Become a DDCS Contracted Provider
Becoming a state-contracted provider and joining AS360 connects your services to families actively seeking support--while offering stable revenue, increased visibility and the opportunity to grow within a trusted, statewide ecosystem.
Step 1: Complete your background check
Anyone authorized to sign contracts on behalf of your business must pass a background check. Go to the DSHS Background Check Central Unit and complete the questions. When asked where to send your confirmation, add pamela.sanders@dshs.wa.gov.
Go to the DSHS background-check website ↗
Step 3: Gather your supporting documents
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Washington State business license, such as an Adult Family Home, Foster Care, or other applicable license.
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Program brochure, or a short written description of the services you plan to offer so DDCS can issue the right contract.
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Website address where people can learn about your services and see your fee schedule. This is required.
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Certificate of insurance that meets the requirements below.
Exact documentation and insurance coverage can depend on the type of contract. Confirm the requirements for your services with the DDCS contracts team.
Include current copies of the following documents with your forms:
Coverage and small-business waiver
Your professional or commercial insurance certificate must list the Department of Social and Health Services (DSHS) as an additional insured and use the certificate holder information below.
$4 million general agregate
Standard Coverage
$2 million per occurrence
These are the stated minimums. Detailed coverage requirements depend on the contract type.
$2 million general agregate
Small Business Waiver
$1 million per occurrence
Eligible small businesses may request approval for reduced coverage.
Your business must be based in Washington, be independently owned and operated, and certify under penalty of perjury that it meets at least one of these criteria:
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Fifty or fewer employees.
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Gross annual revenue under $7 million, as reported on federal or state tax returns for the previous three consecutive years.
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Certification with the Office of Minority and Women’s Business Enterprises under RCW 39.19.
Waiver Eligibility
Step 4: Submit your packet
Mail or email your completed packet using the details below. If you are eligible, DDCS will send you a contract to sign.
Mail your packet
DSHS Region 1, Yakima
Attention: Contracts
PO Box 12500, MS: B39-7
Yakima, WA 98909
Email your packet
Questions?
Step 2: Complete the application forms
Download the DDCS application package and complete each applicable form below. Review every item carefully and provide complete information to prevent delays.
This form is for setting up an account to run employee's backgrounds. Any employee who will be working with clients unsupervised, will need to have a background ran.
BCS Account Form
1
If you are a sole proprietor, you must include a copy of your driver’s license and Social Security card.
Contractor Intake
2
You must complete and submit the MPDS before being contracted with the Aging and Disability Services (ADS) whether you will be accepting Medicaid or not. This is a federal and state requirement. You must provide full and accurate disclosure of ownership as well as financial, managerial, and controlling interests. Any Board Members with input on business or financial must be listed with both Social Security numbers and Date of Births, this is also mandatory. Failure to submit this information may cause ADS to refuse to contract with you and/or terminate any existing contracts.
Medicaid Provider Disclosure Statement (MPDS)
3
Provide license number or other valid proof of HIPAA-compliant technology platform at the time of the contract’s start date and every 12 months after.
Service Delivery Verification Form (teleservices only)
4
Complete a W-9. Nonprofits should also include a copy of their 501(c)(3) determination letter.
W-9
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Include a list of the counties where you are willing to work.
Service area
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Next Steps
To provide services through Developmental Disabilities Community Services (DDCS), you will need to complete a background check, submit a contract application packet, and receive a fully signed contract.
Step 1: Complete a background check
Step 2: Complete application forms