BEHAVIORAL HEALTH SERVICES PROVIDER IN HAWAII

PROMOTING EMOTIONAL WELL-BEING, SELF-REGULATION, AND RECOVERY THROUGH COMPREHENSIVE SUPPORTS

Behavioral Health Services in Hawaii provide individuals with mental health conditions, behavioral challenges, or emotional disorders access to therapy, counseling, crisis intervention, and supportive care. These services are authorized under Hawaii’s Medicaid State Plan and Home and Community-Based Services (HCBS) waiver programs, focusing on fostering resilience, self-management, and community living.

​​​1. GOVERNING AGENCIES

Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division

Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Behavioral Health Services

Agency: Hawaii Department of Health (DOH) — Adult Mental Health Division (AMHD) and Child & Adolescent Mental Health Division (CAMHD)

Role: Administers community mental health services and crisis intervention supports

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring Behavioral Health Services meet Medicaid standards for accessibility, quality, and person-centered care

2. BEHAVIORAL HEALTH SERVICE OVERVIEW

Behavioral Health Services encompass a range of therapeutic, rehabilitative, and crisis support services aimed at improving emotional regulation, managing psychiatric symptoms, and enhancing overall mental wellness.

Approved providers may deliver:

• Psychotherapy (individual, group, or family sessions)

• Psychiatric evaluation and medication management

• Behavioral intervention and crisis de-escalation

• Skills training for emotional regulation, coping strategies, and interpersonal communication

• Community-based rehabilitative services (CBRS)

• Peer support services (where authorized)

• Mobile crisis intervention and stabilization (for urgent needs)

All services must align with a participant’s treatment plan or Individualized Service Plan (ISP) and promote recovery-oriented, person-centered goals.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register your business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)

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

• Obtain licensure as a behavioral health agency if operating a facility (through the Hawaii DOH)

• Employ credentialed professionals (licensed psychologists, psychiatrists, LCSWs, LPCs, LMFTs, APRNs, etc.)

• Maintain general liability, professional liability, and malpractice insurance

• Enroll as a Medicaid provider with Hawaii’s Med-QUEST Division

4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit Provider Enrollment Application for Behavioral Health Services through Hawaii Med-QUEST

• Identify services to be provided (therapy, psychiatric services, crisis intervention, rehabilitation, peer support, etc.)

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, professional licensure verifications, operational and clinical policies, and proof of insurance

Program Readiness Review:

• DHS and Med-QUEST review provider readiness, including clinical staffing, service models, documentation systems, and participant rights protections

Approval & Medicaid Enrollment:

• Upon approval, configure billing codes appropriate to service types (e.g., psychotherapy sessions, psychiatric evaluations, crisis intervention events)

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Hawaii DCCA)

• IRS EIN confirmation

• NPI confirmation

• Licenses for clinical staff (LCSW, LPC, LMFT, psychologist, psychiatrist, APRN, etc.)

• Behavioral Health Agency license (if operating a facility)

• Proof of general, professional, and malpractice insurance

• HCBS-Compliant and Behavioral Health-Compliant Policy & Procedure Manual including:

  • Participant intake, assessment, diagnosis, and treatment planning procedures

  • Clinical service delivery protocols (therapy, crisis response, medication management)

  • Confidentiality, HIPAA compliance, and participant rights protections

  • Incident reporting, emergency response, and suicide prevention plans

  • Staff credentialing, background checks, and clinical supervision records

  • Medicaid billing, service authorization tracking, and quality assurance procedures

6. STAFFING REQUIREMENTS

Role: Clinical Director / Behavioral Health Program Manager

Requirements: Doctorate or Master’s degree in psychology, social work, counseling, or related field; active Hawaii licensure; supervisory experience; background screening clearance

Role: Therapists / Licensed Clinicians (LCSW, LPC, LMFT, Psychologists)

Requirements: Active Hawaii licensure in their discipline; experience with community mental health; background screening clearance

Role: Psychiatrists / Psychiatric Nurse Practitioners (APRNs)

Requirements: Hawaii medical or advanced practice nursing license; DEA registration for prescribing; background screening clearance

Role: Behavioral Health Specialists / Peer Support Workers

Requirements: Certification and/or lived experience where applicable; training in recovery models and crisis de-escalation preferred; background screening clearance

All staff must complete:

• HIPAA confidentiality, client rights, and abuse prevention training

• Crisis intervention, suicide prevention, and de-escalation training

• Emergency preparedness and incident management training

• Annual clinical continuing education and Medicaid compliance training

7. MEDICAID PROGRAMS

Behavioral Health Services are authorized under:

• Hawaii Medicaid State Plan

• Community Care Services (CCS) Program

• Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver (for behavioral supports related to disabilities)

• QUEST Integration Behavioral Health Programs

• Crisis Mobile Outreach Services (separate authorization through AMHD or CAMHD)

Approved providers may deliver:

• Therapy sessions (individual, group, family)

• Psychiatric evaluations and medication management

• Crisis intervention and stabilization services

• Skills training and rehabilitative supports

• Peer supports and recovery assistance

8. TIMELINE TO LAUNCH

Phase: Business Formation and Licensing Application

Timeline: 1–2 months

Phase: Clinical Program Development and Staff Hiring

Timeline: 2–4 months

Phase: Medicaid Provider Enrollment and Service Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing System Setup and Claims Testing

Timeline: 30–45 days

9. CONTACT INFORMATION

Hawaii Department of Human Services (DHS) — Med-QUEST Division

Website: https://medquest.hawaii.gov/

Hawaii Department of Health (DOH) — Adult Mental Health Division (AMHD)

Website: https://health.hawaii.gov/amhd/

Hawaii Department of Health (DOH) — Child & Adolescent Mental Health Division (CAMHD)

Website: https://health.hawaii.gov/camhd/

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov/

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII BEHAVIORAL HEALTH SERVICES PROVIDER

WCG supports behavioral health agencies, private practices, and crisis response organizations in launching Medicaid-compliant Behavioral Health Services under Hawaii’s HCBS and Medicaid State Plan programs.​​​​​​​​​​

Scope of Work:

• Business registration and EIN/NPI setup

• Medicaid provider enrollment and licensing assistance

• Development of Behavioral Health Services Policy & Procedure Manual

• Staff credentialing templates and participant intake documentation

• Medicaid billing system setup and claims management

• Website, domain, and email setup

• Clinical intake, assessment, treatment planning, and service tracking systems

• Crisis response, suicide prevention, and emergency preparedness procedures

• Quality assurance and clinical outcome tracking programs

• Community networking and referral partnership development

Continue To Our Client Portal To Get Started

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.