DSP Contractor Packet
DSP Guides
Direct Service Providers are required by the state of Alabama to follow certain guidelines for their employees.
Guidelines can be viewed by clicking the buttons below.
Frail Elderly and Disabled Medicaid Waiver Scopes of Services Links
Adult Day Care – Minimum Requirements – PDF
ACT Medicaid Waiver Scopes of Services Links
Adult Day Health Services – PDF
Forms
Adult Day Health 60 Day Assessment Sept. 2020
Adult Day Health Itemized Billing Sheet Dec. 2022
Billing Itemization by Case Manager – PDF
Billing Itemization by Case Manager – Skilled Nursing – PDF
Certificate of Compliance – PDF
Direct Service Provider Intake Form
DSP Supervisory Visit Report Sept. 2020
HCBS Medical Evaluation Form – PDF
Inservice Checklist – Orientation
MW-25A DSP Orientation Training Approval List – PDF
MW-25B DSP Annual Training Approval List – PDF
Skilled Respite Weekly Service Report – PDF
Skilled Respite Daily Service Report – PDF
SPA – Homemaker, Personal Care, Companion – PDF
SPA – Skilled Nursing – RN/LPN – PDF
Additional Requirements and Links for Direct Service Providers (DSPs)
- It is the responsibility of Direct Service Providers (Contractors) to check the Office of the Inspector General (OIG) Exclusion list prior to hiring employees and to check this on an on-going basis.
- The Direct Service Provider (DSPs) is to place proof of their checks in a file.
- If a provider or employee is found by Medicaid or CMS to have received Medicaid payment while being an excluded provider, recoupment will occur.
- A link for the exclusion website below. Also below are the links for the national sex offender list, the nurse aide registry, and the Alabama Board of Nursing license lookup. The DSP is required to check these and retain proof of the same.
- All requirements noted in the Scopes of Services, such as but not limited to, Background Checks, TB tests for all employees and supervisors which must be completed annually or sooner, required pre-work and annual training, and more, must be completed, documented and filed.
- Failure to complete any requirements may result in recoupments for all services provided by the affected employee.
Office of the Inspector General Exclusion List: Click Here
National Sex Offender List: Click Here
Nurse Aide Registry: Click Here
Link to the Alabama Board of Nursing for Nursing License lookup: Click Here
or link to the Alabama Board of Nursing main page
(follow link to left on main menu to search for License Lookup): Click Here
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