7-HSS-26-019 - Agency with Choice - Attachment 6 - Subcontractor Information Form.docx

This document is a Subcontractor Information Form for Delaware Health and Social Services Division of Developmental Disabilities, specifically for Contract No. HSS-26-019 titled "Agency with Choice". The form is designed to capture details about potential subcontractors for a Financial Management Services (FMS) project using the Agency with Choice (AWC) model. The contract aims to provide self-directed support services for individuals with intellectual and developmental disabilities living at home with their families.

The form includes sections for vendors to provide subcontractor information, including business classifications such as Women Business Enterprise, Minority Business Enterprise, Disadvantaged Business Enterprise, and Veteran Owned Business Enterprise. While specific details about pricing, funding sources, or contract term are not explicitly stated in this document, the related contract opportunity description indicates this is part of a broader procurement by the Delaware Division of Developmental Disabilities Services to secure a provider who will serve as the Common Law Employer and deliver financial management services to participants seeking self-directed personal care and respite services.