1. GOVERNING AGENCIES

Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Chore Services

Agency: Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Role: Administers HCBS waiver Chore Services for individuals with intellectual and developmental disabilities (IDD)

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight ensuring Chore Services meet Medicaid HCBS requirements and health/safety standards

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2. CHORE SERVICE OVERVIEW

Chore Services involve heavy-duty household cleaning and minor home maintenance tasks necessary to maintain a clean, sanitary, and safe environment for participants who are unable to perform these tasks independently.

Approved providers may deliver:

• Heavy-duty housecleaning (deep cleaning, carpet shampooing, window washing)
• Yard work necessary to eliminate safety hazards (like lawn mowing, debris removal)
• Moving heavy furniture to ensure safe mobility
• Minor home repairs essential for health and safety (like replacing light bulbs, securing loose flooring)
• Trash removal and pest control coordination (basic services only, not extermination)
• Emergency snow or debris removal to maintain access to the home (where applicable)

Chore Services must be specified in the participant’s Individualized Service Plan (ISP) and cannot duplicate homemaker or routine housekeeping services already authorized.

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3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
• Obtain EIN from the IRS and NPI (Type 2)
• Enroll as a Medicaid provider with Hawaii’s Med-QUEST Division
• Maintain general liability and worker’s compensation insurance
• Develop safety protocols for staff performing physical tasks and home maintenance

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4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit Provider Enrollment Application for Chore Services through Hawaii’s Med-QUEST Division
• Define service capacity, safety protocols, and response time for urgent services

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, proof of insurance, staffing plans, and service policies
• Provide sample service plans, scheduling protocols, and participant intake forms

Program Readiness Review:

• DHS and DOH review provider readiness including worker safety procedures, service tracking documentation, and participant protection measures

Approval & Medicaid Enrollment:

• Upon approval, configure billing codes for Chore Services (typically unit-based or task-based rates)

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Hawaii DCCA)
• IRS EIN confirmation
• NPI confirmation
• Proof of general liability and worker’s compensation insurance

HCBS-Compliant Policy & Procedure Manual including:

• Participant intake, needs assessment, and service planning procedures
• Chore task performance protocols and worker safety standards
• Emergency backup service plans
• HIPAA confidentiality, participant rights, and grievance resolution procedures
• Staff credentialing, background checks, and physical task training documentation
• Medicaid billing, service tracking, and audit readiness documentation

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6. STAFFING REQUIREMENTS

Role: Chore Services Program Manager / Supervisor
Requirements: Experience managing personal assistance, home maintenance, or janitorial services preferred; background screening clearance

Role: Chore Service Workers / Maintenance Aides
Requirements: Ability to perform physically demanding tasks; training in safety protocols; background screening clearance

All staff must complete:

• HIPAA confidentiality and participant rights training
• Worker safety, lifting, and emergency response training
• Abuse prevention, incident reporting, and household hazard identification training
• Annual refreshers on health and safety compliance standards

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7. MEDICAID WAIVER PROGRAMS

The following Hawaii Medicaid Waivers authorize Chore Services:

• Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver
• Community Care Services (CCS) Program (where maintaining a safe environment is necessary for community living)

Approved providers may deliver:

• Heavy housecleaning to ensure health and safety
• Yard maintenance necessary for safe home access
• Basic home repairs tied to participant safety needs

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8. TIMELINE TO LAUNCH

Phase: Business Formation and Initial Credentialing Setup
Timeline: 1–2 weeks

Phase: Med-QUEST Provider Application and Readiness Review
Timeline: 60–90 days

Phase: Staff Hiring, Credentialing, and Chore Service System Setup
Timeline: 30–45 days

Phase: Medicaid Enrollment and Billing System Configuration
Timeline: 45–60 days

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9. CONTACT INFORMATION

Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/

Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Website: https://health.hawaii.gov/ddd/

Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/

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