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
676 Church St NE, 2nd Floor
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 send fax to 971-673-2971. Attn: Tara Davidenas
- For Medically Involved Program:
Call 971-673-2995 or send fax to 971-673-2971, Attn: Tara Davidenas
- For Medically Fragile Children's Unit:
Call 971-673-3000 or send fax to 971-673-2971, Attn: MFCU intake
- For Provider Application and Processing information:
Call 503-378-5051
- For families of children with disabilities outside of the Salem area:
Call 1-888-390-5437
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