CDDO Forms & Other Downloads                                   
                                     
                                    

BASIS Related Forms

Behavior Tracking Logs  -  for tracking behaviors for the BASIS assessment
Seizure Tracking Logs  -  for tracking seizure activity for the BASIS assessment
Status Action Form for TCMs to notify CDDO of changes in Information or Services Section - Learn More
BASIS Questionnaire
 -  optional method for gathering input from providers or DSPs


Funding
Funding Request Checklist
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) 

3161  - Notice of updates and changes to DCF & KDHE
IDD-1  - I/DD Medicaid Waiver Individual Choice

MR-6
 - Consumer-directed In-home supports
Emergency Backup Plan
Self Directed Guidelines

CDDO Provider Choice Form
Service provider Transition Checklist 

Manuals & Other Materials:

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



Quality Oversight

Adverse Incident Reporting (AIR) Form
AIR Updated Definitions
AIR User Manual
AIR Information (KDADS Website)

BCI Quality Oversight Entry (Click here to go to BCI, then click Quality Survey to log in)
QO Consumer Visit Form



Forms to be Submitted to CDDO

BCI Application
Cottonwood CDDO Area Transfer 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

  
 
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.  The KDADS Parental Fee Program webpage is currently down)

Resources Listing for Douglas/Jefferson County



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