HABILITATION SERVICES PROVIDER IN OREGON

Fatumata Kaba
Oct 6
4 min read

SUPPORTING SKILL-BUILDING, COMMUNITY INTEGRATION, AND INDEPENDENT LIVING FOR OREGONIANS WITH DEVELOPMENTAL DISABILITIES

Habilitation Services in Oregon are Medicaid-funded supports that help individuals with intellectual and developmental disabilities (IDD) acquire, retain, and improve daily living skills. Unlike rehabilitation (which focuses on restoring lost skills), habilitation focuses on developing new skills in communication, mobility, socialization, self-care, and community living. These services are a cornerstone of Oregon’s HCBS (Home and Community-Based Services) waiver programs and the K Plan (Community First Choice Option), all authorized under the Oregon Health Plan (OHP).

1. GOVERNING AGENCIES

Agency: Oregon Department of Human Services (ODHS) – Developmental Disabilities Services (DDS)

Role: Oversees approval, funding, and oversight of habilitation services delivered through local Community Developmental Disabilities Programs (CDDPs).

Agency: Oregon Health Authority (OHA)

Role: Administers the Oregon Health Plan and manages Medicaid provider enrollment and compliance.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Ensures federal compliance for habilitative services under HCBS waiver programs and 1915(k) authorities.

Agency: Oregon Secretary of State (SOS)

Role: Registers provider organizations as legal business entities in Oregon.

2. HABILITATION SERVICES OVERVIEW

Habilitation Services help individuals with IDD develop meaningful skills that promote autonomy, integration, and personal growth.

Approved providers may deliver:

Community Habilitation: Support for participation in community activities, public transportation use, and social skill-building.
In-Home Habilitation: Daily living skills training such as hygiene, cooking, money management, and safety awareness.
Supported Employment (optional): Job coaching and skill development for competitive employment (if authorized).
Adaptive Skill Development: Instruction in communication, personal responsibility, and emotional regulation.
Recreation and Socialization Support: Access to inclusive activities and opportunities for peer engagement.
Care Planning & Documentation: Individual support plans, data collection, and Medicaid billing records.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business with the Oregon Secretary of State.
Obtain an EIN from the IRS and a Type 2 NPI.
Enroll as a Medicaid provider via the Oregon Health Plan Provider Portal.
Become a certified DD service provider through ODHS/DDS in collaboration with the local CDDP.
Carry general liability and workers’ compensation insurance.
Develop a Habilitation Services Policy & Procedure Manual aligned with Oregon Medicaid and DDS requirements.

4. OREGON PROVIDER ENROLLMENT PROCESS

Step 1: Form your LLC or nonprofit and obtain EIN/NPI and insurance.

Step 2: Apply for Medicaid enrollment through OHA’s Provider Portal.

Step 3: Complete ODHS/DDS application process and background checks.

Step 4: Meet training requirements and submit your policies and program materials.

Step 5: After certification, begin coordinating with the local CDDP and accepting client referrals.

5. REQUIRED DOCUMENTATION

Business registration and Articles of Incorporation
EIN and NPI confirmations
Insurance certificates (liability, workers’ comp)
DDS Provider Certification (via local CDDP)
Habilitation Services Policy & Procedure Manual including:
- Individual Support Plan development guidelines
- Community inclusion and skill-building protocols
- Behavior and safety planning (if applicable)
- Staff training and supervision policies
- HIPAA compliance and participant rights materials
- Data collection and documentation templates
- Quality assurance and incident reporting systems
- Medicaid billing and service tracking forms

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP) / Habilitation Specialist

Requirements: Background check; trained in person-centered planning, ADL/IADL skill-building, and safety practices.

Role: Program Coordinator / Supervisor

Requirements: Manages client schedules, supervises DSPs, and ensures compliance with ISP goals and Medicaid regulations.

Role: Behavior Support Consultant (optional)

Requirements: Assists in supporting individuals with behavioral needs; must hold appropriate licenses/certifications.

All staff must complete:

ODHS core competency training for DSPs
First Aid/CPR and abuse reporting certification
HIPAA and rights training
ISP goal tracking and documentation training
Annual recertification and performance evaluation

7. MEDICAID WAIVER PROGRAMS

Habilitation Services in Oregon are funded through:

Comprehensive Waiver (for IDD): Full-service habilitation supports, including community inclusion and skill development.
Support Services Waiver (for IDD): Tailored services for adults living in their own homes or with family.
Children’s DD Waiver: In-home and community habilitation for children with IDD.
K Plan (1915(k)): Includes personal support and habilitation services for individuals eligible under the Community First Choice option.

8. TIMELINE TO LAUNCH

Phase: Business Registration & Manual Development

Timeline: 1–2 months

Phase: Medicaid Enrollment & DDS Certification

Timeline: 2–3 months

Phase: Staff Hiring, Training, and Background Checks

Timeline: 30–60 days

Phase: Referral Coordination & Service Activation

Timeline: Begins as soon as approved and connected with local CDDPs

9. CONTACT INFORMATION

Oregon Department of Human Services – Developmental Disabilities Services (DDS)

Website: https://www.oregon.gov/dhs/DD

Oregon Health Authority (OHA)

Website: https://www.oregon.gov/oha

Oregon Health Plan Provider Enrollment

Website: https://www.oregon.gov/oha/HSD/OHP/Pages/Providers.aspx

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov

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

WCG guides habilitation providers in Oregon to establish fully compliant, person-centered service programs for individuals with developmental disabilities.

Scope of Work: