KANSAS DEPARTMENT FOR CHILDREN AND FAMILIES NOTICE OF USE OF PRIVATE HEALTH INFORMATION THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU
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https://www.dcf.ks.gov/Agency/Documents/HIPPA-NOP.pdf
If you need help or have
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address and signature on Page 3 and return the form
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You must re-register each time you change your name, address, or party affiliation for voting
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Street Address
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-3100_11-20.pdfView duplicates
can make a State-wide impact (or address targeted disparity location of Finney County KS
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families, through advocacy and systems change Assessment/Analysis: The project proposal
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https://www.dcf.ks.gov/Agency/Operations/ARReports/KCDD - RFP Pre bid PowerPoint.pdf
amount of stock, bond and money market funds in the portfolios is set and will not change
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the beneficiary’s social security number and address from my child support case and use that
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https://www.dcf.ks.gov/services/CSS/Documents/529 Custodial Arrears Booklet 11.16.16.pdf
Page 3 of 8 Address CMS objections related to some specific billing practices and the use
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About Elements of System Change PAHP Performance & Implementation Activities - First Four
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https://www.dcf.ks.gov/Agency/Testimony/Documents/2007/11-9-07_LBC_MH_reimb.pdf
Appendix A: FY 2020 Budget Proviso
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Crossover Youth Data Team: Wednesday, July 24, 2019
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and gather the best information possible to address the topics outlined in the proviso
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https://www.dcf.ks.gov/Agency/Documents/FY 2020 Crossover Youth Working Group Interim Report.pdf
assistance for failure to report
a change for cash or medical assistance purposes, unless the change was
also required to be reported for
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https://content.dcf.ks.gov/EES/KEESM/Robo02-24/keesm9123.htmView duplicates
(FCCC) cases, change in contact information or address, changes in hours, or changes
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Is this change form for a change in contact information
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Phone Email Street Address
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https://content.dcf.ks.gov/EES/KEESM/Forms/ES-1512FC-CC Change Form.pdfView duplicates
Date Placed: Previous Placement Name Address: Address: From: To: Current Placement Name: Address: Address: From: Medicaid Card Mailing Address (if different
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Section_5000_Forms/PPS5460.pdf
forms appendices include revisions affecting the meaning or involves a change to practice
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This change was instituted as part of the issues identified by DCF’s Leading for Results
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https://www.dcf.ks.gov/services/PPS/Documents/PPM_Forms/Summary of Changes/Summary of Changes - 2022.7.pdf