Arizona Service Bureau Agreement - Alternative Format
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How to fill out Service Bureau Agreement - Alternative Format?
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FAQ
The Bureau of Child Care Licensing is a part of the Arizona Department of Health Services. BCCL certifies child care group homes and licensed child care facilities.
As a Qualified Vendor, the agency or therapist will need to submit an application packet to OLCR for HCBS Certification and AHCCCS enrollment. The application process is completed through the OLCR Tracking application in Focus, which also includes specific instructions for submitting the application.
All individuals and provider agencies are required to have an HCBS certificate in order to provide services to DDD members. HCBS Certification ensures that all individuals providing direct care have met qualifications for assisting individuals with developmental disabilities. These services include: Attendant Care.
To operate a licensed care home, the property owner must submit a request for an application and receive the license to open the home. The home can have a maximum of 10 residents, and it cannot be located within 1,250 feet of another active care home.
You must obtain a fingerprint clearance card, complete training, permit an OLCR inspection of your home, and participate in interviews and assessments for the home study. Once you've completed the requirements for licensure, the licensing agency will submit your application and home study to OLCR.
The Division of Developmental Disabilities (DDD) is a service system administered through the Arizona Department of Economic Security (DES) that supports people who develop severe and/or chronic disabilities that may limit a person's ability to do the tasks related to daily living.
Any vendor that provides goods or services to an Arizona state agency and receives payment from the State of Arizona must complete the Arizona W9 form. Use the Arizona W9 form to establish or update a vendor account with the State of Arizona.
