RRH_T|/yEpg0VtPY>'k] <> The electrodes will be attached to an electrocardiograph (ECG) machine which will be used to monitor your heart's electrical signals during the CT scan so images can be made between contractions or beats. During the scan, the CT table will move you slowly through the CT scanning machine, often making several passes to obtain an entire clear series of images. STATE OF NEW HAMPSHIRE Department of Health and Human Services Division of Economic and Housing Stability Bureau of Child Development and Head Start Collaboration Form 1863 May 2020 BCDHSC Form 1863 May 2020 Mail a copy to DHHS Central Scanning Unit, P.O. 111 North Sanders Helena, MT 59601-4520 PO Box 4210 Helena, MT 59604-4210, 1400 Broadway, Rm C314, Helena, MT 59601-5231, Asthma and Diabetes Prevention and Control Programs, Nutritional and Physical Activity Program, 1400 Broadway, Room C202 Helena, MT 59601-5231 TOP, 1400 Broadway, Room B102 Helena, MT 59620, 1400 Broadway, Room C216 Helena, MT 69601-5231, 1400 Broadway, Room C216 Helena, MT 59601, Program Planning Unit 111 N Last Chance Gulch, Helena, MT 59601-6282 PO Box 8005, Helena, MT 59604-8005 TOP, Centralized Intake Unit 111 N Last Chance Gulch, Helena, MT 59601-6282 PO Box 8005, Helena, MT 59604-8005, 1625 11th Ave, Helena MT 59601 PO Box 4210, Helena MT 59620, 1625 11th Ave, Helena MT 59601 PO Box 4210, Helena MT 59620 TOP, Food Distribution/Commodity Warehouse Program 1400 Carter Drive, Helena, MT 59601-6400 PO Box 202956, Helena MT 59620-2956 TOP, Energy & Community Services Program (LIEAP & Weatherization) 1400 Carter Drive, Helena, MT 59601-6400 PO Box 202956, Helena, MT 59620-2956 TOP, Medicaid & Healthy Montana Kids Drug Rebate Program, 1400 Broadway, Room A104 Helena, MT 59601-5231, Audit Bureau 2401 Colonial Dr, 3rd Floor Helena, MT 59601-4909, Administrative Support Supervisor,Afrah Al Asadi, Administrative Assistant,Andrew Erickson, 1100 N. Last Chance Gulch, 2 nd Floor, Helena, MT 59601 TOP, State Information Technology Services Division PO Box 200113 Helena, MT 59620-0113 CONTACT US, STD DIS Program Specialist, Miranda Reddig, U.S. BUREAU OF LABOR STATISTICS FOR MONTANA, MONTANA OFFICE OF TOURISM AND BUSINESS DEVELOPMENT, MONTANA HISTORICAL SOCIETY RESEARCH CENTER, Behavioral Health and Developmental Disabilities, Office of Inspector General (formerly Quality Assurance), State Information Technology Services Division, Economic Security Services Executive Director, Erica Johnston, Medicaid and Health ServicesExecutive Director, Mike Randol, Medicaid and CHIP State Plan Amendment and Waiver Coor., Mary Eve Kulawik, Strategic Planning, Research andAnalysis, Eric Higginbotham, Operations Revenue Forecasting Specialist, Jamie Bartole, Office of Inspector General, Michelle Truax (Interim), State Medical Officer, Dr. Maggie Cook-Shimanek, Office of Health and Human Services Innovation, CIO, Marie Matthews, Legislative and Regulatory Affairs, Brenton Craggs, Communications Specialist, Herbert Council, Program Analyst/Technical Writer, Megan Grotzke, Faith and Community Based Services, Tracy Moseman, American Indian Health Director, Stephanie Iron Shooter, Chief Human Resources Officer, Karol Anne Davis, Deputy Human Resources Officer, Ciarra Krantz, Civil Rights and EEO Officer , Lloyd Sparks, Senior Human Resource Partner/Employee & Labor Relations, Sarah Green, Senior Human Resource Partner/Facility Liaison, Vacant, Human Resources Office Coordinator, Sam Askin, Risk Management and Safety Officer, Joe McAnally, Occupational Health and Safety Officer, Tawni Jo Carmody, Deputy Chief Legal Counsel, Chad G. Parker, Attorney, HIPAA Program Officer, Theran Fries, Office Manager / Administrative Rule Specialist, Valerie St. Clair, Administrative Rule Specialist, Kassie Thompson, Administrative Legal Assistant, Bailey Yuhas, Medicaid Systems Operations Manager, Shellie McCann, State MedicalDirector, Dr. Maggie Cook-Shimanek, MD, Local & Tribal Support Coordinator, Kerry Pride, DVM, System Improvement Coordinator, Terry Ray, Public Health Accreditation Coordinator, Vacant, Workforce Development Coordinator, Neva Loney, Performance Management and Information Systems Coordinator, Marilyn Trevino, State Refugee Coordinator, Kathe Quittenton, Epidemiology Program Manager, Heather Zimmerman, Office Manager/Financial Specialist, Jodee Prevel, Disability Health Education Specialist, Mackenzie Jones, Office Manager/Financial Specialist, Susan Day, Administrative Specialist, Carolyn Linden, Determinates of Health Program Manager, Margaret Mullins, Secondary Prevention Specialist, Mike McNamara, Quality Improvement Coordinator, Callan Brick, Asthma Control Program Manager, BJ Biskupiak, EMS Licensing and PI Specialist, Francine Janik, Cardiac Ready Program Manager, Janet Trethewey, Community Integrated Health Program Specialist, Kelly Little, Trauma System Manager, Alyssa Johnson, RN, BSN, Violent Death Registry Program Manager, William "Buck" Herron, Injury Prevention Coordinator, Maureen Ward, Health Education Specialist, Alivia Winters, Administrative Support/Licensing, Sandra Tirrell, Body Art/Trailer Court Camp Grounds/ Cottage Food/ Farmers Markets, Mark Hall, Wholesale Mfg. % 3 0 obj Calcium scoring is a diagnostic imaging system that uses CT (computed tomography) scans of the coronary arteries to detect the presence of calcified plaque, a substance that builds up inside the artery walls and hardens, making it difficult for oxygen-rich blood to reach the heart. If you test positive for COVID-19 and have symptoms, antiviral medication can help! S)o vomOM~rO$Op$SM25~V W4:%,U2G|%ru cQSG;Kij"RUNr`#YDz|2)>Fx-#Oo2Zr//,_X'w`t~G:yyk.|PiH4'Z1 ~G/ iy/OPxVe In our free Buyers Guide to Document Management, the other types of scanning can be found. ' .GIr!~)H#H?`6h=T4hB \%,dMRU:N 3 Securing the data left on that old printer. endobj stream New York. 1193 0 obj <>/Filter/FlateDecode/ID[<8C2304EE3BAA2B4BA51333F619C6E237><6A45965FEF636F41A7C4DDF41080F3DD>]/Index[1170 38]/Info 1169 0 R/Length 111/Prev 271610/Root 1171 0 R/Size 1208/Type/XRef/W[1 3 1]>>stream 4]irpmP@;BM'Yp8eV9. % <> While this directory is intended to provide contact information to related programs, it doesn't not include contact information for all DHHS staff members. There are so many options to choose from, so knowing what you want to get out of your scanner is key. (3YC) Employment Verification (Completed by Employer Only) FROM: Centralized Scanning Unit (CSU) P.O. The health and well-being of patients is our primary concern. (o}Wy]vCf \^ Main DHHS Switchboard: (402) 471-3121. <> endobj '[:?&g=$m (DGP@);]+yFyY|yx3OV The following procedures are performed by our Interventional Radiology team at designated hospitals. 2 0 obj |Ei=r %&gU/%v2_K?=d)7UL^_i!4?F'(ws/T%qhDBVadZJ%N#l&9$xu}"x.HEuM7$XeVqU`Uy\z>XVu(cxuf-|Kq#njrL5p9o y44 hx*4csBSsR9xFh":fl2mv qH%@9f m'}vlZeZ9RTkCV,4\1\$hZS Box 181, Concord, NH 03302 Keep a copy of this form for your records. /ag}s3'gEOBFFE{?=A7/B1`iE@x0`G@ ] <>>> endobj 4 0 obj An Employee Assistance Program (EAP) is a program that can help with everyday issues to traumatic events. When calcified plaques occur in the coronary arteries, the condition is called coronary artery disease, or CAD, which is a leading cause of heart attack and death. Call 1-844-ASK-DHHS (1-844-275-3447) }.oWn~zvX,yzqQeiY'RS$*Ks#A=}s4$Tc Federal privacy law says that a form like this one must say that if you sign it and your health information gets shared (disclosed), you should know the information may be shared again (re-disclosed). Box 181 Concord, NH 03301 Tenant's name: Tenant's mailing address: Street Apt# City State Zip . Thank you for your submission. <>>> It is both a confidential and voluntary program, assisting employees and their family members in resolving personal concerns that may interfere with work or home life. Employees and departments participating in the Employee Assistance Program may be concerned about the matter of confidentiality. <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 4 0 obj stream 3 0 obj 2023 State of New Hampshire All rights reserved, An official NEW HAMPSHIRE government website, www.covid19.nh.gov/resources/treatment-resources, Communication Access & Language Assistance, Alcohol, Tobacco & Other Substance Misuse, Resources for DHHS Providers, Small Business & Nonprofits, Identify issues before they disrupt your personal or professional life, Improve an employee's ability to carry out his/her job, Any form of neglect or abuse to children or the elderly, Posing a threat of harm to self or others. Introduces Three New Compact A3 Color Models, Analysis of recent cyber-attack statistics. Long Beach, CA 90807, USA. Fax: +1 201 455 0151. nyc@scan-shipping.com endobj <> A family member is extended the same rights of confidentiality as the employee, and of course, the program is voluntary for family members as well. It requires high-volume production scanners, so looking for a scanner with a large document feeder and a high scan speed is key. In addition to specific services directed to individuals, EAP provides consultation services to managers and supervisors effectively addressing group problems or group-focused improvements. Q\z15b>='w23\K|&6`.lo]2VdITi2-'\NOJL6'o3?nZ. 4 0 obj The health and well-being of patients is our primary concern. endobj NH Department of Health & Human Services (DHHS) DDU Form 177 Bureau of Family Assistance (BFA) - Disability Determination Unit (DDU) rev 12/22 Page: 1 of 9 . Need Help Applying? hbbd```b``6@$2,^qA$k*X6L`Y00V/ "OkAd>-`@D% E Box 181, Concord, NH 03301 BFA SR 19-29 CentralizedScanUnit@dhhs.state.nh.us (A) ATTESTATION AND VERIFICATION OF SNAP (FORMERLY FOOD STAMPS) HOUSEHOLD DISASTER . Centralized Scanning - This is an environment where paper documents are sent to a central location for processing. By law, the EAP staff must notify appropriate agencies of: We are committed to the principle that any information or material we receive, other than that required by law to be reported to authorities will not be communicated to anyone without your permission. 3 0 obj x]mo7 aiQ"&mmR,&A[#_hH{v#Ky'gtd]|]n? %%EOF The images will be analyzed by the CT scanner software to assess the number of plaques, their density and their distribution so a final calcium score can be determined. ).#b x=ko9?4_Ei>XLngs{3AX[Jdd?$[-Q>\R*zr[nvr-/?/l\^z|y&y/_di*,QxY|'/~~Kd KxI!T%>-,BJO/_2TNw1=\]?jrK E>;n:E_HJ>Mo6UBNn Click here for our full COVID-19 response. TO: FROM: Centralized Scanning Unit P.O. endobj % @WM7-1.O]d)wXn{Bap\Z-6`7]q){ biB3~K:3l2/a_P{q The following tips can help you fill out NH DHHS DFA 756 quickly and easily: Open the document in the feature-rich online editing tool by clicking Get form. 4 0 obj endobj YsC5 d!GPg$Pk$PkPg$Pk$PkPg$PNT U(;te1dbHO/'Gm]i;_!1W}Lz{=\cWTJ'-SCi]Vi]DGx*X#65:kXa2sn Q=yG*2qtt#BShE EvQvQeIO0p'xmYb=4nll%PkEP2$mIf;dmYicC4begYUQ(ZU@*JV##b`,WE*zWdX;]^/J9'[5nr7Fu$6vR^]hst .tf1=s.7$[\%l\7VJ). 1 0 obj <> <> Centralized Intake Bureau Chief, Laura McCullough (406) 444-6849: Centralized Intake Specialist Supervisor, Vacant (406) 444-3286: Centralized Intake Specialist Supervisor, Rachel Rolston (406) 444-9846 Fill in the requested boxes which are yellow-colored. Fax: +1 866 922 4936. lax@scan-shipping.com. Also, looking into a maintenance agreement on the scanner can ensure that your scanner will run at . NH Department of Health and Human Services (DHHS) DFA Form 720 Division of Family Assistance (DFA) 02/13 rev 1/15 DFA SR 13-04 (5YC) DETERMINATION OF INCAPACITY STATUS Name: Return Completed Form to: Centralized Scanning Unit (CSU) Case Number: P.O. Specialist within DHHS, via DHHS's Centralized Scanning Unit, PO Box 181, Concord, NH 03301. 1 0 obj NH Department of Health & Human Services (DHHS) DFA Form 65 Division of Family Assistance (DFA) 11/01 Rev 3/2011 rev2 3/15 DFA SR 01-36 (3YC) Client's Printed Name Date Client's Case Number CLIENT STATEMENT Shelter Statement Fraud Statement Voluntarily Withdrawing Application Voluntarily Terminating ppx~r}^_y~vuqYg=|)x=QT(T]Xmx^~_5]|Wk(f_rs(B,^~]4\! U-~H~{(}u:{_/_M=fI$e~fev~Uyv2-3aaaL?Ky9s.2R3 /7 +T*Qa\]ZL 4g9"eO,j]I+Q y~sw =)Ir JJJuRYvsobd endstream endobj startxref EAP services are confidential and voluntary to assist NH government employees and their families in addressing issues that may affect their overall well-being. NH Department of Health and Human Services (DHHS) BFA Form 765 Bureau of Family Assistance (BFA) 06/15 rev 2/19 DFA SR 15-15 Return to: Centralized Scanning Unit (CSU), P.O. These services are intended to enhance communication, cooperation, productivity, and teamwork in the workplace. Once the exam begins, you'll lie flat on the CT exam table and sticky electrodes will be adhered to your chest. Box 181 You'll be asked to hold your breath at certain points in the scan to move the lungs up and out of the way while images are being made. NH Department of Health and Human Services DHHS Division of Family Assistance DFA DFA Form 720 02/13 rev 1/15 DETERMINATION OF INCAPACITY STATUS Name Return Completed Form to Centralized Scanning Unit CSU P. How It Works. [j T*[oD? i. endstream endobj 1171 0 obj <. endobj BFA SR 22-31 * Forms to be completed for Adult Disability Programs* . 2 0 obj Medicaid Assistance: (855) 632-7633. more.. iServe Nebraska . 2 0 obj x TF3e>,YecW=f~+J}VQiIvCYA~,IE`z1Fb2aw(G#&Jv-4m6n} `|UzT4MPjJ5"3t* The State of New Hampshire Employee Assistance Program (EAP) is designed to offer assistance to all State employees and their family members. DHHS has a wide range of programs located in offices across the state. BFA SR 19-29 This institution is an equal opportunity provider. NH Department of Health and Human Services (DHHS) BFA Form 474 Bureau of Family Assistance (BFA) 10/19 Return this form to: Centralized Scanning Unit (CSU), P.O. If you test positive for COVID-19 and have symptoms, antiviral medication can help! 7/2OPcMTvsoDZ)jYJle^VzYdJ]UyU:U%W_U.JQubFMPs0. Amazon Fulfillment Center-Djz4. But for now, here are the differences between centralized scanning and decentralized scanning. NH Department of Health and Human Services (DHHS) DFA Form 770 Estate Recoveries Unit/Division of Family Assistance (DFA) 11/11 rev 1/15 rev2 9/16 Return to: Centralized Scanning Unit (CSU), P.O. }yB%YFY'j/QRaa O^`"=g/*nxrzdz-TE;BVXG+hi`nW'IbcAf~"KUtGd*tZF~r An RAI representative will be contacting you shortly. 2 0 obj Before the exam, you'll need to remove any jewelry or metal objects including eyeglasses, and you may be asked to put on a hospital gown. ?L)8h^x3aBGN xQAmdcW2q stream Choose from 85,000 state-specific document templates available for download in Word and PDF format. We are proud to offer this exam for the everyday price of $79. }G~8Y-m)5j@7'023jPCLYI1*mMZg kM$u:)X@*=pg" 3v~=wmnj{cnIX^ G96"g !R <>>> nRqIP,lK?2|/!.Qf]Sya^>Pec{$h-0e18nr:DQE8O`]fd. Tel: +1 310 634 0130. 50 Central Ave Kearny NJ 07032. 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