SUPPORTING SKILL DEVELOPMENT AND INDEPENDENT LIVING FOR INDIVIDUALS WITH DISABILITIES THROUGH STRUCTURED, PERSON-CENTERED SERVICES

1. GOVERNING AGENCIES

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

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

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight ensuring Habilitation Services meet Medicaid HCBS community-based and person-centered standards

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2. HABILITATION SERVICE OVERVIEW

Habilitation Services are person-centered supports focused on building or maintaining skills essential for daily living, communication, social interaction, and community integration.

Approved providers may deliver:

• Training and assistance with Activities of Daily Living (ADLs) such as bathing, dressing, grooming, and eating
• Support with Instrumental Activities of Daily Living (IADLs) such as cooking, money management, shopping, and household tasks
• Communication skills development
• Social skills training and participation in community activities
• Mobility and orientation assistance
• Self-advocacy and decision-making support
• Pre-employment skill-building and support

All services must align with the participant’s Individualized Service Plan (ISP) and promote independence, dignity, and meaningful community engagement.

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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 through the Hawaii Med-QUEST Division
• Complete DDD Provider Standards Certification (for services under DD/ID Waiver)
• Maintain general liability and professional liability insurance
• Develop comprehensive policies addressing participant rights, skill development strategies, safety, and emergency response

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4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit Provider Enrollment Application for Habilitation Services under Hawaii’s HCBS waivers
• Indicate service types (Community-Based Habilitation, In-Home Habilitation)

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, operational and staffing plans, sample service plans, and insurance certificates
• Include participant intake forms, skill assessment templates, and daily documentation tools

Program Readiness Review:

• DHS and DOH review provider readiness including training protocols, participant safeguards, documentation compliance, and service models

Approval & Medicaid Enrollment:

• Upon approval, configure billing codes for Habilitation Services (community-based and/or in-home supports)

5. REQUIRED DOCUMENTATION

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

HCBS-Compliant Policy & Procedure Manual including:

• Participant intake, assessment, and individualized habilitation planning
• Skill development support strategies and training protocols
• Daily service documentation and outcome tracking
• HIPAA confidentiality, participant rights, and grievance policies
• Staff credentialing, background screening, and competency verification
• Medicaid billing, service authorization tracking, and audit readiness systems

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6. STAFFING REQUIREMENTS

Role: Habilitation Program Manager / Supervisor
Requirements: Bachelor's degree in human services, social work, education, or related field preferred, experience with skill-building and disability supports, background screening clearance

Role: Direct Support Professionals (DSPs) / Habilitation Specialists
Requirements: High school diploma or GED, CPR/First Aid certification, specialized training in habilitation service delivery, background screening clearance

All staff must complete:

• HIPAA confidentiality and participant rights training
• Person-centered planning and community integration training
• Emergency preparedness, abuse prevention, and incident reporting training
• Annual refresher training on habilitation service delivery and Medicaid compliance

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7. MEDICAID WAIVER PROGRAMS

The following Hawaii Medicaid Waivers authorize Habilitation Services:

• Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver

Approved providers may deliver:

• Community-Based Habilitation Services (focused on skill development in integrated settings)
• In-Home Habilitation Services (skill-building supports delivered in a participant’s residence)
• Intensive habilitation supports where behavioral, medical, or specialized skill instruction is necessary

8. TIMELINE TO LAUNCH

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

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

Phase: Staff Hiring, Credentialing, and Habilitation Program Setup
Timeline: 30–45 days

Phase: Medicaid Enrollment and Billing System Setup
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/

10. SCOPE OF WORK

• Business registration and EIN/NPI setup
• Medicaid and DDD provider enrollment support
• Development of Habilitation Services Policy & Procedure Manual
• Staff credentialing templates and participant skill assessment forms
• Medicaid billing system setup and claims management
• Website, domain, and email setup
• Participant intake, habilitation planning, and daily service documentation templates
• Emergency preparedness and incident reporting systems
• Quality assurance programs for skill development outcome tracking
• Community networking and interdisciplinary collaboration strategies

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII HABILITATION SERVICES PROVIDER

We support community organizations, disability service agencies, and human service providers in launching Medicaid-compliant Habilitation Services under Hawaii’s HCBS waiver programs.

To get started, click the link to request portal access.