1. Program Definition and Services

Supported Employment Services in Rhode Island provide short-term and ongoing support to children and adults with intellectual/developmental disabilities and chronic conditions. The program aims to help maintain individuals with disabilities in the community, averting the need for long-term services and supports by achieving competitive, integrated employment. Services include:

• In-Home Personal Care: Individual support in the individual/family home or community (Career Planning & Discovery, Vocational Assessments, Resume Preparation, and Self-Employment Support)
• Residential Personal Care: Supervision and care in a licensed residential, community-based setting or workplace (On-the-Job Coaching, Workplace Accommodations Coordination, Follow-Along Job Retention Supports, and Behavioral Support)

2. Regulations

The program is governed by the following regulations:

• Rhode Island Rules and Regulations for Developmental Disability Organizations (DDO) (212-RICR-10-05-1)
• Rhode Island General Laws  40.1-21-4.3 (Developmental Disabilities Services Framework & Clinical Eligibility)
• Rhode Island Medicaid 1115 Comprehensive Demonstration Waiver
• Federal HCBS Settings Final Rule (42 CFR  441.301)

3. Licensing or Certification

Providers must be formally certified as a Developmental Disability Organization (DDO) by the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities & Hospitals (BHDDH) and follow all Home and Community-Based Services (HCBS) requirements.

4. Responsible State Agency

The Rhode Island Executive Office of Health and Human Services (EOHHS) and the Department of Behavioral Healthcare, Developmental Disabilities & Hospitals (BHDDH) Division of Developmental Disabilities are responsible for reviewing applications and certifying supported employment services providers.

5. Application Process

The application process is conducted through the electronic Rhode Island Medicaid Healthcare Portal. Providers must submit foundational forms online to initiate the core enrollment process after securing programmatic validation from BHDDH.

6. Required Documentation

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

• Proof of compliance with state safety and operational rules (including BHDDH DDO Certification)
• Agency policies and procedures (detailing employer engagement plans, job coaching workflows, and incident reporting)
• Staff qualifications and training records
• State-mandated criminal background fingerprint clearances (BCI checks)
• Proof of general, professional, and commercial liability insurance

7. Timeline for Approval

The exact timeline for approval fluctuates based on agency capacity. Providers should contact their BHDDH regional program coordinator for detailed information on current processing timeframes, which usually span 2 to 4 months.

8. Pre-Application Process

Prospective providers must complete specific foundation tasks before applying. They must establish their business entity with the Rhode Island Secretary of State, purchase necessary corporate liability binders, and secure necessary federal identification numbers (EIN and a Type 2 NPI).

9. Pre-Application Training

The state hosts mandatory administrative and compliance training sessions online. Agency leadership and job coaches must complete foundational modules covering the HCBS Settings Rule, Rhode Island Employment First Goals, and Person-Centered ISP Implementation via the electronic TRAIN Rhode Island platform.

10. Additional Notes

• Providers must ensure that intensive care settings meet all state accessibility and environmental safety guidelines
• In-Home Personal Care must be provided directly by the certified agency's employed personnel
• All direct care staff must conduct mandatory background clearances and fingerprinting screenings through the RI Attorney General's Bureau of Criminal Identification (BCI)
• Providers must maintain detailed records of face-to-face services for Medicaid documentation and billing, ensuring strict alignment with 2014 DOJ Consent Decree community integration requirements

Why Choose Waiver Consulting Group?

Starting or expanding your Medicaid waiver-funded agency can feel overwhelming, but it doesn't have to be. At Waiver Consulting Group, we simplify the process by guiding you through licensing, compliance, provider enrollment, policies & procedures, and regulatory approvals in any state.

With proven expertise, a structured process, and ongoing support, we take the guesswork out of launching your healthcare business. Whether you're a first-time entrepreneur or an established provider looking to expand, our team ensures you stay compliant, competitive, and fully operational.

To get started, click the link to request portal access