RESIDENTIAL CARE SERVICES PROVIDER IN RHODE ISLAND

Fatumata Kaba
Oct 9
4 min read

SUPPORTING COMMUNITY-BASED LIVING WITH 24/7 CARE AND INDEPENDENCE FOR INDIVIDUALS WITH DISABILITIES OR COMPLEX NEEDS

Residential Care Services in Rhode Island provide long-term, round-the-clock support to individuals who require supervised living arrangements due to developmental disabilities, behavioral health needs, or complex medical conditions. These services are primarily funded under the state’s Medicaid 1115 Global Waiver and managed by the Department of Behavioral Healthcare, Developmental Disabilities & Hospitals (BHDDH) and the Executive Office of Health and Human Services (EOHHS). Residential options range from group homes to shared living environments and staffed apartments.

1. GOVERNING AGENCIES

Agency: Rhode Island Executive Office of Health and Human Services (EOHHS)

Role: Oversees Medicaid funding, provider enrollment, and residential program compliance under the 1115 waiver.

Agency: Department of Behavioral Healthcare, Developmental Disabilities & Hospitals (BHDDH)

Role: Licenses and monitors residential service providers for individuals with IDD.

Agency: Rhode Island Department of Health (RIDOH)**

Role: Regulates facility safety, infection control, and clinical oversight if health-related services are provided.

Agency: Centers for Medicare & Medicaid Services (CMS)**

Role: Ensures federal HCBS compliance and residential setting standards.

2. RESIDENTIAL CARE SERVICES OVERVIEW

Residential care provides a structured, home-like environment with individualized services that support personal development, health, and community involvement.

Approved providers may deliver:

24-Hour Supervision & Support: Trained staff present at all times for assistance and safety.
Personal Care & ADL Support: Bathing, dressing, grooming, toileting, and mobility assistance.
Medication Administration: RN oversight or delegated staff for medication delivery.
Behavioral Support Services: Implementation of behavior plans and mental health support.
Life Skills Development: Cooking, laundry, cleaning, and self-advocacy coaching.
Community Integration: Day programming, volunteer work, outings, and social skill-building.
Individualized Service Plan (ISP) Implementation: Tailored goals and progress documentation.
Transportation Coordination: To appointments, work, or social events.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register your business entity with the Rhode Island Secretary of State.
Obtain an EIN and Type 2 NPI.
Submit a residential services provider application to BHDDH.
Comply with RIDOH health and safety regulations for facilities (if applicable).
Meet HCBS Final Rule standards for person-centered, integrated residential settings.
Develop a Residential Services Policy & Procedure Manual that includes safety, staffing, ISP implementation, and documentation protocols.

4. RHODE ISLAND PROVIDER ENROLLMENT PROCESS

Step 1: Form a legal entity and acquire EIN, NPI, and required insurance.

Step 2: Apply for provider approval with BHDDH for residential supports.

Step 3: Prepare a staffing plan, physical site review, and policy manual submission.

Step 4: Enroll with Medicaid through the RI provider portal and submit credentials.

Step 5: Upon approval, receive participant referrals and begin ISP-based service delivery.

5. REQUIRED DOCUMENTATION

Articles of Incorporation and business registration
EIN and NPI confirmations
Proof of Medicaid and BHDDH enrollment
Property compliance (zoning, fire safety, occupancy limits)
Insurance certificates (liability, workers’ comp, property, vehicle)
Residential Services Policy & Procedure Manual including:
- Supervision and staffing ratios
- Emergency procedures and incident reporting
- ISP implementation and progress monitoring
- Medication administration and health oversight
- Participant rights, privacy, and abuse prevention
- House rules and visitor policies

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP)

Requirements: CPR/First Aid, background check, abuse prevention training, person-centered service experience.

Role: House Manager or Residential Supervisor

Requirements: Staff scheduling, training oversight, ISP coordination, and home operations.

Role: Registered Nurse (if required)

Requirements: Supports medication oversight, health monitoring, and documentation reviews.

Role: Behavior Specialist (if authorized)

Requirements: Develops and monitors behavioral support plans.

All staff must complete:

HIPAA and mandatory reporting training
ISP documentation and outcome tracking
Emergency preparedness and safety drills
Annual skills review and professional development
Community inclusion and client rights education

7. MEDICAID WAIVER PROGRAMS

Residential Care Services are funded through:

BHDDH IDD Waivers (Community Living Arrangement): Primary source for residential group home funding.
Shared Living Arrangement Waiver: Family-style living with stipends and oversight.
1115 Global Waiver (HCBS): Allows innovative models for residential support.
Self-Directed Waivers: Participants may choose residential services from approved providers.

8. TIMELINE TO LAUNCH

Phase: Business Formation & Policy Manual Creation

Timeline: 1–2 months

Phase: BHDDH Application & Medicaid Enrollment

Timeline: 2–3 months

Phase: Property Setup, Staff Hiring & Training

Timeline: 30–60 days

Phase: Participant Referral & Service Start

Timeline: Begins after enrollment and successful readiness review

9. CONTACT INFORMATION

Rhode Island Executive Office of Health and Human Services (EOHHS)

Website: https://eohhs.ri.gov