ASSISTED LIVING FACILITY SERVICES PROVIDER IN ALABAMA

SUPPORTING INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES IN A SAFE, COMMUNITY-BASED RESIDENTIAL SETTING WITH 24-HOUR SUPPORT

Assisted Living Facility (ALF) Services in Alabama are designed to offer a supportive, community-based residential option for individuals with intellectual and developmental disabilities (IDD) who need assistance with daily living but do not require nursing home care. These facilities promote independence, personal choice, and community integration while ensuring the safety and well-being of residents. Assisted Living Services are delivered under Alabama’s Home and Community-Based Services (HCBS) Medicaid Waivers and must meet regulations from the Alabama Department of Mental Health (ADMH) and the Alabama Department of Public Health (ADPH).

1. GOVERNING AGENCIES

Agency: Alabama Department of Mental Health (ADMH)

Role: Authorizes participation under HCBS waivers, monitors quality of care, and ensures services meet standards for IDD populations

Agency: Alabama Department of Public Health (ADPH)

Role: Licenses and regulates Assisted Living Facilities in Alabama, including safety, staffing, and infection control compliance

Agency: Alabama Medicaid Agency

Role: Handles Medicaid enrollment and reimbursement for eligible assisted living services provided to waiver participants

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight and ensures compliance with federal HCBS settings rule and Medicaid guidelines

2. ASSISTED LIVING FACILITY SERVICE OVERVIEW

Assisted Living Facility Services provide residential support in a licensed setting for individuals with IDD who need help with personal care, medication administration, and daily activities while promoting independence and choice. Services must be person-centered and outlined in each resident’s service plan. Approved providers may offer:

• 24-hour supervision and support

• Assistance with activities of daily living (ADLs) such as bathing, dressing, grooming, toileting, and eating

• Medication management and health monitoring

• Meal preparation and nutritional oversight

• Housekeeping and laundry services

• Social and recreational programming

• Coordination with health care providers and case managers

All services must be delivered in accordance with resident preferences, regulatory guidelines, and facility licensing standards.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Alabama Secretary of State

• Obtain EIN from the IRS and NPI (Type 2)

• Obtain an Assisted Living Facility License from the Alabama Department of Public Health (ADPH)

• Comply with building codes, fire safety, ADA accessibility, and infection control standards

• Develop a resident care model aligned with ADMH HCBS guidelines

• Implement staffing schedules, policies, and documentation systems

4. ADMH PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Request the Assisted Living Services Provider Application Packet from ADMH

• Submit a facility operations plan including staffing, care coordination, emergency response, and medication protocols

• Include building layout, safety inspection results, and resident services framework

Background & Credentialing:

• Background checks and drug screening for all staff

• Licensure or certification of staff providing personal care or medication administration

• Verification of administrator qualifications and staff training compliance

Program Readiness Review:

• Facility inspection to verify safety, cleanliness, and regulatory readiness

• Review of daily schedules, resident rights policies, care plans, and service documentation

• Evaluation of emergency preparedness and health services coordination

Approval & Medicaid Enrollment:

• Once approved by ADMH, enroll with Alabama Medicaid as an Assisted Living Facility provider

• Add applicable billing codes to your Medicaid service profile

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or LLC Certificate

• IRS EIN Letter

• NPI confirmation

• ADPH ALF License

• Property ownership/lease agreement

• Fire and safety inspection certificates

• ADMH-Compliant Policy & Procedure Manual including:

  • Admission and discharge criteria

  • Resident rights and grievance procedures

  • ADL support protocols and documentation templates

  • Staff training, supervision, and evaluation plans

  • Medication management, incident reporting, and emergency procedures

  • Confidentiality and infection control policies

• Resident care plans and consent forms

6. STAFFING REQUIREMENTS

Role: Facility Administrator

Requirements: Must meet ADPH qualifications; experience in healthcare or IDD residential care management

Role: Direct Care Staff

Requirements: High school diploma or GED; training in ADLs, medication assistance (if permitted), and resident rights

Role: Nurse (optional, depending on resident needs)Requirements: Licensed RN or LPN; responsible for medication oversight and health-related tasks

All staff must complete:

• ADMH orientation and HCBS waiver training

• Annual ethics, abuse prevention, and emergency response training

• Confidentiality, infection control, and documentation protocols

7. MEDICAID WAIVER SERVICES

The following Alabama Medicaid Waivers authorize Assisted Living Facility Services:

• ID Waiver (Intellectual Disabilities Waiver)

• State of Alabama Community Waiver Program

Approved providers may deliver:

• Daily support in a residential setting

• Personal care, health monitoring, and social engagement

• Coordination of all services identified in the person-centered plan

8. TIMELINE TO LAUNCH

Phase: Business Formation

Timeline: 0–1 week

Phase: Facility Licensing and ADPH Approval

Timeline: 60–120 days

Phase: ADMH Application Review

Timeline: 60–90 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 Department of Public Health (ADPH) – Provider Licensure

Website: https://www.alabamapublichealth.gov

Alabama Medicaid Agency – Waiver Services

Website: https://medicaid.alabama.gov

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — ALABAMA ASSISTED LIVING FACILITY SERVICES PROVIDER

We assist new providers in launching Assisted Living Facilities under Alabama’s HCBS waiver programs.​​​​​​​​​​​​​

Scope of Work:​

• Business formation (LLC, EIN, NPI)

• ADPH licensing and facility readiness guidance

• ADMH provider application preparation

• Assisted Living Policy & Procedure Manual

• Staff training programs and documentation templates

• Resident admission packets, care plans, and service logs

• Medicaid enrollment and billing configuration

• WEBSITE, DOMAIN, AND EMAIL SETUP

• MARKETING AND ADVERTISING MATERIALS

• OPERATIONAL TRAINING

• COMPLIANCE AND REGULATORY SUPPORT

• QUALITY ASSURANCE PROGRAMS

• MARKETING AND CLIENT ACQUISITION STRATEGIES

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