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 firstname.lastname@example.org:
- Provider name
- Setting address
- 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.