ICF/DD State Plan Amendment Information

• The April 1, 2011 letter to ICF providers explaining the ICF/DD SPA in further detail;
• The two forms required for completion by the ICF providers. New ICF providers will need to complete both forms and return them to:

  California Department of Developmental Services Community Living Section – ATTN: ICF/DD SPA 1215 O Street (MS 8-30) Sacramento, CA 95814 Fax: 916-654-2187

  • STD 204 Payee Data Record 
  • ICF DD SPA Acknowledgment and Authorization form  ; and
• Frequently Asked Questions from ICF providers, related to the ICF/DD SPA.

Last modified: July 1, 2021