HABILITATION SERVICES PROVIDER IN HAWAII

SUPPORTING SKILL DEVELOPMENT AND INDEPENDENT LIVING FOR INDIVIDUALS WITH DISABILITIES THROUGH STRUCTURED, PERSON-CENTERED SERVICES

Habilitation Services in Hawaii are designed to assist individuals with disabilities in acquiring, retaining, and improving skills necessary for daily living, employment, and full community participation. These services are authorized under Hawaii’s Medicaid Home and Community-Based Services (HCBS) waiver programs and are a critical part of promoting independence and enhancing quality of life.

​​​1. GOVERNING AGENCIES

Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division

Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Habilitation Services

Agency: Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)

Role: Administers HCBS waiver habilitation services for individuals with intellectual and developmental disabilities

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring Habilitation Services meet Medicaid HCBS community-based and person-centered standards

2. HABILITATION SERVICE OVERVIEW

Habilitation Services are person-centered supports focused on building or maintaining skills essential for daily living, communication, social interaction, and community integration.

Approved providers may deliver:

• Training and assistance with Activities of Daily Living (ADLs) such as bathing, dressing, grooming, and eating

• Support with Instrumental Activities of Daily Living (IADLs) such as cooking, money management, shopping, and household tasks

• Communication skills development

• Social skills training and participation in community activities

• Mobility and orientation assistance

• Self-advocacy and decision-making support

• Pre-employment skill-building and support

All services must align with the participant’s Individualized Service Plan (ISP) and promote independence, dignity, and meaningful community engagement.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register your business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)

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

• Enroll as a Medicaid provider through the Hawaii Med-QUEST Division

• Complete DDD Provider Standards Certification (for services under DD/ID Waiver)

• Maintain general liability and professional liability insurance

• Develop comprehensive policies addressing participant rights, skill development strategies, safety, and emergency response

4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit Provider Enrollment Application for Habilitation Services under Hawaii’s HCBS waivers

• Indicate service types (e.g., Community-Based Habilitation, In-Home Habilitation)

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, operational and staffing plans, sample service plans, and insurance certificates

• Include participant intake forms, skill assessment templates, and daily documentation tools

Program Readiness Review:

• DHS and DOH review provider readiness, including training protocols, participant safeguards, documentation compliance, and service models

Approval & Medicaid Enrollment:

• Upon approval, configure billing codes for Habilitation Services (community-based and/or in-home supports)

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Hawaii DCCA)

• IRS EIN confirmation

• NPI confirmation

• Proof of general and professional liability insurance

• HCBS-Compliant Policy & Procedure Manual including:

  • Participant intake, assessment, and individualized habilitation planning

  • Skill development support strategies and training protocols

  • Daily service documentation and outcome tracking

  • HIPAA confidentiality, participant rights, and grievance policies

  • Staff credentialing, background screening, and competency verification

  • Medicaid billing, service authorization tracking, and audit readiness systems

6. STAFFING REQUIREMENTS

Role: Habilitation Program Manager / Supervisor

Requirements: Bachelor's degree in human services, social work, education, or related field preferred; experience with skill-building and disability supports; background screening clearance

Role: Direct Support Professionals (DSPs) / Habilitation Specialists

Requirements: High school diploma or GED; CPR/First Aid certification; specialized training in habilitation service delivery; background screening clearance

All staff must complete:

• HIPAA confidentiality and participant rights training

• Person-centered planning and community integration training

• Emergency preparedness, abuse prevention, and incident reporting training

• Annual refresher training on habilitation service delivery and Medicaid compliance

7. MEDICAID WAIVER PROGRAMS

The following Hawaii Medicaid Waivers authorize Habilitation Services:

• Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver

Approved providers may deliver:

• Community-Based Habilitation Services (focused on skill development in integrated settings)

• In-Home Habilitation Services (skill-building supports delivered in a participant’s residence)

• Intensive habilitation supports where behavioral, medical, or specialized skill instruction is necessary

8. TIMELINE TO LAUNCH

Phase: Business Formation and Initial Credentialing Setup

Timeline: 1–2 weeks

Phase: Med-QUEST and DDD Provider Application and Readiness Review

Timeline: 60–90 days

Phase: Staff Hiring, Credentialing, and Habilitation Program Setup

Timeline: 30–45 days

Phase: Medicaid Enrollment and Billing System Setup

Timeline: 45–60 days

9. CONTACT INFORMATION

Hawaii Department of Human Services (DHS) — Med-QUEST Division

Website: https://medquest.hawaii.gov/

Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)

Website: https://health.hawaii.gov/ddd/

Centers for Medicare & Medicaid Services (CMS)

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

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII HABILITATION SERVICES PROVIDER

WCG supports community organizations, disability service agencies, and human service providers in launching Medicaid-compliant Habilitation Services under Hawaii’s HCBS waiver programs.

​​​​​​​​​​​​​​​​​​​​​​​​Scope of Work:

• Business registration and EIN/NPI setup

• Medicaid and DDD provider enrollment support

• Development of Habilitation Services Policy & Procedure Manual

• Staff credentialing templates and participant skill assessment forms

• Medicaid billing system setup and claims management

• Website, domain, and email setup

• Participant intake, habilitation planning, and daily service documentation templates

• Emergency preparedness and incident reporting systems

• Quality assurance programs for skill development outcome tracking

• Community networking and interdisciplinary collaboration strategies

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