1. GOVERNING AGENCIES

Agency: Alabama Department of Mental Health (ADMH)
Role: Oversees provider authorization, compliance, and training requirements under HCBS waivers

Agency: Alabama Medicaid Agency
Role: Manages Medicaid provider enrollment and billing for Adult Companion Services

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure adherence to HCBS waiver program guidelines

2. ADULT COMPANION SERVICE OVERVIEW

Adult Companion Services provide support to individuals with IDD who require assistance to remain safely in their home and participate in their community. These services are delivered by trained companions and are focused on non-medical support and interpersonal engagement. Approved providers may offer:

• Supervision and safety monitoring
• Social and recreational support
• Assistance with light housekeeping and meal preparation
• Accompaniment to appointments, errands, or community events
• Companionship and emotional support

Services must be person-centered, non-intrusive, and based on the individual’s needs and preferences as outlined in their service plan.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business with the Alabama Secretary of State
• Obtain EIN from the IRS and NPI (Type 2)
• Maintain a physical office location in Alabama or operate under a home-based business model
• Establish service delivery procedures for in-home and community-based companionship
• Implement systems for tracking time, activities, and service outcomes
• Hire and train staff to ensure quality and compliance with non-medical care standards

4. ADMH PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Request the Adult Companion Services Provider Application Packet from ADMH
• Submit a business and service plan outlining staffing, safety procedures, and documentation processes
• Include consumer interaction protocols, supervision structure, and daily activity planning

Background & Credentialing:

• Background checks for all staff providing direct support
• Drug screening and verification of eligibility to work with vulnerable populations
• Staff documentation of training in safety, ethics, and consumer support

Program Readiness Review:

• Review of policies and procedures for service delivery and consumer protection
• Sample documentation for daily logs, consumer notes, and incident reports
• Plan for staff scheduling, supervision, and emergency protocols

Approval & Medicaid Enrollment:

• Upon ADMH approval, complete Alabama Medicaid enrollment as an Adult Companion Services provider
• Add applicable billing codes to service offerings

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or LLC Certificate
• IRS EIN Letter
• NPI confirmation
• Office lease or proof of home office operations

ADMH-Compliant Policy & Procedure Manual including:

• Service planning and consumer eligibility criteria
• Safety, supervision, and emergency procedures
• Confidentiality and abuse prevention protocols
• Staff qualifications, training, and supervision plans
• Documentation of service hours and consumer interaction
• Signed individual service plans and companion logs
• Incident reports and grievance procedures

6. STAFFING REQUIREMENTS

Role: Program Coordinator
Requirements: Background in disability services, supervision, and consumer support

Role: Companion Caregiver
Requirements: High school diploma or GED; experience with caregiving or disability support preferred; training in consumer rights and safety

All staff must complete:

• ADMH orientation and HCBS Waiver training
• Annual ethics, abuse prevention, and safety training
• Documentation, confidentiality, and emergency response training

7. MEDICAID WAIVER SERVICES

The following Alabama Medicaid Waivers authorize Adult Companion Services:

• ID Waiver (Intellectual Disabilities Waiver)
• LAH Waiver (Living at Home Waiver)
• State of Alabama Community Waiver Program

Approved providers may deliver:

• In-home and community-based companionship
• Supervision and emotional support
• Activity documentation and progress tracking
• Support with safe, independent living

8. TIMELINE TO LAUNCH

Phase: Business Formation
Timeline: 0–1 week

Phase: ADMH Application Review
Timeline: 60–90 days

Phase: Program and Staff Readiness
Timeline: 30–60 days

Phase: Medicaid Enrollment
Timeline: 60–90 days

9. CONTACT INFORMATION

Alabama Department of Mental Health (ADMH) – Division of Developmental Disabilities
Email: ddprovider@mh.alabama.gov
Phone: (334) 242-3702
Website: https://mh.alabama.gov

Alabama Medicaid Agency – Waiver Services
Website: https://medicaid.alabama.gov

10. SCOPE OF WORK

• Business formation (LLC, EIN, NPI)
• ADMH application completion and submission
• Adult Companion Services Policy & Procedure Manual development
• Staff hiring, training materials, and supervision plans
• Medicaid provider enrollment and billing setup
• Daily log templates and consumer documentation systems
• WEBSITE, DOMAIN, AND EMAIL SETUP
• CLIENT ADMISSION PACKET
• MARKETING AND ADVERTISING MATERIALS
• OPERATIONAL TRAINING
• COMPLIANCE AND REGULATORY SUPPORT
• QUALITY ASSURANCE PROGRAMS
• MARKETING AND CLIENT ACQUISITION STRATEGIES