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Home Divisions Developmental Disabilities Provider Enrollment DD & Medically Fragile Waiver Provider Enrollment

Developmental Disabilities, Medically Fragile and Supports Waiver Provider Enrollment

This section provides all the details on applying to become a provider for either the Developmental Disability Waiver (DDW) or the Medically Fragile Waiver (MFW).

Application Documents

The documents below will assist you with the application process.

Service Standards

The following links contain helpful information for both first-time and current providers.

Developmental Disabilities Waiver Service Standards

Medically Fragile Waiver Service Standards


For billing assistance, contact Conduent (formally known as Xerox) at 1-800-299-7304.

Secondary Freedom of Choice

The Secondary Freedom of Choice (SFOC) form is utilized by case management provider agencies to present to registrants when selecting DDW and/or MFW services.

Please send email to address if you need to request an SFOC form.

Policy and Procedure Exception Request

ImagePursuant to the SFOC Policy and Procedure, provider agencies cannot not deny services to any individual once a SFOC has been signed, unless they can demonstrate that they do not have the capability to ensure the health and safety of that individual.

If your agency has received a signed SFOC and is unable to accept the individual for the reasons outlined within the SFOC Policy and Procedure, please fax a copy of the SFOC Policy & Procedure Exception Request Form to one of our Regional Offices for review.