Additional Resources

Click on each link to download the form

Waivers

Submitting Claims

Provider Search Tool

Provider Network Management (PNM) Module – Training & Info Guide

Locally Contracted Providers

OPERS Questionnaire

PEDACKN (OPERS) Form

Competency Based Add-On

Competency Based Add-On *RENEWAL*

Service Delivery Forms

Below are documentation templates that DODD has put together. These are not mandatory to use but providers need to ensure that their documents have all the required elements.

Please note that if a provider is locally contracted with the Erie County Board of DD, the required elements are the same as DODD except for the requirement of the Medicaid number and Provider number.

Homemaker Personal Care (HPC) Documentation

Homemaker Personal Care (HPC) Transportation Documentation

Shared Living

Transportation Daily Inspection Template

Adult Day Services Documentation Template

Vocational Habilitation Documentation Template

Outcome Documentation Template

Non-medical Transportation (NMT) Per Mile Documentation Template

Non-medical Transportation (NMT) Per Trip Documentation Template

Non-medical Transportation (NMT) Daily Inspection Template

Employment Quality Payment Attestation for Individual Budgets

Employment Quality Payment Attestation for Waivers