COMMUNITY INTEGRATION SERVICES PROVIDER IN IDAHO

Fatumata Kaba
Jul 18
3 min read

FOSTERING INCLUSION, INDEPENDENCE, AND FULL PARTICIPATION IN COMMUNITY LIFE

Community Integration Services in Idaho support individuals with disabilities, chronic health conditions, or aging-related needs in developing skills and accessing opportunities to engage actively and meaningfully in their communities. These services are authorized under Idaho’s Medicaid Home and Community-Based Services (HCBS) waiver programs, promoting personal growth, social connection, and greater independence.

1. GOVERNING AGENCIES

Agency: Idaho Department of Health and Welfare (IDHW) — Division of Medicaid

Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Community Integration Services

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring Community Integration Services meet Medicaid HCBS standards for person-centered, community-based support

2. COMMUNITY INTEGRATION SERVICE OVERVIEW

Community Integration Services help participants achieve greater involvement in social, educational, recreational, and vocational activities outside of their homes, tailored to their unique goals and preferences.

Approved providers may deliver:

Assistance in identifying and accessing community activities (e.g., classes, social clubs, religious events, recreation centers)
Training in using public transportation and navigating community environments
Social skills development, including communication and relationship-building
Support for participating in volunteer activities, employment exploration, or civic engagement
Coaching in accessing public resources (e.g., libraries, parks, support groups)
Advocacy support to help participants express preferences and make personal choices

Services must align with goals identified in the participant’s Individualized Service Plan (ISP) and promote real inclusion, independence, and active community involvement.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register business with the Idaho Secretary of State
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid provider through Idaho Medicaid Provider Enrollment
Maintain general liability and professional liability insurance
Develop policies for participant-centered planning, service delivery, safety in community settings, and incident management

4. IDHW PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Submit Provider Enrollment Application for Community Integration Services through Idaho’s Medicaid Management Information System (MMIS)

Application and Documentation Submission:

Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, staff qualifications, operational policies, and participant intake forms
Provide sample activity schedules, transportation safety plans, and service tracking templates

Program Readiness Review:

IDHW reviews provider readiness, including participant protections, risk management procedures, Medicaid billing systems, and community access strategies

Approval & Medicaid Enrollment:

Upon approval, configure billing codes for Community Integration Services (often billed hourly)

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License (Idaho Secretary of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
HCBS-Compliant Policy & Procedure Manual including:
- Participant intake, community goals assessment, and planning procedures
- Risk management, community access safety, and emergency preparedness protocols
- Service tracking, outcome monitoring, and quality assurance policies
- HIPAA confidentiality, participant rights, and grievance procedures
- Staff credentialing, background checks, and ongoing competency documentation
- Medicaid billing and audit readiness systems

6. STAFFING REQUIREMENTS

Role: Community Integration Program Manager / Supervisor

Requirements: Experience in social services, disability supports, or community engagement; background screening clearance

Role: Community Support Specialists / Direct Support Professionals (DSPs)

Requirements: High school diploma or GED; CPR/First Aid certification preferred; background screening clearance

All staff must complete:

Person-centered planning and community integration training
HIPAA confidentiality, participant rights, and abuse prevention training
Emergency preparedness, transportation safety, and incident reporting training
Annual refresher training on community-based supports and Medicaid compliance

7. MEDICAID WAIVER PROGRAMS

The following Idaho Medicaid Waivers authorize Community Integration Services:

Developmental Disabilities (DD) Waiver
Aged and Disabled (A&D) Waiver (where social inclusion goals are identified)

Approved providers may deliver:

Training in community navigation and social engagement
Supervised participation in civic, recreational, and educational activities
Advocacy and self-advocacy skill-building supports
Transportation coordination tied to community involvement (if authorized)

8. TIMELINE TO LAUNCH

Phase: Business Formation and Credentialing Setup

Timeline: 1–2 weeks

Phase: Idaho Medicaid Provider Application and Readiness Review

Timeline: 60–90 days

Phase: Staff Hiring, Credentialing, and Community Activity Planning

Timeline: 30–45 days

Phase: Medicaid Billing System Configuration and Claims Management

Timeline: 45–60 days

9. CONTACT INFORMATION

Idaho Department of Health and Welfare (IDHW) — Medicaid Division

Website: https://healthandwelfare.idaho.gov/services-programs/medicaid-health

Centers for Medicare & Medicaid Services (CMS)

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

COMMUNITY INTEGRATION SERVICES PROVIDER IN IDAHO

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — IDAHO COMMUNITY INTEGRATION SERVICES PROVIDER

WCG supports community-based organizations, direct support agencies, and disability service providers in launching Medicaid-compliant Community Integration Services under Idaho’s HCBS waiver programs.

Scope of Work: