How to Complete an Application

Seeking services for individuals with intellectual disabilities through ADMH

  1. Contact the Division of Developmental Disabilities Call Center at 1-800-361-4491.
  2. Call Center Specialist will complete initial contact application within two business days to submit to the local designated support coordination agency
  3. Once initial application is received the support coordinator will contact applicant or applicant’s representative within five business days to gather documentation for eligibility determination review. The support coordinator will need the following information:
    • A description of needs and preferences of the applicant
    • Information about applicant’s current situation, personal and family history, and Medicaid eligibility status.

    Additional information to be completed by the designated support coordination agency:

    • Criticality summary completed within 90 days of application;
    • A psychological evaluation with the IQ range of the applicant (IQ score 72 or below documented by a standardized intelligence test) including a review of all past intellectual assessments and IQ scores;
    • Documentation that the applicant has challenges with adaptive functioning (significant limitations in the applicant’s effectiveness in meeting the standards of maturation, learning, personal independence, and/or social responsibility that are expected for his/her age level and cultural group, as determined by clinical assessment, and usually, standardized scales) such as the ICAP (Inventory for Client and Agency Planning); When there is cause to question the ICAP score, an additional clinical adaptive functioning assessment and other documentation may be requested;
    • Documentation that the applicant’s level of adaptive and intellectual functioning occurred prior to the age of 22 (developmental history).
  4. The support coordination agency will submit the completed application packet for review to the regional community services office that serves the applicant’s county and, if approved, the applicant’s name will be placed on the priority list.