Application and Certification Assessment
The application is the online form used to apply for certification as a health care home. The certification assessment is the online form used to verify that an applicant meets the health care home standards and criteria. Submission of a complete online application form, certification assessment and supporting verification documents is required.
Completing the application and certification assessment
Note: Applicants must complete the letter of intent process before moving on to the application. Before starting the application process, applicants should wait to receive instructions from MDH.
NOTE: Please download the printable assessment tool for use internally in your clinic to determine if your clinicians are currently implementing all of the standards and criteria in the rule relating to health care homes. Please note that you should not submit this assessment at this time -- it is simply a tool to help you determine the readiness of your clinician(s)/clinic(s) for certification. Later in the application process you will be prompted to fill in the same assessment tool online. Below are two versions of the printable assessment tool:
- One version for use by clinics for planning purposes
Certification assessment tool (DOC: 210KB/20 pages)
- One version containing sample language that a clinic might enter in the assessment tool, for training purposes
Certification assessment tool with examples (DOC: 218KB/21 pages)
Steps in the application and certification assessment process:
- Download and review printable application for planning purposes
Application - Updated May 2011 (PDF: 152KB/6 pages)
- Sign in to certification portal
- Fill in application and certification assessment tool and attach supporting verification documents
- Submit online application form, certification assessment and supporting verification documents
- OPTIONAL: If necessary, fill in request for variance and submit request for variance with application (see Optional Requests as Needed)
- MDH will respond to application submission within one to two weeks in order to provide instructions for next steps and to set up a site visit
If you have questions, please contact the MDH health care homes staff.