PM 06-11-02.
DHS Community-Based Services are provided through DHS - ODD and DHS - OMH.
DHS - ODD/OMH, or the agency under contract with DHS, notifies the Family Community Resource Center of spenddown cases receiving DHS Community-Based Services using the Notice of DHS Community-Based Services (Form 2653). Form 2653 sent to the Family Community Resource Center verifies the
services.
DHS - ODD/OMH is responsible for distributing Form 2653 to agencies providing these services.
Form 2653 includes the following information for spenddown cases:
- the type of service received (i.e., In-home/Remedial Care, CILA, Community Habilitation, or Community Mental Health services),
- monthly cost, and
- the start date or expected start date of services.
Use the monthly cost amount on Form 2653 to determine monthly spenddown met/unmet status until notified of a change.
Do not require a new Form 2653 at REDE. DHS - ODD/OMH, or the agency under contract with DHS, completes Form 2653 to report any changes.
