Medicaid Messenger
Authorization for Medicaid Services Special Edition

Medicaid Department
Please feel free to contact us with any questions.
We're here to help!
Michelle Maxfield - (734) 334-1461 ~maxfiem@resa.net
Leanne Smith - (734) 334-1464 ~smithle@resa.net
Tia Williams - (734) 334-1397 ~williat@resa.net
Please watch the video below for information regarding changes to the POC form
Changes to the Plan of Care (POC) Signature Form in MISTAR
Changes Include:
- Name is now - Authorization for Medicaid Services
- Includes the Authorization for Personal Care Services
- No longer have a separate Authorization for Personal Care Services
- When the student is under the age of 21
- The student's IEPT/IFSP has at least one direct medical/behavioral/mental health ancillary service prescribed as direct or direct/consult (i.e. speech, social work, OT/PT, audiology, nursing, etc.)
- At the Annual IEPT/IFSP, three-year evaluation, and when an IEPT amendment includes changes to the Programs/Services Page of the IEPT/IFSP
- MUST be kept in the student's file for a minimum of SEVEN years in case of a State or Federal audit
Personal Care Authorization Form
The Personal Care Authorization Form is now included in the Authorization for Medicaid Services. The forms were combined to eliminate the need for an additional form and signature. If the need for assistance with daily living skills, redirection and behavior, or health-related (not academic) monitoring or cueing by a paraprofessional aide box is marked YES, you will need to fill out the Personal Care Services section of the Authorization for Medicaid Services form.
List ALL of the personal care services the student may need and share that information with their personal care aide.
You may see both versions of the Personal Care Authorization Form as the updated Authorization for Medicaid Services form continues to be rolled out and implemented.
Who Can Sign the Authorization for Medicaid Services Form?
If the student does not have Personal Care Services prescribed on the IEPT/IFSP, the following staff are qualified to sign the Authorization for Medicaid Services form per The Center for Medicare and Medicaid Services (CMS):
•Board Certified Behavior Analyst
•Licensed Marriage and Family Therapist
•Qualified School Nurse, Registered Nurse, Certified Nurse Specialist, or Nurse Practitioner
•Licensed Physician
•Licensed or Limited Licensed Professional Counselor
•Licensed Psychiatrist
•Licensed, Limited Licensed, or MDE-Credentialed Psychologist
•Licensed or Limited Licensed Master Social Worker
•Licensed Occupational Therapist
•Licensed Physical Therapist
•Licensed Speech Pathologist
•Certified Orientation & Mobility Specialist
•Licensed Audiologist
If the student has Personal Care services prescribed on their IEPT/IFSP the list of staff who can sign the authorization form is automatically restricted to the list of staff who are considered qualified to authorize Personal Care Services by CMS:
•Licensed Physician
•Registered Nurse
•Licensed Occupational Therapist
•Licensed Physical Therapist
•Licensed Masters Social Worker
•Fully Licensed Speech Language Pathologist