How to Complete an Application

Those seeking services for persons with intellectual disabilities through ADMH should:

  1. Contact the Division of Developmental Disabilities Call Center at 1-800-361-4491.
  2. Within the next business day, an initial contact form will be faxed to the local designated 310 agency (case management agency) or other designated point of entry.
  3. Once contacted by the 310 agency, you will need to do the following:
    • Describe the needs and preferences of the applicant (the person for whom services are being requested).
    • Provide information on the applicant’s current situation, personal and family history, and Medicaid eligibility status.
  4. Additional information to be completed by the designated 310 agency:
    • Criticality summary completed within 90 days of application;
    • A psychological evaluation with the IQ range of the applicant (IQ score below 70 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 18 (developmental history).
  5. The 310 agency will submit the completed informational 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 waiting list. ADMH will make a determination of eligibility within 30 days of the receipt of the completed application. Note: the date of application, is the day a completed packet is received at the regional community services office.