BASIS RELATED FORMS

Behavior Tracking Logs To track behaviors for the BASIS assessment
Seizure Tracking Logs To track seizure activity for the BASIS assessment
Status Action Form for TCMs to notify CDDO of changes in Info or Services section
Supporting Documentation List for BASIS Assessments
BASIS Questionnaire Optional method for gathering input from providers or DSPs

FUNDING

Funding Request Checklist For KDADS training on Funding requests click here
HCBS IDD Waiver Access Request This form to be used for Crisis Requests, Transitions from other waivers and funding requests related to children in DCF custody.
Upload requests to BCI and click “Save & Send” in order to notify the CDDO
IDD-1 I/DD Medicaid waiver individual choice
MR-6 Consumer-directed in-home supports
Emergency Backup Plan
Self-directed Guidelines
Service Provider Transition Checklist

MANUALS AND OTHER MATERIALS

HCBS DD Provider Manuals
Extraordinary Funding Policy (KDADS)
Extraordinary Funding Materials

QUALITY OVERSIGHT

Adverse Incident Reporting (AIR) Forms
AIR Updated Definitions
AIR User Manual
AIR Information (KDADS Website)
BCI Quality Oversight Entry (link directs to BCI, Log-in then access “Quality Survey”)
QO Consumer Visit Form

FORMS TO BE SUBMITTED TO CDDO

BCI Application
CDDO Area Transfer – Courtesy Share Form
CCM-QO Member Nomination Form
Dispute Resolution Form
ICF-IID Request Checklist
ICF Gatekeeping Policy ICF Referral & Prescreen Form: Word Version
Parsons State Hospital Behavioral Outreach Application
KNI Outreach Services Request Form
Dental Consent Form
Medical Consent Form

OTHER RESOURCES

Consumer Rights Hand-out
K-PASS Self-direction tool kit
KS EES Manual – Kansas Economic and Employment Services
List of Abbreviations
Parental Fee Program (Note: this PDF may contain old information. KDADS webpage is down)
Resources for Douglas/Jefferson Counties

CDDO BROCHURES

Transition Planning Guide – Planning from age 5 through High School graduation and into Adult Services
Choosing Service Providers – A list of topics to discuss and questions to ask potential service providers