Provider Training, Certification, and Resources
If you’re a provider or Direct Support Professional (DSP) in Ohio, or are interested in becoming one, this guide can help you navigate the necessary training and certification requirements. You’ll also find resources for billing and documentation support.
What Is a Provider?
A provider is a person who will assist an individual (or group of individuals) with a developmental disability to live as independently as possible in accordance to their individual service plan (ISP).
What kinds of things would I do as a provider?
Providers perform a variety of tasks to support the individual they serve. These tasks could include: light housekeeping, laundry, grocery shopping, assisting with personal care, assisting and transporting individuals to medical appointments, accessing activities in the community and more.
Ways to provide services to individuals with developmental disabilities:
- Start your own agency
- Become an independent provider
- Work for an existing agency as a direct support professional (DSP)
Additional information regarding Home and Community-Based Waivers can be found here. Find Waiver Services Definitions here.
Certified Provider Support
WestCON is committed to supporting our providers so they can provide the highest quality services to the individuals served by our member county boards. Below, learn what steps to take after becoming a certified provider.
I’m a certified provider. Now what?
Once you become certified as a provider, you’ll be connected with clients through a referral and interview process. Below are the typical steps taken during that process.
Please note: The referral process may differ by county board.
When an individual needs a provider, a request for interviews with information about the services needed will be sent via email to providers. The individual can request a specific provider to interview, a countywide search or a statewide search. If you are interested in working with the individual, follow the instructions on the request for interview email.
Once the responses from the request for interviews have been compiled, the interview between the individual, their family, the SSA and you will be scheduled. All communication regarding when and where the interview will take place will be sent via email.
During an interview with an individual, personal and confidential information will be shared. The provider must adhere to confidentiality.
Once the individual has finished interviewing, it may take time for them to make their decision or they could make it immediately. The provider has the right to decline working with the individual if they feel they are not a good match with the individual or cannot meet their needs.
Training Requirements after Initial Certification and Provider Referral/Selection
For Independent Providers
Prior to providing services, you’ll need to meet with a representative of the county board to discuss the independent provider’s responsibilities and requirements set forth in the ISP.
Within 60 days of first providing services, you need to complete training in accordance with standards established by the Ohio Department of Developmental Disabilities in:
- Service documentation
- Billing for services
You can access these trainings through MyLearning.
For Agency Provider CEOs
Within 60 days of first providing services, agency providers must complete training in accordance with standards established by the Ohio DODD in:
- Service documentation
- Billing for services
- Internal Compliance programs
- Rule 5123:2-17-02 including Health and Welfare Alerts issued by the Department
You can access these trainings through MyLearning.
Annual Training Requirements
In order to maintain certification, independent providers, agency provider DSPs and agency provider Chief Executive Officers (CEO) are required to obtain a total of 8-hours of training including training on the following topics:
- A provider’s role and responsibilities with regard to services including person-centered planning, community integration, self-determination, and self-advocacy.
- The rights of individuals set forth in sections 5123.62 to 5123.64 of the Ohio Revised Code.
- The requirements of rule 5123-17-02 of the Administrative Code, including a review of health and welfare alerts issued by the department since the previous year’s training
You can access these trainings through MyLearning. When you’ve reached the MyLearning page, click the Providers box to access the Annual Training for Providers.
TIP: make sure all certificates that show you have completed required training show your name on them!
All providers must accurately document the services they provide. There are also requirements regarding what information must be documented. Learn more about financial documentation and waiver and supported living service documentation below.
Waiver & Supported Living Service Documentation
All documentation must include the following items:
- Name of Individual
- Place of Service
- Medicaid Number of Individual (for waiver services only)
- Month and year of service
- Provider Name
- Provider Contract Number
- Description and details of the services delivered that directly relate to the services specified in the approved individual service plan as the services to be provided.
- Group Size
- Date of ISP
An individual’s ability to handle his/her own money is determined through assessment and by the ISP team. When an individual is deemed to need assistance handling money and paying bills, the paid provider is subject to rule 5123:2-2-07, Personal Funds of the Individual.
If you’re a designated and paid support providing assistance with personal funds, the following documentation items are required:
- The individual’s name
- The source, amount and date of all funds received
- The signature of the person depositing funds to the account, unless electronically deposited
- The purpose, amount, recipient and date of all funds withdrawn
- The signature of the person withdrawing funds from the account, unless electronically withdrawn
- For checking accounts and savings accounts, a current account balance reconciled to the most recent bank statement which is signed and dated by the person conducting the reconciliation
- For any cash accounts, including gift cards or gift certificates belonging to an individual, a verification of the reconciliation of the documented balance to the actual funds available no less than once every 30 calendar days which is signed and dated by the person conducting the reconciliation
- Receipt for an expenditure
Additional training regarding Personal Funds and the related documentation requirements can be found in WestCON’s online training classes.
How Do I Bill?
There are two primary ways services are funded—either through Medicaid waivers or Supported Living.
Medicaid Waivers (Level One, Individual Options, SELF)
Billing for waiver services is submitted directly to the Ohio Department of Developmental Disabilities. All services must be authorized through the PAWS (Payment Authorization for Waiver Services) and fall within the limits of the PAWS.
As an independent contractor, each waiver provider will receive a Form 1099 from the state of Ohio each January for use in reporting self-employment income.
For more information, read the IRS Bulletin 2014-4, which offers guidance regarding the taxability of payments to independent waiver providers.
Billing Resources for Medicaid-funded Waiver Services
The following are resources from the Ohio DODD:
- Step-by-step instructions to submit claims through eMBS
- Accessing provider weekly reports to review paid and unpaid claims
- Claims assistance through DODD Provider Support
Supported living services are billed to and paid through the local County Board of Developmental Disabilities. WestCON issues payment checks for the counties on a set schedule. You can find the schedule here.
Provider Billing Agents
Rather than submitting their own claims, providers may choose to hire a billing agent, a third party who submits billing and tracks the claims. There is a fee associated with this service and you can find the list of billing agents here.
WestCON conducts provider compliance reviews of independent and agency providers on behalf of county boards.
Types of compliance reviews:
- Compliance Review – regularly scheduled reviews of a provider are conducted prior to the end of the provider’s term license, accreditation term or at least once every 5 years for non-licensed waiver settings. The review is conducted utilizing a single review tool.
- Special Compliance Review – an unscheduled review, which occurs due to identified concerns such as complaints, Major Unusual Incidents, reports of fraud or adverse outcomes identified by other entities such as the Ohio Department of Health or the Ohio Department of Job and Family Services
Additional information and tools can be found at the DODD Office of Provider Standards and Review.
Major Unusual Incidents (MUI/UIs)
Certified Major Unusual Incident (MUI) Investigative Agents receive reports of abuse, neglect, misappropriation or any other MUI as defined in state law regulation and county board policy. These incidents are investigated to ensure the health and welfare of the affected individual is protected. The MUI Investigative Agents work cooperatively with county boards of DD, providers, county children services boards and law enforcement agencies to ensure that incidents are investigated per Ohio law, and mandated reporter requirements are met.
An “unusual incident” means an event or occurrence involving an individual that is not consistent with routine operations, policies and procedures, or the individual’s care or individual service plan, but is not a major unusual incident.
All providers who are contracted, certified or licensed to serve persons with developmental disabilities are required to report MUIs/UIs to the county board. All county board staff and department staff are also required to report MUIs/UIs. Additionally, anyone paid to provide Medicaid waiver services must report MUIs/UIs.
This free online training module meets the requirements of the initial eight-hour training for new direct service providers (DSPs). Individual course certificates can also count toward provider renewal training or be used to gain DODD Continuing Professional Development units.
TIP: Here’s a helpful resource on how to access MyLearning!
Below are the forms that you will need as a provider. You can download printable versions by clicking the link.
Service Documentation Forms
These forms are recommended for documenting waiver and supported living services provided to the individuals you serve
These forms may be helpful in providing quality services to the individuals you serve:
Financial Documentation Forms
These forms are recommended if you are a designated, paid support providing assistance with personal funds.
Personal Funds Policy Template for Independent Provider
Unusual Incident Report/Major Unusual Incident Forms
These forms can be used in the event of a Major Unusual Incident:
Unusual Incident Report Log
Unusual Incident Report Form (Fillable)
Annual Analysis Review Form-Agency
Annual Analysis Review Form-Independent
Unapproved Behavior Support Form
Unanticipated Hospitalization Form
Law Enforcement Form
Here are some additional resources for providers in Ohio:
- Providers and provider agencies are expected to comply with Ohio DODD guidelines. Find a list of rules and compliance standards in effect here.
- Missed a Health and Welfare Alert? Find previous alerts here.
- Need to maintain your Provider Services Management (PSM) profile? Login to your profile here.
- Access DODD online applications here.
- Need additional information regarding person-centered planning? Find helpful information and tools here.
Other Helpful Trainings
Additional training resources are available on topics of interest to those serving individuations with developmental disabilities. These trainings are NOT required for certification—they are listed for your personal enrichment.
You can stay current with provider compliance guidelines and other helpful updates by subscribing to our FastFacts newsletter.
Join Our Directory
Are you a provider serving the Auglaize, Champaign, Darke, Hardin, Logan, Mercer, Miami, Preble, Shelby, or Union counties? Sign up to join our directory to connect with individuals in need of services and county boards.