DSP Training Program Letter of Application: Checklist G or Checklist H

The agency must submit a letter of application for program approval, and required documentation to the Division of Developmental Disabilities.

Note:  Retroactive approval of training programs will not be granted or reimbursed if DSP training begins prior to written approval of the training program by DHS.

The letter of application must include Checklists G or H and the items below that relate to the proposed training program:

  1. When an agency is using the DHS standardized training curriculum the "Intent to Adopt Statement" must be signed by the agency Executive Director to be accepted by the Division of Developmental Disabilities. This statement is located at the bottom of Checklist G (pdf) (IL462-1280).  If an organization chooses to develop its own course, Checklist H (pdf) (IL-1281) must be completed.
  2. A statement indicating the organization is submitting its own course for review and approval to meet the basic DSP training requirements.
  3. A copy of the agency-developed course materials (instructor's guide, handouts, overheads, names and descriptions of videos or DVDs, assessment tools, etc.) identifying the methodology and content for the agency-developed DSP training program.
  4. A copy of the sponsor's certificate of approval issued by the State Board of Education or the Board of Higher Education is required if the training sponsor is a private business, vocational school or college.
  5. A statement of the program rationale, philosophy and purpose of the training program. The training program must address each of the required basic DSP competency areas identified in the DSP Training Program Informational Competencies Evaluation Form (pdf) (IL462-1285).  This statement is included in the DHS standardized training program and is required only when completing Checklist H.
  6. The location of the first training program.
  7. Projected dates and times of training for each module.
  8. The number of hours for each classroom module and OJT activity.
  9. Name of agency's DSP training course coordinator and the instructors for each module.
  10. A completed Checklist I (pdf) (IL462-1282) and resume describing the education, experience and qualifications (including a copy of any valid Illinois professional licenses) for each program instructor.
  11. Copies of clinical on-the-job activities must be submitted with the application packet. Agencies may use one of the following options to meet this requirement:
    • Only the Department's approved OJTs/CTBAs.
    • Combination of the Department's and Agency's Department approved on-the-job activities.
    • Only agency-modified OJTs/CTBAs approved by the Department.
    • Agency-specific on-the-job activities.  On-the-job activities developed by an agency are required to follow the Department's DSP Approved OJT Activities and CBTAs Training Assessments (pdf) (supersedes Appendix 3 effective 6/1/2013) format. A completed copy of the on-the-job DSP Training Program Interventional Competencies Evaluation Form (pdf) (IL462-1284) must be completed and submitted with the on-the-job activities.
    • A copy of the competency-based assessment tool that will be used to evaluate the DSP's understanding of informational and interventional competencies at the conclusion of the training. The DSP Training Program Core Competency Area Checklist (pdf) (IL462-1286) may be used for this requirement, but agencies must indicate its intention to use this document.
    • A statement that defines the Agency's performance standards for passing the DSP classroom training and on-the-job training components. This statement should include minimum acceptable percentage of 80% for classroom training. The performance standard statement for on-the-job training must be 100%.
    • A copy of the agency's attendance policy, including how attendance is tracked and how missed sessions will be made up.

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