DCF Credentialing Forms & Resources
DCF is accepting applications from organizations for the delivery of School of Origin Transportation (SOOT) Services in the following regions only.
Your organization and vehicle(s) must be located in one of the following regions:
REGION 1 (Bridgeport/Norwalk/Stamford)
REGION 2 (Milford/New Haven)
REGION 5 (Danbury/Torrington/Waterbury)
REGION 6 (Meriden/New Britain)
THE NETWORK IS CLOSED TO NEW ORGANIZATIONS FOR ALL OTHER SERVICES AT THIS TIME.
Please be advised: DCF will accept new staff from approved providers for all services.
Notification from DCF relating to Credentialed Services ** 08-03-2020 **
Resources
- Quick Reference Directory 2020
- Regional Contact Information (DCM)
- Quick Reference Guide - Region Specific Invoice Submission Guidelines
- DCF Academy Training ** WINTER 2020 EDITION **
- CTSBDC Connecticut Small Business Development Center
- The Governor's Prevention Partnership
- DCF Provider Learning Inventory of Skills (LIST) Train the Trainer (TOT) Certification Course (For experienced LIST providers only) ** NEW **
- Learning Inventory of Skills (LIST) Provider Trainer Roles & Responsibilites
- DCF Provider Learning Inventory of Skills (LIST) Training Online Registration ** NEW **
Technical Assistance
Forms
- DCF Credentialed Provider Referral Form
- Documentation for Credentialed Providers
- DCF Credentialed Provider Documentation Form (For Therapeutic Support & Support Staff Service)
- DCF Credentialed Provider Documentation Form (For Supervised Visitation)
- DCF Credentialed Provider Documentation Form (For After School Service)
- Supervision Guidelines
- Supervisory Agreement Template
- Supervision Note
- Provider Information Change Form
- Site Visit Letter to Providers
- DCF Credentialed Provider Review Tool
- DCF Credentialed Provider Review Tool (For General Livery and School Transportation Providers)
- Provider Assessment Tool
Billing Procedures
- Aging Statement - SAMPLE
- DCF Invoicing Requirements
- Direct Deposit Set-Up
- Region Specific Invoice Submission Guidelines
- Credentialed Provider Invoice (Excluding Transportation)
- Transportation Invoice (For General Livery Transportation as a Service)
- Transportation Rate Calculation Form
- Connecticut False Claims Act
- Relevant Sections of the CT False Claims Act
Policies and Provider Notices
- Current Operational Status ** 12-16-2020 **
- COVID Safety Requirements ** 10-28-2020 **
- Notification from DCF relating to Credentialed Services ** 08-03-2020 **
- OTG COVID-19 Update ** 03-30-2020 **
- CHAP CHEER COVID-19 Operations ** 03-24-2020 **
- Use of Credentialed and Wrap Funded Services ** 03-20-2020 **
- SOO Provider Memo
- DCF Credentialing for Service Providers Policy
- Transportation Protocol and Procedure for Credentialed Services
- Letter to Providers (DCF CPS Background Check)
- Memo to Contracted Providers (Consolidated Administrative Case Review Meetings)
Application Supplements
- DCF Mandated Reporter Training
- DCF CPS Background Check (CPS)
- State Police Record Request Form (DESPP)
- DMV Record Check (For CHAP Providers only)
- Staff Roster
- Statement of Experience Form
- DCF Confidentiality Statement and Ethics Agreement
- Professional Review Questionnaire
- Release of Confidential Disciplinary Records (Consent Form)
- W9
FAQ
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