COMMUNITY INTEGRATION SERVICES PROVIDER IN PENNSYLVANIA

Fatumata Kaba
Oct 8
3 min read

FACILITATING SOCIAL CONNECTION, INCLUSION, AND SKILL-BUILDING FOR INDIVIDUALS WITH DISABILITIES THROUGH COMMUNITY-BASED SUPPORTS

Community Integration Services in Pennsylvania are Medicaid-funded supports designed to help individuals with intellectual and developmental disabilities (IDD) access and engage with their communities. These services promote inclusion, build natural supports, and empower individuals to participate in meaningful social, recreational, educational, and civic activities. Community Integration is authorized under Pennsylvania’s HCBS waivers through the Office of Developmental Programs (ODP).

1. GOVERNING AGENCIES

Agency: Pennsylvania Department of Human Services (DHS) – Office of Developmental Programs (ODP)

Role: Oversees waiver-funded Community Participation Support (CPS) and in-home community habilitation programs.

Agency: Administrative Entities (AEs) / County MH/ID Offices

Role: Coordinate provider qualification, service authorization, and ongoing compliance monitoring.

Agency: Centers for Medicare & Medicaid Services (CMS)**

Role: Provides federal regulation for HCBS-funded community integration services.

Agency: Pennsylvania Department of State

Role: Handles legal registration of business entities providing waiver-funded community services.

2. COMMUNITY INTEGRATION SERVICES OVERVIEW

These services assist individuals with disabilities in engaging with the broader community through meaningful and individualized experiences outside the home.

Approved providers may deliver:

In-Home and Community Habilitation: One-on-one or small group support to develop social and functional skills in real-world settings.
Community Participation Support (CPS): Facility-based or community-based services designed to increase access to and involvement in community activities.
Social Integration & Life Skills Training: Building relationships, navigating public spaces, and accessing transportation.
Civic & Volunteer Engagement: Support for participating in volunteerism, religious events, and community leadership.
Cultural, Recreational & Educational Access: Accompanying individuals to libraries, parks, fitness centers, museums, and community classes.
Documentation: Activity logs, service delivery notes, goal tracking, and billing records.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Pennsylvania Department of State.
Obtain an EIN and Type 2 NPI.
Complete the provider qualification process through ODP via HCSIS.
Develop and submit a Community Integration service description (e.g., for In-Home & Community Habilitation or CPS).
Maintain general liability and workers’ compensation insurance.
Develop a Community Integration Services Policy & Procedure Manual aligned with ODP expectations.

4. PENNSYLVANIA PROVIDER ENROLLMENT PROCESS

Step 1: Form your business entity and obtain EIN, NPI, and insurance.

Step 2: Apply for provider qualification via HCSIS and submit required documentation.

Step 3: Work with your local Administrative Entity (AE) or County MH/ID office for approval.

Step 4: Finalize policy manuals, staff credentials, and service models.

Step 5: Begin receiving referrals from Supports Coordinators once authorized.

5. REQUIRED DOCUMENTATION

Articles of Incorporation and business registration
EIN and NPI confirmation
Insurance certificates (liability and workers’ comp)
Community Integration Policy & Procedure Manual including:
- Participant intake and goal-setting procedures
- Community activity planning and safety protocols
- ISP implementation tracking and documentation
- Transportation safety and risk assessment policies
- HIPAA and participant rights materials
- Emergency and incident response procedures
- Daily activity logs and Medicaid billing forms

6. STAFFING REQUIREMENTS

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

Requirements: High school diploma (minimum), background clearance, training in person-centered support and community-based services.

Role: Program Coordinator

Requirements: Manages schedules, documentation review, and ensures ISP alignment with community goals.

Optional Role: Behavior Support Aide

Requirements: May assist individuals with behavioral challenges during community activities.

All staff must complete:

ODP orientation and annual refresher training
HIPAA and abuse prevention certification
Emergency response and safety planning
Activity documentation and Medicaid billing procedures

7. MEDICAID WAIVER PROGRAMS

Community Integration Services are authorized through:

Consolidated Waiver (ODP):
- In-Home & Community Habilitation
- Community Participation Support
- Companion Services
Community Living Waiver (ODP):
- Similar services as above for individuals not living in licensed residential settings
Person/Family Directed Support (P/FDS) Waiver:
- Community integration services within the individual’s budget cap