Documents/Forms

FORMS FOR POTENTIAL CLIENTS:

PROGRAM INFORMATION:
Fact Sheet

Overview of Medicaid Waiver Programs in Connecticut

Community Options Waiver Application
CT Home Care Program for Elders Waiver Renewal 2010

Assisted Living
Assisted Living Options
Assisted Living Program Flyer - English
Assisted Living Flyer - Spanish
Participating Assisted Living Facilities (Rev. 12/12/2018)
Participating Adult Day Health Centers (revised 3/16)
Private Pay Assisted Living Project

Eligibility
Spousal Assessment (Rev. 4/16)
Transfer of Assets
Categorical Eligibility Chart (revised 1/16)

PCA
Personal Care Attendant Guidelines (Rev. 7/10)

CT Home Care Program for Disabled Adults
CT Home Care Program for Disabled Adults

CHCPE Annual Report
Please follow this link for CHCPE Annual Report.

Follow this link to the Protective Services for the Elderly brochure. (English version) - (Spanish version)
Follow this link to Review LTC Investigation Procedures and the Mandated Reporting Form (W-410).