Arizona - I/DD Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

The Arizona Department of Economic Security (DES) Division of Developmental Disabilities (DDD) contracts for Home and Community-Based Services (HCBS) through the Request for Qualified Vendor Application (RFQVA). Funding flows through the Arizona Long Term Care System (ALTCS) under the state's Section 1115 demonstration waiver, covering services from attendant care and day treatment to habilitation and supported living.

Approval requires securing a Qualified Vendor Agreement (QVA) with DDD before applying for HCBS Certification through the Office of Licensing, Certification and Regulation (OLCR). Applicants must then complete Medicaid enrollment via the AHCCCS Provider Enrollment Portal (APEP) and ensure all direct care staff hold a valid Level One Fingerprint Clearance Card from the Arizona Department of Public Safety.

1. Service Definition and Scope

In Arizona, I/DD services are administered by the Division of Developmental Disabilities (DDD) under the ALTCS program. These services are designed to support individuals with developmental disabilities in their homes and communities, promoting independence and integration.

The service array encompasses a wide range of supports, from basic personal care to intensive habilitation and facility-based day programs. Providers must specify which exact services they intend to offer when applying to become a Qualified Vendor.

• Attendant Care: Assistance with personal care and activities of daily living.
• Day Treatment and Training: Facility or community-based programs providing training, supervision, and activities.
• Habilitation: Services designed to assist individuals in acquiring, retaining, and improving self-help, socialization, and adaptive skills.
• Respite Care: Short-term care provided to relieve primary caregivers.
• Supported Living: Assistance provided to individuals living in their own homes to maintain independence.

2. Regulatory and Oversight Agencies

The primary oversight for I/DD services in Arizona is split between the Department of Economic Security (DES) and the state Medicaid agency, AHCCCS. DES handles the contracting and certification, while AHCCCS manages the overarching Medicaid enrollment and funding.

Within DES, two distinct divisions handle provider approval: the Division of Developmental Disabilities (DDD) manages the vendor contracts, and the Office of Licensing, Certification and Regulation (OLCR) issues the actual HCBS certificates.

• Arizona Health Care Cost Containment System (AHCCCS): The state Medicaid agency responsible for provider enrollment and overall ALTCS administration (https://www.azahcccs.gov/).
• DES Division of Developmental Disabilities (DDD): The agency that manages the I/DD waiver and issues Qualified Vendor Agreements (https://des.az.gov/services/disabilities/developmental-disabilities).
• DES Office of Licensing, Certification and Regulation (OLCR): The regulatory body that processes and issues HCBS Certification for agencies and facilities (https://des.az.gov/services/disabilities/developmental-disabilities/certification-licensing/hcbs-certification).
• AHCCCS Provider Enrollment Portal (APEP): The online system used for all Medicaid provider enrollment applications and revalidations (https://www.azahcccs.gov/APEP).

3. Gatekeeping Prerequisites: Who Can Even Apply

The foundational prerequisite for providing I/DD waiver services in Arizona is the Request for Qualified Vendor Application (RFQVA). An agency cannot simply apply for an HCBS license or enroll in Medicaid; they must first be approved as a Qualified Vendor by DDD.

DDD regularly reviews its provider network across the state to determine which services are currently needed. If an agency is not contracted as a Qualified Vendor with DDD (or alternatively contracted directly with a Managed Care Organization for specific populations), they cannot proceed with HCBS certification through OLCR.

• Qualified Vendor Agreement (QVA): The mandatory contract with DDD required before applying for HCBS certification.
• RFQVA Process: The formal application process to become a Qualified Vendor, governed by DDD network needs.
• Focus System Access: Required for Qualified Vendors to process their HCBS certification applications.
• MCO Contracting: An alternative pathway for providers contracted with a Managed Care Organization rather than directly with DDD, requiring form LCR-1083A.

4. Licensure and Certification Requirements

Once an agency becomes a Qualified Vendor, they must obtain HCBS Certification from the DES Office of Licensing, Certification and Regulation (OLCR). For DDD Qualified Vendors, this process is completed entirely through the state's Focus system.

If services are provided in a provider-owned or leased facility, additional physical plant inspections are required. The agency must maintain this certification to remain an active Medicaid provider.

• HCBS Certification Application: Submitted to OLCR via the Focus system for Qualified Vendors.
• Form LCR-1083A: The paper application form used only by providers contracted with an MCO instead of DDD.
• Life Safety Inspection: Required every two years for facility-based services, requested using form LCR-1033A.
• Life Safety Rules: Governed by document LCR-1036A for provider-owned or leased facilities.

5. Medicaid Provider Enrollment

After obtaining HCBS Certification, providers must enroll with the Arizona Health Care Cost Containment System (AHCCCS) using the AHCCCS Provider Enrollment Portal (APEP). This online system has replaced all paper-based enrollment applications.

Institutional providers are subject to an application fee, which matches the Medicare rate. Providers must also set up Electronic Funds Transfer (EFT) to receive payments.

• APEP System: The mandatory online portal for AHCCCS provider enrollment.
• Application Fee: $750 for calendar year 2026, required for institutional providers to offset screening costs.
• W-9 Tax Form: Must be completed and uploaded during the APEP application process.
• EFT Authorization Form: Required for payment; failure to complete this step results in application denial.

6. Staffing, Training and Background Checks

Arizona imposes strict background check and training requirements for all personnel providing direct care to individuals with developmental disabilities. The most critical requirement is the Level One Fingerprint Clearance Card.

Staff must also complete specific state-mandated training modules before providing services, ensuring they understand member rights and emergency procedures.

• Level One Fingerprint Clearance Card: Must be issued by the Arizona Department of Public Safety; out-of-state cards are not accepted.
• Article 9 Training: Mandatory state training on member rights, behavior support, and incident reporting.
• CPR Certification: Required for all direct care staff (exemptions apply for licensed therapists).
• First Aid Certification: Required for all direct care staff (exemptions apply for licensed therapists).

7. Documentation, Policies and Records

Providers must submit comprehensive documentation to OLCR during the certification process to prove their administrative and operational readiness. This includes detailed rosters and background disclosures.

Agencies must maintain these records continuously and update them whenever staff changes occur or certifications expire.

• Agency Roster of Employees: An Excel template listing all staff providing services and any agency-owned vehicles used for transport.
• Criminal History Self Disclosure Affidavit: Form LCR-1034A, required for the Owner/Executive.
• Letters of Reference: Three professional references required for the Owner/Executive or agency.
• Agency Brochure/Website: A copy of marketing materials or a link to the agency's website must be provided.

8. Billing, Rates and Claims

Billing for I/DD waiver services in Arizona is primarily handled through the DDD Focus system for Qualified Vendors. Rates are established by DDD and published in the state's rate book.

Services must be prior authorized based on the member's person-centered service plan, developed in conjunction with their DDD Support Coordinator.

• Focus System Billing: The primary portal for submitting claims for services rendered under a QVA.
• Prior Authorization: Required for HCBS, determined by the member's planning team and Support Coordinator.
• DDD Rate Book: The official schedule of published rates for all contracted HCBS services.
• AHCCCS MMIS: The underlying Medicaid Management Information System that ultimately processes the federal match.

9. Approval Sequence and Timeline

The approval process is strictly sequential. An applicant cannot enroll in APEP without HCBS Certification, and cannot get HCBS Certification without first becoming a Qualified Vendor.

The AHCCCS enrollment portion generally takes 60 days, but the preceding RFQVA and OLCR certification steps can add several months to the total timeline.

• Step 1: Submit RFQVA and secure a Qualified Vendor Agreement with DDD.
• Step 2: Apply for HCBS Certification through OLCR via the Focus system.
• Step 3: Complete Medicaid enrollment in APEP.
• APEP Processing Time: AHCCCS generally processes Provider Enrollment applications within 60 days of submission.

10. Common Denials and Survey Findings

Applications are frequently delayed or denied due to incomplete documentation or failure to follow the exact sequence of approvals. Background check errors are particularly common.

During facility inspections, life safety violations can halt the certification process until remediated.

• Out-of-State Fingerprints: Submitting a fingerprint card from another state instead of the required Arizona DPS Level One card.
• Missing EFT Form: Failure to submit the Electronic Funds Transfer form with the correct APEP application ID.
• Incomplete Roster: Failing to list all direct care staff or missing required training dates on the Agency Roster.
• Life Safety Failures: Failing the biennial physical plant inspection for facility-based services.

11. Key Contacts and Resources

Providers should direct contracting questions to DDD, certification questions to OLCR, and Medicaid enrollment questions to the AHCCCS Solutions Center.

Utilizing the correct contact for each specific phase of the process is essential for timely approval.

• DDD Network Development: Handles RFQVA and Qualified Vendor inquiries ([email protected]).
• DES OLCR: Processes HCBS Certification applications (https://des.az.gov/services/disabilities/developmental-disabilities/certification-licensing/hcbs-certification).
• AHCCCS Solutions Center: The portal for submitting inquiries regarding APEP applications, EFT setup, and refunds (https://servicenow.azahcccs.gov/gsp).
• Arizona Department of Public Safety: Issues the mandatory Level One Fingerprint Clearance Cards (https://www.azdps.gov/).

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