REFERRALS

HOME & COMMUNITY CARE SERVICES HSS REFERRAL REQUEST FORM

  • Waiver case managers, social workers, and care coordinators can either submit the referral online or download the form below and follow the provided steps.

  • In cases you don’t have a waiver, a Professional Statement of Need (PSN) can be arranged .

  • Also we can assist in finding an alternative HSS agency for Consultation.

  • Once a referral is established, we take on the responsibility of enrolling the individual with the Department of Human Services (DHS).

  • Upon approval, a designated member of our Housing Stabilization team will work closely to meet the needs of the client.

If you’re a waiver Case Managers, Social Workers, and Care Coordinators, you can fill out this form online or download the referral document below this online form and follow the instruction.

Please make sure a current CSSP is attached to this referral form

Contact: 612-501-1363

homecommunitycareservices@gmail.com

For Case Managers, Social Workers, And Care Coordinators:

  • Download the Housing Stabilization Services referral form here

  • Complete the referral form and attach a copy of the client CSSP (if available).

  • Submit the referral via email at homecommunitycareservices@gmail.com

  • For additional questions, contact us at 612-501-1363 or 612-483-8269