Get Mn Dhs 245d 2021-2025

The MN DHS 245D form is essential for individuals and organizations applying for a Home and Community-Based Services license in Minnesota. This guide provides clear, step-by-step instructions to help you successfully complete the application online.

Follow the steps to accurately complete the MN DHS 245D form online.

1. Click ‘Get Form’ button to obtain the form and open it in the online editor.
2. Determine the type of license holder. Select either ‘individual’ or ‘non-individual’ and provide the appropriate details such as legal name, tax ID, and address as requested.
3. Designate an authorized agent. Choose one of your controlling individuals as your authorized agent and provide their name, title, and contact information. Note that a notarized signature form is required.
4. Identify all controlling individuals involved in the license application. Provide necessary details including full legal names and percentages of ownership, if applicable.
5. Specify the type of 245D services you intend to provide, including basic and intensive support services. Mark the relevant services as applicable.
6. Determine the program name and location. Fill in the legal name of the program and address of the location where services will be provided.
7. Complete additional documentation. Upload required documents such as organizational charts and policies in PDF or Microsoft Word format to the online application.
8. License holder acknowledgment of public funding reimbursement. Indicate whether you elect to receive public funding, provide required compliance officer information, and acknowledge requirements.
9. Complete Home and Community-Based Services Waiver & Alternative Care - Provider Training 101. Ensure that you've registered and accessed the relevant training.
10. Finalize and submit your online application after ensuring that all fields and required documents are accurate and complete.
11. Review additional information. Prepare to pay the application fee of $500, and understand conditions that may affect licensure.
12. Complete background studies for the Authorized Agent and all controlling individuals as required.
13. Check your email frequently for communication from the DHS regarding your application status. Respond promptly to any requests for further action.

Begin your application process for the MN DHS 245D online today!