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Phase 2 Provider Attestation

Providers must complete an attestation if they provide or have a license to provide the following services to people who receive waiver funding:

  • Adult foster care or supported-living services provided in a licensed setting
  • Child foster care or child supported-living services provided in a licensed setting
  • Customized living
  • Adult day services — family and center-based
  • Day training and habilitation, prevocational services and structured day

Providers who already submitted an attestation form for a setting do not need to complete a new one for that setting. These settings are part of Phase 1 of the attestation process. Phase 1 includes the first wave of providers who submitted attestations from April to September 2017. DHS received attestations from 6,000 providers. Next steps for these providers will be a DHS desk audit of supporting documentation submitted in the attestation process. DHS will follow up directly with providers if we need more information.

Phase 2 will include a second wave of providers with new settings in 2017 who have not already submitted an attestation:

DHS plans to identify settings with new claims, licenses or change in ownership during 2017. We will reach out to these providers starting in January 2018.

Providers do not need to wait to hear from us; they may submit an attestation for new settings at any time. To receive an ID number and fill out an attestation, providers must send all of the following information to hcbs.settings@state.mn.us:

  • Provider name
  • Setting address
  • City
  • State
  • ZIP code
  • Phone number
  • Service type at the setting

Once they receive ID numbers, providers may complete the attestation using the Home and Community-Based Services (HCBS) Provider Attestation form, DHS-7176-ENG (PDF), and the resources below.

Attestation resources by service

Identifying settings that may have the effect of isolating

In Phase 2, DHS must identify other residential settings in which providers deliver services paid for by BI, CAC, CADI or DD waivers, and group or cluster people with disabilities. For example, services in Phase 2 may include supported-living services or independent living skills services provided by a single provider to several people with disabilities who receive HCBS and live in the same apartment building.

DHS developed a residential settings survey to learn more about these settings from people who receive services, as well as from the public. The survey asks where people who receive services live and what regular opportunities they have for work and recreation in the community. It also asks the public to identify settings that may have the effects of isolating people with disabilities from the community.

This survey does not include Phase 1 provider-controlled, licensed residential settings that have already been assessed by DHS, including:

  • Adult foster care or supported-living services provided in a licensed setting
  • Child foster care or child supported-living services provided in a licensed setting
  • Customized living

Take the residential settings survey on the Identify other residential settings for effects of isolating survey page.

The survey will be open from Oct. 25 to Dec. 31, 2017. If you are a person who receives services or represents a person who receives services and need help to complete the survey, please see the October 2017 Disability Hub letter for more information.

DHS will inform providers if they have been identified as a setting that may have the effect of isolating. DHS will use the attestation process to assess these settings for compliance with the HCBS settings requirements.

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