1. GOVERNING AGENCIES

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

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

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight ensuring Personal Assistance Services meet Medicaid HCBS standards and promote person-centered care

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2. PERSONAL ASSISTANCE SERVICE OVERVIEW

Personal Assistance Services (PAS) provide hands-on support to help participants accomplish tasks of daily living that they would otherwise be unable to perform independently.

Approved providers may deliver:

• Assistance with Activities of Daily Living (ADLs) such as bathing, dressing, toileting, grooming, eating, and mobility
• Support with Instrumental Activities of Daily Living (IADLs) such as meal preparation, laundry, light housekeeping, medication reminders, and shopping
• Community access support (escorting to appointments, recreational activities)
• Health and safety monitoring
• Communication assistance and social support
• Emergency response assistance as needed

All services must be individualized and consistent with the goals identified in the participant’s Individualized Service Plan (ISP).

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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
• Complete DDD Provider Certification if serving DD/ID Waiver participants
• Maintain general liability and professional liability insurance
• Develop policies for participant intake, service delivery, emergency response, and participant rights protections

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4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit Provider Enrollment Application for Personal Assistance Services through Hawaii’s Med-QUEST Division
• Identify service areas and staff qualifications

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, operational policies, staff training plans, and proof of insurance
• Provide sample daily service logs, participant intake forms, and emergency response protocols

Program Readiness Review:

• DHS and DOH review provider readiness including participant safety systems, service tracking documentation, and Medicaid compliance

Approval & Medicaid Enrollment:

• Upon approval, configure billing codes for Personal Assistance Services (hourly or daily units)

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, needs assessment, and service planning procedures
• Daily living assistance protocols and emergency response procedures
• Daily documentation and incident tracking systems
• HIPAA confidentiality, participant rights, and grievance handling policies
• Staff credentialing, background checks, and competency verification
• Medicaid billing, service authorization tracking, and audit readiness procedures

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6. STAFFING REQUIREMENTS

Role: Personal Assistance Program Manager / Supervisor
Requirements: Experience in managing personal care services, community supports, or disability services; background screening clearance

Role: Personal Care Aides / Direct Support Professionals (DSPs)
Requirements: High school diploma or GED; CPR/First Aid certification preferred; background screening clearance

All staff must complete:

• HIPAA confidentiality, abuse prevention, and participant rights training
• Emergency preparedness, CPR/First Aid, and incident management training
• Person-centered service delivery and cultural sensitivity training
• Annual continuing education in personal support services and Medicaid compliance

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7. MEDICAID WAIVER PROGRAMS

The following Hawaii Medicaid Waivers authorize Personal Assistance Services:

• Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver
• Community Care Services (CCS) Program (for adults with serious mental illnesses and chronic conditions)

Approved providers may deliver:

• ADL and IADL support in homes and community settings
• Health and safety monitoring and non-clinical health supports
• Assistance with accessing community-based activities and appointments

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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 Participant Intake 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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10. SCOPE OF WORK

• Business registration and EIN/NPI setup
• Medicaid provider enrollment and certification support
• Development of Personal Assistance Services Policy & Procedure Manual
• Staff credentialing templates and participant intake/service planning documents
• Medicaid billing system setup and claims management
• Website, domain, and email setup
• Participant intake, daily service delivery, and incident reporting templates
• Emergency preparedness and participant health monitoring systems
• Quality assurance programs for service delivery and participant satisfaction tracking