Certification for Qualified Vendors
The Office of Licensing, Certification and Regulation (OLCR) is responsible for issuing HCBS certificates. All individuals and provider agencies are required to have an HCBS certificate in order to provide services to DDD members. HCBS Certification ensures that all individuals providing direct care have met qualifications for assisting individuals with developmental Disabilities.
These services include:
- Attendant Care
- Day Treatment and Training
- Personal Care
- Respite Care
- Therapy Services
- Several other services designed for DDD members
HCBS Certification for Providers Contracted with DDD (Qualified Vendors)
For DDD Qualified Vendors, certification is completed through the Focus system.
HCBS Certification for Providers Contracted with a Managed Care Organization (MCO), Effective 10/1/2019
For providers contracted with an MCO and not DDD, HCBS certification is completed as follows:
- The provider agency or therapist will need to submit an application (LCR-1083A) to OLCR for HCBS Certification.
- In addition to the application, the provider agency or therapist must submit:
- Three letters of reference for the Owner/Executive or agency
- A copy of a valid level one fingerprint clearance card for the Owner/Executive
- A copy of agency brochure or link to agency website
- A completed Criminal History Self Disclosure Affidavit for the Owner/Executive
- If the Owner/Executive is also a direct care provider:
- Copy of valid CPR certification
- Copy of valid First Aid certification (therapists exempted)
- Copy of Article 9 certificate
- Copy of professional license (therapists and professional providers)
- An Agency Roster of Employees listing all staff who will be providing services to members. The roster also requires information on agency owned vehicles that may be used to transport members. Refer to the following Agency Roster Instructions. The Agency Roster Template affirms that agency staff have met the HCBS training and qualification requirements.
- If services are delivered in a provider owned or leased facility, a Life Safety Inspection must be completed every two years. The rules for life safety inspections can be found at LCR-1036A. A life safety inspection may be requested using form
The application and supporting documentation may be mailed, faxed or e-mailed:
P.O. Box 6123-Mail Drop 2HF1
Phoenix, AZ 85005-6123
Phone: (602) 771-4861
Fax: (602) 257-7045
Email: [email protected]
Providers who are contracted with both DDD and an MCO must complete the certification process through Focus.
Certification for Individual Service Providers
Effective December 1, 2015, the Division stopped accepting new (initial) applications for Independent Provider Agreements (IPA).