Direct Support Worker (DSW), Individual Enrollment Criteria and Forms

Revised: February 10, 2025

· How to Enroll

· Individual Personal Care Assistance (PCA) and Community First Services and Supports (CFSS) Direct Support Workers

· Consumer Directed Community Supports (CDCS) and Consumer Support Grant (CSG) Direct Support Workers

· Background Study

· Reinstating an inactive affiliation

· Revalidation

· Reporting Changes

Individual CFSS, PCA, CDCS or CSG direct support workers must meet the following requirements to enroll with Minnesota Health Care Programs (MHCP):

1. Meet the PCA/CFSS worker criteria, requirements and responsibilities (for all direct support workers).

2. Successfully complete the Individual PCA and CFSS Training requirements. (CDCS and CSG workers do not need to complete the training.)

3. Complete a background study through NETStudy 2.0. Use the agency ID assigned to the agency at the time of enrollment with MHCP. (CSG workers do not need to complete a background study to enroll with MHCP.)

How to Enroll

Individual PCA and CFSS Direct Support Workers

The PCA or CFSS agency enrolls the direct support worker in MHCP for members who choose the CFSS agency model.

The financial management services (FMS) agency enrolls the direct support worker in MHCP for members who choose the CFSS budget model.

Prior to enrolling an individual DSW, the agency must:

1. Verify the person is not in the Office of Inspector (OIG) Exclusions Database.

2. Verify the person is not on the MHCP Excluded Provider Lists as an excluded individual provider.

After DHS has verified the agency is a qualified provider, agencies who wish to enroll or affiliate an individual PCA or CFSS direct support worker with their agency can do so in one of the following two ways:

Register to access the Minnesota Provider Screening and Enrollment (MPSE) portal and complete the enrollment online using the MPSE portal.

· Review the Direct Support Worker Affiliations step-by-step guide and watch the video module for Adding an Affiliation to a Direct Support Worker in MPSE (12 min., 35 sec.) for assistance with this process.

· Upload the Individual Support Worker (CDCS, CSG, PCA, CFSS) Provider Agreement (DHS-4611) (PDF) in the MPSE portal.

or

Complete the following documents required to enroll as a PCA or CFSS direct support worker and fax your materials to 651-431-7465.

· Individual PCA Enrollment Application (DHS-4469) (PDF) or Individual Community First Services and Supports (CFSS) Worker Enrollment Application (DHS-4469B) (PDF)

· Individual Support Worker (CDCS, CSG, PCA, CFSS) Provider Agreement (DHS-4611) (PDF)

MHCP will approve the affiliation to the agency using either the date the individual PCA or CFSS direct support worker clears or receives a set-aside with the agency, or the date the individual DSW successfully completes the Minnesota Individual PCA and CFSS Training, whichever date is later.

MHCP shares enrollment and affiliation information with managed care organizations (MCOs), on a weekly basis.

Wait to receive notice from DHS Licensing that the person is one of the following before you allow them to begin work (except for CSG workers):

· not disqualified

· has a set-aside to the disqualification

CDCS and CSG Direct Support Workers

FMS agencies will also use the previous process to enroll CDCS and CSG direct support workers. After DHS has verified the agency is a qualified provider, those who wish to enroll or affiliate a DSW with their agency can do so in one of the following two ways:

Register to access the Minnesota Provider Screening and Enrollment (MPSE) portal and complete your enrollment online using the MPSE portal.

· Review the Direct Support Worker Affiliations step-by-step guide and watch the video module for Adding an Affiliation to a Direct Support Worker in MPSE (12 min., 35 sec.) for assistance with this process.

· Upload the Individual Support Worker (CDCS, CSG, PCA, CFSS) Provider Agreement (DHS-4611) (PDF) in the MPSE portal.

or

Complete the following documents required to enroll as a CDCS and CSG direct support worker and fax your materials to 651-431-7465.

· Individual DSW Enrollment Application (CDCS and CSG) (DHS-4469A) (PDF)

· Individual Support Worker (CDCS, CSG, PCA, CFSS) Provider Agreement (DHS-4611) (PDF)

Wait to receive notice from DHS Licensing that the person is one of the following before you allow them to begin work (except for CSG workers):

· not disqualified

· has a set-aside to the disqualification

Background Study

MHCP must screen all individual PCAs, CFSS and CDCS direct support workers and verify they are qualified providers before the DSWs can begin to provide services. Submit a background study through NetStudy 2.0. PCA, CFSS and FMS agencies must use the agency ID assigned to the agency at the time of enrollment with MHCP.

PCA, CFSS and FMS agencies are responsible for the accuracy of their entry when submitting a background study for a DSW’s enrollment. The agency must ensure that all the following are correct:

· PCA, CFSS or FMS agency facility ID

· Spelling of first, last and full middle name

· All previous names (add in the Alias section of the background study)

· Date of birth

· Social Security Number (SSN) of the individual, if entered

MHCP will assign the individual DSW an UMPI once they are enrolled.

Review and keep a copy of the MHCP Data Privacy Notice (DHS-6287) (PDF).

We process forms in order of date received. Whether enrolling using the MPSE portal or by fax, allow 30 days for processing. If we need more information to complete your enrollment, we will send a notice or letter telling you what we need or what you need to do to complete your enrollment.

Reinstating an Inactive Affiliation

To reactivate an individual direct support worker affiliation with your agency, follow the same steps as for initial enrollment. If your agency previously ended the DSW’s affiliation and the worker is being rehired, MHCP requires a new background study.

Revalidation

MHCP is required to follow the Centers for Medicare & Medicaid Services (CMS) final federal provider screening regulations.

MHCP will notify you when you are due for revalidation. When you are notified, you must submit a revalidation request through the MPSE portal or fax all required forms and documents listed in the How to Enroll section to DHS.

We recommend using the MPSE portal and following the Revalidation Instructions in the MPSE user manual to revalidate your record. Log in to your MN–ITS account on the MN–ITS: Home webpage and choose the Minnesota Provider Screening and Enrollment (MPSE) portal link. If you have not registered your MN–ITS account, your login information is on your original Welcome Letter. Call the MHCP Provider Resource Center at 651-431-2700 or 800-366-5411 if you do not have your Welcome Letter.

Refer to Revalidation in Provider Screening Requirements under Provider Basics in the MHCP Provider Manual for important information, including timelines, about the revalidation process and impacts to your enrollment. Providers who do not meet the revalidation timelines will have their enrollment terminated.

Reporting Changes

It is the responsibility of the agency to keep all enrollment information updated. The most effective way to report changes, end an affiliation or update information for an enrollment application is by submitting an affiliation request through MPSE. MHCP offers quarterly webinars on making changes to MHCP enrollment information using the MPSE portal. Agencies can learn more and register for this course on the MPSE Training Site.

Agencies also have the option to fax the Individual DSW Change Request (DHS-5716) (PDF).