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Get KY MAP-350 2009

ON OR DEVELOPMENTAL DISABILITIES, MODEL WAIVER II, ACQUIRED BRAIN INJURY WAIVER A. HCBS - This is to certify that I/legal representative have been informed of the HCBS waiver for the aged and disabled. Consideration for the HCBS program as an alternative to NF placement is requested ; is not requested . Signature / / Date B. This is to certify that I/legal representative have been informed of the home and commu.

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