The Michigan Gov Homehelp form, formally designated as ASB 2013-004 ASM 135, is an essential document that outlines the provisions and requirements for individual and agency providers engaged in home help services. It details provider selection, criteria, enrollment processes, and the responsibilities both of the provider and the client. Key components include provider eligibility, the importance of maintaining service logs, and ensuring appropriate payment for services rendered. For residents of Michigan looking for support through home help services or interested in becoming providers, completing the Homehelp form is a crucial step.
Interested in applying for or learning more about Home Help services? Click the button below to fill out the Michigan Gov Homehelp form.
In Michigan, the provision of home help services is a critical component in supporting individuals who require personal care within their living environments. The comprehensive framework detailed in the Michigan Gov Homehelp form encompasses vital information for both individual and agency providers, establishing the ground rules for provider selection, criteria, enrollment, and ongoing responsibilities. Central to the program is the principle that clients hold the fundamental right to select their home help providers, emphasizing a personal choice in meeting their care needs. Such choices extend to hiring and firing providers, underpinning the client's autonomy over their care services. The document outlines specific exclusions for provider eligibility, such as spouses and parents under certain conditions, and minors, ensuring that care is professional and accountable. Additionally, it sets forth minimum criteria for providers, including age, ability, health, and training requirements, aimed at maintaining a high standard of care. The initialization of services is marked by a detailed protocol for the interview process and the formal agreement on employment and service expectations, which includes the completion of forms like the MSA-4676, Home Help Services Statement of Employment, and mandates for keeping a personal care services provider log. The rigorous enrollment process for providers ensures that only qualified individuals are allowed to provide care, and it facilitates the logistical aspects of payment and service verification. Through these structured procedures, Michigan's Home Help Program seeks to offer a robust support system that empowers clients and assures the quality of home care services provided.
ASB 2013-004
ASM 135
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HOME HELP PROVIDERS
12-1-2013
INTRODUCTION
The items in this section apply to both individual and agency provid- ers.
PROVIDER
SELECTION
The client has the right to choose the home help provider(s). As the employer of the provider, the client has the right to hire and fire pro- viders to meet individual personal care service needs. Home help services is a benefit to the client and earnings for the provider.
The determination of provider criteria is the responsibility of the adult services specialist.
Home help services cannot be paid to:
A spouse caring for a spouse or a parent caring for an unmarried child under 18 (responsible relative).
Note: Couples who are separated must provide verification
that they are no longer residing in the same home
(unavailable). Verification may include their driver’s license, rent receipt or utility bill reflecting their separate mailing address. A spouse who is legally separated from a spouse cannot be paid to provide home help.
A minor (17 and under).
Fiscal Intermediary (FI).
Note: Fiscal intermediary services is defined by CMH as services that assist the client in meeting their goals of
community participation and integration, independence or productivity, while controlling the client’s individual budget and
choosing staff who will provide the services and supports identified in the individual plan of service. The fiscal intermediary facilitates in the employment of service providers and is not the provider of direct hands on care services.
Home help providers who also provide day-care services must not provide both services concurrently; see BEM 704.
Example: Home help services cannot be provided from 8:00 a.m. until 10:00 a.m., if the provider is also providing day-care services during that time frame.
ADULT SERVICES MANUAL
STATE OF MICHIGAN
DEPARTMENT OF HUMAN SERVICES
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CRITERIA
Determine the provider's ability to meet the following minimum cri- teria in a face-to-face interview with the client and the provider:
Age
The provider must be 18 years and older.
Ability
To follow instructions and home help program procedures.
To perform the services required.
To handle emergencies.
Physical Health
The provider’s health must be adequate to perform the needed ser- vices.
Knowledge
The provider must know when to seek assistance from appropriate sources in the event of an emergency.
Personal
Qualities
The provider must be dependable and able to meet job demands.
Training
The provider must be willing to participate in available training pro- grams if necessary.
Home help payment may be terminated if the provider fails to meet any of the provider criteria.
INTERVIEW
An initial face-to-face interview must be completed with the home help provider. A face-to-face or phone contact must be made with the provider at the six month review or redetermination to verify ser- vices are being furnished.
Explain the following points to the client and the provider during the initial interview:
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The provider is employed by the client not the State of
Michigan.
As the employer, the client has the right to hire and fire the provider.
A provider who receives public assistance must report all income received as a home help provider to their family independence specialist or eligibility specialist.
The client and provider are responsible for notifying the adult services specialist within 10 business days of any change in providers or hours of care.
The provider and/or client is responsible for notifying the adult services specialist within 10 business days if the client is hospitalized.
Note: Home help services cannot be paid the day a client is admitted into the hospital but can be paid the day of discharge.
The provider must keep a log of the services provided on the DHS-721, Personal Care Services Provider Log and submit it
on a quarterly basis. The log must be signed by both the provider and client or the client’s representative.
All earned income must be reported to the IRS; see
www.irs.gov.
No federal, state or city income taxes are withheld from the warrant.
Parents who are caring for an adult child do not have FICA withheld.
Note: Parents who wish to have FICA withheld must be assigned in ASCAP as other relative in the Provider Assignment screen.
All individual providers will receive a W-2 by the Michigan
Department of Community Health.
Provider must display a valid picture identification card and social security card.
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The client and provider must sign the MSA-4676, Home Help Services Statement of Employment, before payments are authorized.
Note: Providers determined to be a business/agency are exempt from signing the MSA-4676.
All providers must sign a MSA-4678, Home Help Services
Provider Agreement, before payments are authorized.
Note: Providers are required to complete and sign the agreement only once. If there is a signature date on Bridges/ASCAP provider screen, another MSA-4678 does not need to be completed and signed.
ENROLLMENT
All home help providers must be enrolled in Bridges by a designee at the local county DHS office prior to authorizing payment. Once a provider is enrolled, Bridges will assign the provider a seven digit identification number. The adult services specialist must allow 24 hours from the time of enrollment for Bridges to interface with
ASCAP.
Instructions for enrolling a provider on Bridges are found on the Office of Training and Staff Development home page. Instruc- tions on assigning a provider in ASCAP are in the ASCAP User Guide located on the adult services home page.
PERSONAL CARE SERVICES PROVIDER LOG (DHS-721)
Each individual provider must keep a log of home help services delivered. The DHS- 721 is used for this purpose.
Tasks on the provider logs are automatically marked with an X when printed from ASCAP based on the client’s home help
functional assessment.
The provider must indicate what services were provided and on which days of the month.
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The client and the provider must sign the log when it is completed to verify that the services approved for payment were delivered.
The log must be submitted to the local office quarterly. Provider logs must be received within 10 business days after the last service date on the log. Failure to do so will result in suspension of payment.
The adult services specialist must initial and date the log upon receipt, demonstrating review of the log.
Retain the log in the client’s case record.
A separate log is required for each provider.
Incomplete logs must be returned to the client/provider for completion.
Agency/business providers have the option of submitting monthly invoices in lieu of the DHS-721, Provider Log. Each invoice must specify the following:
The service (s) provided, and
The date(s) of service.
See ASM 136, Agency Providers.
HOME HELP STATEMENT OF EMPLOYMENT (MSA-4676)
The purpose of the MSA-4676, Home Help Services Statement of Employment, is to serve as an agreement between the client and provider which summarizes the general requirements of employ- ment. The form is completed by the adult services specialist as part of the provider enrollment process.
An employment statement must be signed by each provider who renders service to a client.
The statement of employment does the following:
Confirms an understanding of the personal care services provided, how often services are provided, and wages to be paid.
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Requires positive identification of the provider by means of a picture ID and social security card.
Documents an understanding by both parties that the client, not the State of Michigan, is the employer of the provider.
Stipulates that the client must report any changes in the work schedule to the adult services specialist.
Instructs the provider to repay the State of Michigan for services they did not provide.
Informs the provider that a DHS-721, Personal Care Services Provider Log, must be completed and returned to the specialist on time to avoid delay in payment.
Informs a provider receiving public assistance that this employment must be reported to the Department of Human Services
Requires the client and provider must sign the MSA-4676 statement indicating their understanding of the terms of the agreement.
Distribution of Employment Statement
The adult services specialist will make two copies of the completed and signed form and distribute as follows:
Give one copy to the client.
Give one copy to the provider.
Place the original form in the client’s case record.
MEDICAL ASSISTANCE HOME HELP PROVIDER AGREEMENT (MSA-4678)
Federal regulations require that all providers of Medicaid covered services complete and sign a provider agreement. This agreement states providers will abide by Medicaid policies in providing services to program clients and in receiving payment from the program. In order to meet this requirement, the Michigan Department of Community Health (MDCH) developed the MSA- 4678, Medical Assistance Home Help Provider Agreement.
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All home help services providers must have a completed and signed MSA-4678 on file with the MDCH in order to receive pay- ment. Providers are required to complete and sign the agreement only once. The signed agreement is valid for all counties across the state of Michigan. Home help agencies must complete this agree- ment in addition to meeting all other agency requirements. The MSA-4678 must be signed by the owner of the agency; see ASM 136, Agency Providers.
Procedure
The adult services specialist will furnish a copy of the MSA-4678 with instructions to all new individual and agency providers at the time of enrollment. Follow the provider enrollment process by com- pleting a DHS-2351X, Provider Enrollment/Change Request. The designated staff who enroll home help providers will insert the MSA-4678 signature date in Bridges.
Before forwarding the MSA-4678 to the MDCH, the adult services specialist must enter the seven digit provider identification number in the For Official Use Only box at the top of the form. Verify the signature date is stored in Bridges by checking ASCAP under the
Assign Provider Tab.
Send the MSA-4678 via ID mail to:
Provider Enrollment Lewis Cass Building 3rd Floor
320 S. Walnut
Lansing, Michigan 48913
MDCH Provider Enrollment scans the provider agreements and files them under the provider identification numbers.
Locating MSA-
4678 Signature
Date in ASCAP
To locate the MSA-4678 signature date in ASCAP:
Select Client.
Select the HIS $ icon.
Click on the Provider/TimeTask/Service Plan button. Highlight the provider.
Locate the 4678 Date field. This is a read only field, reflecting what is in Bridges.
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If there is a date in the signature date field, a MSA-4678 has been completed. If there is not a date in this field, the adult services spe- cialist must contact the provider to complete the provider agree- ment. A negative action must be sent to the client to inform them that payment must be suspended until a provider agreement is received.
Note: The signature date can also be found in ASCAP under the Client’s for Provider tab. Access this screen by clicking on the utilities menu and selecting Client’s for Provider. Search by the
provider name or identification number and click on the provider name. The provider information is displayed on the detail screen, including the MSA-4678 signature date.
LOCAL OFFICE
INDIVIDUAL HOME
HELP PROVIDER
HOURLY RATE
Each local DHS office has an established individual home help pro- vider rate. Specialists must not authorize above or below the estab- lished rate.
Cases with hourly rates above the established county rate must be substantiated by an approval letter (DCH-1785) from the Michigan Department of Community Health. If there is not an approval from MDCH, the hourly rate must be lowered to the established rate of the county.
INCOME
VERIFICATION
Requests received by the local office for verification of provider income or employment should be forwarded to MDCH at:
Michigan Department of Community Health
Long Term Care Services Policy Section
Capital Commons Building, 6th Floor
P.O. Box 30479
Lansing, Michigan 48909
OR
FAX to 517-335-7959
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JOINT POLICY
DEVELOPMENT
The Adult Services Manual (ASM) policy has been developed jointly by the Michigan Department of Community Health (MDCH) and the Department of Human Services (DHS)
After selecting a home help provider, it’s crucial to properly document and formalize their employment with the necessary paperwork. This not only establishes a clear understanding between the client and the provider but also ensures compliance with the Michigan Department of Human Services regulations. To facilitate this process, here’s a straightforward guide to filling out the Michigan Gov Homehelp form. These steps are designed to ensure the provider's eligibility and service delivery are accurately recorded and maintained.
Following these steps meticulously will streamline the home help provider enrollment and payment process. It also provides a clear framework for accountability and service verification, thereby ensuring the client receives the support as intended and the provider is compensated in accordance with the state’s policies.
This form is designed to facilitate the enrollment and employment of home help providers who assist individuals with personal care services under the Home Help Program. It encompasses various facets including provider selection, criteria, enrollment, and the obligations of both the provider and the client. The form is integral in ensuring that the services delivered meet the program's standards and requirements.
Eligible providers must meet several criteria:
Yes, certain restrictions apply:
A Home Help provider must:
Enrollment is processed through the local county DHS office. The provider must be registered in the Bridges system, which will assign a seven-digit identification number. Detailed instructions for enrollment are available on the Office of Training and Staff Development home page and the ASCAP User Guide on the adult services home page.
The adult services specialist is responsible for determining the provider's eligibility, conducting interviews, enrolling the provider, and ensuring the provider meets the program's criteria. They also handle the review and initialing of provider logs, verify services rendered, and facilitate the payment process.
Several forms must be completed and signed for a provider to receive payment:
Filling out forms can be a tricky process, and when it comes to the Michigan Government Home Help form, avoiding common mistakes can save you time and ensure services are set up correctly. Here's a breakdown of some frequent missteps people make during the process:
Each of these mistakes can lead to payment delays, issues in service provision, or even termination of home help payment. It's crucial to approach the form with attention to detail. Providers and clients alike must understand their roles and responsibilities clearly, especially in terms of employment agreements, provider logs, and adherence to program guidelines. Submitting accurate and complete information is key to a smooth enrollment and payment process.
To avoid such errors:
This attention to detail and proactive communication will help ensure that the services received are not only beneficial but also compliant with the regulations set forth by the Michigan Department of Health and Human Services.
When you're dealing with the Michigan Gov Home Help form, it's important to understand that it may not be the only document you need. This form is a step in ensuring personal care services are correctly delivered and paid for, but other documents also play crucial roles in setting up comprehensive care. Here are some of the documents often used in conjunction with the Michigan Gov Home Help form:
In managing care through the Michigan Gov Home Help program, these documents collectively ensure that all aspects of the provider-client relationship are clearly defined, services are thoroughly documented, and legal and financial responsibilities are understood. It's not just about completing a form; it's about establishing a structured, transparent care environment for both the provider and receiver of care. Paying close attention to this paperwork can greatly enhance the care process, ensuring all regulatory and administrative requirements are met.
The Michigan Gov Homehelp form is similar to several other important documents used within various assistance programs and employment arrangements. By understanding these similarities, it becomes easier to grasp the purpose and the operational framework of the Homehelp program.
Personal Care Agreement Forms: The Homehelp form closely mirrors the structure and intent of general personal care agreement forms used in other contexts. Much like personal care agreements, which detail the services to be provided, expected outcomes, and payment details, the Michigan Gov Homehelp form specifies the relationship between the client (employer) and the provider. Both documents serve to formalize the employment relationship, outline the duties and responsibilities of the care provider, including the types of services to be performed, and establish the frequency and compensation for these services. Furthermore, they set forth criteria such as minimum age, physical health, and training requirements for providers, ensuring the client's needs can be met effectively and safely.
Employment Tax Forms: Another parallel can be drawn with employment tax forms, particularly in how the Homehelp form addresses the tax implications for providers. For instance, the statement within the Michigan Gov Homehelp documentation regarding the necessity for providers to report income to the Internal Revenue Service (IRS) echoes the reporting requirements outlined on forms like the W-2 or 1099-MISC. Such documents are critical for tax compliance, underscoring the provider’s role as an employee or independent contractor and the corresponding tax obligations. The Homehelp form goes a step further to clarify specific cases, such as the exemption from FICA withholding for parents caring for an adult child, which closely relates to the tax nuances explained in IRS guidelines for household employees.
Provider Enrollment and Verification Documents: The Homehelp form's segments on provider enrollment and the necessary employment verification align with various provider credentialing and verification documents used in healthcare and personal care service industries. These documents, including enrollment forms for Medicaid or Medicare providers, require detailed information about the provider's qualifications, background checks, and the verification of credentials before service provision. Similarly, the Homehelp form stipulates a thorough enrollment process handled by the Department of Health and Human Services (DHS), mandating face-to-face interviews, the signing of an employment statement (MSA-4676), and an agreement form (MSA-4678) to ensure that providers are appropriately vetted and understand their responsibilities.
When you're filling out the Michigan Gov Homehelp form, it's crucial to understand the dos and don’ts to ensure you're completing the form accurately and efficiently. Here's a guide to help you navigate the process:
Things You Should Do:
Things You Shouldn't Do:
Misconceptions about the Michigan Government's Home Help form can easily arise due to its complexity and the breadth of information it covers. Let's clear up some common misunderstandings:
Understanding these key points helps demystify the Michigan Gov Homehelp form and clarifies the expectations and requirements for both providers and recipients of home help services.
When dealing with the Michigan Gov Homehelp form, there are several key takeaways that individuals should keep in mind to ensure they accurately complete and utilize the form for home help services. These points are crucial for both providers and recipients to understand the process and requirements.
Understanding and adhering to these outlined steps and requirements ensures that home help services are delivered and documented in compliance with Michigan's governing rules and regulations, facilitating a smoother process for both service recipients and providers.
State of Michigan Divorce Forms - A formal request to a Michigan court to legally end a marriage, detailing basic information about both parties involved.
What Is a Livescan - The form ensures compliance with federal and state regulations, allowing the sharing of fingerprint data with governmental organizations for security purposes.