Connecticut - Housing Stabilization — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

The Connecticut Department of Social Services (DSS) funds tenancy support and housing retention through the Connecticut Housing Engagement and Support Services (CHESS) initiative, authorized under a combined 1915(i) State Plan Amendment and 1915(b)(4) waiver. This program targets Medicaid members with behavioral health needs or disabilities who are experiencing homelessness or housing instability, integrating Medicaid-funded services with non-Medicaid housing subsidies.

Prospective CHESS providers cannot simply enroll via the standard Medicaid portal; they must first pass a specialized qualification review managed by Carelon Behavioral Health acting as the state's Administrative Services Organization (ASO), which restricts enrollment to agencies demonstrating specific supportive housing experience under the state's selective contracting authority.

1. Service Definition and Scope

Connecticut divides CHESS into two primary service components: Pre-Tenancy Supports and Tenancy Sustaining Supports. These services are designed to assist individuals in locating, securing, and maintaining safe and affordable housing in the community.

The scope of work strictly excludes the payment of rent, room and board, or capital costs, focusing entirely on the administrative, interpersonal, and planning supports required to keep a participant housed.

• Pre-Tenancy Support: Assisting participants with housing search, completing rental applications, and securing necessary documentation.
• Move-In Assistance: Helping individuals arrange for moves, set up utilities, and acquire basic household furnishings.
• Tenancy Sustaining Support: Providing ongoing landlord mediation, lease compliance education, and early identification of behaviors that jeopardize housing.
• Care Coordination: Collaborating with the participant's broader clinical and behavioral health care teams to ensure housing stability.
• Service Limitations: CHESS cannot duplicate services provided under other Medicaid waivers, such as Community First Choice (CFC) or the Mental Health Waiver.

2. Regulatory and Oversight Agencies

The Department of Social Services (DSS) serves as the single State Medicaid Agency and holds ultimate authority over the CHESS program. DSS partners closely with the Department of Mental Health and Addiction Services (DMHAS) and the Department of Housing (DOH) to coordinate the non-Medicaid housing vouchers that accompany the service.

Day-to-day provider credentialing and network management are delegated to Carelon Behavioral Health, the state's behavioral health ASO, while claims and standard Medicaid enrollment are processed by Gainwell Technologies through the Connecticut Medical Assistance Program (CMAP) portal.

• Department of Social Services (DSS): https://portal.ct.gov/dss
• Department of Mental Health and Addiction Services (DMHAS): https://portal.ct.gov/dmhas
• Department of Housing (DOH): https://portal.ct.gov/doh
• Carelon Behavioral Health (ASO): https://www.ctbhp.com
• Connecticut Medical Assistance Program (CMAP): https://www.ctdssmap.com

3. Gatekeeping Prerequisites: Who Can Even Apply

Connecticut utilizes a 1915(b)(4) selective contracting waiver for the CHESS program, which legally permits the state to limit the provider network. Agencies cannot enroll as CHESS providers on an open-enrollment basis through the MMIS.

Before a CMAP enrollment application is accepted, an agency must submit a qualification packet to Carelon Behavioral Health and receive official designation as a CHESS provider. This requires demonstrating an established history of providing supportive housing services to complex populations.

• Selective Contracting Authority: The 1915(b)(4) waiver restricts the provider pool to those explicitly approved by the state's ASO.
• ASO Credentialing Gate: Carelon Behavioral Health must approve the agency's CHESS qualification application before CMAP enrollment is permitted.
• Experience Prerequisite: Agencies must document prior organizational experience delivering housing stabilization or supportive housing services.
• Network Need Review: DSS and DMHAS reserve the right to limit new provider approvals based on regional network adequacy and participant volume.

4. Licensure and Certification Requirements

The Connecticut Department of Public Health (DPH) does not issue a specific facility or agency license for "Housing Stabilization" or "Tenancy Support." Because this is a community-based administrative and support service, standard clinical licensure is not the primary regulatory vehicle.

Instead of a DPH license, providers achieve certification through the DSS/DMHAS CHESS Provider Qualification process. Agencies that also provide clinical behavioral health services may hold DPH psychiatric outpatient or substance abuse licenses, but these are not strictly required for the standalone CHESS housing support function.

• DPH Licensure: Not required for agencies providing only non-clinical CHESS tenancy supports.
• State Certification: Achieved exclusively through the joint DSS/DMHAS CHESS qualification review.
• Corporate Status: Must be registered to do business in Connecticut and in good standing with the Secretary of the State.
• Insurance Requirements: Must maintain general liability, professional liability, and workers' compensation insurance as dictated by the ASO contract.

5. Medicaid Provider Enrollment

Once an agency receives its CHESS qualification approval letter from Carelon, it must formally enroll in the Connecticut Medical Assistance Program (CMAP) to bill Medicaid. This process is managed by Gainwell Technologies.

Providers must complete the enrollment application via the www.ctdssmap.com portal, selecting the specific provider type and specialty codes designated for CHESS, and uploading their ASO approval documentation.

• Enrollment Portal: Applications must be submitted electronically through the CMAP portal at www.ctdssmap.com.
• Provider Type: Agencies enroll under the specific Provider Type and Specialty designated for CHESS (typically within the Behavioral Health or HCBS categories).
• Application Fee: Subject to the federal Medicaid institutional provider application fee unless the agency is already enrolled in Medicare or Medicaid in another state and paid it there.
• Re-enrollment: Providers must revalidate their CMAP enrollment every three to five years as notified by Gainwell Technologies.

6. Staffing, Training and Background Checks

CHESS relies on unlicensed housing support specialists, but the state imposes strict minimum qualifications for these direct care workers. Agencies must maintain personnel files proving that all staff meet these standards before billing for their time.

Supervision must be provided by individuals with advanced experience or clinical credentials, ensuring that housing specialists have guidance when dealing with complex behavioral health crises or eviction threats.

• Direct Staff Education: Typically requires a Bachelor's degree in a human services field, or an Associate's degree/High School diploma with equivalent years of direct experience in supportive housing.
• Supervisor Qualifications: Must possess a Master's degree in a related field or extensive documented experience managing supportive housing programs.
• Background Checks: All staff must undergo state and national criminal history background checks prior to client contact.
• Required Training: Staff must complete state-mandated training modules on person-centered planning, trauma-informed care, and the specific CHESS service model.

7. Documentation, Policies and Records

Connecticut requires CHESS providers to maintain rigorous documentation linking the housing support services directly to the participant's Medicaid care plan. The 1915(i) SPA mandates that providers submit documentation attesting that the participant is actively moving to or maintaining housing.

Auditors from DSS and Carelon frequently review these records to ensure that billed time corresponds to concrete housing activities rather than general case management.

• Housing Assessment: Must complete a standardized housing assessment identifying specific barriers to tenancy.
• Person-Centered Plan: Services must be explicitly authorized in the participant's person-centered care plan.
• Progress Notes: Daily or per-encounter notes must detail the specific housing-related intervention, duration, and participant response.
• Attestation Forms: Providers must maintain signed attestations regarding the participant's housing status and transition progress.

8. Billing, Rates and Claims

CHESS services are billed to the CMAP system using specific HCPCS procedure codes. Rates are established by DSS and published on the CMAP provider fee schedule.

Services are typically billed in 15-minute increments. Providers must ensure that claims do not overlap with other Medicaid-funded case management or waiver services billed on the same day.

• Billing System: Claims are submitted electronically via the CMAP portal or through an approved EDI clearinghouse.
• Procedure Codes: Billed using standard HCBS HCPCS codes (e.g., H0043 for supported housing), modified specifically for the CHESS program.
• Fee Schedule: Current rates are published on the www.ctdssmap.com portal under the Provider Fee Schedule link.
• Prior Authorization: Services require prior authorization from Carelon Behavioral Health before claims will pay in the CMAP system.

9. Approval Sequence and Timeline

Becoming a CHESS provider is a sequential process that cannot be expedited. Agencies must secure their programmatic approval before interacting with the Medicaid billing system.

The entire process from initial ASO application to active CMAP billing status typically takes several months, depending on the completeness of the application and the state's review cycles.

• Step 1: Submit the CHESS Provider Qualification application to Carelon Behavioral Health.
• Step 2: Undergo programmatic review and network need assessment by DSS/DMHAS.
• Step 3: Receive official ASO approval and credentialing letter.
• Step 4: Submit the Medicaid provider enrollment application via the CMAP portal.
• Timeline: Expect 3 to 6 months from initial ASO submission to final CMAP activation.

10. Common Denials and Survey Findings

Applications for CHESS qualification are most frequently denied at the ASO level because the agency fails to demonstrate sufficient organizational experience in supportive housing, treating the application as a generic case management program.

During post-payment audits, DSS and Carelon frequently recoup funds if progress notes describe general check-ins rather than specific, actionable tenancy sustaining interventions.

• Application Denial: Insufficient documentation of prior supportive housing experience.
• Application Denial: Failure to meet the selective contracting network need criteria.
• Audit Finding: Billing for services that duplicate other Medicaid case management programs.
• Audit Finding: Missing or expired person-centered care plans authorizing the housing supports.

11. Key Contacts and Resources

Providers should rely on the official portals and ASO contacts for the most current CHESS requirements, as program manuals and fee schedules are updated regularly.

The CMAP portal serves as the primary resource for billing manuals, provider bulletins, and enrollment assistance.

• CMAP Provider Portal: https://www.ctdssmap.com
• DSS CHESS Information: https://portal.ct.gov/dss
• Carelon Behavioral Health CT: https://www.ctbhp.com
• Gainwell Provider Services: 1-800-842-8440 (In-state toll-free for CMAP assistance)

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