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How to Open a Business Working With MR/DD

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Group homes, daycare centers and in-home aides typically form the types of businesses that are needed to serve people with mental retardation and developmental disabilities, often referred to as MR/DD. The services they require include help with activities of daily living such as bathing, dressing and eating. Socialization, help with paying bills, shopping, running errands and providing emotional support also are services your business could provide once you meet all the requirements for a new business serving people with MR/DD.

Earn Requisite Certifications

Individual states regulate the requirements for recognized MR/DD providers. You must meet those requirements before you can receive referrals from state agencies that provide services to that population. In Ohio, for example, you must undergo a criminal background check and earn a CPR certificate to work with MR/DD clients. Contact your local Department of Health and Human Services to find the requirements for your state.

Get Appropriate Licenses

Most MR/DD payments to providers are made through the federally funded Medicaid program. While Medicaid is a federal program, local jurisdiction applies to requirements for funding. For example, if you intend to serve MR/DD clients with special medical needs, you may need to have a licensed nurse on staff or run your business under the direction of a medical director who is an M.D. Many states require a social worker or person with extensive MR/DD experience to oversee the operations. Learn what licenses and requirements your state requires as you build your business and make special applications.

Build Referral Sources

To get paid, you must meet the Medicaid requirements of your state. Additionally, you must build relationships with your state social services departments to get referrals to your program. Medicaid only covers those people who are served under a prepared care plan and have a recognized referral to a private business. You may accept private-pay clients without undergoing the scrutiny of the state, but those clients will be few and far between. Once you meet state requirements, referrals then come after social workers and care providers get to know you and the services you provide.

Direct Your Offerings

Before you open, your business plan should include the various kinds of services your company will provide. While most of your funding will come from Medicaid for direct-care services, you also may elect to provide services not usually covered by Medicaid to broaden the scope of your business. For example, full-time caregivers will pay you directly for experienced respite care so they can take an evening or weekend off from the constant care required for MR/DD people. You may offer transportation services not covered by insurance, in which case you’ll need special rider insurance for your vehicles and drivers. If you only plan to provide daycare drop-off services or are building a group home, then the state requirements should cover your staffing needs with the manuals and directives you can get from your state's DHHS.


Linda Ray is an award-winning journalist with more than 20 years reporting experience. She's covered business for newspapers and magazines, including the "Greenville News," "Success Magazine" and "American City Business Journals." Ray holds a journalism degree and teaches writing, career development and an FDIC course called "Money Smart."

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