1. Governing Agencies

Agency: Alabama Department of Mental Health (ADMH)

Role: Licenses and certifies HCBS waiver providers, including respite services

Agency: Alabama Medicaid Agency

Role: Administers Medicaid enrollment and reimbursement

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Federal oversight and regulation of HCBS Waiver programs

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2. Respite Service Overview

Respite care offers short-term, temporary services to relieve unpaid caregivers. Services can be provided in:

• The individual’s home
• A certified respite home
• A community-based residential facility

Approved providers must deliver:

• Supervision and support with ADLs
• Health and safety monitoring
• Basic habilitation or recreational engagement
• Care in accordance with the person-centered plan

3. Licensing & Provider Approval Requirements

Prerequisites:

• Register business with Alabama Secretary of State
• Obtain EIN and NPI (Type 2)
• Have a physical office in Alabama
• Meet ADMH provider standards for service delivery and documentation
• Ensure staff are trained in CPR, First Aid, abuse prevention, and IDD-specific competencies

4. ADMH Provider Enrollment Process

Initial Interest and Application:

• Complete ADMH Provider Application Packet (request via ADMH)
• Submit business plan and proposed services
• Include policies, organizational chart, and staffing plan

Background & Credentialing:

• Fingerprint-based criminal background checks
• Central registry checks for abuse and neglect
• Drug screening and staff eligibility validation

Site Inspection & Review (if applicable):

• Life safety and fire inspection (for out-of-home respite)
• Floor plan, emergency exits, infection control
• Review of training records, manuals, and client protections

Approval & Medicaid Enrollment:

• Enroll with Alabama Medicaid as an HCBS provider
• Add service lines for Respite (code T1005 or S5150 depending on setting)

5. Required Documentation

• Articles of Incorporation or LLC Certificate
• IRS EIN Letter
• NPI confirmation
• Lease/deed and floor plan (for out-of-home respite)
• Fire Marshal inspection (if applicable)
• Staff training documentation

ADMH-compliant Policy & Procedure Manual covering:

• Admission/discharge
• Emergency response
• Incident reporting
• Medication protocols (if applicable)
• Staffing and supervision
• Individual rights
• Person-Centered Respite Care Plans

6. Staffing Requirements

Role: Administrator
Requirements: Experience in developmental disability services

Role: Direct Support Professional (DSP)
Requirements: High school diploma/GED, CPR/First Aid, abuse prevention training

Role: Respite Staff
Requirements: May include paraprofessionals or CNAs depending on care needs

All staff must complete:

• ADMH-mandated orientation and annual in-service hours
• Individual-specific training based on the care recipient’s needs

7. Medicaid Waiver Services

Waivers that include respite services in Alabama:

• ID Waiver (Intellectual Disabilities Waiver)
• LAH Waiver (Living at Home Waiver)
• State of Alabama Community Waiver Program

Approved providers may deliver:

• In-home Respite
• Out-of-home Respite
• Emergency Respite (if certified)

8. Timeline to Launch

Phase: Business Formation

Timeline: 0–1 week

Phase: ADMH Application Review

Timeline: 60–120 days

Phase: Licensing & Site Review

Timeline: 30–60 days

Phase: Medicaid Enrollment

Timeline: 60–90 days

9. Contact Information

Alabama Department of Mental Health (ADMH) – Division of Developmental Disabilities

Email: ddprovider@mh.alabama.gov

Phone: (334) 242-3702

Website: https://mh.alabama.gov

Alabama Medicaid Agency – Waiver Services

Website: https://medicaid.alabama.gov

10. Scope of Work

• Business formation (LLC, EIN, NPI)
• ADMH application support and compliance documentation
• Creation of complete Policy & Procedure Manual
• Site readiness for inspection (if applicable)
• Medicaid enrollment support
• Staff training templates and onboarding materials
• Program design and care documentation tools
• Branding, compliance, and operational guidance