1. Program Definition and Services

Non-Residential Homebound Services in Tennessee provide individualized care, functional skill-building, and therapeutic daytime engagement for children and adults with significant intellectual, developmental, or complex medical disabilities who are unable to safely or consistently participate in standard community-based or congregate day programs. The program aims to maintain these individuals within their home environments, preventing the regression of critical daily skills and averting long-term institutional placement. Services include:

• In-Home Functional Habilitation: Targeted, face-to-face instruction in everyday independent living skills, including personal hygiene, meal preparation, household management, adaptive communication, routine planning, and safety navigation
• Cognitive, Wellness, and Virtual Socialization: Structured delivery of goal-based mental stimulation exercises, adapted physical stretching, and controlled virtual or remote peer engagement designed to eliminate isolation while directly executing objectives from the individual’s authorized Person-Centered Support Plan (PCSP)

2. Regulations

The program is governed by the following regulations:

• Rules of the Tennessee Department of Intellectual and Developmental Disabilities (DIDD), Chapter 0465-02-03 (Application of Rules for Distinct Service Categories)
• TennCare Rules and Regulations, Chapter 1200-13-01 (Medicaid Long-Term Services and Supports Policies and Service Definition Limits)
• Federal Home and Community-Based Services (HCBS) Final Settings Rule (42 CFR  441.301)
• Tennessee Adult Protective Services Act (Tennessee Code Annotated Title 71, Chapter 6)

3. Licensing or Certification

Providers must be formally certified as an approved Home and Community-Based Services (HCBS) provider by the Department of Intellectual and Developmental Disabilities (DIDD) and explicitly credentialed under the appropriate day service delivery network panels of the state's contracted TennCare Managed Care Organizations (MCOs).

4. Responsible State Agency

The Bureau of TennCare (Tennessee Medicaid) and the Department of Intellectual and Developmental Disabilities (DIDD) maintain administrative and regulatory authority over this service. They are responsible for vetting corporate applications, enforcing provider qualifications, and carrying out quality compliance audits.

5. Application Process

The application process is completed through the electronic TennCare Provider Registration Portal and the DIDD Provider Enrollment Unit. Providers must submit their initial business documentation online, supply an explicit service description outlining their in-home day service delivery strategy, and secure authorization from the participant’s respective Managed Care Organization (MCO).

6. Required Documentation

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

• Legal business formation papers, an active Federal EIN, and a registered Type 2 National Provider Identifier (NPI)
• Non-Residential Homebound Services Policy & Procedure Manual (including localized emergency response, home safety protocols, and distinct task-duplication separation matrices)
• Staff qualifications, proof of background registry alignment, and baseline training verification sheets
• Proof of commercial general liability, professional liability, and state-mandated workers' compensation insurance

7. Timeline for Approval

The exact timeline for approval fluctuates based on state agency capacity and corporate readiness. Providers should contact the DIDD Provider Enrollment Unit for current processing schedules, which typically average 2 to 3 months for complete application tracking and MCO credentialing.

8. Pre-Application Process

Prospective providers must complete specific foundation tasks before applying. They must legally incorporate their healthcare business with the Tennessee Secretary of State, establish internal operating structures, and acquire all required federal identifying tags (EIN and Type 2 Group NPI) matching the provider category.

9. Pre-Application Training

The state hosts mandatory administrative and compliance training sessions online. Access instructions for the electronic state registration modules, DIDD orientation tracks, and Electronic Visit Verification (EVV) documentation workflows are sent to qualified applicants once preliminary paperwork is verified.

10. Additional Notes

• Non-Residential Homebound Support Services are capped by strict utilization guidelines and must never duplicatively overlap with standard Personal Assistance, Home Health Aide, or Respite care hours
• Service hours and billing codes must be completely authorized via the participant's Interdisciplinary Care Team and embedded into the Person-Centered Support Plan (PCSP) prior to delivery
• All Direct Support Professionals (DSPs) must clear mandatory background checks, criminal history checks, and national/state abuse registries prior to home placement
• Providers must maintain detailed, chronological records of daily face-to-face contact hours, shift progress notes, and verified tracking sheets to fulfill Medicaid compliance audits

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