How to apply for Support Coordination
Requirements for Division Eligibility
An individual must be determined eligible for DDD before the Division can provide services. An individual must meet the functional criteria of having a developmental disability. In general, individuals must document that they have a chronic physical and/or mental impairment that: Manifests in the developmental years, before age 22; Is lifelong; and substantially limits them in at least three of these life activities: self-care; learning; mobility; communication; self-direction; economic self-sufficiency; the ability to live independently.
In order to receive Division services, individuals are responsible to apply, become eligible for, and maintain Medicaid eligibility. An individual must establish that New Jersey is his or her primary residence at the time of application. At 18 years of age, individuals may apply for eligibility. At 21 years of age, eligible individuals may receive Division services. The determination of an applicant’s eligibility for Division services shall be completed as expeditiously as possible.
Intake/Application Process
In order to receive services funded by the Division, an individual must apply to become eligible. This process can begin once the individual reaches 18 years of age; however, Division-funded services and supports will not be available until the individual reaches 21 years of age. Eligibility criteria are outlined in Section 3.1 of this manual.
The application process begins by contacting the Division Community Services Office representing the region in which the individual resides or downloading the application from the Division website at http://www.nj.gov/humanservices/ddd/services/apply/application.html. Upon request, the intake worker can provide assistance in completing the application.
Application
The following application forms must be completed and signed as part of a complete application package:
- Application for Eligibility - The person completing the application must sign this form;
- ICD/10 Form – Completed by medical professional;
- Health Information and Portability and Accountability Act (HIPAA) information;
- Notice of Privacy Practices and Acknowledgement Form – Please read the Department of Human Services Notice of Privacy Practices and sign the Acknowledgement Form;
- Authorization for Disclosure of Health Information to Family and Involved Persons – Gives the Division permission to talk with people the Applicant chooses about his or her health information. This form must be completed and signed;
- Authorization for the Release of Health Information – Gives the Division permission to send copies of the Applicant’s health records to people or organizations chosen by the Applicant. This form must be completed and signed;
- Consent Form – for use with any documentation related to the developmental disability and/or functional limitations.