RESIDENTIAL HABILITATION SERVICES PROVIDER IN NEW YORK

Fatumata Kaba
Sep 4
4 min read

DELIVERING PERSONALIZED SUPPORT TO PROMOTE INDEPENDENCE AND LIFE SKILLS IN COMMUNITY-BASED SETTINGS

Residential Habilitation Services in New York support individuals with developmental disabilities or other special needs in acquiring, maintaining, and improving skills necessary for living independently. These services are delivered in home-like residential settings, focusing on personal care, daily living skills, and community integration. Residential Habilitation Services are authorized under New York Medicaid Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: New York State Department of Health (NYSDOH)

Role: Administers Medicaid waiver funding for Residential Habilitation Services and manages provider enrollment, service authorization, and reimbursement.

Agency: Office for People With Developmental Disabilities (OPWDD)

Role: Provides oversight for residential services targeting individuals with developmental disabilities.

Agency: New York State Office of Mental Health (OMH)

Role: Ensures compliance for residential programs serving individuals with mental health conditions.

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight ensuring Medicaid-funded Residential Habilitation Services meet quality and person-centered care standards.

2. RESIDENTIAL HABILITATION SERVICES OVERVIEW

Residential Habilitation Services are designed to enhance independence and community integration through individualized support and training in daily living skills.

Approved providers may deliver:

Personal Care Assistance: Support with grooming, dressing, hygiene, and meal preparation.
Skill Building: Training in cooking, cleaning, and managing personal finances.
Community Integration: Facilitating social interactions and community involvement.
Health and Safety Training: Teaching emergency response and personal safety techniques.
Behavioral Support: Implementing positive behavior support plans as needed.
Self-Advocacy Skills: Encouraging decision-making and self-determination.
Recreational Activities: Organizing community outings and group activities.
Transportation Support: Assistance with accessing community services and events.
Documentation: Maintaining records of individualized service plans (ISP) and progress reports.

All services are delivered according to the Individualized Service Plan (ISP) to meet the participant’s specific goals and support needs.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

Register the business entity with the New York Department of State.
Obtain EIN from the IRS and NPI (Type 2).
Enroll as a Medicaid Waiver Residential Habilitation provider via the New York Medicaid Provider Enrollment Portal (eMedNY).
Maintain general liability and professional liability insurance.
Develop policies for residential care, community integration, and person-centered planning.
Ensure staff complete background checks, health screenings, and habilitation training.

4. NEW YORK PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

Complete the Provider Enrollment Application via the eMedNY Portal for Residential Habilitation Services under HCBS waivers.

Application and Documentation Submission:

Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, habilitation policies, and staff training documentation.

Program Readiness Review:

NYSDOH, OPWDD, and OMH evaluate provider readiness, including residential safety protocols, staff qualifications, and care standards.

Approval & Medicaid Enrollment:

Upon approval, providers are authorized to bill Medicaid for Residential Habilitation Services using designated billing codes.

5. REQUIRED DOCUMENTATION

Articles of Incorporation or Business License (New York Department of State)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Residential Habilitation Policy & Procedure Manual, including:
- Daily living skills training and support procedures
- Community integration and socialization guidelines
- Safety and emergency response protocols
- Staff credentialing, background checks, and ongoing training records
- Documentation standards for care tracking and Medicaid billing
- HIPAA compliance, participant rights, and grievance handling
- Quality assurance and compliance monitoring

6. STAFFING REQUIREMENTS

Role: Residential Program Director

Requirements: Bachelor’s or Master’s in social work, human services, or healthcare administration; experience in residential care and program management.

Role: Direct Support Professionals (DSPs)

Requirements: High school diploma or GED; habilitation training preferred; experience working with individuals with developmental disabilities; background clearance.

Role: Habilitation Specialists

Requirements: Bachelor’s degree in human services or related field; experience with skill building and community integration.

All staff must complete:

Training in person-centered planning, habilitation techniques, and community engagement
HIPAA compliance and participant rights education
Annual competency evaluations and ongoing professional development
Safety, crisis intervention, and emergency response training
Documentation and record-keeping best practices