MEAL AND NUTRITION SERVICES PROVIDER IN HAWAII

SUPPORTING HEALTH, INDEPENDENCE, AND WELL-BEING THROUGH NUTRITIONAL PLANNING AND MEAL DELIVERY

Meal and Nutrition Services in Hawaii provide individuals with disabilities, chronic health conditions, or aging-related needs access to healthy, nutritionally balanced meals. These services are authorized under Hawaii’s Medicaid Home and Community-Based Services (HCBS) waiver programs, promoting community living, health maintenance, and overall 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 Meal and Nutrition Services

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

Role: Administers HCBS waiver meal and nutrition support services for individuals with intellectual and developmental disabilities (IDD)

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight, ensuring Meal and Nutrition Services meet Medicaid HCBS health and safety standards

2. MEAL AND NUTRITION SERVICE OVERVIEW

Meal and Nutrition Services help ensure that individuals have consistent access to meals that meet their dietary needs, support their health conditions, and enable independent living.

Approved providers may deliver:

• Preparation and delivery of nutritious meals (home-delivered or provided at congregate sites)

• Menu planning based on participants’ medical and dietary needs

• Nutrition education and counseling (where authorized)

• Specialized meals for participants with medical conditions such as diabetes, cardiac disease, or swallowing disorders

• Culturally appropriate meal planning and adaptations

• Monitoring participant nutrition and alerting case managers to concerns

Meals must meet minimum nutritional standards and be tailored to individual dietary preferences and medical needs, as specified in the participant’s Individualized Service Plan (ISP).

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 with Hawaii’s Med-QUEST Division

• Maintain general liability and product liability insurance

• Follow Hawaii Department of Health (DOH) food safety regulations (obtain a food establishment permit if preparing meals)

• Develop policies for meal preparation, delivery safety, food handling, and emergency backup meal services

4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit Provider Enrollment Application for Meal and Nutrition Services through Hawaii’s Med-QUEST Division

• Identify whether services will include home-delivered meals, congregate meals, or nutritional counseling

Application and Documentation Submission:

• Submit Articles of Incorporation, proof of EIN/NPI, food safety certification, proof of insurance, operational policies, and sample menus

Program Readiness Review:

• DHS and DOH review provider readiness, including food safety compliance, meal preparation practices, delivery protocols, and service documentation systems

Approval & Medicaid Enrollment:

• Upon approval, configure billing codes for Meal Preparation, Meal Delivery, and Nutrition Counseling Services (where authorized)

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Hawaii DCCA)

• IRS EIN confirmation

• NPI confirmation

• Food establishment permit (if operating a commercial kitchen)

• Proof of general and product liability insurance

• HCBS-Compliant Policy & Procedure Manual including:

  • Participant intake and dietary needs assessment procedures

  • Meal preparation, packaging, and delivery protocols

  • Food safety and sanitation practices

  • Emergency meal planning and delivery backup systems

  • HIPAA confidentiality, participant rights, and grievance handling policies

  • Staff credentialing, background checks, and food safety training records

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

6. STAFFING REQUIREMENTS

Role: Meal Services Program Manager / Nutrition Coordinator

Requirements: Background in nutrition, dietetics, food service management, or related field preferred; ServSafe certification or equivalent; background screening clearance

Role: Cooks / Food Service Workers / Meal Delivery Drivers

Requirements: Food handler’s card (where required); CPR/First Aid certification recommended for drivers; background screening clearance

All staff must complete:

• Food safety and handling training (e.g., ServSafe)

• HIPAA confidentiality and participant rights training

• Emergency preparedness and incident reporting training

• Annual refresher training in food sanitation and participant safety

7. MEDICAID WAIVER PROGRAMS

The following Hawaii Medicaid Waivers authorize Meal and Nutrition Services:

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

• Community Care Services (CCS) Program (if meal supports are essential for maintaining health and community living)

Approved providers may deliver:

• Home-delivered meals (including specialized diets)

• Congregate meals (in authorized community settings)

• Nutritional assessments and counseling (where authorized)

8. TIMELINE TO LAUNCH

Phase: Business Formation and Food Service Credentialing Setup

Timeline: 1–2 weeks

Phase: Food Safety Compliance and Facility Setup

Timeline: 1–2 months

Phase: Med-QUEST Provider Application and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Enrollment and Billing System Configuration

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/

Hawaii Department of Health (DOH) — Sanitation Branch (for food establishment permits)

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

Centers for Medicare & Medicaid Services (CMS)

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

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII MEAL AND NUTRITION SERVICES PROVIDER

WCG supports food service companies, home health agencies, and community-based organizations in launching Medicaid-compliant Meal and Nutrition Services under Hawaii’s HCBS waiver programs.

Scope of Work:

• Business registration and EIN/NPI setup

• Food establishment licensing and Medicaid provider enrollment support

• Development of Meal and Nutrition Services Policy & Procedure Manual

• Staff credentialing templates and participant dietary assessment forms

• Medicaid billing setup and claims management

• Website, domain, and email setup

• Meal intake tracking, delivery verification, and nutrition monitoring documentation

• Food safety systems and emergency meal planning protocols

• Quality assurance programs for participant satisfaction and health outcome monitoring

• Community networking and case manager referral strategies

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