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MN Addendum to the Community Support Plan - Ramsey County Form 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering the Client Name and PMI # in the designated fields. This information is crucial for identifying the individual associated with the plan.
- Fill in the Fiscal Intermediary and Addm. Completed by sections to ensure proper documentation of who is managing the addendum.
- Input the Date of Birth, Case Manager and Agency, Support Planner, and Waiver Span. Accurate details here help streamline communication with your case manager.
- Identify any changes you wish to make by checking the appropriate boxes. Clearly state your reasons for these changes in the provided section.
- Outline expected outcomes from these changes, along with their costs and FMS fees. This transparency aids in understanding financial implications.
- Finally, ensure all necessary signatures are obtained from participants, guardians, and case managers before submitting your form for approval.
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Related links
Jan 1, 2016 Enrollee will be provided with a copy of the Community Support Plan produced by the STATEs assessment process.
Apr 3, 2025 Addendums- An Addendum or revision is a change to the plan, during the service plan year. The following changes require only an email to theRead more
This document has been reviewed in accordance with U.S. Environmental Protection Agency policy and approved for publication and distribution.Read more