Supports for Children
Children’s Intensive In-Home Services (CIIS)
Overview
CIIS was developed in response to the needs of families caring for their children with intensive medical or behavioral needs at home. The program was designed to offer flexible, ongoing supports based on the individual needs of the child and family.
Service Coordinators for the program collaborate with individual families statewide to identify and assess needed supports. They then work together to develop plans of support while coordinating with other government and community agencies.
The goal of the program is to offer the most flexible form of supports necessary to enable children to stay in their own home.
CIIS Programs and Eligibility
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CIIS Provider Application Processing
Individuals and agencies interested in providing in home care or consultation services to children receiving services through CIIS must obtain a provider number through the program. The application process includes:
1. CIIS Provider Application (Word )
2. Criminal History Request - English: (pdf or Word); Spanish: (pdf)
3. Consent for Release of Information (pdf)
4. Employment Eligibility Verification: I-9 form
Mail completed, original applications (items 1-4) to:
Nita Cannon
DHS/SPD/CIIS
500 Summer St., E10
Salem, OR 97301
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Printable Forms
The following forms are posted for your convenience.
Contacts
- For further information or to make a referral:
Anyone can refer a child to the program. When appropriate, DD eligibility must be established through the local Community Developmental Disabilities Programs before an evaluation for services can take place.
- For Behavior Program:
Call (971) 673-2995 or fax (971) 673-2971 Attn: Tara Davidenas
- For Medically Involved Program:
Call (971) 673-2995 or fax (971) 673-2971 Attn: Tara Davidenas
- For Medically Fragile Children’s Unit:
Call (971) 673-3000 or fax (971) 673-2971 Attn: MFCU intake
- For Provider Application and Processing information:
Call (503) 947-5188 or
- For families of children with disabilities outside of the Salem area:
Call 1-888-390-5437
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