AGING AND DISABILITY SERVICES ADMINISTRATION
2005 BH "Dear Provider" Letters
July 20, 2005
ADSA: BH #2005-007
COMPLETION & PROCESSING OF Background Authorization Forms
SUBMITTING CHANGE REQUESTS IN WRITING
Dear Boarding Home Provider:
The intent of this letter is to clarify how Background Authorization forms are to be filled out and how processed results are returned to the facility. It is also to inform providers that there is a written requirement to change the facility fax number or mailing address for processed background results to be returned to the facility.
- In Box #1 of the Background Authorization form, the exact facility name as shown on your Boarding Home license must be listed. The facility name must be the same as the registered trade name on your master business license. If the names are not the same, you must register the current facility name as a trade name. The site address must also be listed.
- Background Authorization forms that are mailed to the Background Check Central Unit (BCCU) for processing will only be mailed back to the mailing address as listed in the Department’s Boarding Home (BH) Tracking System.
- Background Authorization forms faxed to the BCCU for processing will only be faxed back to the fax number listed in the Department’s BH Tracking System. If the facility has no fax number listed in the Department’s tracking system, the processed forms will be mailed back to the mailing address as listed in the Department’s tracking system.
- Effective immediately, to change a facility name, fax number or mailing address the facility must provide the RCS Field Manager with a written request. The request must contain the new information to be entered into the Department’s BH Tracking System.
If you have further questions, please contact the Business Analysis & Applications Unit at (360) 725-2420, Extension 2.
Sincerely,
Joyce Pashley Stockwell, Director
Residential Care Services
