Official Site of The State of New Jersey

Webinars

• New Provider Overview: A Practical Guide for New Providers
• Division Oversight and Quality Monitoring System
• Steering Clear of Medicaid Fraud, Waste and Abuse

Service Delivery Logs

• Community Based / Individual Supports Log
• Community Inclusion Activities Log
• Community Inclusion Individualized Goals Log
• Community Inclusion Annual Update
• Day Habilitation Activities Log
• Day Habilitation Individualized Goals Log
• Day Habilitation Annual Update
• Natural Supports Training Log
• Prevocational Training Activities Log
• Prevocational Training Individualized Goals Log
• Prevocational Training Annual Update
• Supported Employment Pre-Employment Service Log
• Supported Employment Intervention Plan and Service Log

Medication Practicum Documents (2025)

• Mock Medication Administration Observation Checklist (new-hires)
• Medication Administration Skills Evaluation (new-hires and annually thereafter)
• Medication Competency Assessment (new-hires and annually thereafter)
• Medication Practicum: A Guide for Evaluators

Updated Preventing Abuse, Neglect, and Exploitation (PANE) Assessment Documents (2025)

• PANE Competency Assessment
• PANE Competency Assessment: A Guide for Evaluators

Fingerprinting Information

• Fingerprinting Procedures
• Flag Removal Form
• Archive Request Template
• Archiving FAQ
• Appendix A

Request Forms

• Human Rights Committee Referral Form
• Behavior Management Committee Referral Form | Behavior Management Committee FAQ

Requirements for Provider-Developed / Provider-Acquired Training

• Crisis Management Training Requirements and Approved Curriculums
• Positive Behavior Supports Training Requirements

Fiscal Sustainability Template

• Voucher Process When Medicaid Terminates
• Voucher Approval Request
• Payment Voucher Template
• Payment Voucher

Conversion of Housing Payments to the Supportive Housing Connection

• Guidance for Service Providers Regarding the Conversion of Housing Payments from Division Contract to the Supportive Housing Connection
• Webinar Slides: Conversion of Housing Payments
• Subsidy Contribution Worksheet for SRO Settings
• Subsidy Contribution Worksheet for Non-SRO Settings
• Fee-for-Service Provider Spreadsheet
• DDD Rental Subsidy Agreement
• Housing Assistance FAQs for Residential Providers

Housing Development

• Innovation in Housing: Developing HCBS Compliant Settings 
• Housing Development Policy (February 2018)
• Notice of Intent to License Form
• Program Description for Licensed Community Residence
• Construction Requirements for New Development
• The New Jersey Housing and Mortgage Finance Agency (HMFA) has a variety of financing options for residential development.
• The New Jersey Department of Community Affairs, the New Jersey Housing and Mortgage Finance Agency and the New Jersey Department of Human Services, Division of Developmental Disabilities have launched The Special Needs Housing Partnership Loan Program (SNHPLP), aimed at creating affordable supportive housing.

Section 1919(e)(7) of the Social Security Act and Chapter 42 of the Code of Federal Regulations, Sections 483.100 through 483.138 specify the requirements for preadmission screening of all individuals with intellectual and developmental disabilities before they enter a Medicaid certified nursing facility (NF), regardless of payment source.

Federal regulations require the PASRR Level I screenings take place prior to admission in order for a state to receive federal financial participation for Medicaid reimbursement of nursing home care.  Individual determined to require Specialized Services through the PASRR Level II process are prohibited from being admitted to a NF, or remaining in a NF.>

For further information about the Level I process, and forms that are used for that process, please visit the Division of Aging Services / PASSR.

If an individual who is currently living in a NF and who has an intellectual or developmental disability has been identified through the Minimum Data Set 3.0 (MDS 3.0)as having a significant change in condition, then the Division of Developmental Disabilities must be notified via completion and submission of the PASRR Resident Review Referral Form.

Below are documents for preparation of a Division of Developmental Disabilities (DDD) contract application, as well as annual contract reporting. Third-party contract providers should familiarize themselves with the NJ Department of Human Services Contract Policy and Information Manual.  

**NOTE: If you previously had a contract with DDD and are now fully fee-for-service, please email ddd.providerhelpdesk@dhs.nj.gov for assistance.

Items 1-14 are for annual reporting:

1. Required Documents Checklist
   1. Condensed Annex A
2. Standard Language Document
   1. Non-State Agency (for provider agencies)
   2. State Agency (for State agencies)
3. Annex B (Budget Template)
4. Business Associate Agreement (revised 2023)
5. Source Disclosure Certification
6. Standardized Board Resolution
7. Form AA-302: Affirmative Action Employee Information Report
   1. AA-302 Form
   2. AA-302 Instructions
8. Business Registration Memo
9. Notification of Licensed Public Accountant
10. Equipment Inventory List
11. Public Law 2005 (only applicable to For-Profit Organizations)
    1. Chapter 51 Form
    2. Certification and Disclosure Form
12. NJ Charitable Registration (only applicable to Charitable Organizations)
13. Agency Contact Form
14. Cluster Designation
    1. Cluster Designation Form
    2. Cluster Policy
15. P1.10: Contract Modification
    1. P1.10 Form
    2. P1.10 Policy 
16. ACH/Electronic Payment Authorization
    1. ACH Form
    2. ACH Instructions
17. W-9 Vendor Questionnaire
18. Payment Voucher
    1. Payment Voucher Instructions
    2. Payment Voucher Form (Word)
    3. Payment Voucher Form (Excel)