Health Standards Section Licensing Fees - Waiver Programs

For a listing of program contact numbers please see the directory listing.

Case Management Waiver Program Information

 

Case Management

 
Initial Renewal Delinquent Renewal CHOW   Change Name Change Address Change of Service
$600 $600 $100 $600  $25 $600

$25

Home and Community Based Service Provider  Waiver Program Information

HCBS Fees
Initial $600 plus an additional $200 for ADC and $200-250 for CBR
Renewal $600 plus an additional $200 for ADC, $200-250 for CBR, and $200 for each Branch/Satellite
Delinquent Renewal $100
Deleting a Module $25
CHOW $600 (does not include $200 FNR fee)
Name Change $25
Change in Address $600 plus an additional $200 for ADC, $200-250 for CBR, and $200 for each Branch/Satellite
Change in Capacity for ADC or Center-Based Respite $25
Adding a Branch/Satellite $200 for Branch/Satellite. $200 for ADC. $200-250 for CBR
Change of Service
PCA $200
Respite: In-Home Care $200
Respite: Center-Based.  Stand-Alone. No Parent Company $200
Respite: Center-Based. Parent Company. Satellite Branch $250
SIL $200
ADC $200
Family Support $200
Substitute Family Care $25
Supported Employment $25
MIHC $200

Surgeon General Ralph L. Abraham, M.D.

Interim Secretary Drew Maranto

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