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Traumatic Brain and Spinal Cord Injury Medicaid Waiver Core Services Community Support Coordinators Medicaid Waiver Specialists (pdf 17.32 kb) Medicaid Waiver Providers How to Apply

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Medicaid Provider Training

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Welcome to the Division of Emergency Preparedness and Community Support

Bureau of Emergency Medical Oversight

Department of Health Mission
To protect, promote & improve the health of all people in Florida through integrated state, county, & community efforts.

Vision: To be the Healthiest State in the Nation

Values: (ICARE)

I nnovation: We search for creative solutions and manage resources wisely.

C ollaboration: We use teamwork to achieve common goals & solve problems.

A ccountability: We perform with integrity & respect.

R esponsiveness: We achieve our mission by serving our customers & engaging our partners.

E xcellence: We promote quality outcomes through learning & continuous performance improvement.

Medicaid Waiver Programs

Brain and Spinal Cord Injury Program
CDC-Plus Program - Participant Level II Background Requirements

Effective August 1,2010, the law was revised to require more stringent background screening
of job applicants, employees and volunteers who come in contact with children, the
developmentally disabled and vulnerable adults.

The most significant change I the law for our CDC-Plus providers is that applicants will not be
allowed to begin work until they are cleared for employment by a complete background screen
to include a fingerprint-based search of criminal records in Florida and nationally. (Level II
screening).

In order to work as an employee, a provider, a contractor or a volunteer for a CDC consumer
under the Brain and Spinal Cord Injury Program, you must first comply as noted in the
attached BSCIP Background Screening Submission -- Fingerprinting Process for CDC-Plus
Applicants as follows:

1. All NEW applicants must submit a special AHCA TP#517 fingerprint card (obtainable
by going to your Medicaid Waiver Specialist  (pdf 17.32 kb )and requesting ORI Fingerprint Card
#922020Z);

2. Comply with DOH/AHCA procedures as found in the AHCA-BSCIP Background Screening Procedures,(pdf 117kb ) using the BSCIP Background Screening  (pdf  73kb ) submittal form to transmit required forms via US Mail.  Email submittals, given the level of security required, are not permitted and will not be accepted. 

3. Fill out AHCA's Affidavit of Compliance with Background Screening (pdf 28.18 kb) obtain by going to http://ahca.myflorida.com/MCHQ/Long_Term_Care/Background_Screening/index.html

4. Fill out and initial with your representative or Community Support Coordinator, the
Affidavit of Good Moral Character (pdf 38.06kb) and returning it to your Community Support
Coordinator;

5. Fill out the two new provider verification forms below as applicable:

• CDC+ Service Provider Eligibility Form (pdf 31.03kb)
• CDC+ Employee/Vendor Termination Form (pdf 22.07kb)

For more information on this and other background screening questions you may have
please visit http://ahca.myflorida.com/MCHQ/Long_Term_Care/Background_Screening/index.html