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Record Series Code
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Record Series Title
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Minimum Retention
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Disposition
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DESCRIPTION
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Agency Specific Schedules: Developmental Service, Department of: All DDS Agency Programs
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DDS-01-001
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Audit completion date + 6 Year(s)
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Destroy after receipt of signed Form RC-108
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This series documents audits and inspections of DDS facilities and operations. Including but not limited to: annual quality audits; group home audits; Independent Professional Reviews (IPR); Individual Compliance Audits (ICA); internal audits for resource allocations; medication administration audits; quality monitor reports; quality service reviews; quarterly audit of infection control; state fire marshal inspection reports; utilization reviews; and audits.
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DDS-01-002
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Application date + 10 Year(s)
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Destroy after receipt of signed Form RC-108
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This series documents resource allocation and eligibility for clients to participate in DDS program. Including but not limited to: eligible, inactive, and ineligible determinations; and related correspondence.
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DDS-01-003
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3 Year(s)
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Disposition is 3 years, or until audited, whichever is later. Destroy after receipt of signed Form RC-108
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This series documents financial records of clients in DDS programs. Including but not limited to: bank statements; check registers; old checks; daily transaction records; monthly account balance forms; cash receipts and disbursements journals; tax records; and related correspondence.
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DDS-01-004
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Death date + 10 Year(s)
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Disposition is 10 years from date of client’s death. Destroy after receipt of signed Form RC-108
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This series documents investigation into abuse and/or neglect of clients. Including but not limited to: Intake Reports; Investigation Reports; Recommendation Reports; Abuse and Neglect Form M5; and related correspondence.
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DDS-01-005
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Death date + 10 Year(s)
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Disposition is 10 years from date of client’s death. Destroy after receipt of signed Form RC-108
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This series documents service provided to clients aka "Individual Plan Files." Including but not limited to: Individual Plans; Follow Along Plans; Program reviews; Interdisciplinary Team Meeting minutes I notes I etc.; Monthly data summaries; Monthly reviews; Over-all plan of service or Individual Plan invitations; quarterly or six month reviews; Transition plan checklist; Daily living notes and activity schedules; and End Books (aka Group Books, Individual Books, Residential Books). Includes competency cards; likes I dislikes I preferred activities; active treatment schedules; positioning documentation; levels of supervision; communication overview packet; teaching strategies; guidelines I procedures; Recreation - Leisure Interest I Time Surveys; Recreation - Participation I progress notes; and related correspondence.
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DDS-01-006
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Review date + 10 Year(s)
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Disposition is 10 years from date review completed. Destroy after receipt of signed Form RC-108
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This series documents reviews of deaths of clients. Including but not limited to: Mortality Review Packet (includes Mortality Review Committee form aka Face Sheet); Letters to Families and Notices of Review; Independent Mortality Review Board (IMRB) Corrective Actions and Plans; Mortality Review Records Tracking (including the Mortality Review Tracking Report and the Request for Information - Mortality Review); Post-Mortem Review Files; Weekly Death Reports; and related correspondence.
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DDS-01-007
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Expiration date + 3 Year(s)
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Disposition is 3 years from end of license, or until audited, whichever is later. Destroy after receipt of signed Form RC-108
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This series documents licensure of public and private residential facilities which provide care, treatment or lodging for people with developmental disabilities. Including, but not limited to: Licenses /Certificates; Licensing letter of renewals; Vacate / Relocation Reports; and Licensing Files, including Licensing Application Packet, Initial Licensure Checklists, Requests for Licensure, Summary of Citations, Statement of Deficiencies (SOD), Plan of Corrections, (POC), and Summary Application for Renewal (SAR).
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DDS-01-008
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Contract end date + 6 Year(s)
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Disposition is 6 years from end of contract or until audited, whichever is later. Destroy after receipt of signed Form RC-108
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This series documents the review and administration of community residential facility loans to organizations for construction or purchase and renovation of community-based residential facilities pursuant to CGS Sec17a-223. Including but not limited to: applications; approval letters; promissory notes; mortgage documents; and related correspondence.
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DDS-01-009
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Death date + 10 Year(s)
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Disposition is 10 years from date of client’s death. Destroy after receipt of signed Form RC-108
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This series documents client records kept at each day program site. Including but not limited to: participant profiles and information sheets; participant contact sheets; assessments and evaluations; goals and objectives; and medical services.
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DDS-01-010
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Contract end date + 10 Year(s)
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Disposition is 10 years from end of contract, or until audited, whichever is later. Destroy after receipt of signed Form RC-108
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This series documents the application, issuance, management, and administration of Grant in Aid. Including but not limited to: Grant in Aid Applications; Grant in Aid Contracts; Lien Documentations; and related correspondence.
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DDS-01-011
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Contract end date + 6 Year(s)
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Disposition is 6 years from end of contract or until audited, whichever is later. Destroy after receipt of signed Form RC-108
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This series documents the application, issuance, management, and administration of house and community bond waivers from the federal government. Including but not limited to: waiver applications; waiver amendments; quality monitoring reports; and related correspondence.
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DDS-01-012
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Death date + 10 Year(s)
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Disposition is 10 years from date of client’s death. Destroy after receipt of signed Form RC-108
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This series documents client advocacy to ensure client rights were not taken away. Including but not limited to: case files; HRC packet (includes HRC face sheet and approval form); referrals and recommendations; quarterly and annual reports; and related correspondence.
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DDS-01-013
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Contract end date + 6 Year(s)
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Disposition is 6 years from end of contract or until audited, whichever is later. Destroy after receipt of signed Form RC-108
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This series documents the application, issuance, management, and administration of individual and family support grants designed to support home care for clients. Includes approved applications. Including but not limited to: Grant Request/Authorization Forms and supporting documentation; Individual and Family Grant Agreements; and Loan Compliance Documents (includes documentation of all expenditures).
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DDS-01-014
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Denied or withdrawn date + 1 Year(s)
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Disposition is 1 year from date application withdrawn/denied. Destroy after receipt of signed Form RC-108
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This series documents the application, issuance, management, and administration of individual and family support grants designed to support home care for clients. Includes withdrawn and denied applications. Including but not limited to: Grant Request/Authorization Forms and supporting documentation; Individual and Family Grant Agreements; and Loan Compliance Documents (includes documentation of all expenditures).
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DDS-01-015
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Final expenditure report submission + 3 Year(s)
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Disposition is 3 years from date of submission of final expenditure report, or until audited, whichever is later. Destroy after receipt of signed Form RC-108
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This series document the billing process for individuals who receive Medicaid services from DDS. Including but not limited to: billing reports; attendance forms; provider enrollment forms; federal financial reimbursement records; fiscal intermediary (IFS) waiver service documentation forms; Medicaid claims; TANF (Temporary Aid to Needy Families) billing; and Medicaid waiver (title XIX) redeterminations.
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DDS-01-016
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Approved date + 6 Year(s)
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Disposition is 6 years from date rate approved by DSS. Destroy after receipt of signed Form RC-108
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This series documents the rate setting process for individuals who receive Medicaid services from DDS. Including but not limited to: provider utilization forms; rate calculations; and DSS rate correspondence.
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DDS-01-017
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Waiver Determination date + 6 Year(s)
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Destroy after receipt of signed Form RC-108
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This series documents the waiver enrollment process for individuals who receive Medicaid services from DDS. Including but not limited to: individual consumer files; form 1576 - change/discharge; service documentation (service note documentation, time logs, environmental modification proposals, vehicle maintenance proposals, etc.); waiver application; enrollment and eligibility forms (includes DDS forms 219, 222, 223, DSS form W-1518, and the Waiting List Assessment Tool, form 225 PRAT HCBS Waiver Recommendation Form).
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DDS-01-018
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Audit completion date + 6 Year(s)
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Destroy after receipt of signed Form RC-108
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This series documents the auditing process for individuals who receive Medicaid services from DDS. Including, but not limited to: service utilization billing documentation and waiver quality monitoring reports.
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DDS-01-019
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Decision date + 10 Year(s)
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Disposition is 10 years from date of review, or date of decision, whichever is later. Destroy after receipt of signed Form RC-108
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This series documents the management of PRAT, whereby DDS identifies available resources, identifies individual consumer needs, assigns priority, implements waiting list policies and procedures, makes recommendations regarding applicants for waivers, and processes allocation of resources and referrals to available out-of-home residential group living settings and provider agency-based day services. Including but not limited to: planning lists; priority checklists waiting lists and allocation tracking records.
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DDS-01-020
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Contract end date + 10 Year(s)
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Disposition is 10 years from end of contract, or until audited, whichever is later. Destroy after receipt of signed Form RC-108
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This series documents contracts with private provider residential facilities and day programs. Including but not limited to: Annual Report of Residential And Day Services (formerly ACORE and CORE); master contracts and amendments; cost settlement letters; operations plans; rate letters for CLA's; room and board rates from DSS; Regional Transfer forms; Forensic Fiscal Planning forms; and related correspondence.
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DDS-01-021
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Expiration date + 6 Year(s)
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Disposition is 6 years from end of license, or until audited, whichever is later. Destroy after receipt of signed Form RC-108
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This series documents private providers who were licensed but vacated facility. Including but not limited to: review files (requests to vacate licensed residential facility, intra-agency correspondence, reviews of the Statewide Master Inventory of homes needing replacement, Facility assessment reports, and Relocation Plan); and related correspondence.
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DDS-01-022
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Death date + 10 Year(s)
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Disposition is 10 years from date of client’s death. Destroy after receipt of signed Form RC-108
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This series documents administration of the program review committee. Including but not limited to: Program Review Committee (PRC) / Human Rights Committee (HRC) Review of Pre-Sedation for Medical/Dental Care packets (face sheets, documentation of review, Considerations for Pre-Sedation for Medical/Dental Care, Signed Consent forms that includes documentation of medication side effects, Use of Pre-Sedation Medication for Medical/Dental Care Tracking form, etc.); PRC Approval/Signature Sheets; PRC Case Files; PRC Information Packets (PRC Fact Sheets, Requests for Medication/Program Review, etc.) and related correspondence.
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DDS-01-023
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Last entry date + 3 Year(s)
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Disposition is 3 years from last entry date in log book. Destroy after receipt of signed Form RC-108
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This series documents information pertaining to general daily communications and occurrences in residential facilities. Including but not limited to: daily log books.
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DDS-01-024
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Death date + 10 Year(s)
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Disposition is 10 years from date of client’s death. Destroy after receipt of signed Form RC-108
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This series documents service provided to clients in respite facilities, including basic information on needs, medication, contacts, etc. May include copies of medical records supplied by case manager or family.
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DDS-01-025
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Contract end date + 6 Year(s)
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Disposition is 6 years from end of contract or until audited, whichever is later. Destroy after receipt of signed Form RC-108
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This series documents contracts with respite providers to provide services to DDS clients. Including but not limited to: respite agreements and respite evaluations.
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