Prototype- MSFS LA OCDD Employer Enrollment Packet

Morning Sun Financial Services of Louisiana OCDD Employer Enrollment Packet

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Select role*

Step 1- Employer

Morning Sun Financial Services of Louisiana OCDD Employer Enrollment Packet

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Click the print icon in the top right corner to print

Louisiana Employer Welcome Letter

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
This page is read-only. The information shown is for your reference.
Welcome to Morning Sun Financial Services!

Morning Sun Financial Services is an experienced provider of fiscal agent services. We have operated as a fiscal agent since 1998 with a reputation for excellent customer service in Minnesota. Morning Sun Financial Services began offering financial management services to other states in 2006. Whether you are transferring from another financial management service or starting these services for the first time, we are eager to work with you. Morning Sun Financial Services strives to provide a helpful, efficient and responsive service so that your financial needs as an employer are met.

We will process timecards and pay your employees in a timely and efficient manner. We will make sure that all payroll taxes are paid and that your status as an employer is in good standing with the IRS. For OAAS, we will work with you and the Office of Citizens with Disabilities to provide you with the tools to manage your services. For OCDD, we will work with you and the Office of Aging and Adult Services to provide you with the tools to manage your services. We will act as your billing agent to ensure that service expenditures are accounted for and accurately reflected in compliance with state program guidelines.

We have enclosed all of the forms and instructions you need to get started as an employer or to transfer your financial management services to us. Please take a few minutes to thoroughly read the forms and instructions. Also, please make sure you have filled in all sections of the paperwork so that processing of your paperwork is not delayed.

We are pleased to offer our services to you. We strive to be helpful and courteous at all times. We will be available to answer questions and to assist you when you need it.

Customer Service
- Our Customer Care team is available between the hours of 8am to 5pm CST, Monday through Friday to assist with questions you may have. Please call 1-844-450-5444.
Complaints and Grievances
- If Employers have a complaint or problem, please let the Morning Sun Program Administrators know right away.
  - Program Administrator, Laci Polotzola, 337-282-5155, lpolotzola@morningsunfs.com
- If you are not satisfied with the Program Administrator’s response, you may also contact any of the following individuals:
  - Chief Operating Officer, Cheryl Vennerstrom at 612-239-3768, cherylv@orionassoc.net
  - Chief Financial Officer, Stephanie DeForrest at 763-450-3780, sdeforrest@orionassoc.net
  - Executive Director of Payroll Operations, Justin Dukowitz at 763-450-3781, jdukowitz@orionassoc.net

Louisiana Employer Roles and Information

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Fiscal Employer Agent

The Fiscal Employer Agent (FEA) or Payroll Agent is responsible for processing time records, paying employees, paying payroll taxes, and maintaining employment law compliance.
Employer Agent Name (Read Only)
Phone Number (Read Only)
Human Resources Email (Read Only)
Human Resources Fax (Read Only)
Human Resources Mailing Address (Read Only)
Morning Sun Financial Services of Louisiana
820 Lilac Drive North, Suite 200
Golden Valley, MN 55442
Payroll Email (Read Only)
Payroll Fax (Read Only)
Payroll Mailing Address (Read Only)
Morning Sun Financial Services of Louisiana
9400 Golden Valley Road
Golden Valley, MN 55427
Participant

This is the person that receives services. Other terms include, Consumer, Client, or Person Served
Participant Legal Name*

Legal First NameLegal Middle NameLegal Last Name
Participant Address*

Street Address

Apartment or Unit Number

CityState

Zip Code
Participant Parish*
Participant Date of Birth*

MonthDayYear
Date
Participant Gender*

MaleFemale
Louisiana Program*

OCDD CCWOCDD NOWOCDD ROW
Is this a transition FROM another Fiscal Agent TO Morning Sun Financial Services?*

NoYes
Other Fiscal Agent Name*
Does the Participant have a Responsible Representative? If yes, your Support Coordinator will complete and submit to Morning Sun Financial Services*

NoYes
Employer

This is the person that is responsible for supervising an Employee. In some cases, the Employer can be the Participant or their Authorized Representative.
Employer Legal Name*

Legal First NameLegal Middle NameLegal Last Name
Employer Email*
example@example.com
Employer Phone Number*
Please enter a valid phone number.
Employer Address*

Street Address

Apartment or Unit Number

CityState

Zip Code
Employer Parish*
Employer Date of Birth*

MonthDayYear
Date
Employer Social Security Number*
Support Coordinator

The person licensed by Health Standards and has an agreement with Louisiana to provide support coordination services to waiver participants
Support Coordinator Name

Legal First NameLegal Last Name
Support Coordinator Email
example@example.com
Support Coordinator Phone Number
Please enter a valid phone number.
Authorized Representative

This is a person that can act on the Employer's behalf
Authorized Representative Legal Name

Legal First NameLegal Last Name
Authorized Representative Email
example@example.com
Authorized Representative Phone Number
Please enter a valid phone number.
Authorized Representative Address

Street Address

Apartment or Unit Number

CityState

Zip Code
Authorized Representative Parish
Authorized Representative Date of Birth

MonthDayYear
Date

Louisiana Employer Responsibilities and Services

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
This page is read-only. The information shown is for your reference.
What does Morning Sun Financial Services Do For You?

As Your Financial Management Agency, Morning Sun Financial Services will:
- Pay your workers after you submit their time entries on a regular schedule
- Withhold and pay the payroll taxes
- Make sure all laws are followed
- Keep Employee files with employee paperwork, training and other records
- Keep Employer files with Federal and State required forms
- Issue tax statements at the end of the year
- Help you stay within your budget
- Help you fill out your employer and employee paperwork
- Help you with managing your employee's time entries in the Electronic Visit Verification (EVV) system

Louisiana Employer Guide to Employer and Employee Forms

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Guide to Employer Forms
- 1. SS-4 – Application for Employer Identification Number -This form is used to obtain an Employer Identification Number. If you already have a Federal Employer Identification number please provide proof of that number. *If you do NOT have an EIN # you will need to complete the following sections of this form and send it back to Morning Sun Financial Services.
  - 1. Please complete Lines 1 – 7b
  - 2. Please print and sign your name at the bottom of the form, including your telephone and fax number (if
    appropriate)
- 2. Form 2678 – Employer / Payer Appointment of Agent – This form gives authorization for Morning Sun Financial Services to act as your Payroll Agent. Please complete the highlighted lines in Part 2 of this form and return it to Morning Sun Financial Services.
  - 1. Employer Identification Number (if you have an EIN or know your EIN – otherwise leave it blank)
  - 2. Employer’s Name
  - 3. Employer’s home mailing address
  - 4. At the bottom of Part 2 on page 1 – sign, date, printed name, telephone number
- 3. IRS Form 2848 - Power of Attorney and Declaration of Representative - This form authorizes Morning Sun to represent your business before the IRS and complete necessary filings. Please complete highlighted sections in Part 1 and Part 7 of this form.
  - 1. Part 1: Employer name and home mailing address
  - 2. Part 1: Employer phone number
  - 3. Part 7: In the middle of page 2 – sign, date, printed name.
- 4. Form 8821 – Tax Information Authorization – This form authorizes Morning Sun Financial Services to inquire and request information related to payroll reports on your behalf.
  - 1. Please complete all of section 1
  - 2. Please complete all of section 7
- 5. Louisiana POA – State Unemployment Employer Authorization of Designated Representative - This form is an authorization designating Morning Sun as your representative with the Louisiana Workforce Commission for unemployment insurance purposes.
  - 1. Please complete the top section of the form
  - 2. Please sign and date the bottom of this form
- 6. R-7006 Louisiana POA and Declaration of Representative - This form is an authorization designating Morning Sun as your representative with the Louisiana Department of Revenue for Louisiana Employment Withholding Taxes. When Morning Sun pays your employees, those earnings will be taxed under Louisiana law. Morning Sun will report those taxes and pay them to the Louisiana Department of Revenue on your behalf.
  - 1. Please complete section I, and
  - 2. Sign and date on page 2 as the Taxpayer on Taxpayer Signature Line
- 7. Work Agreement – This is a Working Agreement between you, the Employer and Morning Sun Financial Services. Please read through this agreement, complete the highlighted sections, and return to Morning Sun.
- 8. Consent for the Release of Information – This form allows Morning Sun to exchange information with the state, your representative or anyone in your life you want Morning Sun to talk to. Please complete the highlighted sections, and return to Morning Sun.
- 9. EVV Data Information Form – This form is use to set-up of the employer, employee's, and participant's information within the Electronic Visit Verification system (EVV). Please read and complete all sections to provide the contact information for the Participant, Employer, and Authorized Representative (if applicable).
Guide to Employee Forms for the Employer
- 1. Morning Sun of Louisiana Payroll Schedule –This form details the start and end dates of each pay period. This includes the date time entry approvals are due to the Morning Sun payroll department and the date employees can expect to receive their pay checks. The bottom of the Payroll Schedule also has the different ways to contact Morning Sun.
- 2. “Cost to You” Sheet– This form is a guide to be used by the employer to determine the hourly wage to pay the employees hired to work with the participant. You as the employer may pay your employees whatever wage you like, as long as it is at least the Louisiana minimum wage. Just make sure that the wage chosen stays within reason because it is subject to your annual approved budget.
  - If you have a question on what wage to pay your employees, please contact your Support Coordinator.
- 3. EVV Instructions – This document details how an employee's time must be recorded inorder to be approved for payment. Time entry received in the payroll department that is not complete per instructions will be returned to you.
- 4. Service Logs- Service logs are required to be completed by every employee on a daily basis and are made up
  of two sections:
  - Tasks List- identify and record the specific tasks that were performed throughout the course of the day.
  - Progress Notes- are completed as applicable in the below situations:
    
    There are observed changes in physical and mental condition.
    
    Documentation of any significant deviation from what is in the plan of care.
    
    Important information that is necessary for the next worker of caregiver.
  - Service logs must be legible and completed according to the OAAS or OCDD Service Log Instructions. These logs are kept in your home and do not need to be returned to Morning Sun.
- More information can be found in your Employer Handbook.

Louisiana Employer Working Agreement

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
This agreement is made to be effective as of*

MonthDayYear
Date
By and between Morning Sun Financial Services, a Minnesota organization with principal offices located at 9400 Golden Valley Road, Golden Valley, MN, 55427 and
Employer Legal Name*

First NameLast Name
an individual or their representative self – administering their own support, due to Title 19 Home and Community Based Services with principal place of service provided at
Employer Address*

Street Address

Apartment or Unit Number

CityState

Zip Code
WITNESSETH

WHEREAS, Morning Sun Financial Services is in the business of providing Fiscal Agent Services (Payroll Agent) to individuals through the self-directed services option and desires to contract with individuals to develop and support such services; and WHEREAS, the Employer is an individual, or their representative, hiring and managing your own support due to the self-directed services through the waiver amendments; and WHEREAS, the Employer desires to engage Morning Sun Financial Services to perform certain payroll and tax Management, billing and support services related to the waiver amendments. NOW, THEREFORE, in consideration of the foregoing and the representations and covenants set forth in the Agreement, the parties agree as follows:

ARTICLE I

SERVICES TO BE PROVIDED

The services to be provided under this agreement include Payroll and Tax Administration, Billing and Support Services.

DESCRIPTION OF SERVICES OFFERED

Section 1.1. Payroll and Tax Administration. Payroll and Tax Administration support includes Employment Forms, Wage and Schedule Administration, Timecard Processing, Issue Payroll Checks, Withhold an Deposit Taxes, Quarterly and Annual Reporting, and Issue W-2's.

Section 1.2 Insurance. The Employer (you) will provide all applicable insurances when contracted as the Employer. These insurances may include Professional and General Liability and Property Insurance. The Employer is solely responsible, at its sole costs and expense, for determining, in accordance with any and all applicable governmental agency rules, statutes or regulations, the need for coverage, the types of coverage, and coverage amounts of all applicable insurances. Worker’s Compensation coverage will be arranged per State of Louisiana waiver rules.

Section 1.3 Finance and Accounting Systems. Morning Sun Financial Services will provide fiscal and administrative support in establishing you as the Employer. Morning Sun Financial Services will supply a packet of information containing forms and instructions establishing you as the employer.

ARTICLE II

TAXES, LAWS, AND REGULATIONS

Section 2.1 Taxes. Morning Sun Financial Services understands and agrees that it is responsible for the withholding and payment of all taxes, whether federal, state, or local, related to the Employer’s employees.

Section 2.2 Laws and Regulations. Morning Sun Financial Services agrees that it will comply with all federal, state, and local laws and regulations pertaining to the services it is performing under this Agreement.

ARTICLE Ill

INDEMNIFICATION AND INSURANCE

Section 3.1 Indemnification. Morning Sun Financial Services shall not be liable to the Employer, its representatives, employees, or agents for any loss, damage, injury, expense, or cost whatsoever suffered by them in connection with the performance of this Agreement. The Employer agrees to indemnify and hold Morning Sun Financial Services harmless from any claim, liabilities, damage, cost, or expense, including reasonable attorney fees, that may be made against Morning Sun Financial Services as a result of the misconduct, or negligence of the Employer, it’s representative, employees, or agents in connection with the performance of service hereunder.

Section 3.2 Insurance. When Morning Sun Financial Services is identified as
Vendor/Fiscal Employer Agent, Morning Sun Financial Services shall not be responsible for the retention and payment General and Professional Liability, Automobile Liability, Excess Liability, Property Insurance, and any all other insurance in respect to the Employer’s business and employees.

ARTICLE IV

RELATIONSHIP OF PARTIES

Section 4.1 Independent Contractor. Morning Sun Financial Services status under the Agreement shall be that of an independent contractor, and Morning Sun Financial Services is alone responsible for its acts and the acts of its representatives, agents, or employees, whether or not in the course of their employment or authority.

Section 4.2 Cooperation with State. Morning Sun Financial Services will
continually work with and under contract with the State of Louisiana to develop an organizational structure, a set of service principles, a program design, and operate within those guidelines and policies and procedures.

ARTICLE V
TERM

Section 5.1 Term. This Agreement shall be deemed effective the date first written above and shall continue in effect for one year. This Agreement shall automatically renew for successive terms of one year each unless either party provides the other party with a written notice of termination at least thirty (30) days prior to the expiration of any term.

Section 5.2 Termination. This Agreement may be cancelled by either party at any time, with or without cause, upon written notice, delivered by certified mail or in person.

ARTICLE Vl
MISCELLANEOUS

Section 6.1 Headings. The headings of the articles and sections of this Agreement are for convenience of reference only and shall have no substantive effect upon the provisions of this Agreement.

Section 6.2 Assignment. This Agreement is personal in its nature and neither of the parties hereto shall, without the written consent of the other, assign or transfer the Agreement or any rights or obligations hereunder. In the event of any assignment, the parties shall remain liable for all of their obligations set forth herein.

Section 6.3 Controlling Law. This Agreement shall be construed In accordance with the laws of the State of Louisiana.

Section 6.4 Entire Agreement. This Agreement, and any attachments, constitute the full and complete understanding of the parties respecting the matters within its scope, and supersedes all prior understandings and agreements and may be modified only in writing.

Section 6.5 No Waiver. The waiver by either party hereto of any breach of any provision of this Agreement shall not be construed as a continuing waiver of any other breach or provision of this Agreement.

IN WITNESS WHEREOF, the parties hereto have executed this Agreement as of the day and year first above written.

Morning Sun Financial Services of Louisiana, LLC

By:

Its: CFO, Morning Sun Financial Services of Louisiana
Signatures

I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
Employer Legal Name*

First NameLast Name
Employer Email*
example@example.com
Employer Phone Number*
Please enter a valid phone number.
Employer Signature*

Clear
Date of Signature*

MonthDayYear
Date

Louisiana Employer Consent for the Release of Information

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Participant Legal Name*

Legal First NameLegal Last Name
I, the Participant, hereby authorize Morning Sun Financial Services to exchange information with the following persons or agencies

Participants, Louisiana Department of Health- Office of OCDD and OAASAuthorized RepresentativeOther
The following information may be exchanged

Funding and budget informationOther
I understand that my records are protected under State and Federal confidentiality laws and cannot be disclosed without my written consent unless otherwise provided for in the regulations. I also understand that I may revoke this consent at anytime. I understand that information at Morning Sun Financial Services is limited to staff whose work assignments reasonably require access to my data within the purposes specified in the services provided.
Signatures

I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
Employer Legal Name*

Legal First NameLegal Last Name
Employer Email*
example@example.com
Employer Signature*

Clear
Date of Signature*

MonthDayYear
Date

Louisiana Employer Worker's Compensation Guidelines

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Click the print icon in the top right corner to print

Louisiana Employer EVV Data Information Form

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Morning Sun as your Fiscal Employer Agent (FEA), is authorized to represent you for purposes of employer tax reporting responsibilities. Morning Sun will also manage the initial setup of the employer, employee's and participant's information within the Electronic Visit Verification system (EVV). Please complete all sections to provide the contact information for the Participant, Employer, and Authorized Representative (if applicable). If you have more than one employee, please enter contact information for ALL employees.
Participant

This is the person that receives services. Other terms include, Consumer, Client, or Person Served
Participant Legal Name*

Legal First NameLegal Last Name
Participant Email
example@example.com
Participant Address*

Street Address

Apartment or Unit Number

CityState

Zip Code
Participant Parish*
Participant Date of Birth*

MonthDayYear
Date
Participant Gender*

MaleFemale
Employer

This is the person that is responsible for supervising an Employee. In some cases, the Employer can be the Participant or their Authorized Representative.
Employer Legal Name*

Legal First NameLegal Middle NameLegal Last Name
Employer Email*
example@example.com
Employer Phone Number*
Please enter a valid phone number.
Employer Address*

Street Address

Apartment or Unit Number

CityState

Zip Code
Employer Parish*
Employer Date of Birth*

MonthDayYear
Date
Authorized Representative

This is a person that can act on the Employer's behalf
Authorized Representative Legal Name

Legal First NameLegal Last Name
Authorized Representative Email
example@example.com
Authorized Representative Phone Number
Please enter a valid phone number.
Authorized Representative Address

Street Address

Apartment or Unit Number

CityState

Zip Code
Authorized Representative Parish
Authorized Representative Date of Birth

MonthDayYear
Date
Employee

This is the person that is responsible for providing services to the Participant

Employee 1
Employee 1 Legal Name

Legal First NameLegal Middle NameLegal Last Name
Employee 1 Email
example@example.com
Employee 1 Phone Number
Please enter a valid phone number.
Employee 1 Address

Street Address

Apartment or Unit Number

CityState

Zip Code
Employee 1 Parish
Employee 1 Date of Birth

MonthDayYear
Date

Employee 2
Employee 2 Legal Name

Legal First NameLegal Middle NameLegal Last Name
Employee 2 Email
example@example.com
Employee 2 Phone Number
Please enter a valid phone number.
Employee 2 Address

Street Address

Apartment or Unit Number

CityState

Zip Code
Employee 2 Parish
Employee 2 Date of Birth

MonthDayYear
Date

Employee 3
Employee 3 Legal Name

Legal First NameLegal Middle NameLegal Last Name
Employee 3 Email
example@example.com
Employee 3 Phone Number
Please enter a valid phone number.
Employee 3 Address

Street Address

Apartment or Unit Number

CityState

Zip Code
Employee 3 Parish
Employee 3 Date of Birth

MonthDayYear
Date

Employee 4
Employee 4 Legal Name

Legal First NameLegal Middle NameLegal Last Name
Employee 4 Email
example@example.com
Employee 4 Phone Number
Please enter a valid phone number.
Employee 4 Address

Street Address

Apartment or Unit Number

CityState

Zip Code
Employee 4 Parish
Employee 4 Date of Birth

MonthDayYear
Date

Employee 5
Employee 5 Legal Name

Legal First NameLegal Middle NameLegal Last Name
Employee 5 Email
example@example.com
Employee 5 Phone Number
Please enter a valid phone number.
Employee 5 Address

Street Address

Apartment or Unit Number

CityState

Zip Code
Employee 5 Parish
Employee 5 Date of Birth

MonthDayYear
Date

HIDE- End
Signatures

I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
Any changes to personal information above requires a notification to Morning Sun Financial Services using the Employee Change Form, found on our website at www.morningsunfs.com.

Your signature means you have read and understand why this is needed.
Employer Legal Name*

Legal First NameLegal Last Name
Employer Signature*

Clear
Date of Signature*

MonthDayYear
Date

Louisiana Employer Employee Wages: "Cost to You"

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Louisiana Program*

OCDD CCWOCDD NOWOCDD ROW
OCDD CCW
OCDD NOW
OCDD ROW

Louisiana Payroll Schedule

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
January 2025 through December 2025

Pay Period Start Date	Pay Period End Date	Time Entry Due to Payroll(Before 12:00 noon)	Direct Deposit or Check Date	Off-Cycle Check Date
12/15/2024	12/28/2024	12/30/2024	01/10/2025	01/15/2025
12/29/2024	01/11/2025	01/13/2025	01/24/2025	01/29/2025
01/12/2025	01/25/2025	01/27/2025	02/07/2025	02/12/2025
01/26/2025	02/08/2025	02/10/2025	02/21/2025	02/26/2025
02/09/2025	02/22/2025	02/24/2025	03/07/2025	03/12/2025
02/23/2025	03/08/2025	03/10/2025	03/21/2025	03/26/2025
03/09/2025	03/22/2025	03/24/2025	04/04/2025	04/09/2025
03/23/2025	04/05/2025	04/07/2025	04/18/2025	04/23/2025
04/06/2025	04/19/2025	04/21/2025	05/02/2025	05/07/2025
04/20/2025	05/03/2025	05/05/2025	05/16/2025	05/21/2025
05/04/2025	05/17/2025	05/19/2025	05/30/2025	06/04/2025
05/18/2025	05/31/2025	06/02/2025	06/13/2025	06/18/2025
06/01/2025	06/14/2025	06/16/2025	06/27/2025	07/02/2025
06/15/2025	06/28/2025	06/30/2025	07/11/2025	07/16/2025
06/29/2025	07/12/2025	07/14/2025	07/25/2025	07/30/2025
07/13/2025	07/26/2025	07/28/2025	08/08/2025	08/13/2025
07/27/2025	08/09/2025	08/11/2025	08/22/2025	08/24/2025
08/10/2025	08/23/2025	08/25/2025	09/05/2025	09/10/2025
08/24/2025	09/06/2025	09/08/2025	09/19/2025	09/24/2025
09/07/2025	09/20/2025	09/22/2025	10/03/2025	10/08/2025
09/21/2025	10/04/2025	10/06/2025	10/17/2025	10/22/2025
10/05/2025	10/18/2025	10/20/2025	10/31/2025	11/05/2025
10/19/2025	11/01/2025	11/03/2025	11/14/2025	11/19/2025
11/02/2025	11/15/2025	11/17/2025	11/28/2025	12/03/2025
11/16/2025	11/29/2025	12/01/2025	12/12/2025	12/17/2025
11/30/2025	12/13/2025	12/15/2025	12/26/2025	12/31/2025
12/14/2025	12/27/2025	12/29/2025	01/09/2026	01/14/2026
12/28/2025	01/10/2026	01/12/2026	01/23/2026	01/28/2026

Important Notes
- The timesheet due date is the last date your time entry will be accepted for on-time payment
- You must approve your time entries on or before the due date, even if the due date is a holiday
- Hours worked on holidays through self-directed services paid through Morning Sun Financial Services are not eligible for additional pay or time off
Payroll Contact Information
- Phone: 1-844-450-5444
- Fax: 1-844-992-0488
- Email: MS-LApayroll@morningsunfs.com
- Mailing: Morning Sun Financial Services of Louisiana, ATTN: Payroll, 9400 Golden Valley Road, Golden Valley, MN, 55427

Louisiana Self-Direction Option for OCDD Waivers Employer Service Agreement Form

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Instructions
Participant Legal Name*

First NameLast Name
Employer Legal Name*

First NameLast Name
Employer Phone Number*
Please enter a valid phone number.
Employer Email Address*
example@example.com
Signatures

I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
Employer Signature

Clear
Date of Signature*

MonthDayYear
Date

Louisiana Self-Direction Option for OCDD Waivers Employer Attestation Form

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Instructions
Employer Legal Name*

Legal First NameLegal Middle NameLegal Last Name
Participant Legal Name*

Legal First NameLegal Last Name
HIDE- Participant Legal Name

Legal First NameLegal Last Name
HIDE- FEA Vendor Name
Do the Employer and Participant share an address?*

YesNo
Employer Address*

Street Address

Apartment or Unit Number

CityState

Zip Code
Enter the shared address*

Street Address

Apartment or Unit Number

CityState

Zip Code
Employer Attestations & Initials
As the Self-Direction Employer for the Participant, I am attesting to all of the following must initial by each section):
I declare that I am at least 21 years of age, live in Louisiana and in close proximity to the participant to be able to carry out all responsibilities. *

Clear
I understand I must adhere to the health and welfare safeguards identified by the team (the beneficiary, the Support Coordinator, family, any professionals involved and anyone the beneficiary wants involved in their life), including the application of a comprehensive monitoring strategy and risk assessment. *

Clear
I understand all services must be documented in service notes, which describes the services rendered and progress towards the beneficiary’s personal outcomes in the plan of care. I understand I must see that the Direct Support Professional (DSP) does this for each shift worked. *

Clear
I understand the Electronic Visit Verification (EVV) system must be used when the DSP starts and ends the established work shift and that if the schedule changes from what is in the Plan of Care daily schedule, it must be documented as to why the change occurred. *

Clear
I understand the beneficiary’s Rights and Responsibilities and I will ensure that these rights are respected. *

Clear
I understand critical incidents must be reported within 24 hours to the beneficiary’s support coordinator/support coordination agency and any emergency room visits and/or hospitalizations must be reported as soon as possible but within the 24-hour period. Some examples of critical incidents are emergency room visits, evacuations, and hospitalizations. *

Clear
I understand service hours shall be capped at 40 hours per week, Sunday to Saturday, for services delivered by family members living in the home and any hours over this time must not be billed to Medicaid. *

Clear
I understand services must be provided with the beneficiary present. A DSP cannot leave a beneficiary at home while they run errands nor can they run personal errands while “on the clock” working with the beneficiary. *

Clear
I understand DSPs cannot work another job at the same time they are caring for the beneficiary and billing Medicaid nor can they care for other children or adults while caring for the beneficiary and billing Medicaid. *

Clear
I agree to notify the Department of Children and Family Services/Adult Protective Services/Elderly Protective Services or LAW ENFORCEMENT immediately should any form of abuse or neglect occur. *

Clear
I understand I am to read the most up to date Self-Direction employer’s handbook and to understand the provisions in it. If there is something I don’t understand I am to ask questions until I do understand. *

Clear
I understand that, as an employer, my DSPs should not be asked to do any activities that are not directly for the beneficiary, on the plan of care and should not be subjected to harassment in any form, verbal, sexual or other. If problems occur, it is my job to address them immediately. *

Clear
I understand that I am responsible for reviewing each payroll report to make sure employees are being paid the correct rate for the correct number of hours worked, and there is enough hours in the account to continue receiving paid services for the reminder of the coordinator. I understand I should contact the Fiscal Employer Agent if I do not receive payroll reports. *

Clear
I understand that I am responsible for approving all time worked by each DSP and that all activities delivered by the DSP meet the requirements outlined in this attestation form. *

Clear
I understand that I must ensure employee background checks and required screenings are conducted prior to the employee working and at intervals as required in Appendix H of the OCDD Self-Direction Handbook. *

Clear
I understand that if all rules and regulations of the Self-Direction waiver option are not followed, the beneficiary may be asked to leave Self-Direction and choose a provider agency. *

Clear
I understand that the HCBS Waiver program is funded by State and Federal dollars and at any time without advanced notice I may be asked to turn over DSP notes and/or records to the OCDD Monitoring Unit, Louisiana Department of Health’s Program Integrity, the Louisiana Legislative Auditor, the United States Department of Justice, and/or the United States Office of the Inspector General’s Office. *

Clear
Signatures

I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
Signing this document is an attestation that, to the best of my knowledge, the information on this form is true and accurate and I understand the responsibilities of working under the HCBS waiver program. I understand that falsifying or omitting information may result in an investigation by Medicaid Program Integrity and/or the Louisiana Attorney General’s Office or any other state or federal agency with oversight of home and community based services and/or Medicaid funds resulting in jail time and/or a recoupment of paid claims.
Employer Signature*

Clear
Date of Signature*

MonthDayYear
Date

Louisiana Unemployment (UI) Tax Liability and Adjudication

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Employer Legal Name*

Legal First NameLegal Last Name
HIDE- Employer Legal Name 2*

Legal First NameLegal Last Name
Employer Phone Number*
Please enter a valid phone number.
Employer Address*

Street Address

Apartment or Unit Number

CityState

Zip Code
Signature

I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
Employer Signature*

Clear
Date of Signature*

MonthDayYear
Date

Louisiana Department of Revenue Power of Attorney and Declaration of Representative (R-7006)

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Employer Legal Name*

Legal First NameLegal Last Name
Employer Address*

Street Address

Apartment or Unit Number

CityState

Zip Code
Employer Social Security Number*
Signatures

I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
Employer Signature*

Clear
Date of Signature*

MonthDayYear
Date

E-Verify Memorandum of Understanding

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
The documents included in this form include:
- E-Verify Participation Poster
- Immigrant and Employee Rights (IER) Right to Work Notice
- Page 15 of the E-Verify Memorandum of Understanding for E-Verify Employer Agents. The full document is availble at this link goo.gl/TrRjau
The forms are viewable by scrolling down. The PDFs are located above their corresponding signature box.

These documents describe the process of E-Verify when using an employer agent (Morning Sun Financial Services) to complete verification checks. The documents also list your responsibilities as an employer.

You are asked to complete and sign this form to authorize Morning Sun Financial Services to act on the Employee and Employer's behalf to check employment eligibility for the individuals hired.

What is E-Verify?

E-Verify is an Internet-based system that compares information entered by an employer from an employee’s Form I-9, Employment Eligibility Verification, to records available to the U.S. Department of Homeland Security and the Social Security Administration to confirm employment eligibility.

More information regarding E-Verify can be found on the Department of Homeland Security website: https://www.e-verify.gov/

If you want more information about E-Verify in a paper format, please contact Morning Sun Financial Services.
HIDE- State Prefill
Employer Email*
example@example.com
Signatures

I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
E-Verify-Participation Poster
Immigrant and Employee Rights (IER) Right to Work Notice
Employer Legal Name*

Legal First NameLegal Last Name
Employer Signature*

Clear
Date of Signature*

MonthDayYear
Date
E-Verify Authorization

I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
Page 15 of the E-Verify Memorandum of Understanding for E-Verify Employer Agents
Employer Legal Name*

Legal First NameLegal Last Name
Employer Signature*

Clear
Date of Signature*

MonthDayYear
Date

Federal Application for Employer Identification Number (SS-4)

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Instructions
Employer Legal Name*

Legal First NameLegal Last Name
Employer Address*

Street Address

Apartment or Unit Number

CityState

Zip Code
HIDE- Employer Legal Name

Legal First NameLegal Last Name
6- State where principal business is located*
6- County where principal business is located*
HIDE- Employer Name*

First NameLast Name
7b- Employer Social Security Number, EIN, or ITIN*
18 Has the applicant entity shown on line 1 ever applied for and received an EIN?

YesNo
If “Yes,” write previous EIN here
Third Party Designee
Under penalties of perjury, I declare that I have examined this application, and to the best of my knowledge and belief, it is true, correct, and complete.
Employer Legal Name*

Legal First NameLegal Last Name
Employer Phone Number*
Employer Fax Number
Signatures

I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
Employer Signature*

Clear
Date of Signature*

MonthDayYear
Date

Federal Tax Information Authorization (8821)

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Employer Legal Name*

Legal First NameLegal Last Name
Employer Phone Number*
Please enter a valid phone number.
Employer Address*

Street Address

Apartment or Unit Number

CityState

Zip Code
Signature

I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
Employer Legal Name*

First NameLast Name
Employer Signature*

Clear
Date of Signature*

MonthDayYear
Date

Federal Employee/Payer Appointment of Agent (2678)

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Instructions
New Mailing Addresses
Employer Legal Name*

Legal First NameLegal Last Name
Employer Phone Number*
Please enter a valid phone number.
Employer Address*

Street Address

Apartment or Unit Number

CityState

Zip Code
Note: Generally you cannot appoint an agent to report, deposit, and pay tax reported on Form 940, Employer's Annual Federal Unemployment (FUTA) Tax Return, unless you are a home care service recipient.
I am authorizing the IRS to disclose otherwise confidential tax information to the agent relating to the authority granted under this appointment, including disclosures required to process Form 2678. The agent may contract with a third party, such as a reporting agent or certified public accountant, to prepare or file the returns covered by this appointment, or to make any required deposits and payments. Such contract may authorize the IRS to disclose confidential tax information of the employer/payer and agent to such third party. If a third party fails to file the returns or make the deposits and payments, the agent and employer/payer remain liable.
HIDE- Employer Legal Name

Legal First NameLegal Last Name
Signature

I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
Employer Signature*

Clear
Date of Signature*

MonthDayYear
Date

Federal Power of Attorney & Declaration of Representative (2848)

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Employer Legal Name*

Legal First NameLegal Last Name
Employer Phone Number*
Please enter a valid phone number.
Employer Address*

Street Address

Apartment or Unit Number

CityState

Zip Code
HIDE- Employer Legal Name

Legal First NameLegal Last Name
Signature

I understand and accept that my electronic signature will be as valid as a handwritten signature and considered original to the extent allowed by applicable law. Please see the Consumer Consent Disclosure at https://www.jotform.com/consumer-consent-disclosure/
Employer Signature*

Clear
Date of Signature*

MonthDayYear
Date

Document Upload

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Do you have a photo ID such as a Driver's License or State Identification Card to upload? (For Identification Purposes)*

YesNo
Photo ID for Identification Purposes*

Cancelof
Do you have any other items/documents you would like to upload? (EX: Guardianship paperwork, etc.)*

YesNo
Other Uploads*

Cancelof

Generate a Prefilled Packet

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Once you click submit, a copy of the prefilled packet will be sent to the email entered below. Once you receive the email, print and complete the packet and then upload to the Morning Sun Financial Services Secure Upload at https://oriforms.jotform.com/242327109691962.
Email to send generated packet*
example@example.com

Employer Review & Sign

For questions, please contact Morning Sun Financial Services at 1-844-450-5444
Once you click submit, a copy of the completed packet will be sent to the Employer and Morning Sun Financial Services.

Morning Sun Financial Services will reach out if anything further is needed from the Employer.
Please verify that you are human*
Should be Empty:

Morning Sun Financial Services of Louisiana OCDD Employer Enrollment Packet

Morning Sun Financial Services of Louisiana OCDD Employer Enrollment Packet

Louisiana Employer Welcome Letter

Louisiana Employer Roles and Information

Fiscal Employer Agent

Participant

Employer

Support Coordinator

Authorized Representative

Louisiana Employer Responsibilities and Services

Louisiana Employer Guide to Employer and Employee Forms

Louisiana Employer Working Agreement

Signatures

Louisiana Employer Consent for the Release of Information

Signatures

Louisiana Employer Worker's Compensation Guidelines

Louisiana Employer EVV Data Information Form

Participant

Employer

Authorized Representative

Employee

Signatures

Louisiana Employer Employee Wages: "Cost to You"

Louisiana Payroll Schedule

January 2025 through December 2025

Important Notes

Payroll Contact Information

Louisiana Self-Direction Option for OCDD Waivers Employer Service Agreement Form

Signatures

Louisiana Self-Direction Option for OCDD Waivers Employer Attestation Form

Employer Attestations & Initials

Signatures

Louisiana Unemployment (UI) Tax Liability and Adjudication

Signature

Louisiana Department of Revenue Power of Attorney and Declaration of Representative (R-7006)

Signatures

E-Verify Memorandum of Understanding

Signatures

E-Verify Authorization

Federal Application for Employer Identification Number (SS-4)

Third Party Designee

Signatures

Federal Tax Information Authorization (8821)

Signature

Federal Employee/Payer Appointment of Agent (2678)

Signature

Federal Power of Attorney & Declaration of Representative (2848)

Signature

Document Upload

Generate a Prefilled Packet

Employer Review & Sign