capacity for Independent Living

• The person needs daily supervision to help with health and safety.
• This includes completing household chores, preparing simple meals, using microwaves or other household equipment, using public transportation and shopping for food and clothing.

Economic Self-Sufficiency

• Can’t perform tasks to keep a job.
• The person is limited in what they can earn.
• Considering all expenses and the disability, the person earns below federal poverty level.

Denial of Eligibility: Request an Administrative Review

Find Community Resources

The Eligibility Specialist working your case will need to contact you the first week. This will be done either by phone (during regular business hours), email or U.S.mail. Please respond immediately as this can cause a delay in a decision. If you do not have your Eligibility Specialist's contact information, please email Customer Service or call them at 1-844-770-9500 for assistance.

Eligibility Re-determination

“Re-determination” is the process when the Division of Developmental Disabilities (DDD) looks at the information we have about you or your child and decides if you or your child continues to be eligible or need DDD services. During the re-determination process, you or your child will continue to receive supports and services. Re-determination will happen when your child reaches age eighteen.

Residency

Division policy requires the person applying for services be a permanent resident of the State of Arizona. The only exceptions to this policy include minor children whose residency is deemed to be the same as that of the custodial parent(s).

The Division cannot start or accept your application for eligibility more than thirty (30) days prior to your move to Arizona.

Eligibility

Eligibility is determined based on the same criteria that is outlined in the previous sections based on the applicants age: 0 to 3 years, 3 to 6 years, and 6 years to adulthood.

In addition to applying with the Division, you must complete the eligibility process with the Arizona Health Care Cost Containment System (AHCCCS) Arizona Long Term Care System (ALTCS).

Residential Placement: Please note that placement in a residential setting is not guaranteed and may not be available when you arrive in Arizona due to limited availability and member waiting lists. If the applicant requires placement in a residential setting, you can cover the costs of residential placement privately until placement can be approved and arranged through the Division. Note that any out-of-pocket payments for residential placement are non-reimbursable.

Required Documentation

As with all applicants, you must submit complete and accurate information when you start the application process. Having this information in hand prior to arriving in Arizona and starting the process will reduce delays in eligibility determination.

Required documentation includes:

• Complete and signed DDD Application for Eligibility Determination
• Proof of citizenship including copy of United States birth certificate or legal permanent resident documentation
• Copy of medical insurance (if applicable)
• Documentation of qualifying disability including medical records, psychological evaluation, neurological evaluation, developmental evaluation, or psychiatric evaluation
• Individual Education Plan (IEP) or Evaluation Report from School (MET or Psychoeducational Evaluation)
• Guardianship documents (if applicable)