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Click ‘Get Form’ to open the 470 3372 form in the editor.
Begin by entering the consumer's name and the CDAC provider's name in the designated fields. Ensure that all names are spelled correctly for accurate documentation.
In the 'Agreement' section, both parties must review and agree to the terms outlined. This includes understanding responsibilities and payment rates.
Complete the 'Responsibility' section by detailing emergency plans, evaluating the CDAC provider’s training, and describing how services will be managed and evaluated.
Fill out the 'Standards for the CDAC provider' section, confirming age, skills, and insurance details as required. Make sure to provide clear answers.
Document service activities by specifying time requirements and frequency for each activity listed. Use 'Not applicable' where necessary.
Review all entries for accuracy before signing. Both consumer and CDAC provider must sign to validate the agreement.
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$4K Pay TypeRangeMedian Base Pay $3K - $6K $4K/mo Jun 6, 2024
How much does CDAC pay in Iowa?
The average CDAC Provider base salary at Iowa Total Care is $4K per month.
Who qualifies for CDAc in Iowa?
Eligibility requirements You must also be a resident of Iowa and require assistance with activities of daily living (ADLs) or instrumental activities of daily living (IADLs). CDAC services are available to Medicaid recipients eligible for the Home and Community-Based Services (HCBS) waiver program.
3372 form
How do i get a 470 3372 form pdfHow do i get a 470 3372 form onlineForm 470 2917Form 470 4457Form 470 4612Form 470 2965Form 470 4202Form 470 4227
form 3372
470-4389 Consumer-Directed Attendant Care (CDAC)
Directions: Fill out this form every time you provide services to your consumer. The CDAC Agreement (form 470-3372) lists the services you are authorized to
Form 470-4389 is available for recording CDAC activities. The record must show that the service is necessary due to the members complaint needs as shown by
If transfering to a different department, approval from the other department is required. 12, **Please email expenditure transfer (in excel format) and
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