CASE MANAGEMENT SERVICES PROVIDER IN ALABAMA

Fatumata Kaba
Jun 28
4 min read

Updated: Jun 30

SUPPORTING INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES THROUGH COORDINATED ACCESS TO SERVICES, SUPPORTS, AND RESOURCES

Case Management Services in Alabama are designed to help individuals with intellectual and developmental disabilities (IDD) access the services and supports they need to live safely and independently in the community. Case managers serve as the central point of coordination, ensuring all aspects of an individual's care are aligned with their goals. These services are authorized under Alabama’s Home and Community-Based Services (HCBS) Medicaid Waivers and must follow protocols set by the Alabama Department of Mental Health (ADMH).

1. GOVERNING AGENCIES

Agency: Alabama Department of Mental Health (ADMH)

Role: Oversees provider approval, training, and compliance for Case Management Services under HCBS waivers

Agency: Alabama Medicaid Agency

Role: Handles Medicaid enrollment, billing, and reimbursement for Case Management Services

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight to ensure Case Management meets federal Medicaid requirements for person-centered service coordination

2. CASE MANAGEMENT SERVICE OVERVIEW

Case Management Services ensure individuals with IDD have access to the supports and resources necessary for a safe, stable, and independent life. Services are individualized and must be included in the person-centered plan. Approved providers may deliver:

Comprehensive assessment of needs across life domains
Development and ongoing updates to the person-centered service plan
Coordination and linkage to medical, behavioral, housing, employment, and social supports
Monitoring of service delivery and consumer satisfaction
Advocacy and support with goal development and problem resolution
Crisis planning and navigation of transitions between services

Case Managers must maintain regular contact with individuals and their support teams, ensuring services are responsive, documented, and aligned with changing needs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Alabama Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Maintain a physical or virtual office capable of serving assigned regions
Employ qualified Case Managers with relevant education and experience
Implement systems for service planning, contact tracking, and progress documentation
Demonstrate the ability to coordinate across multiple service domains

4. ADMH PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Request the Case Management Services Provider Application Packet from ADMH
Submit a service delivery model, outlining assessment tools, contact standards, and service plan development processes
Include policies for client confidentiality, emergency response, and inter-agency coordination

Background & Credentialing:

Criminal background checks and drug screenings for all staff
Verification of qualifications (Bachelor’s degree or higher in human services or related field)
Documentation of staff training in person-centered planning, Medicaid compliance, and disability services

Program Readiness Review:

Evaluation of assessment templates, service plan formats, and contact documentation
Review of internal tracking systems, communication protocols, and client file management
Policies for staff supervision, quality assurance, and corrective action

Approval & Medicaid Enrollment:

Once approved by ADMH, enroll with Alabama Medicaid as a Case Management Services provider
Add appropriate billing codes and documentation practices to Medicaid profile

5. REQUIRED DOCUMENTATION

Articles of Incorporation or LLC Certificate
IRS EIN Letter
NPI confirmation
Office lease or virtual infrastructure documentation
Staff resumes, licensure (if applicable), and job descriptions
ADMH-Compliant Policy & Procedure Manual including:
- Eligibility determination and referral management
- Assessment procedures and service planning templates
- Documentation and monitoring protocols
- Consumer rights, informed consent, and confidentiality procedures
- Crisis response, abuse prevention, and grievance processes
- Staff training logs, supervision documentation, and internal audits
Signed service plans and documentation of ongoing contact with clients