Starting an HCBS Agency in Rhode Island

What You Need to Know About Starting a Specific HCBS Agency in Rhode Island


These videos give an overview of the various Home and Community-Based Services (HCBS) available in Rhode Island for providers who want to learn how to start or operate an HCBS agency in the state. Each video explains the purpose of the service, provider requirements, licensing process, and how the program functions. Use these videos to better understand the responsibilities, standards, and steps involved in becoming or working with approved HCBS providers in Rhode Island. Explore each section to find the service that best matches your goals or area of interest.

Respite Care 

Respite Care Services in Rhode Island are short-term, Medicaid-funded supports designed to provide relief to primary caregivers of individuals with disabilities, chronic illnesses, or age-related conditions. These services can be delivered in-home or in community-based settings to ensure the individual’s health and safety while the caregiver takes a break. Respite is authorized under Rhode Island’s Medicaid 1115 Waiver and various Long-Term Services and Supports (LTSS) programs, and can be arranged through managed care entities or self-direction.

 
 

Residential Care

Residential Care Services in Rhode Island provide long-term, round-the-clock support to individuals who require supervised living arrangements due to developmental disabilities, behavioral health needs, or complex medical conditions. These services are primarily funded under the state’s Medicaid 1115 Global Waiver and managed by the Department of Behavioral Healthcare, Developmental Disabilities & Hospitals (BHDDH) and the Executive Office of Health and Human Services (EOHHS). Residential options range from group homes to shared living environments and staffed apartments.

 
 

Supported Employment

Supported Employment Services in Rhode Island provide individualized, ongoing supports to help people with intellectual and developmental disabilities (IDD) prepare for, obtain, and maintain paid employment in integrated community settings. These Medicaid-funded services are authorized under Rhode Island’s Home and Community-Based Services (HCBS) 1115 Waiver and are managed by the Department of Behavioral Healthcare, Developmental Disabilities & Hospitals (BHDDH) in partnership with the Executive Office of Health and Human Services (EOHHS).

 
 

Personal Care

Personal Care Services (PCS) in Rhode Island are non-medical supports funded by Medicaid to assist individuals who need help with activities of daily living (ADLs) such as bathing, dressing, mobility, and meal preparation. These services enable individuals to remain safely in their homes and avoid institutional care. PCS are offered through Rhode Island Medicaid’s Long-Term Services and Supports (LTSS) system and may be authorized under State Plan benefits or the Home and Community-Based Services (HCBS) Waiver programs.

 
 

Adaptive Equipment

Adaptive Equipment Services in Rhode Island are Medicaid-funded supports that help individuals obtain, maintain, and use devices that promote greater independence at home and in the community. These services are primarily funded through the state’s Medicaid 1115 Global Waiver and Developmental Disabilities (DD) Waivers. Adaptive equipment may include mobility aids, communication devices, self-care tools, and home accessibility supports.

 
 

Skilled Nursing

Skilled Nursing Services in Rhode Island are Medicaid-reimbursed healthcare supports provided by licensed nurses to individuals with medical conditions requiring clinical oversight. These services are available under the Rhode Island Medicaid State Plan, 1115 Global Waiver, and various Home and Community-Based Services (HCBS) programs, including services for medically fragile children (Katie Beckett/TEFRA) and adults with disabilities.

 
 

Day Habilitation

Day Habilitation Services in Rhode Island are Medicaid-funded supports designed to promote the acquisition, retention, and improvement of self-help, socialization, and adaptive skills in individuals with intellectual and developmental disabilities (IDD). These services are delivered in non-residential, structured settings and aim to increase independence, communication, and participation in community life. Day habilitation is funded under Rhode Island’s Home and Community-Based Services (HCBS) 1115 Waiver and authorized through the Department of Behavioral Healthcare, Developmental Disabilities & Hospitals (BHDDH).

 
 

Adult Health

Adult Health Services in Rhode Island encompass a broad array of Medicaid-funded supports for adults who require ongoing assistance with personal care, medical monitoring, and wellness activities. These services are primarily delivered in home-based or community settings and are authorized through the Rhode Island Medicaid State Plan, 1115 Global Waiver, and various Home and Community-Based Services (HCBS) Waivers. Adult health supports are designed to prevent institutionalization, promote independence, and maintain overall health and well-being.

 
 

Assistive Technology

Assistive Technology (AT) Services in Rhode Island are Medicaid-funded supports designed to increase, maintain, or improve the functional capabilities of individuals with disabilities or chronic conditions. These services may include the evaluation, purchase, customization, and training for devices that support mobility, communication, daily living, or safety. AT services are available through Rhode Island’s Medicaid 1115 Waiver, Developmental Disability (DD) Waivers, and Long-Term Services and Supports (LTSS) programs.

 
 

Behavioral Health

Behavioral Health Services in Rhode Island address the emotional, psychological, and psychiatric needs of individuals across the lifespan. These services are funded through Rhode Island Medicaid (including the 1115 Global Waiver), State Plan, and various federal initiatives. Providers support individuals with mental illness, substance use disorders, or behavioral challenges through therapeutic interventions, counseling, crisis stabilization, and recovery supports in home and community settings.

 
 

Home Modification

Home Modification Services in Rhode Island provide physical adaptations to a person’s primary residence to ensure accessibility, safety, and independence. These services are authorized through Medicaid Home and Community-Based Services (HCBS) under the 1115 Global Waiver, BHDDH IDD Waivers, and certain pediatric and aging-related supports. Modifications are typically non-routine and must be related to the individual’s disability or functional limitations.

 
 

Nursing Facility Transition

Nursing Facility Transition (NFT) Services in Rhode Island assist individuals in moving from nursing homes or institutional settings back into the community. These Medicaid-funded services are designed to support older adults and individuals with disabilities who are eligible for Home and Community-Based Services (HCBS) but require planning, coordination, and supports to successfully live in a home or residential setting. NFT services are available under Rhode Island’s Medicaid 1115 Waiver and managed through the Executive Office of Health and Human Services (EOHHS), Long-Term Services and Supports (LTSS), and Medicaid Managed Care Organizations.

 
 

Community Integration

Community Integration Services in Rhode Island empower individuals with intellectual/developmental disabilities (IDD), behavioral health needs, or chronic conditions to participate fully in everyday community life. These Medicaid-funded supports are authorized under the 1115 Global Waiver, BHDDH IDD Waivers, and other Home and Community-Based Services (HCBS) programs. The goal is to reduce isolation and promote independence through community engagement and skill-building.

 
 

TEFRA Program

The TEFRA-like Program in Rhode Island (also known as Katie Beckett eligibility) allows children with significant disabilities or complex medical needs to qualify for Medicaid based solely on the child’s income and assets—not the parents’. This program enables families to access necessary medical and support services at home, rather than requiring institutional placement for Medicaid eligibility. Administered through the Executive Office of Health and Human Services (EOHHS), TEFRA aligns with federal provisions outlined in Section 134 of the Tax Equity and Fiscal Responsibility Act of 1982.

 
 

Case Management

Case Management Services in Rhode Island are Medicaid-funded supports that help individuals navigate health, behavioral, and social service systems. These services are crucial to ensuring that people with disabilities, chronic illnesses, or aging-related needs receive person-centered care aligned with their goals. Case management is authorized under the 1115 Global Waiver, BHDDH DD Waivers, Katie Beckett/TEFRA, and Medicaid State Plan services.

 
 

Non-Medical Transportation

Non-Medical Transportation (NMT) Services in Rhode Island are Medicaid-funded supports designed to help individuals with disabilities, older adults, and waiver participants access essential services, day programs, and community resources. Unlike Non-Emergency Medical Transportation (NEMT), NMT is aimed at improving community integration, independence, and participation in activities outside of health care. These services are reimbursable under Rhode Island’s 1115 Medicaid Waiver, Long-Term Services and Supports (LTSS), and Developmental Disabilities (DD) Waivers.

 
 

Home Health

Home Health Care Services in Rhode Island are Medicaid-covered medical and supportive services provided in an individual’s home by licensed professionals. These services are essential for individuals recovering from illness, managing chronic conditions, or requiring long-term skilled care. Home health care is administered under Rhode Island Medicaid, the State Plan, and waiver programs, with oversight from the Rhode Island Department of Health (RIDOH) and the Executive Office of Health and Human Services (EOHHS).

 
 

Meal & Nutrition

Meal & Nutrition Services in Rhode Island help individuals maintain their health through access to balanced, medically appropriate meals and nutritional education. These supports are funded through Rhode Island Medicaid, including the 1115 Global Waiver, State Plan, and various Home and Community-Based Services (HCBS) Waiver programs. Services are designed to support individuals at risk of malnutrition, poor health outcomes, or who are unable to prepare meals independently.

 
 

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.