HABILITATION SERVICES PROVIDER IN IDAHO

BUILDING SKILLS FOR GREATER INDEPENDENCE, PERSONAL GROWTH, AND COMMUNITY PARTICIPATION

Habilitation Services in Idaho support individuals with disabilities in learning and maintaining skills necessary for daily living, social interaction, and community integration. These services are authorized under Idaho’s Medicaid Home and Community-Based Services (HCBS) waiver programs and are a critical component in promoting long-term independence, self-determination, and quality of life.

1. GOVERNING AGENCIES

Agency: Idaho Department of Health and Welfare (IDHW) — Division of Medicaid

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

Agency: Centers for Medicare & Medicaid Services (CMS)

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

2. HABILITATION SERVICE OVERVIEW

Habilitation Services assist participants in acquiring, retaining, and improving self-help, socialization, adaptive, and daily living skills necessary to live successfully in home and community settings.

Approved providers may deliver:

• Personal care skill-building (e.g., hygiene, grooming, dressing)

• Domestic skills (e.g., meal preparation, laundry, housekeeping)

• Money management and budgeting skills

• Community navigation skills (e.g., using transportation, shopping)

• Social and communication skill development

• Self-advocacy, self-direction, and personal safety education

• Behavioral support skills to manage emotions and interactions

• Employment readiness activities (where included in the service plan)

All services must align with goals outlined in the participant’s Individualized Service Plan (ISP) and focus on helping individuals achieve maximum independence.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Idaho Secretary of State

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

• Enroll as a Medicaid provider through Idaho Medicaid Provider Enrollment

• Maintain general liability and professional liability insurance

• Develop participant-centered policies for skill assessment, service delivery, safety, and emergency response

• Employ staff trained in habilitation support, person-centered planning, and positive behavior supports

4. IDHW PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit Provider Enrollment Application for Habilitation Services through Idaho’s Medicaid Management Information System (MMIS)

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, staff qualification documentation, insurance certificates, and service policies

• Provide examples of skill-building plans, daily documentation logs, and participant safety protocols

Program Readiness Review:

• IDHW reviews provider readiness including staff training programs, participant protection measures, Medicaid billing compliance, and service monitoring systems

Approval & Medicaid Enrollment:

• Upon approval, configure billing codes for Habilitation Services (typically billed hourly)

5. REQUIRED DOCUMENTATION

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

• IRS EIN confirmation

• NPI confirmation

• Proof of general and professional liability insurance

• HCBS-Compliant Policy & Procedure Manual including:

  • Participant intake, skill assessment, and goal planning procedures

  • Daily skill-building activity protocols and progress monitoring

  • Risk management, emergency response, and incident reporting systems

  • HIPAA confidentiality, participant rights, and grievance handling policies

  • Staff credentialing, background checks, and competency documentation

  • Medicaid billing, authorization tracking, and audit readiness documentation

6. STAFFING REQUIREMENTS

Role: Habilitation Program Manager/Supervisor

Requirements: Bachelor’s degree preferred in human services, education, psychology, or related field; experience in skill-building or disability support services; background screening clearance

Role: Habilitation Technicians/Direct Support Professionals (DSPs)

Requirements: High school diploma or GED; CPR/First Aid certification recommended; experience in direct care preferred; background screening clearance

All staff must complete:

• HIPAA confidentiality and participant rights training

• Person-centered planning and habilitation skill-building training

• Emergency preparedness and abuse prevention training

• Annual continuing education and competency evaluations

7. MEDICAID WAIVER PROGRAMS

The following Idaho Medicaid Waivers authorize Habilitation Services:

• Developmental Disabilities (DD) Waiver

• Aged and Disabled (A&D) Waiver (for specific habilitation needs)

Approved providers may deliver:

• Skill development activities tailored to daily living and community participation

• Social and communication skill-building supports

• Behavior management and coping strategy education

• Self-advocacy and decision-making skills training

8. TIMELINE TO LAUNCH

Phase: Business Formation and Credentialing Setup

Timeline: 1–2 weeks

Phase: Staff Hiring, Credentialing, and Program Development

Timeline: 2–3 months

Phase: Idaho Medicaid Provider Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing System Configuration and Claims Management

Timeline: 30–45 days

9. CONTACT INFORMATION

Idaho Department of Health and Welfare (IDHW) — Medicaid Division

Website: https://healthandwelfare.idaho.gov/services-programs/medicaid-health

Centers for Medicare & Medicaid Services (CMS)

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

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

WCG supports habilitation providers, direct support agencies, and community-based organizations in launching Medicaid-compliant Habilitation Services under Idaho’s HCBS waiver programs.

Scope of Work:

• Business registration and EIN/NPI setup

• Medicaid provider enrollment assistance

• Development of Habilitation Services Policy & Procedure Manual

• Staff credentialing templates and participant skill-building tracking forms

• Medicaid billing system setup and claims management

• Website, domain, and email setup

• Participant intake, skill plan development, and daily progress documentation systems

• Quality assurance programs for skill acquisition and participant satisfaction tracking

• Community networking and social engagement partnership development strategies

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.