Lynne A. Valenti
Cabinet Secretary

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CopiesEdit the Number of CopiesDocument NumberDocument NameDelete
1EditBRO/EBT1EBT Client HandbookDelete
1EditCCSElectronic Payment ExemptionsDelete
1EditMS-146Sterilization Consent FormDelete
1EditMISC/BH1South Dakota Community Mental Health Center FlyerDelete
1EditBRO/CPS11Central Registry of Child Abuse & NeglectDelete
1EditBRO/DCS4National Medical Support Notice Brochure - An Employers GuideDelete
1EditPAPrior Authorization Forms: Applied Behavior Analysis TherapyDelete
1EditPosterConstituent Liaison Services PosterDelete
1EditBH-08Mental Health - IMPACT ApplicationDelete
1EditBRO/DCS6Voluntary Paternity Establishment Handbook and FormDelete
1EditCCS-964Child Care Declaration of Prior Criminal Conviction and Military HistoryDelete
1EditBRO/CPS2Common Sense Parenting BrochureDelete
1EditCPSProvider Mileage RequestDelete
1EditBRO/EA4TANF Work Program BrochureDelete
1EditCCS-964Child Care Declaration of Prior Criminal Conviction and Military HistoryDelete
1EditEA-231Child Support Enforcement ReferralDelete
1EditCPS-500Newborn Medical Report for Voluntary Termination of Parental RightsDelete
1EditCPS-508Reference Form - Adoption / Foster / Kinship CareDelete
1EditCPSFoster Parent HandbookDelete
1EditBRO/CPS9Adoption Subsidy HandbookDelete
1EditCPS-522Request for PaymentDelete
1EditCPS-593Permission to Screen for Reports of Abuse or NeglectDelete
1EditEAWeatherization ApplicationDelete
1EditBRO/MS3Well-Child Care BrochureDelete
1Edit Recipient Forms: HIPAA Privacy Consent FormDelete
1EditPAPrior Authorization Forms: Genetic Testing Delete
1EditBRO/EACommunity Action Agency HandoutDelete
1EditEA-240Application for Resource Assessment, Long Term Care or Related Medical AssistanceDelete
1EditCCS-970Child Care Services Request For PaymentDelete
1EditBH-17Prevention - Accreditation ApplicationDelete
1EditFSSAChildren and Family Medical Assistance ApplicationDelete
1EditBH-09aIndigent Medication Update-Extension ApplicationDelete
1EditBRO/VS3Crime Victims Compensation Program BrochureDelete
1EditBRO/VS2Domestic Violence BrochureDelete
1EditBH-03102a Hardship Considerations Delete
1EditEA-208Authorization to Furnish / Release InformationDelete
1EditCPSPlacement Resource Monthly Reporting Form Ages 0-4Delete
1EditDSS-W9W-9 FormDelete
1EditEA-320Self-Employment LedgerDelete
1EditBH-05Hardship Considerations RefusalDelete
1EditBRO/EA11Weatherization Assistance BrochureDelete
1EditEA-320Self-Employment LedgerDelete
1EditCPS-506Foster/Adoptive Parent Health ReportDelete
1EditEA-240Application for Resource Assessment, Long Term Care or Related Medical AssistanceDelete
1EditBRO/CCS6Child Care Assistance Program BrochureDelete
1EditBRO/EA16Medical Assistance for Children and Families: IHS SpecificDelete
1EditBRO/EA2SNAP BrochureDelete
1EditCPSIndependent Living Program Education and Training Voucher Delete
1EditMSMedicaid Transportation Documentation FormDelete
1EditPAPrior Authorization Forms: BRCADelete
1EditRec and FraudStop Benefit Fraud InsertDelete
1EditBRO/EA10SNAP for StudentsDelete
1EditBRO/BH2Mental Health Services BrochureDelete
1EditBH-14Substance Abuse - Accreditation ApplicationDelete
1EditPAPrior Authorization Forms: Genetic Testing Delete
1EditMS-103Provider Change FormDelete
1EditSE-492Notice of Shared Medical ExpensesDelete
1EditPAPrior Authorization Forms: GeneralDelete
1EditBH-11aAdult SUD Initial Outcome ToolDelete
1EditPOS/EA02Long-Term Care Partnership Fact SheetDelete
1EditSE-431AChild Support Payment Authorization FormDelete
1EditEA-297Energy Assistance ApplicationDelete