COMMUNITY INTEGRATION SERVICES PROVIDER IN NEW HAMPSHIRE

PROMOTING INDEPENDENCE AND SOCIAL CONNECTIONS THROUGH COMMUNITY-BASED SUPPORT

Community Integration Services in New Hampshire support individuals with disabilities or chronic conditions by facilitating their active participation in community life. These services enhance social skills, promote independence, and encourage meaningful connections through personalized support. Community Integration Services are authorized under New Hampshire Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: New Hampshire Department of Health and Human Services (DHHS)

Role: Administers Medicaid waiver funding for Community Integration Services and manages provider enrollment, service authorization, and reimbursement.

Agency: Bureau of Elderly and Adult Services (BEAS)

Role: Ensures quality standards, service delivery, and compliance for Community Integration Services under HCBS waiver programs.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring Medicaid-funded Community Integration Services meet HCBS quality, person-centered planning, and participant protection standards.

2. COMMUNITY INTEGRATION SERVICES OVERVIEW

Community Integration Services support individuals by fostering connections within their local communities and enhancing their ability to live independently.

Approved providers may deliver:

• Social Skills Training: Teaching communication, social interaction, and self-advocacy.

• Community Access Support: Assisting with participation in social, recreational, and civic activities.

• Life Skills Development: Teaching budgeting, meal planning, and self-care.

• Peer Mentoring: Connecting participants with peer supporters to build social networks.

• Vocational Integration: Preparing individuals for work and volunteering through skills training and job shadowing.

• Cultural and Recreational Activities: Encouraging participation in hobbies, clubs, and community events.

• Transportation Support: Assisting with travel planning and accessing community resources.

• Advocacy and Empowerment: Supporting individuals in making informed decisions about their lives.

All services are delivered according to the Individualized Service Plan (ISP) to meet the participant’s goals for independence and social inclusion.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register the business entity with the New Hampshire Secretary of State.

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

• Enroll as a Medicaid Waiver Community Integration provider via the New Hampshire Medicaid Provider Enrollment Portal.

• Obtain any required certifications or licenses for community support services.

• Maintain general liability and professional liability insurance.

• Develop policies for community access, safety, and social skill development.

• Ensure staff meet background checks, health screenings, and training requirements.

4. NEW HAMPSHIRE PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Complete the Provider Enrollment Application through the New Hampshire Medicaid Provider Enrollment Portal for Community Integration Services under HCBS waivers.

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, staff qualifications, and policy manuals.

Program Readiness Review:

• DHHS and BEAS evaluate provider readiness, including staff qualifications, community access protocols, and safety measures.

Approval & Medicaid Enrollment:

• Upon approval, providers are authorized to bill Medicaid for Community Integration Services using designated billing codes.

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (New Hampshire Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Certification for community support services (if applicable)

• Proof of general and professional liability insurance

• Community Integration Services Policy & Procedure Manual, including:

  • Community access planning, social skills training, and integration support protocols

  • Safety procedures for community outings and group activities

  • Staff credentialing, background checks, and ongoing training records

  • Documentation standards for activity tracking and Medicaid billing

  • HIPAA compliance, client rights, and grievance handling

  • Emergency preparedness and crisis intervention protocols

  • Quality assurance and service effectiveness monitoring

6. STAFFING REQUIREMENTS

Role: Community Integration Program Director

Requirements: Bachelor’s degree in social work, human services, or a related field; experience in community support management.

Role: Community Support Specialists

Requirements: High school diploma or GED; training in social integration and community living skills; CPR/First Aid certification; background clearance.

Role: Peer Support Mentors

Requirements: Experience in community involvement and peer support; certification preferred.

All staff must complete:

• Training in community integration and social skills development

• HIPAA compliance and participant rights education

• Annual competency evaluations and ongoing professional development

• Safety and crisis management training

• Training in fostering social inclusion and independence

7. MEDICAID WAIVER PROGRAMS

Community Integration Services are available under the following New Hampshire Medicaid Waivers:

• Choices for Independence (CFI) Waiver

• Developmental Disabilities (DD) Waiver

• Acquired Brain Disorder (ABD) Waiver

• In-Home Support (IHS) Waiver for Children

• Home and Community-Based Services (HCBS) Waiver

Services may include:

• Social skills training and peer mentoring

• Support for community involvement and social engagement

• Life skills development and personal advocacy

• Transportation assistance for community activities

• Vocational training and job shadowing opportunities

8. TIMELINE TO LAUNCH

Phase: Business Formation and Compliance Preparation

Timeline: 1–2 months

Phase: Staff Hiring, Credentialing, and Program Development

Timeline: 2–3 months

Phase: New Hampshire Medicaid Provider Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing Setup and Community Integration Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

New Hampshire Department of Health and Human Services (DHHS)

Website: https://www.dhhs.nh.gov/

Bureau of Elderly and Adult Services (BEAS)

Website: https://www.dhhs.nh.gov/programs-services/aging-and-adult-support

New Hampshire Medicaid Provider Enrollment Portal

Website: https://nhmmis.nh.gov/

Centers for Medicare & Medicaid Services (CMS)

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

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

WCG supports agencies in launching Medicaid-compliant Community Integration Services in New Hampshire, offering:

Scope of Work:

• Business registration, Medicaid enrollment, and licensing assistance

• Policy manual development for community integration planning and safety management

• Staff credentialing, training program templates, and compliance documentation

• Medicaid billing setup and audit-prepared financial management

• Branding, website development, and client engagement strategies

• Quality assurance systems for community involvement and social integration

• Collaboration with local organizations to promote inclusive practices

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.