COMMUNITY INTEGRATION SERVICES PROVIDER IN OREGON

Fatumata Kaba
Oct 6
4 min read

SUPPORTING SOCIAL INCLUSION, SKILL DEVELOPMENT, AND MEANINGFUL PARTICIPATION IN COMMUNITY LIFE FOR INDIVIDUALS WITH DISABILITIES

Community Integration Services in Oregon are Medicaid-funded supports that promote full participation in everyday community activities for individuals with intellectual and developmental disabilities (IDD), physical disabilities, or aging-related limitations. These services are a core component of Oregon’s Home and Community-Based Services (HCBS) Waivers and the K Plan (1915(k)) under the Oregon Health Plan (OHP). Community integration focuses on helping individuals build relationships, access resources, and engage in volunteer, recreational, educational, or cultural opportunities.

1. GOVERNING AGENCIES

Agency: Oregon Department of Human Services (ODHS) – Developmental Disabilities Services (DDS), Aging and People with Disabilities (APD)

Role: Approves and monitors providers, authorizes services through local CDDPs, brokerages, or APD case managers.

Agency: Oregon Health Authority (OHA)

Role: Oversees Medicaid enrollment and ensures services comply with the Oregon Health Plan (OHP) standards.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Ensures Oregon’s waiver and K Plan services meet federal Medicaid guidelines.

Agency: Oregon Secretary of State (SOS)

Role: Registers legal entities operating as providers in Oregon.

2. COMMUNITY INTEGRATION SERVICES OVERVIEW

These services help individuals connect with and actively participate in their communities. Supports are tailored to individual goals and designed to reduce isolation, build social capital, and foster greater independence.

Approved providers may deliver:

Community Mapping & Access Planning: Identifying resources and activities aligned with individual interests.
Social Skills Development: Coaching on communication, interaction, and navigating public settings.
Volunteer & Civic Engagement: Assisting with finding and maintaining volunteer roles.
Recreational Activities: Support to attend cultural events, parks, fitness centers, or faith-based activities.
Travel Training: Teaching individuals how to use public transportation or navigate travel routes.
Safety & Independence Coaching: Guidance on street safety, social boundaries, and emergency preparedness.
Documentation & Progress Tracking: Activity logs, outcome tracking, and Medicaid-compliant reporting.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Oregon Secretary of State.
Obtain EIN from the IRS and a Type 2 NPI.
Enroll with Oregon Medicaid through the OHA Provider Portal.
Apply for approval through ODHS/DD or APD, depending on your service population.
Maintain general liability insurance and workers’ compensation coverage.
Develop a Community Integration Services Policy & Procedure Manual in compliance with Oregon Administrative Rules (OARs).

4. OREGON PROVIDER ENROLLMENT PROCESS

Step 1: Register your business and secure EIN/NPI and insurance.

Step 2: Apply as a Medicaid provider via the OHA Provider Portal.

Step 3: Submit a vendor application to your local CDDP, brokerage, or APD office.

Step 4: Complete required background checks and staff training certifications.

Step 5: Once approved, begin receiving service authorizations and referrals.

5. REQUIRED DOCUMENTATION

Business registration and Articles of Incorporation
EIN and NPI documentation
Liability and workers’ compensation insurance
ODHS/DD or APD vendor approval
Community Integration Policy & Procedure Manual including:
- Activity planning and risk assessment procedures
- Transportation and supervision policies
- Participant choice and rights documentation
- Daily documentation forms and service logs
- Emergency protocols and safety guidelines
- HIPAA compliance and grievance reporting
- Medicaid billing templates and progress tracking tools

6. STAFFING REQUIREMENTS

Role: Community Integration Specialist / Direct Support Professional (DSP)

Requirements: Background check, training in person-centered planning, safety, and communication strategies.

Role: Program Coordinator

Requirements: Oversees staffing, schedules, documentation, and compliance.

All staff must complete:

Abuse prevention and mandatory reporting training
HIPAA and confidentiality modules
Activity safety and behavior support training (as needed)
Annual training updates and documentation refreshers

7. MEDICAID WAIVER PROGRAMS

Community Integration Services are authorized through:

Comprehensive Waiver (IDD): Includes extensive community-based supports for individuals with complex needs.
Support Services Waiver (IDD): For individuals living independently or with families.
K Plan (1915(k)): Covers ADL/IADL-related community access for eligible participants.
APD Waivers: Community-based supports for aging adults and individuals with physical disabilities.
Children’s DD Waiver: Community participation supports for youth with developmental disabilities.

8. TIMELINE TO LAUNCH

Phase: Business Registration & Manual Development

Timeline: 1–2 months

Phase: Medicaid Enrollment & ODHS Approval

Timeline: 2–3 months

Phase: Staff Hiring, Background Checks & Training

Timeline: 30–60 days

Phase: Service Activation & Referral Coordination

Timeline: Begins once vendor status is confirmed and referrals are received

9. CONTACT INFORMATION

Oregon Department of Human Services – DD & APD Programs

Website: https://www.oregon.gov/dhs

Oregon Health Authority – Provider Enrollment

Website: https://www.oregon.gov/oha/HSD/OHP/Pages/Providers.aspx

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

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

WCG helps new Community Integration providers in Oregon develop robust, person-centered programs that connect individuals with meaningful opportunities in the community.

Scope of Work: