Kansas Department for Aging and Disability Services Forms

This application form is used for individuals in Kansas who wish to reinstate their Adult Care Home Administrator License.

This Form is used for conducting functional assessments in Kansas to determine an individual's level of independence and support needs.

This document is a Basis Assessment Instrument used in the state of Kansas. It is used to assess the needs and abilities of individuals for various services and programs.

This document is a worksheet used to determine the private pay rate for individuals in Kansas who are not eligible for Medicaid. It is specific to the private pay census and does not include Medicaid information.

This document is a worksheet used for determining the level of care for individuals who are private pay and not covered by Medicaid or Medicare in the state of Kansas.

This document is a checklist of requirements for obtaining a full/Tcm license in the state of Kansas. It outlines the necessary steps and documents needed for individuals who want to apply for a full/Tcm license in Kansas.

This document is a worksheet that helps calculate the private pay rate for services in Kansas. It provides a tool to determine the cost of services without insurance or government assistance.

This form is used for applying for a license in the state of Kansas.

This Form is used for submitting a Corrective Action Plan in Kansas for KDADS (Kansas Department for Aging and Disability Services).

This Form is used for outlining the rights and responsibilities of customers receiving services from the Kansas Department for Aging and Disability Services (KDADS) under the State Supplemental Payments (SSP) program and the Older Americans Act (OAA).

This Form is used for representing the Customer Code of Conduct in Kansas. It outlines the set of rules and expectations that customers must adhere to when accessing services provided by KDADS (Kansas Department for Aging and Disability Services).

This form is used for making referrals and receiving responses from Case Management Entities (CMEs) in Kansas. It is part of the Kansas Department for Aging and Disability Services (KDADS) State Call Center (SCC) Quality Review process.

This Form is used for documenting customer service interactions and grievances in the state of Kansas.

This document is for healthcare providers to confirm the need for customer-directed attendant care for seniors in Kansas.

This document is a legal services reporting form used in the state of Kansas, specifically by the Kansas Department for Aging and Disability Services (KDADS). It is used to report legal services provided by agencies or individuals.

This form is used for requesting the release of protected health information in the state of Kansas. It authorizes healthcare providers to disclose your medical records to designated individuals or organizations.

This document is used for revoking the appointment or reassigning the responsibilities of a designated representative for participant-directed services in the state of Kansas.

This document is used for consumer evaluation of needs for individuals with physical disabilities in Kansas. It is designed to assess and determine the specific needs of the consumer for Home and Community-Based Services (HCBS) related to physical disability.

This document is a justification for requesting additional funding for a specific project or program in the state of Kansas. It outlines the reasons why the extra funds are needed and provides supporting evidence or explanations.

This form is used for standard intake and gathering information in the state of Kansas.

This form is used for applying for a limited scope license in the state of Kansas with the Kansas Department for Aging and Disability Services (KDADS).

This document is a request for additional funding in the state of Kansas. It is used when there is a need for additional financial resources beyond the regular budget allocation.

This document is used for special admission requests to KDADS Care in Kansas. It is a fax memo that provides information about the request.

This type of document is required for a resident review in the state of Kansas. It is used to gather information and verify the residency status of individuals.

This form is used to assess the functional abilities and level of care needed for individuals in Kansas. It helps determine the level of assistance and support they require based on their functional assessment score.

This document provides instructions for completing Form KDADS-PRTF-01, which is used to report financial and statistical information for psychiatric residential treatment facilities in Kansas. It includes details on how to fill out the cost report and submit it to the appropriate authorities.

This document is a checklist used by residents of Kansas to review and evaluate various aspects of their living situation. It helps residents ensure that their needs are being met and identify areas for improvement.

This form is used for reporting financial and statistical information for nursing facilities in Kansas.

This Form is used for notifying the Idaho Department of Developmental Disabilities (IDD) about a provisional plan of care in Kansas.

This form is used for individuals in Kansas to apply for the I/DD Medicaid Waiver program and exercise their individual choice in selecting services and providers.

This document helps you determine your nutritional health in the state of Kansas. It provides guidance on assessing your dietary habits and overall well-being.

This document is for individuals in Kansas who wish to attest their eligibility for the Brain Injury Program. This program provides services and support for those who have suffered a brain injury.