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Required CDAC Documentation Form
and Additional Training Dates
Iowa DHS Informational Letter
760 recently announced the
requirement of a new form
(470-4389) effective December 1,
2008 to document CDAC services.
In addition, it offered several
informational training sessions
around the state to help
providers understand how to use
the new form. Because training
demand has been strong, and well
received, the IME has decided to provide
additional training dates.
IAHC members are receiving
advance notice of
Informational Letter 764 which,
among other information,
includes the following important
updates:
Important notes:
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The Daily Service Record
form (470-4389) attached to
this announcement is
slightly revised from the
one sent with IL 760.
Please use this version of
the form beginning December
1, 2008.
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In addition, it has been
confirmed that the “consumer
signature” (box 13) is not
actually required. The
consumer signature line will
be removed from the form at
a later date.
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Iowa Medicaid will mail 200
forms to all
Individual CDAC
providers before December 1,
2009. Agency and
Assisted Living CDAC
Providers are encouraged to
copy the form or use the
template on our website; as
necessary bulk forms may be
ordered from IME after
November 17 as well.
Additional Information:
IAHC Resource Center:
Posted: November 3, 2008
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