DAY HABILITATION SERVICES PROVIDER IN NEW YORK

Fatumata Kaba
Sep 4
4 min read

SUPPORTING PERSONAL GROWTH AND COMMUNITY INTEGRATION THROUGH STRUCTURED DAY PROGRAMS

Day Habilitation Services in New York offer structured, community-based programs designed to support individuals with developmental disabilities or chronic conditions in achieving greater independence and community engagement. These services focus on skill development, socialization, and personal growth in a safe and supportive environment. Day Habilitation Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: New York State Department of Health (NYSDOH)

Role: Administers Medicaid waiver funding for Day Habilitation Services and oversees provider enrollment, service authorization, and reimbursement.

Agency: Office for People With Developmental Disabilities (OPWDD)

Role: Provides oversight for day habilitation services targeting individuals with developmental disabilities.

Agency: New York State Office of Mental Health (OMH)

Role: Ensures compliance for day programs serving individuals with mental and behavioral health needs.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight to ensure Medicaid-funded Day Habilitation Services meet quality, safety, and person-centered care standards.

2. DAY HABILITATION SERVICES OVERVIEW

Day Habilitation Services provide individuals with opportunities to develop essential life skills, engage in social and recreational activities, and participate in community integration.

Approved providers may deliver:

Skill Development: Focusing on communication, socialization, and daily living skills.
Personal Enrichment: Activities that build self-confidence and independence.
Community Participation: Outings and group activities to encourage social inclusion.
Health and Wellness Programs: Promoting physical activity and healthy habits.
Recreational Activities: Arts, crafts, music, and other therapeutic engagements.
Behavioral Support: Addressing challenging behaviors with positive interventions.
Life Skills Training: Cooking, budgeting, and using public transportation.
Self-Advocacy Training: Encouraging participants to express their needs and preferences.
Safety and Supervision: Ensuring a secure environment for daily activities.
Documentation: Maintaining accurate records of progress, participation, and outcomes.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Day Habilitation provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for daily programming, safety procedures, and community integration.
Ensure staff complete required background checks, health screenings, and training in habilitation techniques.

4. NEW YORK PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Complete the Provider Enrollment Application via the eMedNY Portal for Day Habilitation Services under HCBS waivers.

Application and Documentation Submission:

Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, habilitation policies, and staff training documentation.

Program Readiness Review:

NYSDOH, OPWDD, and OMH evaluate provider readiness, including safety protocols, habilitation standards, and staff qualifications.

Approval & Medicaid Enrollment:

Upon approval, providers are authorized to bill Medicaid for Day Habilitation Services using designated billing codes.

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Day Habilitation Policy & Procedure Manual including:
- Daily programming and community engagement guidelines
- Skill development and personal enrichment procedures
- Safety, supervision, and behavioral support protocols
- Staff credentialing, background checks, and ongoing training records
- Documentation standards for care tracking and Medicaid billing
- HIPAA compliance, participant rights, and grievance handling
- Emergency response and safety protocols
- Quality assurance and compliance monitoring

6. STAFFING REQUIREMENTS

Role: Day Habilitation Program Director

Requirements: Bachelor’s or Master’s degree in social work, human services, or healthcare administration; experience in day habilitation program management.

Role: Habilitation Specialists

Requirements: Bachelor’s degree in human services or a related field; experience in skill development and community integration.

Role: Direct Support Professionals (DSPs)

Requirements: High school diploma or GED; training in habilitation support; experience working with individuals with developmental disabilities; background clearance.

All staff must complete:

Training in habilitation practices, community engagement, and client interaction
HIPAA compliance and participant rights education
Annual competency evaluations and ongoing professional development
Safety, emergency response, and behavior management training
Documentation and record-keeping best practices