To be an Agency Provider

The Provider Certification Wizard (PCW) is being re-platformed to a new system titled Provider Services Management (PSM) on December 4, 2017.  Any applications started in PCW but not fully submitted (fees paid) by December 1, 2017 will not be saved. 

If your application is not submitted by 4:00 pm on Friday, December 1, 2017, your application information will be lost and you will need to create a new application in the new system.

The department is excited to offer this newly re-platformed application format and look forward to your feedback. 

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
7tips.png
CEO Tips

CertTimeline.png

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

  •       
  • 1
  • 2
  • 3
  • 4
  • 5
  •      

1View the Initial Overview (Orientation for Agency Providers) online training. This orientation for agency providers is required for certification.

Click here for technology requirements for viewing the training.