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Consumer Support Grant (CSG) Employer Enrollment Packet 2026
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- Click ‘Get Form’ to open the Consumer Support Grant (CSG) Employer Enrollment Packet in the editor.
- Begin with the 'Consumer Intake and Designation of Employer' section. Fill in all required fields, including consumer information such as name, Social Security Number, and contact details. Ensure you select who will serve as the employer of record.
- Proceed to the 'Authorized User Designation' form if applicable. Complete this optional section if you wish to appoint someone else to manage health information on your behalf.
- Next, review and complete the 'Employer Responsibilities & Attestation' form. Sign and date where indicated to confirm your understanding of your responsibilities as an employer.
- Fill out the 'Employer Authorization Agreement', ensuring all highlighted fields are completed. This authorizes Palco to act on your behalf regarding tax matters.
- Complete the 'Worker Pay Rate Information' form by indicating the pay rate for your worker. Both consumer and worker must sign this document.
- Finally, ensure all forms are signed and dated before submitting them via fax or email as provided in the packet instructions.
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Related links
Jun 30, 2018 The Consumer Support Grant is a state-funded program that provides individuals otherwise eligible for home care services to receive and control
Both Consumer Support Grant (CSG) Hire support workers and serve as their employer. Hire their spouse or parent (if a minor).