AGENCY: Department of Health and Human Services. Division of Services for People with Disabilities

SERIES: 80125
TITLE: Provider files
DATES: 1985-
ARRANGEMENT: Alphabetical by provider's name

DESCRIPTION: This is a record kept on providers for the Division of Services for People with Disabilities. The records include: registration application and Affidavit of Standard Compliance, license, copies of contracts, contractor evaluations, qualifications of staff members, confidentiality agreement, provider Code of Conduct, insurance, Medicaid application, contract budget (if applicable), problem correction plan, fact finding reports and results, and related memos and correspondence.

RETENTION

Retain for 5 year(s) after expiration of contractual agreement

DISPOSITION

Destroy.

RETENTION AND DISPOSITION AUTHORIZATION

These records are in Archives' permanent custody.

APPROVED: 12/1988

FORMAT MANAGEMENT

Paper: Retain in Office for 1 year after contract has been cancelled or terminated and then transfer to State Records Center. Retain in State Records Center for 4 years and then destroy.

APPRAISAL

Administrative Fiscal Legal

Retention is based on 42 CFR 431.17.

PRIMARY DESIGNATION

Public

SECONDARY DESIGNATION

Private. name, address, and telephone number of the facility

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