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

Last reviewed: 2026-09-10

The Ohio Department of Medicaid (ODM) does not cover a standalone fee-for-service waiver benefit called "Housing Stabilization," instead funding tenancy support, housing search, and landlord mediation through the Specialized Recovery Services (SRS) waiver under the service name "Community Integration," and through Next Generation Medicaid Managed Care Organization (MCO) value-added community reinvestment requirements. Providers seeking to deliver ongoing tenancy retention and housing navigation cannot enroll as a generic housing provider; they must either obtain certification from the Ohio Department of Mental Health and Addiction Services (OhioMHAS) to provide SRS Community Integration or negotiate direct contracts with individual Medicaid MCOs to serve as housing navigators.

Approval requires navigating a bifurcated system where the state delegates provider network management to Public Consulting Group (PCG) for traditional waiver services, while MCOs control their own closed networks for specialized social determinants of health (SDOH) initiatives. An applicant must secure OhioMHAS agency certification under Ohio Administrative Code (OAC) 5122-29-30 before ODM will accept a Medicaid enrollment application for the SRS waiver through the Provider Network Management (PNM) module.

1. Service Definition and Scope

Because Ohio lacks a distinct "Housing Stabilization" waiver service, tenancy support is delivered primarily through the SRS waiver's Community Integration service. This service assists individuals with severe and persistent mental illness (SPMI) or diagnosed chronic conditions in cultivating community connections, which includes finding and retaining independent housing, understanding tenant rights, and communicating with landlords.

Additionally, under Ohio's Next Generation Medicaid program, MCOs are contractually required to address SDOH. MCOs frequently contract with community-based organizations to provide housing navigation, application assistance, and eviction prevention as value-added services outside the traditional waiver fee schedule.

2. Regulatory and Oversight Agencies

The Ohio Department of Medicaid (ODM) holds ultimate authority over the Medicaid program and the Next Generation MCO contracts. However, ODM delegates the certification of behavioral health and SRS waiver providers to the Ohio Department of Mental Health and Addiction Services (OhioMHAS).

For traditional Home and Community-Based Services (HCBS) waivers, ODM contracts with Public Consulting Group (PCG) to manage provider enrollment, network development, and oversight.

3. Gatekeeping Prerequisites: Who Can Even Apply

To provide tenancy supports under the SRS waiver, an agency must first hold active certification from OhioMHAS for Community Integration services; ODM will reject any PNM enrollment application lacking this prerequisite certificate. There is no open enrollment for independent, non-agency providers to bill this service directly to ODM without agency affiliation.

For MCO-funded housing navigation, access is strictly procurement-only. Providers must be selected by an MCO (such as CareSource or UnitedHealthcare) through their specific community reinvestment grant or value-added service contracting processes, which are closed networks not subject to any willing provider laws.

4. Licensure and Certification Requirements

Agencies must apply for OhioMHAS certification via the Licensure and Certification Tracking System (LACTS). The agency must demonstrate compliance with OAC 5122-29-30 (Community Integration) and general agency standards under OAC 5122-26.

The certification process requires submitting a comprehensive policy manual, proof of commercial liability insurance, and passing an initial site survey to verify that the agency's physical location and administrative practices meet state standards.

5. Medicaid Provider Enrollment

Once OhioMHAS certification is obtained, the agency must enroll as a Medicaid provider through ODM's Provider Network Management (PNM) module. The agency enrolls under the specific provider type designated for SRS waiver services.

During enrollment, the agency must upload its OhioMHAS certificate, complete an HCBS Settings Rule attestation, and pay the federal Medicaid application fee if not already paid to Medicare or another state.

6. Staffing, Training and Background Checks

Staff delivering Community Integration must meet the qualifications outlined in OAC 5122-29-30, which typically requires at least a high school diploma or equivalent, plus specific training in severe mental illness and community resources. Agencies must maintain personnel files documenting these qualifications.

All direct care staff must undergo mandatory criminal records checks through the Ohio Bureau of Criminal Identification and Investigation (BCI) and, if they have lived in Ohio for less than five years, the FBI. Disqualifying offenses are strictly enforced under OAC 5160-45-07.

7. Documentation, Policies and Records

Providers must maintain detailed service records that align with the individual's person-centered care plan, developed by the SRS case manager. Documentation must prove that the setting where the individual lives complies with the CMS HCBS Final Rule, ensuring privacy, dignity, and landlord/tenant protections.

Progress notes must be written for every encounter, detailing the specific housing search or retention activity performed, the duration of the service, and the individual's progress toward housing goals.

8. Billing, Rates and Claims

For SRS Community Integration, providers bill ODM or the individual's MCO using specific HCPCS codes (typically H2015 for Comprehensive Community Support Services, though exact modifiers depend on the SRS fee schedule). Claims are submitted electronically via the PNM/Electronic Data Interchange (EDI).

For MCO-contracted housing navigation, billing procedures and rates are entirely dictated by the negotiated contract between the agency and the MCO, often utilizing invoice-based grant drawdowns or specific Z-codes for SDOH interventions rather than standard fee-for-service claims.

9. Approval Sequence and Timeline

The approval sequence begins with the OhioMHAS certification process, which can take 3 to 6 months depending on the agency's readiness for the site survey and LACTS processing times. Only after the certificate is in hand can the agency apply to ODM.

Medicaid enrollment through the PNM module typically takes 30 to 60 days. If the provider intends to serve managed care members, they must subsequently complete credentialing and contracting with each MCO, adding another 90 to 120 days to the timeline.

10. Common Denials and Survey Findings

OhioMHAS frequently denies initial certification applications due to incomplete policy manuals, particularly missing required elements for grievance procedures or incident reporting. During site surveys, failure to demonstrate how services will be delivered in the community rather than a facility is a common citation.

At the Medicaid enrollment stage, applications are routinely rejected if the BCI background checks are not completed correctly, if the HCBS Settings attestation is missing, or if the provider attempts to enroll without the prerequisite OhioMHAS certification.

11. Key Contacts and Resources

Prospective providers must utilize the official portals for OhioMHAS and ODM to navigate the certification and enrollment processes. Public Consulting Group (PCG) serves as the primary contact for HCBS waiver training and network support.

Providers should regularly check the ODM and OhioMHAS websites for updates to the SRS waiver manual, fee schedules, and MCO procurement announcements.

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