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Agency Qualified Providers
Application and Steps to Apply to Become a New Qualified Provider
All providers must be incorporated in the United States and Connecticut. 
A provider may move to a Purchase of Service (POS) contract when DDS revenue for qualified services reaches $200,000.  For more information on the similarities and differences providing services through Individual Budgets and POS Contract, review the following document: Similarities and Differences in services through Individual Budgets and POS Contract
Review the following important resources:
  1. Provider Minimum Qualifications
  2. HCBS Waiver Manual
  3. Waiver Services
Steps to Apply to Become a New Qualified Provider
 Step Description
Submit the following:

a. Agency Application
b. Applicable resumes (see Provider Minimum Qualifications for requirements)
    Submit via email to
    IMPORTANT - Application will not be reviewed until all resumes are submitted.
c. Agency Certification

Notification of meeting minimum qualifications: You will receive an email with the status of your application.
When notified as meeting the minimum requirements:
  1. Submit corporate documents via email to (See list of corporate documents in the Agency Qualified Provider Checklist)

  2. Submit policies via email to (Select hyperlinks in the Policy Requirements Based on Support Level for the policy templates).  Policies must be specific to your agency and the services you plan to offer.  Submit only the policies for the services where you have met the minimum qualifications.  Each policy must be submitted as a separate document.
If applying to provide Clinical Behavioral Supports or Healthcare Coordination, in addition to the corporate documents and policies, submit the documents in the applicable checklist via email to
Note: For other supports, see detailed service definitions on the Waiver Services page.
DDS review of policies and procedures.
Once all the policies have been reviewed, you will receive an email with the status of the policies.
Background Check and Verification of Credentials:
New private providers applying to become a DDS qualified provider are required to complete a Connecticut State Police criminal background check.  This applies to the Principal of the entity, Connecticut Administrator, any managing partners/owners once all application documents have been accepted.
  • The Principal of the entity, Connecticut Administrator, any managing partners/owners and Individual Practitioners must be fingerprinted.
  • The background check must be completed by the Connecticut State Police and the report must be submitted to DDS ( showing results of the findings.  The Criminal Conviction History Record must be searched using fingerprints.
Out of state providers may utilize their state agency for the criminal background check and fingerprinting process.  All reports must be submitted directly to DDS at (
Connecticut Criminal History Record Request Form

IMPORTANT: You must bring the Connecticut Criminal History Record Request Form along with a valid state-issued photo identification card, valid driver license, or valid US passport, and the appropriate payment with you when being fingerprinted and present it to DESPP personnel. When fingerprinting is completed, bring the completed request form and the fingerprints back to the window where you made your payments.

Once all documents have been accepted, DDS will schedule an Interview with Qualified Provider Interview Committee.
 7 Attend mandatory Provider Orientation (scheduled quarterly)

Notification of Qualified Provider Status.  You will receive an email.