Important Notice – Immediate Action Required for Regulatory Compliance – Please Read Carefully
You are receiving this message because you hold a license to operate a facility licensed by the Pennsylvania Department of Human Services (DHS).
There are two changes to the Civil Rights Compliance process. First, there is a new Civil Rights Compliance form when submitting a new licensing application and a new Civil Rights Compliance attestation form when submitting a licensing renewal application. Second, the process of submitting the form has changed.
Entities seeking a new license will utilize a Civil Rights Compliance (CRC) form (HS 2126). This form must be included in the packet submitted as part of any new license request. The new application, supporting documents and CRC form must be emailed to the DHS office that issues your license, the email address can be found in the chart below. Entities licensed by OCDEL or ODP who use CLS or PELICAN to submit new applications must submit the form by email. The CRC forms are not part of the electronic CLS/PELICAN new application process. The CRC form for new applications can be found at: App for License (pa.gov) or https://www.dhs.pa.gov/providers/Clearances-and-Licensing/Pages/App-for-License.aspx
For licensing renewals, a licensee will now submit a CRC Attestation form (HS 2125). The Attestation form must be submitted as part of a renewal licensing application. The renewal notice will still be sent out 130 days prior to expiration. The renewal application and Attestation must be emailed to the DHS office that issues your license; the email address can be found in the chart below. Entities licensed by OCDEL or ODP who use CLS or PELICAN to submit renewal applications must submit the attestations by email. The attestations are not part of the electronic CLS/PELICAN renewal application process. The CRC form for can be found at App for License (pa.gov) or https://www.dhs.pa.gov/providers/Clearances-and-Licensing/Pages/App-for-License.aspx
The DHS Bureau of Equal Opportunity currently issues you a letter verifying that you are in compliance with applicable civil rights laws. With the new process, a letter from BEO will no longer be sent out to licensed entities. Instead, the issuance of the new license or renewal license will indicate that your CRC form or Attestation form submission was approved. If there are issues/questions on the submitted CRC or Attestation form, a staff member from DHS will contact you.
Note: At the discretion of program offices you can amend the communication to allow legal entities to submit an attestation form for multiple locations and include attachment of additional locations.
|If your license is issued by…||Submit your application AND your|
CRC form (if new license)
or CRC Attestation (if license renewal) to:
|The Bureau of Adult Residential Licensing||RA-PWLICADBHSLPRO@pa.gov|
|The Office of Children, Youth, and Families||RA-PWLICADOCYFPRO@pa.gov|
|The Office of Mental Health and Substance Abuse Services||RA-PWLICADOMHSASPRO@pa.gov|
|The Office of Developmental Programs*||RAemail@example.com|
|The Office of Child Development and Early Learning*||Child care providers should include their MPI number in the subject line and email the appropriate regional office:Northeast Region: RAfirstname.lastname@example.org Central Region: RAemail@example.comCounties: Dauphin, Cumberland, Lancaster, York, Adams, Lebanon and York RAfirstname.lastname@example.orgCounties: Snyder, Perry, Juniata, Centre, Mifflin, Tioga, Lycoming, Northumberland, Union and Clinton South Region: RAemail@example.com|
|Western Region: RAfirstname.lastname@example.orgCounties: Allegheny, Armstrong, Beaver, Butler, Cameron, Clarion, Clearfield, Crawford, Elk, Erie, Fayette, Forest, Greene, Indiana, Jefferson, Lawrence, McKean, Mercer, Potter, Venango, Warren, Washington and Westmoreland RAemail@example.comCounties: Bedford, Blair, Cambria, Franklin, Fulton, Huntingdon and Somerset|
*Licensees who use CLS or PELICAN to submit renewal applications must submit the attestations by email. The attestations are not part of the electronic CLS/PELICAN renewal application process.
The new process is effective on Monday, August 22, 2022. Existing licensees and applicants must begin following the new process on or before that date.
If you have any questions about the new process, please contact the applicable DHS office using the emails shown above. Thank you for your commitment to protecting the rights of Pennsylvania’s most vulnerable citizens.