RESIDENTIAL CARE SERVICES PROVIDER IN CONNECTICUT

SUPPORTING INDIVIDUALS WITH SAFE, STRUCTURED, AND COMMUNITY-BASED LIVING ARRANGEMENTS

Residential Care Services in Connecticut offer housing and supportive services to individuals with disabilities, chronic health conditions, or aging-related needs in a structured environment. These services are authorized under Connecticut’s Medicaid Home and Community-Based Services (HCBS) waiver programs and state-supported programs, promoting independence, health, and community integration outside of institutional settings.

1. GOVERNING AGENCIES

Agency: Connecticut Department of Social Services (DSS)

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

Agency: Connecticut Department of Developmental Services (DDS)

Role: Administers HCBS waiver residential programs for individuals with intellectual and developmental disabilities (IDD)

Agency: Connecticut Department of Public Health (DPH)

Role: Licenses Residential Care Homes (RCHs) and monitors regulatory compliance

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight ensuring Residential Care Services meet Medicaid HCBS community-based standards

2. RESIDENTIAL CARE SERVICE OVERVIEW

Residential Care Services support individuals in community-based settings by providing housing, personal care assistance, supervision, and support with activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

Approved providers may deliver:

• Assistance with ADLs (e.g., bathing, dressing, toileting, grooming)

• Medication reminders and health monitoring (non-nursing tasks unless licensed)

• Meal preparation and nutritional support

• Laundry and housekeeping assistance

• 24-hour supervision and safety monitoring

• Recreational, educational, and social activity facilitation

• Community integration and skill-building support

Services must align with the participant’s Individualized Service Plan (ISP) and be designed to promote choice, independence, and community participation.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Connecticut Secretary of State

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

• Obtain Residential Care Home (RCH) license if operating a licensed facility (through DPH)

• Enroll as a Medicaid provider through Connecticut’s Medical Assistance Program (CMAP)

• Maintain general liability and professional liability insurance

• Develop policies for resident intake, service delivery, health and safety, emergency preparedness, and participant rights

4. DSS/DPH PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit application for RCH licensing (if applicable) through the Department of Public Health

• Submit Provider Enrollment Application for Residential Care Services through Connecticut’s DSS

Application and Documentation Submission:

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

• Provide safety protocols, medication assistance plans, participant intake forms, and incident response procedures

Licensure and Readiness Review:

• Undergo a DPH licensure survey (if operating a Residential Care Home)

• DSS reviews program structure, participant protections, Medicaid billing readiness, and service documentation systems

Approval & Medicaid Enrollment:

• Upon approval, configure billing codes for Residential Care Services under the applicable HCBS waivers and CMAP

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business Registration (Connecticut Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Residential Care Home License (if applicable, issued by DPH)

• Proof of general and professional liability insurance

• HCBS-Compliant Policy & Procedure Manual including:

  • Participant intake, assessment, and service planning procedures

  • Health monitoring, medication reminders, and personal care assistance protocols

  • Emergency preparedness, fire safety, and evacuation procedures

  • Recreational activity planning and community integration supports

  • HIPAA confidentiality, participant rights, and grievance handling procedures

  • Staff credentialing, background checks, and training documentation

  • Medicaid billing, service tracking, and audit readiness documentation

6. STAFFING REQUIREMENTS

Role: Residential Program Manager / Administrator

Requirements: Experience in human services management or healthcare administration preferred; background screening clearance

Role: Direct Support Professionals (DSPs) / Residential Aides

Requirements: High school diploma or GED; CPR/First Aid certification; training in personal care support; background screening clearance

Role: Medication Administration Certified Staff (if providing medication reminders or administration)

Requirements: Certification through Connecticut-approved Medication Administration Program (MAP)

All staff must complete:

• HIPAA confidentiality and participant rights training

• Abuse prevention, emergency response, and health and safety training

• Annual competency evaluations and continuing education in residential care best practices

7. MEDICAID WAIVER PROGRAMS

The following Connecticut Medicaid Waivers authorize Residential Care Services:

• Intellectual Disability (ID) Waiver

• Autism Waiver (for certain residential support models)

• Community First Choice (CFC) Option (for home- and community-based personal care supports)

• Personal Care Assistance (PCA) Waiver (in some independent living models)

Approved providers may deliver:

• Residential supports tied to daily living skills, personal care, and supervision

• Assistance with accessing community activities and supports

• Health and safety oversight within community living environments

8. TIMELINE TO LAUNCH

Phase: Business Formation and Licensing Application

Timeline: 2–4 months

Phase: Facility Setup (if required) and Staffing Development

Timeline: 2–3 months

Phase: DSS Provider Enrollment and Program Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing System Setup and Claims Management Readiness

Timeline: 30–45 days

9. CONTACT INFORMATION

Connecticut Department of Social Services (DSS)

Website: https://portal.ct.gov/DSS

Connecticut Department of Developmental Services (DDS)

Website: https://portal.ct.gov/DDS

Connecticut Department of Public Health (DPH)

Website: https://portal.ct.gov/DPH

Centers for Medicare & Medicaid Services (CMS)

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

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — CONNECTICUT RESIDENTIAL CARE SERVICES PROVIDER

WCG supports residential agencies, housing programs, and disability service organizations in launching Medicaid-compliant Residential Care Services under Connecticut’s HCBS waiver programs.

Scope of Work:

• Business registration and EIN/NPI setup

• Licensing guidance for Residential Care Homes (if applicable)

• Medicaid provider enrollment and credentialing support

• Development of Residential Care Services Policy & Procedure Manual

• Staff credentialing templates and participant intake/service planning documents

• Medicaid billing configuration and claims management

• Website, domain, and email setup

• Participant intake, service coordination, and incident documentation systems

• Quality assurance programs for residential service delivery and participant safety monitoring

• Community networking and supportive housing partnership strategies

Continue To Our Client Portal To Get Started

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