Residential Care Provider in Alabama

Fatumata Kaba
2 days ago
3 min read

24/7 Community-Based Living for Individuals with Intellectual and Developmental Disabilities

Residential Care Services in Alabama provide long-term, 24-hour support to individuals with developmental disabilities in a community-based, home-like setting. These services are regulated under the Alabama Department of Mental Health (ADMH) through the Home and Community-Based Services (HCBS) Medicaid Waiver.

1. Governing Agencies

Agency: Alabama Department of Mental Health (ADMH)Role: Licenses and certifies residential HCBS waiver providers, including group homes and supported living services

Agency: Alabama Medicaid Agency

Role: Administers Medicaid enrollment and reimbursement

Agency: Centers for Medicare & Medicaid Services (CMS)Role: Federal oversight and regulation of HCBS Waiver programs

2. Residential Service Overview

Residential care provides 24/7 supervised support in a group home or supported living environment. Services are individualized based on each person's person-centered plan and may include:

Assistance with activities of daily living (ADLs)
Medication administration
Behavioral support and habilitation
Transportation and community integration
Daily routines, skill-building, and self-advocacy training

Residential settings may serve 1–4 individuals and must comply with health, safety, and life safety standards.

3. Licensing & Provider Approval Requirements

Prerequisites:

Register business with Alabama Secretary of State
Obtain EIN and NPI (Type 2)
Secure a physical location suitable for residential services
Ensure home meets zoning, fire, and life safety codes
Develop required staffing and supervision plan
Ensure compliance with ADMH Residential Service Standards

4. ADMH Provider Enrollment Process

Initial Interest and Application:

Complete ADMH Provider Application Packet (request via ADMH)
Submit proposed business model and service approach
Include: policies, staffing structure, financial plan, organizational chart

Background & Credentialing:

Fingerprint-based criminal background checks for all staff
Central registry checks for abuse/neglect
Drug screening and eligibility review

Site Inspection & Review:

Life safety and fire inspections
Environmental safety and infection control measures
Review of training records, staff files, and policy manual
Assessment of home layout, accessibility, and documentation system

Approval & Medicaid Enrollment:

Upon ADMH approval, enroll as a Medicaid provider with Alabama Medicaid
Add service codes for Residential Habilitation and related services

5. Required Documentation

Articles of Incorporation or LLC Certificate
IRS EIN Letter
NPI confirmation
Lease or deed for residential site
Floor plan, Fire Marshal inspection, and occupancy certificate
ADMH-compliant Policy & Procedure Manual covering:
- Admission/discharge
- Emergency response and evacuation
- Staff-to-client ratio and supervision
- Medication management
- Behavioral interventions (if applicable)
- Client rights and safety
- Incident reporting and quality assurance
Staff training plan and job descriptions
Person-Centered Service Plans
Community Integration and Daily Living Activities Schedule

6. Staffing Requirements

Role: Administrator

Requirements: Experience managing IDD residential services; knowledge of ADMH regulations

Role: Direct Support Professional (DSP)Requirements: High school diploma/GED, CPR/First Aid certification, abuse prevention training, medication administration (if delegated)

Role: House Manager or Lead Staff (optional)Requirements: Supervisory experience, scheduling, staff support

All staff must complete:

ADMH-mandated training and orientation
Annual in-service training (as required by ADMH)
Person-specific care training based on resident needs

7. Medicaid Waiver Services

Waivers that authorize residential care services in Alabama:

ID Waiver (Intellectual Disabilities Waiver)
LAH Waiver (Living at Home Waiver, limited residential)
State of Alabama Community Waiver Program

Approved Residential Providers may deliver:

Residential Habilitation
Community Integration Support
Behavioral Services (if qualified)
Respite (in-residence, if approved)

8. Timeline to Launch

Phase: Business Formation

Timeline: 0–1 week

Phase: ADMH Application Review

Timeline: 60–120 days

Phase: Licensing & Site Review

Timeline: 30–60 days

Phase: Medicaid Enrollment

Timeline: 60–90 days

9. Contact Information

Alabama Department of Mental Health (ADMH) – Division of Developmental Disabilities Email: ddprovider@mh.alabama.govPhone: (334) 242-3702 Website: https://mh.alabama.gov

Alabama Medicaid Agency – Waiver Services Website: https://medicaid.alabama.gov