1. GOVERNING AGENCIES

Agency: Alabama Department of Mental Health (ADMH)
Role: Regulates provider qualifications, service delivery standards, and monitors compliance under HCBS waivers

Agency: Alabama Medicaid Agency
Role: Oversees provider enrollment, billing procedures, and Medicaid reimbursement for Homemaker Services

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Ensures federal compliance and alignment with HCBS waiver requirements for in-home support services

2. HOMEMAKER SERVICE OVERVIEW

Homemaker Services assist individuals with IDD in performing household tasks they cannot manage independently. These services are person-centered and included in the individual’s service plan. Approved providers may deliver:

• Cleaning of living areas, including kitchens, bathrooms, and bedrooms
• Laundry and linen changes
• Dishwashing and kitchen sanitization
• Meal preparation and planning (excluding feeding assistance)
• Trash removal and light household organization
• Grocery shopping and household supply errands (as part of the service plan)

Homemaker Services are strictly non-medical and do not include personal care, supervision, or hands-on physical assistance with ADLs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Alabama Secretary of State
• Obtain EIN from the IRS and NPI (Type 2)
• Maintain an office location or mobile service capacity in Alabama
• Hire trained staff capable of providing homemaker tasks with attention to safety and sanitation
• Implement policies for documentation, scheduling, and quality assurance
• Establish systems for staff supervision, time tracking, and service verification

4. ADMH PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Request the Homemaker Services Provider Application Packet from ADMH
• Submit a service model outlining task schedules, quality control, staff roles, and emergency response protocols
• Include documentation templates for homemaker logs, consent forms, and task checklists

Background & Credentialing:

• Background checks for all direct support staff
• Verification of staff eligibility and training in safe housekeeping practices
• Drug screening and documentation of non-medical service qualifications

Program Readiness Review:

• Review of cleaning supply usage, safety protocols, and client interaction standards
• Evaluation of internal documentation systems and time log accuracy
• Policies for emergency procedures, consumer feedback, and complaint resolution

Approval & Medicaid Enrollment:

• Once approved by ADMH, complete enrollment with Alabama Medicaid as a Homemaker Services provider
• Add applicable billing codes and service units to Medicaid provider profile

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or LLC Certificate
• IRS EIN Letter
• NPI confirmation
• Office lease or proof of mobile/home-based service capability

ADMH-Compliant Policy & Procedure Manual including:

• Task documentation procedures and daily service logs
• Staff qualifications and scheduling practices
• Confidentiality and consumer rights policies
• Emergency response, fraud prevention, and infection control guidelines
• Complaint resolution, grievance procedures, and safety standards
• Staff job descriptions and training records
• Signed consumer service agreements and consent forms

6. STAFFING REQUIREMENTS

Role: Homemaker Services Supervisor
Requirements: Background in home support services or disability services; knowledge of household safety and sanitation

Role: Homemaker Aide
Requirements: High school diploma or GED preferred; experience with cleaning or housekeeping services; must complete ADMH-required training

All staff must complete:

• ADMH orientation and HCBS Waiver training
• Annual safety, sanitation, and ethics training
• Confidentiality, documentation, and consumer interaction modules

7. MEDICAID WAIVER SERVICES

The following Alabama Medicaid Waivers authorize Homemaker Services:

• ID Waiver (Intellectual Disabilities Waiver)
• LAH Waiver (Living at Home Waiver)
• State of Alabama Community Waiver Program

Approved providers may deliver:

• Routine household chores that support safe and independent living
• Documentation of services provided and maintenance of clean, safe environments
• Non-medical support to enhance health and well-being within the home

8. TIMELINE TO LAUNCH

Phase: Business Formation
Timeline: 0–1 week

Phase: ADMH Application Review
Timeline: 60–90 days

Phase: Program and Staffing Setup
Timeline: 30–60 days

Phase: Medicaid Enrollment
Timeline: 60–90 days

9. CONTACT INFORMATION

Alabama Department of Mental Health (ADMH) – Division of Developmental Disabilities
Email: ddprovider@mh.alabama.gov
Phone: (334) 242-3702
Website: https://mh.alabama.gov

Alabama Medicaid Agency – Waiver Services
Website: https://medicaid.alabama.gov

10. SCOPE OF WORK

• Business formation (LLC, EIN, NPI)
• ADMH provider application preparation
• Homemaker Services Policy & Procedure Manual development
• Staff onboarding and task documentation templates
• Medicaid enrollment and billing setup
• Daily task logs, consent forms, and safety protocols
• WEBSITE, DOMAIN, AND EMAIL SETUP
• CLIENT ADMISSION PACKET
• MARKETING AND ADVERTISING MATERIALS
• OPERATIONAL TRAINING
• COMPLIANCE AND REGULATORY SUPPORT
• QUALITY ASSURANCE PROGRAMS
• MARKETING AND CLIENT ACQUISITION STRATEGIES