Forms and Documents

 

Click here for Ohio DoDD COVID-19 Resources and Support 

Wood County Provider Pandemic Support Grant

The Wood County Board of Developmental Disabilities is appreciative of our entire Provider network’s response during the Pandemic and we want to show our support in any way we can.  Providers have been a source of strength for those we serve when it’s been needed the most.

Grant Part A:  To help alleviate increased costs providers may have experienced in caring for an individual or individuals who have needed to quarantine during the Pandemic retroactively to March 17, 2020 through December 31, 2020, the WCBDD has authorized the Provider Grant Pandemic Support Grant program. Deadline December 1, 2020

Grant Part B: The Provider Support Pilot Grant Program was revised effective 6/15/2020 to include financial support for ADS Providers.  The Wood County Board of Developmental Disabilities understands this is a difficult time and there have been many expenses that were not planned for.  (Note that the numbers of individuals served is based on pre-pandemic numbers.)  Deadline December 1, 2020.

For information on the criteria to receive either grant click here:  WCBDD Covid -19 Provider Support Pilot Program (pdf)      (Word)

If  you have questions or would like to apply for either one or both of these grants, please contact Service and Support Administration Manager, Amy Knauss, by email at aknauss@woodcountydd.org or phone at 419-315-1231.

Educational COVID-19 Training Materials for ADS/ VH/ STEPS/ HPC:

Here are a variety of educational resources DSP’s can utilize with Individuals served to assist in increasing their knowledge and abilities of the COVID-9 Pandemic.  The resources include social stories, printable PEC’s for donning and doffing masks and other helpful tools.     What is the Coronavirus Social Story          Plain Language Information on COVID-19         Covid19 ab comptest           Covid19 ab         My Day Program Closed        Germs-Social-Story          What is Social Distancing Social Story         Social Story About Social Distancing with Pecs          Wash-Your-Hands-Steps 8×11-1          Non-handshake Greetings Social Story         I-Can-Wear-a-Mask-Social-Story         Cloth Mask Elastic            Cloth Mask Ribbon           Surgical Mask       Wearing a Face Mask Social Story-Adult Version         Wearing a Face Mask Social Story-Child Version           Surgical Mask         Telemedicine Social Story   

                     

Provider Forms and Documents

HPC Documentation Monthly (pdf)    (Word)                                                               HPC Documentation Weekly (pdf)    (Word)

HPC Transportation Individual Mileage Log (pdf)       (Word)                             HPC Transportation Multiple Person Mileage Log (pdf)    (Word)

NMT (Per Trip) w Daily Inspection (pdf)          (Word)                                                NMT (Per Mile) w Daily Inspection (pdf)      (Word)

Ohio Shared Living Documentation Weekly (pdf)      (Word)                             Ohio Shared Living Documentation Monthly (pdf)     (Word)

Waiver Nursing Care Documentation (pdf)     (Word)

Incident Report Form 

Seizure Observation-First Aid Treatment Record

UI Log