Budget Exception Request Form

Participant-Hired Worker 40-Hour Health and Safety Assurance Exception Request, F-01689 Word Cost Share Repayment Agreement, F-01200 Word Budget Amendment Request, F-01210 Word Budget Amendment Provider Quote Comparison, F-01210A Word IRIS Form W-9 PDF Prevocational Services Six-Month Progress Report and Prevocational Plan, F

IDD WAIVER EXCEPTIONS REQUEST FORM REQUEST FOR SERVICES ABOVE THE BUDGET Member Name Record ID This is a request for services above the IDD Waiver member's budget. Please fill out this form completely, and attach all documentation that you feel supports your request for services. BMS will review the request to determine if the services for

Once the lead agency submits the exception request application and all required documentation, DHS has 30 days to process an exception request. select the quotyesquot button on DHS-5820 and identify the reason for the expedited process in the drop-down field on the form. Some reasons to expedite requests include, but are not limited to

The person cannot have any additional exceptions beyond 80,000 within the two-year period. Criteria. DHS may approve an exception when the following criteria are met Lead agency has explored other options with the person. Exception is cost effective. Exception request includes two comparison bids.

DHS-6633-ENG CDCS Budget Exception Request Form. DHS-6633C-ENG Instructions to complete the CDCS Budget Exception Request Form. DHS-6893A-ENG Community First Services and Supports CFSS Assessment. DHS-6893B-ENG Referral for Reassessment for PCACFSS Services. DHS-6893D-ENG CFSS Recommendation for Removal from the Budget Model Form

For instructions to complete, see Instructions to complete the CDCS Budget Exception Request Application, DHS-6633C PDF opens in new window. For more information on CDCS budgets, see the CDCS Manual Exception to CDCS budget methodology for BI, CAC, CADI, and DD waivers page opens in new window. Select NEXT below to get started.

People who currently receive the 20 budget exception but would like to receive the 30 budget exception for one or more of the listed eligibility criteria may request the budget exception by completing the CDCS Budget Exception Request Form, DHS-6633. The lead agency must request renewal of the person's budget exception each span if the

DHS-6633 CDCS Budget Exception Request Form. CDCS Specialized Therapy Request Form, DHS-5788C PDF with your CDCS plan. CDCS Special Diet Request Form, DHS-5788D Self-direction support activities. Provider Agreement. CDCS Program information. CDCS Shared Services Agreement DHS-6633D Waiver Information. DHS-4849- DD Waiver information

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There is an exception that can increase individual CDCS budgets for people on disability waivers who meet the eligibility requirements. For more information about the exception, refer to CDCS Manual - Exception to CDCS b udget m ethodology for disability waivers. CDCS Budget Exception Request Application, DHS-6633 PDF. Conversion