1. SERVICE DEFINITION AND SCOPE

Individual Supported Employment (ISE) in Arizona encompasses job development, placement, and intensive on-the-job coaching. The service is intended to be time-limited, transitioning to long-term support once the member has stabilized in their role, ensuring they receive the same benefits and pay as employees without disabilities.

The scope includes activities such as job exploration, assistance with applications and interviews, workplace accommodation identification, and ongoing support to ensure job retention. It is distinct from Group Supported Employment (GSE), which involves supervised work teams.

• Service Name: Individual Supported Employment (ISE)
• Target Outcome: Competitive integrated employment at or above minimum wage
• Core Activity: Job coaching and on-site training at a community job site
• Exclusion: Services provided in segregated settings or sheltered workshops
• Integration Standard: Members must work with people without disabilities in the same environment
• Support Type: One-on-one assistance tailored to the member's specific vocational goals

• Primary Agency: Arizona Department of Economic Security (DES)
• Program Division: Division of Developmental Disabilities (DDD)
• Medicaid Authority: Arizona Health Care Cost Containment System (AHCCCS)
• Certification Body: Office of Licensing, Certification and Regulation (OLCR)
• Vocational Partner: Rehabilitation Services Administration (RSA) Vocational Rehabilitation
• Federal Framework: Workforce Innovation and Opportunity Act (WIOA)

3. LICENSURE AND CERTIFICATION REQUIREMENTS 

Arizona does not issue a specific 'Integrated Employment License' through the Department of Health Services. Instead, providers must obtain a Home and Community Based Services (HCBS) Certificate issued by the DES Office of Licensing, Certification and Regulation (OLCR).

This certification is mandatory for all Qualified Vendors and is governed by the Arizona Administrative Code (A.A.C.) R6-6-1501 et seq. The certificate confirms that the agency meets state standards for safety, staff qualifications, and service delivery protocols.

• Required Credential: HCBS Certificate issued by OLCR
• Regulatory Citation: Arizona Administrative Code (A.A.C.) R6-6-1501
• Application Form: LCR-1083A (Initial HCBS Certification)
• Inspection Requirement: Life Safety Inspection required every two years for physical sites
• Prerequisite: An approved Qualified Vendor Agreement (QVA) with DDD
• System Portal: Focus (the DES/DDD electronic application system)

4. MEDICAID PROVIDER ENROLLMENT 

Once HCBS certification is obtained, providers must enroll with AHCCCS to receive a Medicaid ID. This process is completed through the AHCCCS Provider Enrollment Portal (APEP), which is the state's electronic system for all provider types.

Employment providers are typically classified as 'Atypical Providers' in Arizona, meaning they do not require a professional clinical license (like a physician) but must still meet all state-specific certification requirements. Providers must select the correct provider type, often Habilitation (Type 39), to bill for ISE services.

• Enrollment Portal: AHCCCS Provider Enrollment Portal (APEP)
• Provider Classification: Atypical Provider
• Common Provider Type: Type 39 (Habilitation) or Type 25 (Group Home)
• Required Identifier: National Provider Identifier (NPI) if applicable, though atypical providers may be exempt
• Documentation: Must upload the OLCR-issued HCBS Certificate to APEP
• System Access: AHCCCS Online Provider Website for claims and eligibility

5. STAFFING, TRAINING AND BACKGROUND CHECKS 

Staff providing ISE services must meet rigorous background and training standards to ensure member safety and service quality. The most critical requirement is the Level One Fingerprint Clearance Card issued by the Arizona Department of Public Safety (DPS).

Training must include state-mandated courses such as Article 9 (Managing Inappropriate Behaviors), which covers the legal rights of members and prohibited intervention techniques. Providers are responsible for maintaining training logs for all direct support professionals (DSPs).

• Background Check: Level One Fingerprint Clearance Card (DPS issued)
• Mandatory Training: Article 9 (Rights and Regulations)
• Safety Training: CPR and First Aid certification
• Health Standard: Documentation of a negative Tuberculosis (TB) test
• Age Requirement: Staff must be at least 18 years of age
• Driver Requirements: Valid Arizona driver's license and insurance if transporting members

6. DOCUMENTATION, POLICIES AND RECORDS 

Providers must maintain comprehensive records for each member, documenting every service encounter and progress toward employment goals. These records are subject to audit by DDD and AHCCCS to ensure compliance with the HCBS Settings Rule, which mandates that services be provided in the most integrated setting possible.

Agencies are required to develop internal policies regarding member rights, incident reporting, and grievance procedures. All service documentation must be stored securely and be accessible for state review.

• Core Document: Qualified Vendor Agreement (QVA)
• Service Record: Progress notes detailing job coaching activities
• Compliance Standard: HCBS Settings Rule (ensuring community integration)
• Reporting Requirement: Incident Reports (IRs) submitted via the DDD Focus system
• Financial Record: Proof of prevailing wage payments to the member
• Policy Manual: Must include Article 9 compliance and Emergency Action Plans

7. BILLING, RATES AND CLAIMS 

Billing for ISE services is conducted through the DDD Focus system or AHCCCS Online, depending on the specific contract. Rates are established by the DES/DDD Rate Book, which sets standardized hourly or unit-based reimbursement for employment services.

Providers must ensure that billing codes match the authorized services in the member's Individualized Service Plan (ISP). Claims must be submitted within the state's timely filing limits, typically 6 months to one year from the date of service.

• Rate Source: DDD Published Rate Book
• Billing System: DDD Focus / CAS (Contract Administration System)
• Service Code: Specific ISE billing codes as defined in the DDD Service Specifications
• Payment Basis: Fee-for-service based on authorized units
• Claim Portal: AHCCCS Online for managed care organization (MCO) coordination
• Audit Risk: Overbilling or billing for non-integrated settings

8. APPROVAL SEQUENCE AND TIMELINE 

The approval process begins with the Request for Qualified Vendor Agreement (RFQVA) through DES/DDD. This is a continuous open enrollment process, but it can take several months to complete the initial contract review.

After the QVA is approved, the provider applies for HCBS Certification through OLCR. Only after receiving the HCBS Certificate can the provider complete the APEP enrollment with AHCCCS. The entire sequence typically takes 4 to 9 months.

• Step 1: Submit RFQVA application via the DES website (2-4 months)
• Step 2: Obtain HCBS Certification from OLCR (30-60 days)
• Step 3: Enroll in APEP for AHCCCS Medicaid ID (30-90 days)
• Step 4: Register for the DDD Focus portal for billing and reporting
• Step 5: Receive service authorizations for specific members

Renewal HCBS Certification must be renewed annually or biennially

9. COMMON DENIALS AND SURVEY FINDINGS 

The most common reason for application denial in Arizona is incomplete documentation in the APEP portal or failure to provide a valid HCBS Certificate. During site surveys, OLCR often finds deficiencies related to expired Fingerprint Clearance Cards or missing Article 9 training records.

Providers also face denials if their service delivery model does not meet the 'Integrated' requirement of the HCBS Settings Rule, such as providing coaching in a facility-based environment rather than a community job site.

• APEP Denial: Missing or expired HCBS Certificate upload
• Survey Finding: Expired Level One Fingerprint Clearance Cards
• Compliance Issue: Failure to document prevailing wage for members
• Training Gap: Missing Article 9 or CPR/First Aid certifications in staff files
• Setting Violation: Providing ISE services in a segregated or 'sheltered' environment
• Administrative Error: Inconsistent billing codes compared to the ISP

10. KEY CONTACTS AND RESOURCES 

Providers should maintain regular contact with the DDD Provider Relations unit and the AHCCCS Provider Enrollment team. These agencies provide technical assistance and updates on rate changes or regulatory shifts.

The DES website serves as the central hub for all forms, rate books, and the Focus portal login. For vocational rehabilitation specific questions, the RSA is the primary point of contact.

DDD Provider Relations

• 602-542-0419

AHCCCS Provider Enrollment (APEP) Help Desk

• 602-417-7670

DES/OLCR Certification Unit

• 602-771-4861

RSA Vocational Rehabilitation

• 1-800-563-1221

Website

• des.az.gov/services/disabilities/developmental-disabilities

Portal

• AHCCCS Online (azahcccs.gov/PlansProviders/APEP)