Applying for Determination of Eligibility
Dear Parents and Caregivers:
PerformCare suggests that you submit eligibility applications for New Jersey Children’s System of Care intellectual and developmental disability services through the CYBER Family Portal.
Online applications process faster at this time. Please do not use smartphones or tablets to fill out the application because you may lose data.
Please note that the CYBER Family Portal only supports Microsoft Edge at this time. Download Microsoft Edge on Microsoft’s website. PerformCare is working on updates that will let families use the portal on other browsers. We will keep you informed when that change is ready.
En español
Por el momento, la solicitud de elegibilidad en internet para los servicios de discapacidad intelectual o del desarrollo está disponible únicamente en inglés. Si le resulta más cómodo leer y escribir en español, por favor imprima y complete los formularios de solicitud disponibles en español que figuran a continuación.
Para descargar la solicitud de elegibilidad en español, haga clic aquí.
For youth to be determined eligible for Developmental Disability Services
For children with developmental disabilities
Eligibility applications for developmental disability services for children younger than age 18 must be filled out and sent to PerformCare, the single access point into the Children’s System of Care.
It is preferred that the application be completed online through the CYBER Family Portal. However, parents and caregivers may also download and complete the application by hand using the forms below.
You may also call PerformCare at 1-877-652-7624 to ask for the application materials to be mailed to you. Please read the instructions below for help filling out the required application forms and sending the required supporting documentation.
Complete the eligibility application online in our secure CYBER Family Portal.
Special notice for young adults ages 18 to 21
Applications for young adults who are ages 18 years or older must be filled out and sent to the Department of Human Services Division of Developmental Disabilities. The Children’s System of Care will honor determinations of eligibility and provide developmental disability services made by the Division of Developmental Disabilities for people between the ages of 18 and 21. Eligibility for services from the Children’s System of Care ends the day before the person turns 21. Please visit the Department of Human Services Division of Developmental Disabilities website for more information on the Division of Developmental Disabilities’ application forms and process.
Downloadable instructions and guidelines
Please review these forms and use them as a guide for filling out and sending your application.
- Intellectual and Developmental Disability Services available through the NJ Children's System of Care (PDF)
- Getting ready checklist (PDF)
- Citizenship and residency requirements (PDF)
- Timeframes for Clinical Assessments Submitted for Developmental Disability Eligibility Determination (PDF)
Application forms
These forms are specific to children up to age 18 and have additional instructions to help families and their advocates apply for eligibility. Many of the changes are based on feedback from families and community representatives that occurred in 2013.
Please note that the requirements for eligibility under New Jersey statute have not changed. These updated forms are designed to make the eligibility process for children easier to understand.
Application forms: required
- Form A: Applicant information and declaration (PDF)
- Form B: Child adaptive behavior summary (CABS) (PDF)
- Form C: Documentation checklist (PDF)
- Form D: Privacy practices acknowledgement (PDF)
You can also access these application forms in additional languages.
Forms A through D listed above are required, along with appropriate medical and other documentation as pointed out in the forms. Some applications may also need an Authorization for Sharing Health Information form (PDF). For more information on this form, please see the Sharing Health Information section below or visit the PerformCare Forms page.
The filled out application forms and supporting documentation should be mailed to PerformCare at this address:
PerformCare New Jersey
Attention: DD Eligibility Unit
300 Horizon Drive, Suite 306
Robbinsville, NJ 08691
Authorization for Sharing Health Information
Some applications may need an Authorization for Sharing of Health Information form. PerformCare may ask you to fill out an authorization form so that another person or organization of your choice, such as a doctor or your child’s school, can speak with PerformCare about your child’s needs in regards to the application. For more information on filling out and mailing the authorization form, please see the Forms page.
| Language | Links |
|---|---|
| English | Authorization for Sharing Health Information (PDF) Frequently Asked Questions — Authorization for Sharing Health Information (PDF) |
| Español (Spanish) |
Autorización para compartir información médica (PDF) Formulario de Autorización de divulgación de información médica: Preguntas frecuentes (PDF) |
| Português (Portuguese) |
Autorização para compartilhar informações médicas (PDF) |
| 中文（普通话) (Chinese (Mandarin)) |
健康信息分享授权 (PDF) |
| 한국어 (Korean) |
건강 정보 공개 승인서 (PDF) |
| ગુજરાતી (Gujarati) |
આરોગ્ય માહિતી શેર કરવા માટે અધિકૃતતા (PDF) |
CYBER Family Portal
You can also fill out this application online, which includes real-time tracking of your application status. It is recommended that you fill out and send applications online as it makes processing easier and faster. Please fill out the application with a desktop or laptop computer because using smartphones and tablets may cause data loss.
Go to the secure CYBER Family Portal.
Please review all the forms and materials above before completing the application online.
What to expect after you apply
Once PerformCare gets your application, it will be sent to the Developmental Disabilities Eligibility Unit to make sure that all required forms and documents are included. After an initial review of the application, you will receive a letter to explain what is still needed if your application is missing any documents or other information needed to make a decision.
From the date that an application has been submitted, the family has up to one year to send any materials that are needed. If the child is younger than age 18 and the application has not been completed within one year of submission, the family will need to send a new application to PerformCare. If the application has not been filled out within one year of being submitted and the youth has turned 18 years old, the family will be referred to the Department of Human Services Division of Developmental Disabilities to start a new application.
A decision will be made within 60 business days after the Developmental Disabilities Eligibility Unit has all the information they need.
If the child is eligible for services, you will get an eligibility letter from PerformCare. If the child does not appear to be eligible, the application materials will be sent for further review. This second review, if needed, may stretch the decision beyond 60 business days.