To be an Agency Provider

The provider certification application will move from Provider Certification Wizard, or PCW, to a new platform called Provider Services Management on July 31, 2017. Provider Services Management, or PSM, will offer an easier platform for providers to submit initial application packets and recertification packets.

Please note:

  • Any initial application packets or recertification packets that are started in PCW must be completed and application fees paid before July 30. Incomplete application or renewal packets will not be saved as the system changes from PCW to PSM on July 31.
  • If an application in PCW is incomplete July 30, the application information will be lost when the system changes July 31 and will need to be restarted in PSM.
  • Please make sure your email address is current in PCW so additional communication regarding the new system reaches you.
  • Your login for PSM will be the same as it was for PCW.

An agency provider is an entity that directly employs a chief executive officer (CEO) and at least one other person for the purpose of providing services to people with developmental disabilities.

Below are some requirements of agency providers and the chief executive officer (CEO).

For more requirements see rule 5123:2-2-01 Provider Certification.

The agency must

  • Be a for-profit corporation, non-profit corporation, limited liability company, or limited liability partnership.
  • Have an employer identification number from the IRS.
  • Have an employer identification number from the bureau of workers' compensation.
  • Have comprehensive general liability insurance in the amount of at least five hundred thousand dollars.
  • Have established internal system to ensure compliance with requirements for providers, employees, and contractors.
    • This includes things like background checks, certification, service delivery, documentation, and billing for services.
  • Employ a CEO (or another person designated in writing by the CEO) that will be actively involved in the day-to-day operation of the agency and oversee the provision of services.
Helpful Documents
CEO Tips


Provider Timeline

The CEO must

Helpful Documents
  • Be at least twenty-one years of age.
  • Have a valid social security number.
  • Have the ability to read, write, and understand English.
  • Have a high school diploma or general education development (GED) certificate.
  • Have a bachelor's degree from an accredited college or university or have at least four years of full-time (or equivalent part-time) paid work experience as a supervisor of programs or services for people with developmental disabilities.
  • Have at least one year of full-time (or equivalent part-time) paid work experience in the provision of services for people with developmental disabilities, which includes responsibility for:

      • Personnel matters
      • Supervision of employees
      • Program services
      • Financial management

Steps to becoming an Agency Provider

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1View the Initial Overview online training. This orientation for agency providers is required for certification.

Click here for technology requirements for viewing the training.