01.
Certification Required. Before any agency can operate and provide services as a DDA, it must apply for, obtain, and maintain DDA certification from the Department.
02.
Department Review Not Guaranteed. The Department may choose not to consider the application of any operator, administrator, or owner of an agency whose license or certification has been revoked until five (5) years have lapsed from the date of revocation.
03.
Open Application. An applicant may apply up to three (3) times within a three hundred sixty-five (365) day period starting on the date of the first submission. If the application is incomplete upon a third submission, the application will be denied. The applicant may not resubmit an application for six (6) months from the date of the denial notice.
04.
Content of Application for Certification. Application for certification must be submitted to the Department on the Department-approved form with the following information and supporting documents at least sixty (60) days prior to the planned opening:
a. An application form that contains name, address, and telephone number of the agency, type of services to be provided, the geographic service area of the agencies, and the anticipated date for the initiation of services;
b. An accurate and complete statement of all business names of the agency as filed with the Secretary of State, whether it is an assumed business name, partnership, corporation, limited liability company, or other entity that identifies each owner and the management structure of the agency;
c. A statement that the agency will comply with these rules and all other applicable local, state, and federal requirements, including an assurance that the agency complies with pertinent state and federal requirements governing equal opportunity and nondiscrimination;
d. A copy of the proposed organizational chart or plan for staffing of the agency;
e. Written policies and procedures addressing qualifications to meet service delivery requirements including resumes, job descriptions, verification of criminal history clearance, and copies of state licenses and certificates, when applicable;
f. Written policies and procedures for the development and implementation of personnel training to meet the requirements of Section 302 of these rules;
g. Personnel and participant illness policy, communicable disease policy, and other health-related policies and procedures;
h. Written transportation safety policies and procedures required in Section 402 of these rules;
i. Written participant grievance policies and procedures to meet requirements in Section 406 of these rules;
j. Written medication policies and procedures to address medication standards to meet requirements in Section 405 of these rules;
k. Written policies and procedures that address the development of positive behavior supports to meet requirements in Section 510 of these rules;
l. Written policies and procedures for reporting incidents to the adult protection, child protection authority, or both, and to the Department to meet requirements in Section 404 of these rules;
m. A written code of ethics policy reflecting nationally recognized professional standards of practice. The policy must articulate basic values, ethical principles and standards for confidentiality, conflict of interest, exploitation, and inappropriate boundaries in an agency's relationship with participants, relatives, or with other agencies;
n. Complete administrator and supervisor records as required in Subsection 301.04 of these rules;
o. Sample of the following documents:
i. Complete participant record as required in Subsection 301.05 of these rules;
ii. Program billing;
iii. Quality assurance program developed to meet requirements in Section 500 of these rules;
iv. All documents referenced in the application.
p. Any other information requested by the Department for determining the agency's compliance of these rules or the agency's ability to provide the services for which certification is requested;
q. When center-based services are to be provided, the agency must include the following and meet requirements under Section 400 of these rules:
i. Address and telephone number for each service location;
ii. Supporting documentation requirements including the ADA checklist, local fire safety inspection, and local building and zoning compliance;
iii. Written policies and procedures covering the protection of all individuals in the event of fire and other emergencies to include emergency evacuation procedures; and
iv. A site review completed by the Department prior to the initiation of center-based services verifying compliance with these rules.
