MN DHS 245D 2013 free printable template
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Minnesota Department of Human Services
Licensing Division
245D Reapplication Worksheet
When applying for a Home and Community-Based Services license under Minnesota Chapter 245D, you must
provide
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How to fill out MN DHS 245D
How to fill out MN DHS 245D
01
Begin by gathering all necessary personal and financial information about the prospective service recipient.
02
Read through the entire MN DHS 245D form to familiarize yourself with its sections and requirements.
03
Fill out the personal information section, including name, address, date of birth, and contact information.
04
Complete the section detailing the individual's service needs, including specific areas of support required.
05
Provide information regarding the individual's guardianship or legal representative, if applicable.
06
Document any relevant medical or health information that impacts the service delivery.
07
Include information about the individual's preferences and goals for receiving services.
08
Review the filled form for completeness and accuracy before submission.
09
Submit the form to the appropriate MN DHS office as indicated in the instructions.
Who needs MN DHS 245D?
01
Individuals with disabilities who require support services.
02
Families seeking assistance for a loved one with special needs.
03
Caregivers looking to apply for funding or services through the Minnesota Department of Human Services.
04
Service providers who need to document care plans for individuals receiving support.
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What is MN DHS 245D?
MN DHS 245D refers to a set of rules and regulations in Minnesota governing the licensing and operation of certain services for individuals with disabilities and mental illness.
Who is required to file MN DHS 245D?
Organizations and individuals providing services to people with disabilities, including supported living services, personal care assistance, and similar services, are required to file MN DHS 245D.
How to fill out MN DHS 245D?
To fill out MN DHS 245D, one must complete the application form provided by the Minnesota Department of Human Services, providing detailed information about the services to be offered, qualifications, staffing, and compliance with required regulations.
What is the purpose of MN DHS 245D?
The purpose of MN DHS 245D is to establish a framework for ensuring quality care and support for individuals with disabilities, ensuring their rights and promoting their well-being.
What information must be reported on MN DHS 245D?
The information that must be reported on MN DHS 245D includes service descriptions, operational plans, staffing qualifications, compliance with health and safety standards, and the rights of individuals served.
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