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  • Mn Dhs-4022c-eng 2021

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Of a newly employed QP, when a QP is no longer affiliated or employed with your agency, and for each QP at the time of your annual review and revalidation. By signing this form, you certify that this QP meets the definition of a QP as outlined in the Minnesota Statutes referenced on this form. Qualified Professional: Complete this form as your acknowledgement of responsibilities and obligations of a QP for the personal care assistance (PCA) program. Agency information Check if signing electroni.

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The county public health nurse is responsible to do the PCA assessment.

Eligibility Criteria for PCA To be eligible to receive PCA services in Minnesota, you must: Live in the state of Minnesota. Be eligible to receive medical assistance or MinnesotaCare. The ability to make decisions about your care or the ability to have someone else make decisions for you.

The MnCHOICES assessment allows for anyone of any age with a disability to access the support services needed to stay in their homes. MnCHOICES helps make decisions about long-term services that help individuals thrive in their communities.

The certificate is valid indefinitely.

Dr. Brooke Cunningham was appointed in January 2023 as commissioner for the Minnesota Department of Health. Dr. Cunningham is responsible for directing the work of the Minnesota Department of Health.

PCAs cannot work more than 16 hours in a 24 hour period. This is not 16 hours per Consumer or per Agency, if you work for multiple Consumers or Agencies your daily total cannot exceed 16 hours in a 24 hour period.

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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