DAY HABILITATION SERVICES PROVIDER IN IOWA

SUPPORTING COMMUNITY ENGAGEMENT, SKILL DEVELOPMENT, AND SOCIAL INCLUSION IN STRUCTURED DAY SETTINGS

Day Habilitation Services in Iowa provide individuals with disabilities access to structured, community-based daytime programming focused on developing and maintaining independent living, communication, and social skills. These services are authorized under Iowa’s Home and Community-Based Services (HCBS) Waiver programs and are delivered outside of participants’ homes to promote personal growth and inclusion.

1. GOVERNING AGENCIES

Agency: Iowa Department of Health and Human Services (HHS) — Iowa Medicaid Enterprise (IME)

Role: Oversees waiver authorization, provider standards, and Medicaid enrollment for Day Habilitation Services

Agency: Managed Care Organizations (MCOs)

Role: Review service authorizations, issue reimbursements, and ensure Day Habilitation activities align with waiver goals

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring Day Habilitation Services comply with HCBS Settings Rule, person-centered planning, and quality of life requirements

2. DAY HABILITATION SERVICE OVERVIEW

Day Habilitation Services help individuals achieve greater independence, participate in the community, and enhance social, communication, and self-advocacy skills in group or individualized settings.

Approved providers may deliver:

• Instruction in self-care, communication, and independent living skills

• Social skill-building and peer interaction support

• Community participation, including volunteerism, recreation, or cultural experiences

• Self-advocacy and personal safety training

• Pre-vocational development and employment readiness (when applicable)

• Behavioral and emotional regulation support in group settings

• Age-appropriate life skill activities aligned with ISP goals

All services must be delivered in a non-residential setting that complies with the HCBS Settings Rule and be based on goals outlined in the participant’s Individualized Service Plan (ISP).

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Iowa Secretary of State

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

• Enroll as a Medicaid provider through Iowa Medicaid’s Provider Portal (IMPA)

• Secure appropriate facility space that meets ADA and HCBS Settings Rule compliance

• Maintain general liability and professional liability insurance

• Develop policies covering ISP alignment, group safety, emergency response, and behavior support

• Ensure all staff complete required background checks and habilitation-specific training

4. IOWA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit provider application via IMPA for Day Habilitation Services

• Coordinate with MCOs for participant-level service authorization

Documentation Submission:

• Submit Articles of Incorporation, EIN/NPI verification, policy manual, safety protocols, and program structure description

Readiness Review:

• IME and/or MCO may conduct a program readiness review, facility walkthrough, and staff interviews

Approval & Medicaid Enrollment:

• Upon approval, providers receive authorization to bill for Day Habilitation Services, typically in daily or 15-minute units

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Iowa Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Proof of general liability and professional liability insurance

• Day Habilitation Policy & Procedure Manual including:

  • Participant intake, skill assessment, and goal tracking procedures

  • Daily activity planning and ISP-aligned programming

  • Behavior support strategies and emergency response plans

  • Participant rights, HIPAA compliance, and grievance policies

  • Staff credentialing, training logs, and background checks

  • Medicaid billing logs, attendance records, and audit-ready documentation

6. STAFFING REQUIREMENTS

Role: Day Habilitation Program Supervisor

Requirements: Background in human services, education, or developmental disability services; supervisory experience; background clearance

Role: Day Habilitation Direct Support Staff

Requirements: High school diploma or GED; experience in habilitation or group facilitation preferred; training in behavioral support and community safety; background screening clearance

All staff must complete:

• Abuse prevention and participant rights training

• Person-centered planning and HCBS Settings Rule training

• Community integration and emergency preparedness training

• Annual competency assessments and continuing education updates

7. MEDICAID WAIVER PROGRAMS

Day Habilitation Services are authorized under the following Iowa HCBS Waivers:

• Intellectual Disability (ID) Waiver

• Brain Injury (BI) Waiver

• Health and Disability (HD) Waiver

Approved providers may deliver:

• Group-based community engagement activities

• Functional skill development aligned with ISP

• Integrated social and self-advocacy programming

• Daily habilitation tasks that enhance independence and reduce reliance on paid support

8. TIMELINE TO LAUNCH

Phase: Business Formation and Facility Compliance Setup

Timeline: 1–2 months

Phase: Staff Hiring, Credentialing, and Program Development

Timeline: 2–3 months

Phase: Iowa Medicaid Enrollment and MCO Authorization

Timeline: 60–90 days

Phase: Billing Setup and Day Habilitation Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

Iowa Medicaid Enterprise (IME)

Website: https://ime.iowa.gov/providers

Iowa Department of Health and Human Services (HHS)

Website: https://hhs.iowa.gov

Managed Care Organizations (MCOs):

• Amerigroup Iowa: https://www.myamerigroup.com/ia

• Iowa Total Care: https://www.iowatotalcare.com

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — IOWA DAY HABILITATION PROVIDER

WCG supports HCBS agencies, adult day programs, and habilitation centers in launching Medicaid-compliant Day Habilitation Services across Iowa.

Scope of Work:

• Business registration, Medicaid provider enrollment, and facility compliance support

• Development of Day Habilitation Services Policy & Procedure Manual

• Staff credentialing templates, attendance logs, and ISP-aligned documentation tools

• Medicaid billing setup and documentation support

• Website, domain, and professional branding

• Quality assurance systems for outcome tracking, skill development, and program audits

• Partnership development with MCO case managers, school transition programs, and family support networks

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.