Virginia Uniform Assessment Instrument (UAI) (1994)

Consent to Exchange Information, DMAS-20 (rev. 4/2003)

Provider Aide Record (Personal/Respite Care), DMAS-90 (rev. 6/2012)

LPN Skilled Respite Record, DMAS-90A (eff. 7/2005)

Personal Assistant/Companion Timesheet, DMAS-91 (rev. 8/2003)

Questionnaire to Assess an Applicant's Ability to Independently Manage Consumer-Directed Services, DMAS-95 Addendum (rev. 8/2005)

Medicaid Funded Long-Term Care Service Authorization Form, DMAS-96 (rev. 8/2012) Medicaid Funded Long-Term Care Service Authorization Form, DMAS-96 (rev.4/2019)

Individual Choice - Institutional Care or Waiver Services Form, DMAS-97 (rev. 8/2012)

Agency or Consumer Direction Provider Plan of Care, DMAS-97A/B (rev. 3/2010) Agency or Consumer Direction Provider Plan of Care, DMAS-97A/B (rev. 8/2026)

Community-Based Care Recipient Assessment Report, DMAS-99 (rev. 9/2009) Community-Based Care Recipient Assessment Report, DMAS-99 (rev. 9/2026)

Community-Based Care Level of Care Review Instrument, DMAS-99LOC (undated)

Medicaid LTC Communication Form, DMAS-225 (rev.10/2011)

Technology Assisted Waiver Provider RN Initial Home Assessment, DMAS-116 (11/2010)

Technology Assisted Waiver/EPSDT Nursing Services Provider Skills Checklist for Individuals Caring for Tracheostomized and/or Ventilator Assisted Children and Adults, DMAS-259 (undated)

Home Health Certification and Plan of Care, CMS-485 (rev. 2/1994)

IFDDS Waiver Level of Care Eligibility Form (eff. 5/2007)

Request for Screening for Individual and Family Developmental Disabilities Support Waiver (DD Waiver), DMAS 305 (rev. 3/2009)

DD Medicaid Waiver - Level of Functioning Survey Summary Sheet, DMAS-458 (undated)

Technology Assisted Waiver Adult Aide Plan of Care, DMAS 97 T (rev. 6/2008)

Technology Assisted Waiver Supervisory Monthly Summary, DMAS 103 (rev. 4/2008)

Technology Assisted Waiver Adult Referral, DMAS-108 (rev. 1/2017)

Technology Assisted Waiver Pediatric Referral, DMAS-109 (rev. 1/2017)

Intellectual Disability: Definition, Classification, and Systems of Supports, 11th edition, 2010, American Association on Intellectual and Developmental Disabilities, 501 3rd Street, NW, Suite 200, Washington, DC 20001-2760

Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR), 2000, American Psychiatric Association, 1000 Wilson Boulevard, Suite 1825, Arlington, Virginia 22209

Diagnostic and Statistical Manual of Mental Disorders (DSM-5®), Fifth Edition, copyright 2013, American Psychiatric Association, 1000 Wilson Boulevard, Suite 1825, Arlington, Virginia 22209, http:/www.psychiatry.org/dsm5

Underwriter's Laboratories Safety Standard 1635, Standard for Digital Alarm Communicator System Units, Third Edition, January 31, 1996, with revisions through August 15, 2005

Underwriter's Laboratories Safety Standard 1637, Standard for Home Health Care Signaling Equipment, Fourth Edition, December 29, 2006

MR/ID Waiver Slot Assignment Process, August 20, 2010, Department of Behavioral Health and Developmental Services

Virginia Medicaid Provider Manual

Chapter I: General Information (rev. 12/1/2011)

Chapter II: Provider Participation Requirements (rev. 2/8/2012)

Chapter III: Recipient Eligibility (rev. 12/1/2011)

Chapter IV: Covered Services and Limitations (rev. 7/14/2010)

Chapter V: Billing Instructions (rev. 1/26/2011)

Chapter VI: Quality Management Review (rev. 7/14/2010)

Chapter VII: Day Support Waiver (rev. 7/14/2010)