Business support
Employment service providers
MFIP employment service provider information
Find information and supports for contracted employment service providers who work with eligible county residents to build pathways to sustainable careers and economic self-sufficiency.
Staff training materials
Hennepin County training resources
- MFIP ES trainings for new workers - April 2024 (PDF, 1MB)
- MFIP employment counselor 30-day training checklist (DOC, 1MB)
Domestic violence
Forms
For DHS forms, go to the Department of Human Service (DHS) eDocs website and search the form by entering the form number.
Overview requirements
- MFIP overview topic checklist – January 2023 (PDF, 1MB)
- Notice of requirement to attend MFIP Overview (DHS-2929) eDocs
- Employment services responsibilities, rights and content (DHS-3172) eDocs
- Education and training in MFIP (DHS-3366) eDocs
- Do you have a disability? ADA (DHS-4133) eDocs
- Domestic violence information (DHS-3477 eDocs
- Do you need help paying for child care? (DHS-3551) eDocs
Assessment
- Request for medical exam and exchange of information general, ECF D431
- Request for medical exam and exchange of information – needed in the home severe emotional disturbance (SED)/serious and persistent mental illness (SPMI)
- Family violence referral form
- Brief screening tool for special learning needs (DHS-3504) eDocs
- Participant medical referral and medical care provider information letter (DHS-3996) eDocs
- Job counselor observation checklist DWP/MFIP observation checklist (DHS-3483)
- Special learning needs scoring form MFIP (DHS-3504A) eDocs
- Self-screen mental health/chemical dependency (DHS-3482) eDocs
- Self-screen scoring form (DHS-3482A) eDocs
- MFIP employment services authorization for release of information (DHS-4093) eDocs
Case management
- Frequently used eligibility documents
- MFIP transition services information (PDF, 1MB)
- Child under 12-months exemption request form
- MFIP opting in/out form or request stand alone SNAP
- Fraud prevention investigation referral (DOC, 1MB)
- Fraud referral form (DOCX, 1MB)
- Incident report (PDF, 1MB)
- State agency appeals summary (DHS-0035) eDocs
- DHS status update form (DHS-3165) eDocs
Education
- Adult education attendance (ABE/GED/ESL) (PDF, 1MB)
- Occupational research packet (DOC, 1MB)
- 18-19-year-old education/employment choice sheet (DOC, 1MB)
- MFIP education activity log (DHS-4209N) eDocs
- Request for verification of school attendance/progress (DHS-2883) eDocs
- Education and training in MFIP (DHS-3366) eDocs
- Graduate to independence – MFIP teen parent informational brochure (DHS-2887) eDocs
- Notice of requirement to attend school for parents under age 20 (DHS-2961) eDocs
- MFIP for minor caregivers (DHS-3238) eDocs
- School verification form
ESP program monitoring
- Full case file review template (DOCX, 1MB)
- ESP case file review template (DOCX, 1MB)
- Staff detail and agency policies (DOCX, 1MB)
Interpreters and limited English proficiency
- Limited English proficiency bill of rights (DOC, 1MB)
- LEP Notice: language block (DHS-5079) eDocs
MFIP 48-60 month transition period
Sanctions
Self-employment
- DWP/MFIP self-employment business plan (DHS-6200) eDocs
- Self-employment report form (DHS-3336) eDocs
- Self-employment business plan decision notice – April 21 (DOCX, 1MB)
- Self-employment local policy update – April 21 (PDF, 1MB)
- Self-employment progress review – April 21 (DOCX, 1MB)
- Small business resources (PDF, 1MB)
Unpaid work experience
- Unpaid work - employer verification form (DOCX, 1MB)
- Claim form (DHS-998) eDocs
- First report of injury (DHS-3995) eDocs
- Participant injury status report (DHS-3997) eDocs
- (IPP) Participant information and authorization to release information (DHS-3994) eDocs
Child care forms and procedures
Minnesota Family Investment Program and Diversionary Work Program child care forms are listed below.
County
- ESP checklist for child care application
- Child care plan online (fillable form)
- HSPHD notice of privacy practices form
- Information disclosure, non-epic HSPHD clients
- Language block (DOC, 1MB)
- Employment verification form (fillable form)
- MFIP exemption – caring for a child under the age of 12 months
- Shelter verification form (fillable form)
State
For DHS forms, go to the Department of Human Service (DHS) eDocs website and search the form by entering the form number.
- Authorization for release of information about residence and shelter expenses (DHS-2952)
- Change report form (DHS-4794)
- Child care addendum (DHS-5223D)
- Child care assistance re-determination (DHS-5274)
- Child care assistance bi-weekly sliding fee schedule (DHS-6413)
- Child care center employer responsibilities (DHS-3914A)
- Child care center employee rights and responsibilities (DHS-3941B)
- Client statement of good cause (DHS-2338)
- Do you need help paying for child care? (DHS-3551)
- Minnesota Child Care Assistance Program application (DHS-3550)
- Parent acknowledgement when choosing a legal unlicensed provider (DHS-5367)
- Parent request for in-home child care (DHS-6475)
- Referral to support and collections (DHS-3163B)
- Reporting responsibilities for CCAP families (DHS-6953)
Resources and reference
- MEC2 screens – quick reference guide for employment service providers (ESPs) (DOCX, 1MB)
- Think Small child care resources
- School hours (DOCX, 1MB)
- DHS child care assistance rules, regulations and manual
- DHS child care co-payment schedules and median income guidelines (DHS 6413c) eDocs
Additional information
System access
Accessing computer systems for MFIP providers
- ESP system access guide (PDF, 1MB)
- ESP system access request form – March 2021 (PDF, 1MB)
- Online training: DHS data privacy
- ECF access through Citrix (PDF, 1MB)
- Online training: ECF next for ESPs – 2023
- ECF next terminology (DOCX, 1MB)
- Status updates to ECF (DOCX, 1MB)
Password resets
The Hennepin County Enterprise service desk handles all password reset requests for Citrix, ECF/SMI, MEC2, and MAXIS. Users can reset their own Workforce One password from the site’s homepage.
Contact Hennepin County IT Enterprise Service Desk by phone at 612-348-6662 and be prepared to provide the following information:
- Your Hennepin County logon ID (usually the first two letters of your first and last name plus a three-digit number, for example AABB001)
- Your contact information (name, work phone, work email)
- That you use Hennepin County systems as an external service provider
- The name of the ESP Agency where you work
- Name of system for which you need the password reset (Citrix, ECF/SMI, MEC2, and/or MAXIS)