Request for Providers

Day Program:

Date Number Type of Waiver Service Description PDF
Date: April 17 2019 Number: 04020 Waiver Type: IO Service Desc: Download

HPC:

Date Number Type of Waiver Service Description PDF
Date: April 17 2019 Number: 04017 Waiver Type: Level 1 Service Desc: Download
Date: April 15 2019 Number: 04016 Waiver Type: Level 1 Service Desc: Download
Date: April 15 2019 Number: 04015 Waiver Type: IO Service Desc: Download
Date: April 15 2019 Number: 04013 Waiver Type: IO Service Desc: Download
Date: April 10 2019 Number: 04012 Waiver Type: IO Service Desc: Download
Date: April 9 2019 Number: 04009 Waiver Type: IO Service Desc: Download
Date: April 9 2019 Number: 04008 Waiver Type: IO Service Desc: Download
Date: April 9 2019 Number: 04007 Waiver Type: IO Service Desc: Download

NMT:

Date Number Type of Waiver Service Description PDF
Date: April 17 2019 Number: 04018 Waiver Type: IO Service Desc: Download

Nursing & Other:

Date Number Type of Waiver Service Description PDF
Date: April 17 2019 Number: 04019 Waiver Type: IO Service Desc: Home modification Download