1. Program Definition and Services

Facility-Based Day Support Services in Tennessee offer structured, habilitative, and skill-building activities within a licensed, non-residential facility setting. The program targets adults with intellectual and developmental disabilities (I/DD) who have extensive support needs and are transitioning toward or not yet prepared for fully integrated community employment. Services include:

• Habilitative Skill Development: Center-based instruction aimed at maximizing personal independence, incorporating basic functional communication, daily living skills, self-advocacy, cognitive problem-solving, and adaptive task instruction
• Pre-Vocational & Community Readiness: Structured training in task focus, schedule management, sorting, motor-skill coordination, simulated community budgeting, public safety navigation, and positive peer social interactions

2. Regulations

The program is governed by the following regulations:

• Rules of the Tennessee Department of Intellectual and Developmental Disabilities (DIDD), Chapter 0465-02-07 (Minimum Program Requirements for Intellectual Disabilities Adult Habilitation Day Facilities/Services)
• Rules of the Tennessee Department of Intellectual and Developmental Disabilities (DIDD), Chapter 0465-02-08 (Minimum Program Requirements for Developmental Disabilities Adult Habilitation Day Facilities/Services)
• TennCare Rules and Regulations, Chapter 1200-13-01 (Medicaid Long-Term Services and Supports and Managed Care Program Parameters)
• Federal Home and Community-Based Services (HCBS) Final Settings Rule (42 CFR 441.301)

3. Licensing or Certification

Providers must secure a formal Adult Habilitation Day Facility License issued by the Tennessee Department of Intellectual and Developmental Disabilities (DIDD) Office of Licensure. Additionally, providers must maintain active Medicaid network enrollment and credentialing through the individual TennCare Managed Care Organizations (MCOs).

4. Responsible State Agency

The Tennessee Department of Intellectual and Developmental Disabilities (DIDD) acts as the primary licensing and code authority, enforcing facility physical site safety standards. The Bureau of TennCare (the state Medicaid agency) retains final administrative authority, regulating overall waiver funds and network enrollment.

5. Application Process

The application process is initiated by filing a formal application packet with the DIDD Office of Licensure. Following an extensive administrative policy manual review, a local DIDD Program Specialist conducts a physical site measurement and architectural walkthrough to determine licensed center capacity and safety compliance before assigning final Medicaid billing numbers.

6. Required Documentation

While specific documentation requirements vary based on the target waiver, providers typically need to submit:

• Legal business formation records, an active Federal EIN, and a registered Type 2 National Provider Identifier (NPI)
• A certificate of zoning clearance and local code compliance from the municipality, along with a valid Certificate of Occupancy
• Facility-Based Day Services Policy & Procedure Manual (including structural fire drill templates, day program curriculum outlines, staff-to-participant ratio charts, and Positive Behavior Support strategies)
• State and local fire inspection approvals, alongside environmental public health sanitation certificates

7. Timeline for Approval

The exact timeline for approval fluctuates based on structural facility modifications, inspection booking delays, and state agency review queues. Providers should contact the DIDD Regional Office of Licensure for current timelines, the full path across physical licensing and MCO network contracting typically spans 3 to 5 months.

8. Pre-Application Process

Prospective providers must complete specific foundation tasks before applying. They must incorporate their business with the Tennessee Secretary of State, secure a commercial physical location zoned properly for day-use care, and obtain a Type 2 organizational NPI matching the day habilitation provider category.

9. Pre-Application Training

The state hosts mandatory administrative and compliance training sessions online. Access credentials to attend the mandatory web-based DIDD Provider Orientation, Title VI Civil Rights instruction, and localized Electronic Visit Verification (EVV)/documentation trainings are provided after a regional specialist validates the agency’s preliminary application layout.

10. Additional Notes

• Facilities must provide a minimum square-footage footprint of indoor activity space per participant to satisfy DIDD structural requirements, completely distinct from office spaces, restrooms, and kitchen zones
• Program activities and participant attendance records must align strictly with the goals, schedules, and authorizations embedded in the individual's authorized Person-Centered Support Plan (PCSP)
• All on-site Direct Support Professionals (DSPs), vehicle drivers, and program coordinators must clear mandatory background clearances, vulnerability abuse registries, and state fingerprint screenings before facility assignment
• Providers must maintain comprehensive records of daily face-to-face service hours, curriculum completion benchmarks, and shift progress logs to remain compliant with state post-payment Medicaid audits

Why Choose Waiver Consulting Group?

Starting or expanding your Medicaid waiver-funded agency can feel overwhelming, but it doesn't have to be. At Waiver Consulting Group, we simplify the process by guiding you through licensing, compliance, provider enrollment, policies & procedures, and regulatory approvals in any state.

With proven expertise, a structured process, and ongoing support, we take the guesswork out of launching your healthcare business. Whether you're a first-time entrepreneur or an established provider looking to expand, our team ensures you stay compliant, competitive, and fully operational.

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