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  • Mn Dhs-5856-eng 2009

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Ach responsible party or their delegate complete the following agreement annually to ensure they are aware of their roles and responsibilities. You must keep a copy of the completed agreement in the recipient’s file and provide a copy to the recipient and their responsible party or delegate. Completed by Responsible Party RESPONSIBLE PARTY NAME (Last/First/MI) RELATIONSHIP TO RECIPIENT RECIPIENT NAME (Last/First/MI) RECIPIENT MHCP ID NUMBER I agree to be the responsible party for the above.

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Related content

PCA - Forms - Dhs.state.mn.us
Sep 12, 2019 - MHCP PCA Program Responsible Party Agreement and Plan, DHS-5856 (PDF) ·...
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The certificate is valid indefinitely.

The average pca salary in Minnesota is $33,150 per year or $15.94 per hour. Entry level positions start at $29,738 per year while most experienced workers make up to $39,000 per year.

To be eligible to receive PCA Services, you must: Live in the state of Minnesota. Be eligible to receive medical assistance or MinnesotaCare (i.e. pregnant women and children under 21 years of age) Be able to make decisions about your care or have someone who can make decisions for you.

Minnesota Health Care Programs (MHCP) covers personal care assistance (PCA) services provided to children and youths with disabilities in the least restrictive environment, so the child or youth may attend school and receive a “Free Appropriate Public Education” (FAPE) just as other children and youths without ...

PCA is one of the lowest reimbursed programs with a current rate of $19.60 and is lower than rates for other similar home and community-based services.

Although many relatives, including an adult child, can be hired, a spouse or parent of a minor cannot be hired via the PCA Program. With CFSS, however, a spouse or a parent of a minor will be able to be hired.

PCA conducts a thorough in-home assessment of an older adult's physical, mental, social and functional abilities and needs, using evidence based assessment tools approved by the Pennsylvania Department of Aging to quantify level of care and needs in the home.

To qualify, you must contact your local county or tribal human services office and ask for an assessment for PCA services. They'll send a person to visit your home, review your health situation, and see how much and what types of help you need.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232