Would be grateful for an outline of basic steps in establishing a MEWA (forms, DOL, IRS and state requirements). Any publications that would be of help?

The first thing is to contact your State Dept of Insurance for their rules. Each state has different rules. Also be aware that if you enroll residents of other states the rules of the other state also applies.

There are also separate rules for whatever it is that you are providing through the MEWA.

If you can meet the state requirements then the DOL is the next step.

There are no IRS rules for MEWAs, however, there are rules that apply to whatever is being provided through the MEWA.

Since MEWAs are either prohibited by most states or are severely limited and regulated, Why a MEWA?????

It is a MEWA by default as the situation involves a company which provides temporary workers who are the common law employees of the service recipients.