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Virginia Administrative Code
Title 12. Health
Agency 30. Department of Medical Assistance Services
Chapter 122. Community Waiver Services for Individuals with Developmental Disabilities
12/12/2024

FORMS (12VAC30-122).

Supports Intensity Scale - Adult VersionTM (ages 16 and up), SIS-A, copyright 2015, American Association on Intellectual and Developmental Disabilities

Supports Intensity Scale - Children's VersionTM (ages 5-16), SIS-C, copyright 2016, American Association on Intellectual and Developmental Disabilities

Virginia Supplemental Questions (eff. 10/2014)

Virginia Developmental Disabilities Autism Competencies, DMAS P-201 (rev. 9/2017)

Medicaid Long-Term Care Communication Form, DMAS-225 (rev. 12/2015)

Virginia Individual Developmental Disabilities Eligibility Survey - Infants' Version, DMAS-P235 (eff. 3/2016)

Virginia Individual Developmental Disabilities Eligibility Survey - Children's Version, DMAS-P236 (eff. 4/2016)

Virginia Individual Developmental Disabilities Eligibility Survey - Adult Version, DMAS-P237 (eff. 3/2016)

Virginia Developmental Disabilities Behavioral Competencies, DMAS P241a (rev. 9/2017)

Developmental Disabilities DSP and Supervisor Competencies Checklist, DMAS 241a (eff. 7/2021)

Direct Support Professional Assurance to Confirm Successful Completion of Training and Testing Requirements for the DD Waivers, DMAS P242a (eff. 5/2021)

Department of Behavioral Health and Developmental Services Health Competencies Checklist, DMAS P244a (rev. 1/2017)

Supervisor Assurance, DMAS P245a (eff. 7/2021)

Community Housing Guide: Housing Road Map (eff. 10/2019)

Community Housing Guide: Tenant Screening (eff. 10/2019)

Family and Individual Supports Request for Supervision Hours in Personal Assistance, DMAS-P257 (eff. 5/2021)

Community Learning Request for Supervision Hours in Personal Assistance, DMAS-P257 (eff. 5/2021)

Website addresses provided in the Virginia Administrative Code to documents incorporated by reference are for the reader's convenience only, may not necessarily be active or current, and should not be relied upon. To ensure the information incorporated by reference is accurate, the reader is encouraged to use the source document described in the regulation.

As a service to the public, the Virginia Administrative Code is provided online by the Virginia General Assembly. We are unable to answer legal questions or respond to requests for legal advice, including application of law to specific fact. To understand and protect your legal rights, you should consult an attorney.