Direct Support Professional Agency

Become a Direct Support Agency serving the Developmentally Disabled 

 

 

 

 

1️⃣ Understand the Role of a Direct Support Agency

 

 

• Clarify what services you’ll provide (personal assistance, community habilitation, respite, supported living, etc.).
• Learn the difference between an agency-directed provider and an independent DSP in your target state.
• Check if your state regulates these agencies through its Developmental Disabilities (DD) division, Medicaid HCBS unit, or Department of Health.

 

 

 

 

 

2️⃣ Research State & Medicaid Requirements

 

 

• Visit your state’s Medicaid Waiver / HCBS site and review provider manuals.
• Identify:
  
• Licensing or certification requirements
• Minimum policies & procedures
• Staffing ratios and training mandates
• Background-check rules (e.g., fingerprinting, abuse registry)
• Required insurance (general liability, professional, workers’ comp).

 

 

 

 

 

3️⃣ Form Your Business Entity

 

 

• Register an LLC or corporation.
• Get an EIN from the IRS.
• Open a dedicated business bank account.
• Secure any local business license or zoning approval.

 

 

 

 

 

4️⃣ Build Administrative Infrastructure

 

 

• Draft policies & procedures (intake, service delivery, medication, rights & responsibilities).
• Set up record-keeping: client charts, employee files, service notes, billing logs.
• Obtain scheduling and electronic documentation tools (EVV if required).
• Put in place HIPAA and confidentiality safeguards.

 

 

 

 

 

5️⃣ Staffing & Training

 

 

• Recruit Direct Support Professionals who meet state qualifications.
• Complete all background checks before hire.
• Provide initial orientation:
  
• Person-centered planning
• Health & safety (infection control, emergency response)
• Client rights, abuse/neglect reporting
• Documentation and EVV use.

 

 

 

 

 

6️⃣ Apply for Provider Enrollment

 

 

• Complete your state’s Medicaid Waiver Provider Application (or equivalent).
• Attach:
  
• Policies & procedures manual
• Insurance certificates
• Staff roster & credentials
• Proof of admin capability (resumes, org chart).
• Pass site inspection (if required).

 

 

 

 

 

7️⃣ Prepare for Service Delivery

 

 

• Develop forms: intake packets, ISP/PCP templates, daily logs, incident reports.
• Establish billing and payroll systems (consider Medicaid clearinghouses).
• Draft marketing plan: referral sources (case managers, regional centers, MCOs).

 

 

 

 

 

8️⃣ Launch & Grow

 

 

• Start with a small caseload to ensure compliance.
• Schedule regular staff supervision and quality audits.
• Track KPIs: attendance, satisfaction, incident rates, cash flow.
• Expand into related services (supported employment, day support, transportation) once stable.

 

 

 

 

 

9️⃣ Ongoing Compliance & Quality

 

 

• Keep up with annual training & certifications.
• Review waiver bulletins and policy changes.
• Conduct quarterly file reviews and client satisfaction surveys.
• Renew licenses and insurance on time.

 

 

 

 

 

💡 Tips from “The Healthcare Fairy”

 

 

• Network early with support coordinators and case managers—they’re the gatekeepers for referrals.
• Start lean: virtual office tools, shared workspaces, subcontract DSPs until volume grows.
• Build relationships with families; word-of-mouth is powerful in this field.