MN DHS-3244P-ENG 2008 free printable template
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DHS-3244P-ENG Referral for PCA Services Initial Assessment or Reassessment DATE OF REFERRAL Recipient information Date Current Service Agreement Ends NAME DATE OF ASSESSMENT County assessor completes GENDER MALE FEMALE ADDRESS CITY county STATE ZIP PHONE NUMBER EVS VERIFICATION DATE // 651 431-4399 or 800 657-3613 You can also verify recipient eligibility online via MN-ITS http //mn-its. Dhs. state. mn.us for up to 50 recipients at one time. Y ...
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How to fill out MN DHS-3244P-ENG
How to fill out MN DHS-3244P-ENG
01
Obtain the MN DHS-3244P-ENG form from the Minnesota Department of Human Services website or local office.
02
Fill in your personal information such as name, address, and contact details in the appropriate sections.
03
Provide relevant background information as requested, including details about your health and any services you may need.
04
Complete the sections that require information about your financial situation if applicable.
05
Review the form carefully to ensure all information is accurate and complete.
06
Sign and date the form at the designated section.
07
Submit the completed form to the appropriate Minnesota DHS office either by mail or in person.
Who needs MN DHS-3244P-ENG?
01
Individuals seeking assistance from the Minnesota Department of Human Services.
02
People applying for health care programs or other supportive services provided by the DHS.
03
Anyone who needs to report changes in their personal or financial situation related to DHS services.
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People Also Ask about
What qualifications do you need for PCA?
Requirements and Qualifications High school diploma or equivalent required. Current certificate in first aid and CPR preferred. Valid driver's license, reliable automobile, and current auto insurance required. Minimum one year of experience working in a health care setting.
Can a parent be a PCA in MN?
Contact your partner's PCA agency or county/tribal case manager with questions. Visit the Minnesota Department of Human Services announcement page to learn more about this extension of PCA services. Can I be my child's PCA? Normally, a parent can't be paid to provide PCA services.
How do I get a PCA assessment in MN?
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.
What are the qualifications for the PCA in Minnesota?
To be eligible for PCA, a person must: Live in the community and not a facility, such as a hospital or nursing home. Be able to direct care or have a representative who can direct care on their behalf. Be enrolled in one of Minnesota's health care programs (Medical Assistance, MA waiver/Alternative Care).
What are the requirements to be a PCA in Minnesota?
To become a PCA, you must complete an online training course and pass a one-time test and a background study. You don't need experience to complete the training or become a PCA. For details, check out PCA consumer information from the Minnesota Department of Human Services.
What is the hourly wage for a PCA in Minnesota?
ST. PAUL, Minn. The agreement includes a wage increase for new workers from $15.25 an hour to $20 an hour for all PCAs by 2025.
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What is MN DHS-3244P-ENG?
MN DHS-3244P-ENG is a form used by the Minnesota Department of Human Services for reporting certain information related to health services and support programs.
Who is required to file MN DHS-3244P-ENG?
Individuals or entities involved in providing specific health services or participating in certain programs governed by the Minnesota Department of Human Services are required to file this form.
How to fill out MN DHS-3244P-ENG?
To fill out MN DHS-3244P-ENG, you should follow the instructions provided on the form, which typically includes entering your personal information, details about the services provided, and relevant dates and signatures.
What is the purpose of MN DHS-3244P-ENG?
The purpose of MN DHS-3244P-ENG is to collect necessary information for the administration of health services and to ensure compliance with state regulations.
What information must be reported on MN DHS-3244P-ENG?
The information that must be reported on MN DHS-3244P-ENG includes personal identifying information, details about the health services provided, dates of service, and any other pertinent information requested on the form.
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