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• Continuing Care Facility

  Continuing Care Facility (CCF) are required to register with the Department of Social Service by filing required disclosure documents. The Disclosure Statement provides residents the necessary information regarding the nature of the program, financial considerations, rights and privileges under the Residency Agreement.

• HIPAA Information

  Client information at DSS is protected by federal and state laws and regulations. This section contains copies of these laws and regulations, the DSS Privacy Policy and official DSS forms related to your privacy rights.

• Reimbursement and Certificate of Need

  The primary functions of Reimbursement and Certificate of Need (CON) include establishment of payment rates for Connecticut's Mediciad medical and residential care services, cost report auditing, and performing certificate of need reviews for nursing facilities, residential care homes, and ICF/MR development projects. Cost based rates are issued on an annual basis by the unit for services including hospitals, nursing facilities, home health care, clinics, and community residences for the elderly and disabled; as well as state-operated psychiatric hospitals, ICF/MR and federal Medicaid waiver services.

• SNAP Periodic Report Form (PRF)

  The SNAP Periodic Report Form, or “PRF,” helps DSS to gather information about any changes you may have had since the last time you completed a renewal. Generally, it is done half-way through your certification period. The PRF will be pre-populated with the information about your household that DSS has in our records. You will receive your PRF from the department in the mail.

• Special Information about Healthcare Tax Form--IRS Form 1095-B

  Enrollees in the HUSKY Health program will not automatically receive IRS Form 1095-B in the mail. Starting in January 2021, the form will be issued upon request only.

• Contracts - (ITS) Information Technology Services

  A listing of contracts associated with Information Technology Services.

• New Hire Orientation Information & Forms

  Information for new employees; what to expect on your first day.

• DSS Client Information Line and Benefits Center

  Our automated ‘interactive voice-response’ telephone system helps DSS clients get the information you need without waiting to speak to an eligibility worker.

• Program Information Bulletins (PIBs)

  A listing of DSS Program Information Bulletins.

• Self Direction Personal Protection Equipment Request Form Submission (*Online)

  Please complete this form to request immediate and urgent PPE needs to support individuals and protect staff due to COVID19.

• Bulk Ordering of Forms

  To order bulk quantities of DSS forms, please follow this link to our Forms Requisition Site.

• Enterprise Master Person Index

  The Department of Social Services (DSS) is responsible for Health Information Technology (Health IT), including Health Information Exchange (HIE) for the State’s Medicaid population.

• Applications and Forms

  Find a List of Applications and Forms

• Rural Health Transformation Program

• PCMH+ Member Information

  Person-Centered Medical Home Plus or PCMH+ provides person-centered, comprehensive and coordinated care to HUSKY members.