These videos give an overview of the various Home and Community-Based Services (HCBS) available in Hawaii for providers who want to learn how to start or operate an HCBS agency in the state. Each video explains the purpose of the service, provider requirements, licensing process, and how the program functions in Hawaii. Use these videos to better understand the responsibilities, standards, and steps involved in becoming or working with approved HCBS providers in Hawaii. Explore each section to find the service that best matches your goals or area of interest.
Respite Care
RESPITE CARE SERVICES PROVIDER IN HAWAII
OFFERING TEMPORARY RELIEF FOR PRIMARY CAREGIVERS WHILE ENSURING CONTINUITY OF CARE AND SUPPORT FOR PARTICIPANTS
Respite Care Services in Hawaii provide short-term, substitute care for individuals with disabilities, chronic health conditions, or aging-related needs to relieve family members or regular caregivers. These services are authorized under Hawaii’s Medicaid Home and Community-Based Services (HCBS) waiver programs and aim to prevent caregiver burnout, promote family stability, and ensure individuals continue to receive person-centered care.
1. GOVERNING AGENCIES
Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Respite Care Services
Agency: Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Role: Administers HCBS waiver respite services for individuals with intellectual and developmental disabilities (IDD)
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight ensuring Respite Care Services meet Medicaid HCBS quality standards
2. RESPITE CARE SERVICE OVERVIEW
Respite Care Services provide temporary relief to caregivers by offering direct care, supervision, and support for the participant.
Approved providers may deliver:
In-home respite services (provided at the participant’s residence)
Out-of-home respite services (in an approved community or facility setting)
Scheduled or emergency respite care
Support with Activities of Daily Living (ADLs) such as bathing, eating, toileting, and mobility
Health and safety monitoring
Engagement in recreational and social activities during respite sessions
Overnight or daytime coverage depending on the participant and caregiver needs
All services must be tied to goals in the participant’s Individualized Service Plan (ISP) and must not duplicate services received through other Medicaid programs.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid provider through Hawaii’s Med-QUEST Division
Complete DDD Provider Certification for respite services (for DD/ID Waiver participants)
Maintain general liability and professional liability insurance
If providing out-of-home respite, meet any applicable licensing requirements for the facility (if overnight care is provided)
4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Submit Provider Enrollment Application for Respite Care Services through Hawaii’s Med-QUEST Division
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, service descriptions, staff credentialing documentation, and insurance certificates
Provide sample respite service schedules, emergency protocols, and participant intake forms
Program Readiness Review:
DHS and DOH review provider readiness including participant protection measures, staff training protocols, service documentation systems, and Medicaid compliance procedures
Approval & Medicaid Enrollment:
Upon approval, configure billing codes for Respite Services (hourly, daily, or overnight rates based on the model)
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (Hawaii DCCA)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
HCBS-Compliant Policy & Procedure Manual including:
Participant intake, caregiver coordination, and service authorization tracking
Respite service delivery and daily activity documentation
Emergency response and health monitoring protocols
Participant rights, HIPAA confidentiality, and grievance resolution procedures
Staff credentialing, background checks, and competency verification
Medicaid billing, service authorization tracking, and audit readiness documentation
6. STAFFING REQUIREMENTS
Role: Respite Services Program Manager / Supervisor
Requirements: Experience in direct care, personal assistance, or human services management preferred; background screening clearance
Role: Respite Care Workers / Direct Support Professionals (DSPs)
Requirements: High school diploma or GED; CPR/First Aid certification preferred; background screening clearance
All staff must complete:
HIPAA confidentiality and participant rights training
Abuse prevention, incident reporting, and emergency preparedness training
Participant safety, ADL/IADL support, and community integration training
Annual continuing education related to direct care best practices and Medicaid compliance
7. MEDICAID WAIVER PROGRAMS
The following Hawaii Medicaid Waivers authorize Respite Care Services:
Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver
Community Care Services (CCS) Program (if respite services support participants’ continued community living)
Approved providers may deliver:
In-home respite care tailored to participant and family needs
Out-of-home respite care in approved community settings
Emergency or scheduled respite services
Daily, hourly, or overnight supervision depending on participant needs
8. TIMELINE TO LAUNCH
Phase: Business Formation and Initial Credentialing Setup
Timeline: 1–2 weeks
Phase: Med-QUEST Provider Application and Readiness Review
Timeline: 60–90 days
Phase: Staff Hiring, Credentialing, and Participant Intake System Setup
Timeline: 30–45 days
Phase: Medicaid Enrollment and Billing System Configuration
Timeline: 45–60 days
9. CONTACT INFORMATION
Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/
Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Website: https://health.hawaii.gov/ddd/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII RESPITE CARE SERVICES PROVIDER
WCG supports direct care agencies, caregiving organizations, and respite providers in launching Medicaid-compliant Respite Care Services under Hawaii’s HCBS waiver programs.
Scope of Work:
Business registration and EIN/NPI setup
Medicaid provider enrollment and DHS respite certification support
Development of Respite Care Services Policy & Procedure Manual
Staff credentialing templates and participant intake/coordination forms
Medicaid billing setup and claims management
Website, domain, and email setup
Participant intake, service scheduling, and daily documentation templates
Emergency response planning and incident management procedures
Quality assurance programs for participant safety and caregiver satisfaction tracking
Community outreach and caregiver support network development strategies
Chores Services
CHORE SERVICES PROVIDER IN HAWAII
ENSURING SAFE AND SANITARY LIVING CONDITIONS THROUGH ESSENTIAL HOUSEHOLD TASK ASSISTANCE
Chore Services in Hawaii assist individuals with disabilities, chronic conditions, or aging-related needs by performing heavy household tasks that they are physically unable to manage themselves. These services are authorized under Hawaii’s Medicaid Home and Community-Based Services (HCBS) waiver programs and help maintain participants’ health, safety, and independence in their own homes.
1. GOVERNING AGENCIES
Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Chore Services
Agency: Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Role: Administers HCBS waiver Chore Services for individuals with intellectual and developmental disabilities (IDD)
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight ensuring Chore Services meet Medicaid HCBS requirements and health/safety standards
2. CHORE SERVICE OVERVIEW
Chore Services involve heavy-duty household cleaning and minor home maintenance tasks necessary to maintain a clean, sanitary, and safe environment for participants who are unable to perform these tasks independently.
Approved providers may deliver:
Heavy-duty housecleaning (deep cleaning, carpet shampooing, window washing)
Yard work necessary to eliminate safety hazards (e.g., lawn mowing, debris removal)
Moving heavy furniture to ensure safe mobility
Minor home repairs essential for health and safety (e.g., replacing light bulbs, securing loose flooring)
Trash removal and pest control coordination (basic services only, not extermination)
Emergency snow or debris removal to maintain access to the home (where applicable)
Chore Services must be specified in the participant’s Individualized Service Plan (ISP) and cannot duplicate homemaker or routine housekeeping services already authorized.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid provider with Hawaii’s Med-QUEST Division
Maintain general liability and worker’s compensation insurance
Develop safety protocols for staff performing physical tasks and home maintenance
4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Submit Provider Enrollment Application for Chore Services through Hawaii’s Med-QUEST Division
Define service capacity, safety protocols, and response time for urgent services
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, proof of insurance, staffing plans, and service policies
Provide sample service plans, scheduling protocols, and participant intake forms
Program Readiness Review:
DHS and DOH review provider readiness including worker safety procedures, service tracking documentation, and participant protection measures
Approval & Medicaid Enrollment:
Upon approval, configure billing codes for Chore Services (typically unit-based or task-based rates)
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (Hawaii DCCA)
IRS EIN confirmation
NPI confirmation
Proof of general liability and worker’s compensation insurance
HCBS-Compliant Policy & Procedure Manual including:
Participant intake, needs assessment, and service planning procedures
Chore task performance protocols and worker safety standards
Emergency backup service plans
HIPAA confidentiality, participant rights, and grievance resolution procedures
Staff credentialing, background checks, and physical task training documentation
Medicaid billing, service tracking, and audit readiness documentation
6. STAFFING REQUIREMENTS
Role: Chore Services Program Manager / Supervisor
Requirements: Experience managing personal assistance, home maintenance, or janitorial services preferred; background screening clearance
Role: Chore Service Workers / Maintenance Aides
Requirements: Ability to perform physically demanding tasks; training in safety protocols; background screening clearance
All staff must complete:
HIPAA confidentiality and participant rights training
Worker safety, lifting, and emergency response training
Abuse prevention, incident reporting, and household hazard identification training
Annual refreshers on health and safety compliance standards
7. MEDICAID WAIVER PROGRAMS
The following Hawaii Medicaid Waivers authorize Chore Services:
Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver
Community Care Services (CCS) Program (where maintaining a safe environment is necessary for community living)
Approved providers may deliver:
Heavy housecleaning to ensure health and safety
Yard maintenance necessary for safe home access
Basic home repairs tied to participant safety needs
8. TIMELINE TO LAUNCH
Phase: Business Formation and Initial Credentialing Setup
Timeline: 1–2 weeks
Phase: Med-QUEST Provider Application and Readiness Review
Timeline: 60–90 days
Phase: Staff Hiring, Credentialing, and Chore Service System Setup
Timeline: 30–45 days
Phase: Medicaid Enrollment and Billing System Configuration
Timeline: 45–60 days
9. CONTACT INFORMATION
Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/
Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Website: https://health.hawaii.gov/ddd/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII CHORE SERVICES PROVIDER
WCG supports home services companies, personal care organizations, and community-based providers in launching Medicaid-compliant Chore Services under Hawaii’s HCBS waiver programs.
Scope of Work:
Business registration and EIN/NPI setup
Medicaid provider enrollment assistance
Development of Chore Services Policy & Procedure Manual
Staff credentialing templates and participant intake/service assessment forms
Medicaid billing setup and claims management
Website, domain, and email setup
Service intake, task scheduling, and documentation systems
Worker safety protocols, emergency preparedness, and quality control procedures
Quality assurance programs for service delivery and participant safety tracking
Community outreach and participant referral development strategies
Supported Employment
SUPPORTED EMPLOYMENT SERVICES PROVIDER IN HAWAII
HELPING INDIVIDUALS WITH DISABILITIES ACHIEVE MEANINGFUL, COMPETITIVE EMPLOYMENT IN THEIR COMMUNITIES
Supported Employment Services in Hawaii assist individuals with disabilities in preparing for, obtaining, and maintaining competitive integrated employment. These services are authorized under Hawaii’s Medicaid Home and Community-Based Services (HCBS) waiver programs and focus on promoting self-sufficiency, financial independence, and full community participation.
1. GOVERNING AGENCIES
Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Supported Employment Services
Agency: Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Role: Administers HCBS waiver-supported employment services for individuals with intellectual and developmental disabilities (IDD)
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight ensuring Supported Employment Services meet Medicaid HCBS standards and community integration goals
2. SUPPORTED EMPLOYMENT SERVICE OVERVIEW
Supported Employment Services help individuals with disabilities engage in paid employment in regular workforce settings with necessary supports.
Approved providers may deliver:
Discovery and career exploration assessments
Job development, job matching, and placement services
Job coaching and on-the-job skills training
Support for learning workplace etiquette and self-advocacy
Support with job retention strategies and problem-solving
Self-employment or microenterprise support (where authorized)
Ongoing follow-up and support services to ensure long-term success
Services must be individualized and based on goals identified in the participant’s Individualized Service Plan (ISP).
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid provider with Hawaii’s Med-QUEST Division
Complete DDD Provider Standards Certification for employment services
Maintain general liability and professional liability insurance
Develop policies for vocational assessment, job placement, on-site support, participant rights, and safety
4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Submit Provider Enrollment Application identifying Supported Employment Services under Hawaii’s HCBS waiver offerings
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, and operational policies
Provide service plans for discovery, job development, job coaching, and retention supports
Submit staff credentialing documentation and sample participant vocational profiles
Program Readiness Review:
DHS and DOH review the provider’s capacity, staffing, program structure, documentation practices, and Medicaid billing systems
Approval & Medicaid Enrollment:
Upon approval, configure billing codes for Supported Employment stages (e.g., discovery, intensive job coaching, extended services)
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (Hawaii DCCA)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
HCBS-Compliant Policy & Procedure Manual including:
Participant intake, vocational profiling, and employment goal setting
Job development, job placement, and on-site support procedures
Ongoing employment monitoring and problem-solving protocols
HIPAA confidentiality, participant rights, and grievance handling procedures
Staff credentialing, background screening, and competency records
Medicaid billing, service authorization tracking, and audit readiness procedures
6. STAFFING REQUIREMENTS
Role: Supported Employment Program Manager / Employment Services Supervisor
Requirements: Bachelor's degree in vocational rehabilitation, human services, education, or related field preferred; experience with employment supports; background screening clearance
Role: Employment Specialists / Job Coaches
Requirements: High school diploma or GED; specialized training in supported employment models (e.g., ACRE certification) preferred; background screening clearance
All staff must complete:
Person-centered employment planning and workplace integration training
Disability awareness and workplace accommodation training
HIPAA confidentiality, participant rights, and abuse prevention training
Emergency preparedness and employment crisis response training
Annual refresher courses on employment supports best practices
7. MEDICAID WAIVER PROGRAMS
The following Hawaii Medicaid Waivers authorize Supported Employment Services:
Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver
Approved providers may deliver:
Discovery and vocational assessment services
Job development and customized employment services
Intensive job coaching and on-the-job training supports
Ongoing extended services for long-term job retention
8. TIMELINE TO LAUNCH
Phase: Business Formation and Initial Credentialing Setup
Timeline: 1–2 weeks
Phase: Med-QUEST and DDD Provider Application and Readiness Review
Timeline: 60–90 days
Phase: Staff Hiring, Credentialing, and Program Development
Timeline: 30–45 days
Phase: Medicaid Enrollment and Billing System Setup
Timeline: 45–60 days
9. CONTACT INFORMATION
Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/
Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Website: https://health.hawaii.gov/ddd/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII SUPPORTED EMPLOYMENT SERVICES PROVIDER
WCG supports employment agencies, disability service organizations, and rehabilitation providers in launching Medicaid-compliant Supported Employment Services under Hawaii’s HCBS waiver programs.
Scope of Work:
Business registration and EIN/NPI setup
Medicaid and DHS Supported Employment provider enrollment support
Development of Supported Employment Policy & Procedure Manual
Staff credentialing templates and participant vocational assessment documentation
Medicaid billing setup and claims management
Website, domain, and email setup
Discovery process, job placement, and employment outcome tracking templates
Emergency response protocols for employment-related crises
Quality assurance systems for job placement success monitoring
Employer outreach and partnership development strategies
Personal Assistance
PERSONAL ASSISTANCE SERVICES PROVIDER IN HAWAII
ENABLING INDEPENDENCE BY SUPPORTING DAILY LIVING ACTIVITIES IN HOMES AND COMMUNITY SETTINGS
Personal Assistance Services (PAS) in Hawaii provide direct support to individuals with disabilities, chronic illnesses, or aging-related needs, helping them perform essential daily activities and participate in community life. These services are authorized under Hawaii’s Medicaid Home and Community-Based Services (HCBS) waiver programs and are designed to promote dignity, self-sufficiency, and full inclusion.
1. GOVERNING AGENCIES
Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Personal Assistance Services
Agency: Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Role: Administers HCBS waiver services, including Personal Assistance for individuals with intellectual and developmental disabilities (IDD)
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight ensuring Personal Assistance Services meet Medicaid HCBS standards and promote person-centered care
2. PERSONAL ASSISTANCE SERVICE OVERVIEW
Personal Assistance Services (PAS) provide hands-on support to help participants accomplish tasks of daily living that they would otherwise be unable to perform independently.
Approved providers may deliver:
Assistance with Activities of Daily Living (ADLs) such as bathing, dressing, toileting, grooming, eating, and mobility
Support with Instrumental Activities of Daily Living (IADLs) such as meal preparation, laundry, light housekeeping, medication reminders, and shopping
Community access support (e.g., escorting to appointments, recreational activities)
Health and safety monitoring
Communication assistance and social support
Emergency response assistance as needed
All services must be individualized and consistent with the goals identified in the participant’s Individualized Service Plan (ISP).
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid provider with Hawaii’s Med-QUEST Division
Complete DDD Provider Certification if serving DD/ID Waiver participants
Maintain general liability and professional liability insurance
Develop policies for participant intake, service delivery, emergency response, and participant rights protections
4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Submit Provider Enrollment Application for Personal Assistance Services through Hawaii’s Med-QUEST Division
Identify service areas and staff qualifications
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, operational policies, staff training plans, and proof of insurance
Provide sample daily service logs, participant intake forms, and emergency response protocols
Program Readiness Review:
DHS and DOH review provider readiness including participant safety systems, service tracking documentation, and Medicaid compliance
Approval & Medicaid Enrollment:
Upon approval, configure billing codes for Personal Assistance Services (hourly or daily units)
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (Hawaii DCCA)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
HCBS-Compliant Policy & Procedure Manual including:
Participant intake, needs assessment, and service planning procedures
Daily living assistance protocols and emergency response procedures
Daily documentation and incident tracking systems
HIPAA confidentiality, participant rights, and grievance handling policies
Staff credentialing, background checks, and competency verification
Medicaid billing, service authorization tracking, and audit readiness procedures
6. STAFFING REQUIREMENTS
Role: Personal Assistance Program Manager / Supervisor
Requirements: Experience in managing personal care services, community supports, or disability services; background screening clearance
Role: Personal Care Aides / Direct Support Professionals (DSPs)
Requirements: High school diploma or GED; CPR/First Aid certification preferred; background screening clearance
All staff must complete:
HIPAA confidentiality, abuse prevention, and participant rights training
Emergency preparedness, CPR/First Aid, and incident management training
Person-centered service delivery and cultural sensitivity training
Annual continuing education in personal support services and Medicaid compliance
7. MEDICAID WAIVER PROGRAMS
The following Hawaii Medicaid Waivers authorize Personal Assistance Services:
Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver
Community Care Services (CCS) Program (for adults with serious mental illnesses and chronic conditions)
Approved providers may deliver:
ADL and IADL support in homes and community settings
Health and safety monitoring and non-clinical health supports
Assistance with accessing community-based activities and appointments
8. TIMELINE TO LAUNCH
Phase: Business Formation and Initial Credentialing Setup
Timeline: 1–2 weeks
Phase: Med-QUEST Provider Application and Readiness Review
Timeline: 60–90 days
Phase: Staff Hiring, Credentialing, and Participant Intake System Setup
Timeline: 30–45 days
Phase: Medicaid Enrollment and Billing System Configuration
Timeline: 45–60 days
9. CONTACT INFORMATION
Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/
Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Website: https://health.hawaii.gov/ddd/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII PERSONAL ASSISTANCE SERVICES PROVIDER
WCG supports personal care agencies, direct support organizations, and home- and community-based service providers in launching Medicaid-compliant Personal Assistance Services under Hawaii’s HCBS waiver programs.
Scope of Work:
Business registration and EIN/NPI setup
Medicaid provider enrollment and certification support
Development of Personal Assistance Services Policy & Procedure Manual
Staff credentialing templates and participant intake/service planning documents
Medicaid billing system setup and claims management
Website, domain, and email setup
Participant intake, daily service delivery, and incident reporting templates
Emergency preparedness and participant health monitoring systems
Quality assurance programs for service delivery and participant satisfaction tracking
Community outreach and partnership development strategies
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Adaptive Equipment
ADAPTIVE EQUIPMENT SERVICES PROVIDER IN HAWAII
IMPROVING INDEPENDENCE, SAFETY, AND QUALITY OF LIFE THROUGH CUSTOMIZED EQUIPMENT SOLUTIONS
Adaptive Equipment Services in Hawaii help individuals with disabilities, chronic conditions, or aging-related needs access specialized equipment that enhances their ability to perform daily activities safely and independently. These services are authorized under Hawaii’s Medicaid Home and Community-Based Services (HCBS) waiver programs, promoting community integration, mobility, and personal autonomy.
1. GOVERNING AGENCIES
Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Adaptive Equipment Services
Agency: Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Role: Administers HCBS waiver services for individuals with intellectual and developmental disabilities, including Adaptive Equipment
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight ensuring Adaptive Equipment Services meet Medicaid HCBS standards and promote functional independence
2. ADAPTIVE EQUIPMENT SERVICE OVERVIEW
Adaptive Equipment Services include assessment, procurement, customization, delivery, training, and maintenance of devices designed to support individuals' health, mobility, communication, and daily living activities.
Approved providers may deliver:
Functional needs assessments for adaptive equipment
Recommendation and acquisition of appropriate devices
Customization and modification of equipment
Delivery, setup, and participant training on device usage
Repairs, maintenance, and replacement support
Examples of adaptive equipment include:
Wheelchairs (manual, power, or customized seating systems)
Mobility aids (e.g., walkers, transfer boards, lifts)
Augmentative and alternative communication (AAC) devices
Sensory equipment (e.g., adapted switches, environmental control units)
Adaptive utensils, grooming aids, and other daily living supports
All services must be tied to outcomes specified in the participant’s Individualized Service Plan (ISP) and promote community-based living and safety.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid provider with Hawaii’s Med-QUEST Division
Maintain commercial general liability and product liability insurance
Employ or partner with qualified professionals (e.g., Assistive Technology Professionals (ATP), Occupational Therapists) as needed
Develop policies for equipment assessment, procurement, training, maintenance, and participant support
4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Submit Provider Enrollment Application for Adaptive Equipment Services through Med-QUEST
Indicate service capacity, vendor partnerships, and service areas
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, staff credentialing, and service delivery models
Provide equipment procurement protocols, emergency repair procedures, and participant intake forms
Program Readiness Review:
DHS and Med-QUEST review provider readiness including assessment protocols, participant safety standards, Medicaid documentation systems, and billing compliance
Approval & Medicaid Enrollment:
Upon approval, configure billing codes specific to Adaptive Equipment evaluation, acquisition, training, maintenance, and repairs
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (Hawaii DCCA)
IRS EIN confirmation
NPI confirmation
Proof of general liability and product liability insurance
HCBS-Compliant Policy & Procedure Manual including:
Participant intake, functional needs assessment, and device selection procedures
Adaptive equipment procurement, delivery, and training systems
Maintenance, repair, and replacement service plans
HIPAA confidentiality, participant rights, and grievance handling policies
Staff credentialing, background screening, and competency documentation
Medicaid billing, service tracking, and audit readiness systems
6. STAFFING REQUIREMENTS
Role: Adaptive Equipment Program Manager / Specialist
Requirements: Certification as an Assistive Technology Professional (ATP) preferred or relevant healthcare experience; background screening clearance
Role: Adaptive Equipment Technicians / Trainers
Requirements: Experience in device setup, modification, and participant training; background screening clearance
All staff must complete:
HIPAA confidentiality and participant rights training
Adaptive equipment handling and safety training
Emergency response and equipment troubleshooting procedures
Annual continuing education in assistive technology advancements and Medicaid compliance
7. MEDICAID WAIVER PROGRAMS
The following Hawaii Medicaid Waivers authorize Adaptive Equipment Services:
Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver
Community Care Services (CCS) Program (if assistive technology is tied to maintaining independence)
Approved providers may deliver:
Functional needs assessments and evaluations
Device procurement, customization, and setup
Participant and caregiver training on device usage
Repairs and technical support for Medicaid-funded equipment
8. TIMELINE TO LAUNCH
Phase: Business Formation and Initial Credentialing Setup
Timeline: 1–2 weeks
Phase: Med-QUEST Provider Application and Readiness Review
Timeline: 60–90 days
Phase: Staff Hiring, Credentialing, and Equipment Procurement System Setup
Timeline: 30–45 days
Phase: Medicaid Enrollment and Billing System Configuration
Timeline: 45–60 days
9. CONTACT INFORMATION
Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/
Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Website: https://health.hawaii.gov/ddd/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII ADAPTIVE EQUIPMENT SERVICES PROVIDER
WCG supports adaptive equipment suppliers, therapy agencies, and community providers in launching Medicaid-compliant Adaptive Equipment Services under Hawaii’s HCBS waiver programs.
Scope of Work:
Business registration and EIN/NPI setup
Medicaid provider enrollment assistance
Development of Adaptive Equipment Services Policy & Procedure Manual
Staff credentialing templates and participant equipment assessment forms
Medicaid billing configuration and claims management
Website, domain, and email setup
Equipment intake, procurement tracking, and training documentation systems
Emergency maintenance and backup service procedures
Quality assurance programs for participant satisfaction and device functionality
Community networking and vendor partnership development strategies
Skilled Nursing
SKILLED NURSING SERVICES PROVIDER IN HAWAII
DELIVERING MEDICALLY NECESSARY, PROFESSIONAL NURSING CARE TO INDIVIDUALS IN THEIR HOMES AND COMMUNITIES
Skilled Nursing Services in Hawaii provide clinical nursing care to individuals with chronic illnesses, disabilities, or post-acute medical needs. These services are authorized under Hawaii’s Medicaid State Plan, Home and Community-Based Services (HCBS) waiver programs, and Medicare, helping individuals maintain optimal health and remain safely at home or in community settings.
1. GOVERNING AGENCIES
Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Skilled Nursing Services
Agency: Hawaii Department of Health (DOH) — Office of Health Care Assurance (OHCA)
Role: Licenses and monitors home health agencies and skilled nursing providers
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight ensuring Skilled Nursing Services meet Medicaid and Medicare standards
2. SKILLED NURSING SERVICE OVERVIEW
Skilled Nursing Services involve medically necessary nursing care provided by licensed nurses to manage health conditions, prevent complications, and promote recovery or stability.
Approved providers may deliver:
Health assessments and monitoring of vital signs and clinical status
Medication administration (including injections, IV therapy)
Wound care and management of pressure injuries
Disease-specific management (e.g., diabetes care, respiratory support)
Catheter care, tube feeding, and ostomy care
Health education for participants and caregivers
Coordination with physicians and interdisciplinary care teams
Services may be intermittent, part-time, or extended depending on the participant’s needs as documented in their Individualized Service Plan (ISP) or Plan of Care (POC).
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
Obtain EIN from the IRS and NPI (Type 2)
Obtain Home Health Agency License or Skilled Nursing Agency License through DOH's Office of Health Care Assurance (if operating as an agency)
Employ licensed Registered Nurses (RNs) and Licensed Practical Nurses (LPNs) under appropriate supervision
Maintain general liability, professional liability, and malpractice insurance
Enroll as a Medicaid provider with Hawaii’s Med-QUEST Division
4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Submit Provider Enrollment Application for Skilled Nursing Services through Hawaii Med-QUEST
If operating a facility-based agency, submit license application to DOH’s Office of Health Care Assurance
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, nursing staff credentialing, insurance certificates, clinical protocols, and quality assurance plans
Provide sample care plans, nursing service logs, and emergency response protocols
Program Readiness Review:
DHS and DOH review provider readiness including nursing protocols, participant safety systems, and Medicaid billing compliance
Approval & Medicaid Enrollment:
Upon approval, configure billing codes for Skilled Nursing Services (e.g., per visit, per hour, continuous care models)
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (Hawaii DCCA)
IRS EIN confirmation
NPI confirmation
Home Health Agency or Skilled Nursing Facility License (if required)
Proof of general, professional, and malpractice insurance
HCBS-Compliant and Skilled Nursing-Compliant Policy & Procedure Manual including:
Participant intake, nursing assessment, and care planning protocols
Skilled nursing intervention and monitoring procedures
Medication administration, wound care, and emergency response protocols
HIPAA confidentiality, participant rights, and grievance handling policies
Staff credentialing, background screening, and ongoing competency verification
Medicaid billing, service authorization tracking, and quality assurance systems
6. STAFFING REQUIREMENTS
Role: Director of Nursing / Clinical Supervisor
Requirements: Active Hawaii RN license; supervisory experience in skilled care preferred; background screening clearance
Role: Registered Nurses (RNs)
Requirements: Active Hawaii RN license; CPR certification; experience in community or home-based care; background screening clearance
Role: Licensed Practical Nurses (LPNs)
Requirements: Active Hawaii LPN license; experience with skilled nursing procedures; background screening clearance
All staff must complete:
HIPAA confidentiality, participant rights, and abuse prevention training
Emergency preparedness and infection control training
Clinical documentation and Medicaid compliance training
Annual competency assessments and continuing nursing education
7. MEDICAID WAIVER PROGRAMS
The following Hawaii Medicaid Waivers authorize Skilled Nursing Services:
Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver (where medically necessary)
Community Care Services (CCS) Program
Medicaid State Plan Home Health Benefit
QUEST Integration Managed Care Program
Approved providers may deliver:
Skilled nursing visits
Ongoing health monitoring and medical management
Extended skilled nursing care for medically fragile participants
8. TIMELINE TO LAUNCH
Phase: Business Formation and Licensing Application
Timeline: 1–2 months
Phase: Facility Readiness (if required) and Staff Hiring
Timeline: 2–4 months
Phase: Med-QUEST and DOH Enrollment and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing Setup and Claims Testing
Timeline: 30–45 days
9. CONTACT INFORMATION
Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/
Hawaii Department of Health (DOH) — Office of Health Care Assurance (OHCA)
Website: https://health.hawaii.gov/ohca/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII SKILLED NURSING SERVICES PROVIDER
WCG supports nursing agencies, home health providers, and healthcare entrepreneurs in launching Medicaid-compliant Skilled Nursing Services under Hawaii’s HCBS waiver programs and Medicaid State Plan.
Scope of Work:
Business registration and EIN/NPI setup
Home Health Agency/Skilled Nursing licensing and Medicaid provider enrollment
Development of Skilled Nursing Services Policy & Procedure Manual
Staff credentialing templates and nursing documentation systems
Medicaid billing configuration and claims management
Website, domain, and email setup
Nursing intake, care planning, and daily service tracking templates
Emergency response, infection control, and risk management systems
Quality assurance programs for clinical outcome monitoring
Community networking and healthcare referral partnership development
Habilitation Services
HABILITATION SERVICES PROVIDER IN HAWAII
SUPPORTING SKILL DEVELOPMENT AND INDEPENDENT LIVING FOR INDIVIDUALS WITH DISABILITIES THROUGH STRUCTURED, PERSON-CENTERED SERVICES
Habilitation Services in Hawaii are designed to assist individuals with disabilities in acquiring, retaining, and improving skills necessary for daily living, employment, and full community participation. These services are authorized under Hawaii’s Medicaid Home and Community-Based Services (HCBS) waiver programs and are a critical part of promoting independence and enhancing quality of life.
1. GOVERNING AGENCIES
Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Habilitation Services
Agency: Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Role: Administers HCBS waiver habilitation services for individuals with intellectual and developmental disabilities
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight ensuring Habilitation Services meet Medicaid HCBS community-based and person-centered standards
2. HABILITATION SERVICE OVERVIEW
Habilitation Services are person-centered supports focused on building or maintaining skills essential for daily living, communication, social interaction, and community integration.
Approved providers may deliver:
Training and assistance with Activities of Daily Living (ADLs) such as bathing, dressing, grooming, and eating
Support with Instrumental Activities of Daily Living (IADLs) such as cooking, money management, shopping, and household tasks
Communication skills development
Social skills training and participation in community activities
Mobility and orientation assistance
Self-advocacy and decision-making support
Pre-employment skill-building and support
All services must align with the participant’s Individualized Service Plan (ISP) and promote independence, dignity, and meaningful community engagement.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid provider through the Hawaii Med-QUEST Division
Complete DDD Provider Standards Certification (for services under DD/ID Waiver)
Maintain general liability and professional liability insurance
Develop comprehensive policies addressing participant rights, skill development strategies, safety, and emergency response
4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Submit Provider Enrollment Application for Habilitation Services under Hawaii’s HCBS waivers
Indicate service types (e.g., Community-Based Habilitation, In-Home Habilitation)
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, operational and staffing plans, sample service plans, and insurance certificates
Include participant intake forms, skill assessment templates, and daily documentation tools
Program Readiness Review:
DHS and DOH review provider readiness including training protocols, participant safeguards, documentation compliance, and service models
Approval & Medicaid Enrollment:
Upon approval, configure billing codes for Habilitation Services (community-based and/or in-home supports)
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (Hawaii DCCA)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
HCBS-Compliant Policy & Procedure Manual including:
Participant intake, assessment, and individualized habilitation planning
Skill development support strategies and training protocols
Daily service documentation and outcome tracking
HIPAA confidentiality, participant rights, and grievance policies
Staff credentialing, background screening, and competency verification
Medicaid billing, service authorization tracking, and audit readiness systems
6. STAFFING REQUIREMENTS
Role: Habilitation Program Manager / Supervisor
Requirements: Bachelor's degree in human services, social work, education, or related field preferred; experience with skill-building and disability supports; background screening clearance
Role: Direct Support Professionals (DSPs) / Habilitation Specialists
Requirements: High school diploma or GED; CPR/First Aid certification; specialized training in habilitation service delivery; background screening clearance
All staff must complete:
HIPAA confidentiality and participant rights training
Person-centered planning and community integration training
Emergency preparedness, abuse prevention, and incident reporting training
Annual refresher training on habilitation service delivery and Medicaid compliance
7. MEDICAID WAIVER PROGRAMS
The following Hawaii Medicaid Waivers authorize Habilitation Services:
Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver
Approved providers may deliver:
Community-Based Habilitation Services (focused on skill development in integrated settings)
In-Home Habilitation Services (skill-building supports delivered in a participant’s residence)
Intensive habilitation supports where behavioral, medical, or specialized skill instruction is necessary
8. TIMELINE TO LAUNCH
Phase: Business Formation and Initial Credentialing Setup
Timeline: 1–2 weeks
Phase: Med-QUEST and DDD Provider Application and Readiness Review
Timeline: 60–90 days
Phase: Staff Hiring, Credentialing, and Habilitation Program Setup
Timeline: 30–45 days
Phase: Medicaid Enrollment and Billing System Setup
Timeline: 45–60 days
9. CONTACT INFORMATION
Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/
Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Website: https://health.hawaii.gov/ddd/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII HABILITATION SERVICES PROVIDER
WCG supports community organizations, disability service agencies, and human service providers in launching Medicaid-compliant Habilitation Services under Hawaii’s HCBS waiver programs.
Scope of Work:
Business registration and EIN/NPI setup
Medicaid and DDD provider enrollment support
Development of Habilitation Services Policy & Procedure Manual
Staff credentialing templates and participant skill assessment forms
Medicaid billing system setup and claims management
Website, domain, and email setup
Participant intake, habilitation planning, and daily service documentation templates
Emergency preparedness and incident reporting systems
Quality assurance programs for skill development outcome tracking
Community networking and interdisciplinary collaboration strategies
Adult Day Health Services
ADULT DAY HEALTH SERVICES PROVIDER IN HAWAII
ENHANCING WELL-BEING AND COMMUNITY PARTICIPATION THROUGH DAILY MEDICAL AND SUPPORT SERVICES
Adult Day Health Services (ADHS) in Hawaii provide structured, community-based programs offering health, therapeutic, and social services to individuals with disabilities, chronic illnesses, or aging-related needs. These services are authorized under Hawaii’s Medicaid Home and Community-Based Services (HCBS) waiver programs and Medicaid State Plan benefits, supporting independence while providing essential medical monitoring and social engagement.
1. GOVERNING AGENCIES
Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Adult Day Health Services
Agency: Hawaii Department of Health (DOH) — Office of Health Care Assurance (OHCA)
Role: Licenses Adult Day Health centers and ensures regulatory compliance
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight ensuring Adult Day Health Services meet Medicaid HCBS community integration and quality standards
2. ADULT DAY HEALTH SERVICE OVERVIEW
Adult Day Health Services are provided in a licensed, community-based setting and combine health services, therapeutic interventions, and social activities to maintain or enhance participants’ health and community living abilities.
Approved providers may deliver:
Skilled nursing services (e.g., health monitoring, medication administration, wound care)
Personal care assistance (e.g., toileting, eating, mobility support)
Physical, occupational, and speech therapy (either on-site or through referrals)
Structured social, educational, and recreational activities
Nutritionally balanced meals and snacks
Transportation services to and from the center (where authorized)
Programs must be individualized and based on each participant’s Individualized Service Plan (ISP), focusing on improving health outcomes, reducing isolation, and preventing institutionalization.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
Obtain EIN from the IRS and NPI (Type 2)
Obtain Adult Day Health Center License through Hawaii’s Office of Health Care Assurance (OHCA)
Maintain general liability, professional liability, and worker’s compensation insurance
Comply with applicable building safety codes, ADA accessibility requirements, and staffing ratios
4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Submit Provider Enrollment Application for Adult Day Health Services through Hawaii’s Med-QUEST Division
Submit license application to OHCA for center operations
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, center floor plans, staffing rosters, insurance certificates, and operational policies
Provide participant intake forms, care plans, therapy schedules, daily activity calendars, and emergency preparedness plans
Licensure and Readiness Review:
Undergo an OHCA on-site inspection to verify facility compliance
DHS reviews staffing, care delivery, participant protection systems, and Medicaid documentation practices
Approval & Medicaid Enrollment:
Upon approval, configure billing codes for Adult Day Health attendance (half-day and full-day units)
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (Hawaii DCCA)
IRS EIN confirmation
NPI confirmation
Adult Day Health Center License (OHCA)
Proof of general, professional, and worker’s compensation insurance
HCBS-Compliant Policy & Procedure Manual including:
Participant intake, health assessment, and care planning procedures
Skilled nursing care, therapy services, and personal care assistance protocols
Daily programming, activity scheduling, and meal service guidelines
Emergency preparedness, evacuation, and disaster recovery procedures
HIPAA confidentiality, participant rights, and grievance policies
Staff credentialing, background checks, training documentation
Medicaid billing, service tracking, and audit readiness procedures
6. STAFFING REQUIREMENTS
Role: Adult Day Health Program Administrator
Requirements: Bachelor’s degree in healthcare, human services, or related field; experience managing adult day or health services; background screening clearance
Role: Registered Nurse (RN) / Health Services Supervisor
Requirements: Active Hawaii RN license; experience in community health or geriatrics; background screening clearance
Role: Certified Nurse Aides (CNAs) / Direct Care Staff
Requirements: State certification preferred; CPR/First Aid certification; background screening clearance
Role: Activity Coordinators / Program Aides
Requirements: Experience with therapeutic recreation, social services, or education; background screening clearance
All staff must complete:
HIPAA confidentiality, participant rights, and abuse prevention training
Emergency preparedness and infection control training
First aid, CPR, and medication administration (where applicable)
Annual continuing education and competency evaluations
7. MEDICAID WAIVER PROGRAMS
The following Hawaii Medicaid programs authorize Adult Day Health Services:
Community Care Services (CCS) Program
Medicaid State Plan Long-Term Services and Supports (LTSS)
Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver (community-based day services for certain participants)
Approved providers may deliver:
Health monitoring, skilled nursing, and therapy integration
Social and recreational programming to promote cognitive and emotional well-being
Personal care services supporting daily living activities
Nutritional support and participant safety monitoring
8. TIMELINE TO LAUNCH
Phase: Business Formation, Licensing, and Facility Preparation
Timeline: 2–4 months
Phase: Staffing, Training, and Program Development
Timeline: 2–3 months
Phase: Med-QUEST Enrollment and Medicaid Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing System Configuration and Claims Readiness
Timeline: 30–45 days
9. CONTACT INFORMATION
Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/
Hawaii Department of Health (DOH) — Office of Health Care Assurance (OHCA)
Website: https://health.hawaii.gov/ohca/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII ADULT DAY HEALTH SERVICES PROVIDER
WCG supports adult day health centers, healthcare agencies, and senior service organizations in launching Medicaid-compliant Adult Day Health Services under Hawaii’s HCBS waiver programs and Medicaid State Plan benefits.
Scope of Work:
Business registration and EIN/NPI setup
Adult Day Health licensing and Medicaid provider enrollment support
Development of Adult Day Health Services Policy & Procedure Manual
Staff credentialing templates and participant intake/care planning forms
Medicaid billing system setup and claims management
Website, domain, and email setup
Health monitoring, service documentation, and daily programming templates
Emergency preparedness planning and incident reporting systems
Quality assurance programs for participant safety, health outcomes, and satisfaction
Community networking and referral development strategies
Assistive Technology
ASSISTIVE TECHNOLOGY SERVICES PROVIDER IN HAWAII
ENHANCING INDEPENDENCE AND COMMUNITY PARTICIPATION THROUGH CUSTOMIZED TECHNOLOGICAL SOLUTIONS
Assistive Technology (AT) Services in Hawaii help individuals with disabilities, chronic illnesses, or aging-related needs acquire and use adaptive devices to perform everyday activities more independently. These services are authorized under Hawaii’s Medicaid Home and Community-Based Services (HCBS) waiver programs and aim to remove barriers to community living, employment, and personal autonomy.
1. GOVERNING AGENCIES
Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Assistive Technology Services
Agency: Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Role: Administers HCBS waiver services for individuals with intellectual and developmental disabilities, including AT services
Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight ensuring Assistive Technology Services meet Medicaid HCBS standards and person-centered planning principles
2. ASSISTIVE TECHNOLOGY SERVICE OVERVIEW
Assistive Technology Services involve assessing the individual’s needs, selecting appropriate devices, training participants and caregivers, and maintaining or repairing devices to ensure optimal function.
Approved providers may deliver:
Functional assessments to determine AT needs
Recommendations for appropriate devices and equipment
Purchase, leasing, or customization of assistive devices
Installation, setup, and participant training on device usage
Repair, maintenance, and technical support for AT equipment
Integration of AT solutions into the participant’s daily routines at home, work, or in the community
Examples of covered devices may include:
Communication aids (e.g., speech-generating devices)
Mobility aids (e.g., power wheelchairs, transfer devices)
Environmental control units (e.g., adapted switches, smart home devices)
Sensory equipment (e.g., visual or auditory alerting systems)
Adaptive computer hardware and software
Services must align with the participant’s Individualized Service Plan (ISP) and be aimed at enhancing functional independence and community engagement.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid provider with Hawaii’s Med-QUEST Division
Complete enrollment and approval through Hawaii’s HCBS Waiver Provider Standards (specifically for AT services)
Maintain general and product liability insurance
Employ qualified staff such as Assistive Technology Professionals (ATP) when required
Develop service protocols for device assessment, installation, maintenance, and participant training
4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Submit Provider Enrollment Application for HCBS services to Hawaii Med-QUEST
Include identification as an Assistive Technology Services provider under the applicable waiver (e.g., DD/ID Waiver)
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, service descriptions, policies for AT assessment and support, and staff qualifications
Include service delivery protocols, warranty policies, and emergency backup support plans
Program Readiness Review:
DHS and Med-QUEST review the provider’s staffing, operational readiness, participant support systems, and Medicaid documentation compliance
Approval & Medicaid Enrollment:
Upon approval, configure billing codes for Assistive Technology Assessment, Device Procurement, Training, and Maintenance
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business Registration (Hawaii DCCA)
IRS EIN confirmation
NPI confirmation
Proof of general and product liability insurance
HCBS-Compliant Policy & Procedure Manual including:
Participant intake and functional needs assessment protocols
AT device selection, procurement, and setup procedures
Training procedures for participants and caregivers
Emergency backup, repair, and maintenance service plans
Client rights, HIPAA confidentiality, and grievance policies
Staff credentialing, background checks, and training documentation
Medicaid billing, authorization tracking, and audit readiness systems
6. STAFFING REQUIREMENTS
Role: Assistive Technology Specialist / Program Manager
Requirements: Assistive Technology Professional (ATP) certification preferred or equivalent experience; background screening clearance
Role: Adaptive Equipment Technicians / Trainers
Requirements: Experience with device setup, customization, and user training; background screening clearance
All staff must complete:
HIPAA confidentiality and participant rights training
Emergency response and device safety training
Training on Medicaid service documentation and device integration practices
Annual continuing education on emerging technologies and best practices in assistive technology service delivery
7. MEDICAID WAIVER PROGRAMS
The following Hawaii Medicaid Waivers authorize Assistive Technology Services:
Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver
Community Care Services (CCS) Program (for adults with serious mental illness and chronic conditions)
Approved providers may deliver:
Functional assessments and evaluations
Device procurement and customization
Participant and caregiver training
Maintenance, repair, and replacement services for AT devices
8. TIMELINE TO LAUNCH
Phase: Business Formation and Initial Credentialing Setup
Timeline: 1–2 weeks
Phase: Med-QUEST Provider Application and Review
Timeline: 60–90 days
Phase: Staff Hiring, Credentialing, and Service System Development
Timeline: 30–45 days
Phase: Medicaid Enrollment and Billing Setup
Timeline: 45–60 days
9. CONTACT INFORMATION
Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/
Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Website: https://health.hawaii.gov/ddd/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII ASSISTIVE TECHNOLOGY SERVICES PROVIDER
WCG supports adaptive technology vendors, service providers, and community health organizations in launching Medicaid-compliant Assistive Technology Services under Hawaii’s HCBS waiver programs.
Scope of Work:
Business registration and EIN/NPI setup
Med-QUEST and DHS provider enrollment assistance
Development of Assistive Technology Services Policy & Procedure Manual
Staff credentialing templates and participant assessment forms
Medicaid billing configuration and claims management
Website, domain, and email setup
Participant intake, needs assessment, and equipment delivery templates
Emergency repair, maintenance, and device support systems
Quality assurance programs for service delivery monitoring
Community networking and referral building strategies
Behavioral Health
BEHAVIORAL HEALTH SERVICES PROVIDER IN HAWAII
PROMOTING EMOTIONAL WELL-BEING, SELF-REGULATION, AND RECOVERY THROUGH COMPREHENSIVE SUPPORTS
Behavioral Health Services in Hawaii provide individuals with mental health conditions, behavioral challenges, or emotional disorders access to therapy, counseling, crisis intervention, and supportive care. These services are authorized under Hawaii’s Medicaid State Plan and Home and Community-Based Services (HCBS) waiver programs, focusing on fostering resilience, self-management, and community living.
1. GOVERNING AGENCIES
Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Behavioral Health Services
Agency: Hawaii Department of Health (DOH) — Adult Mental Health Division (AMHD) and Child & Adolescent Mental Health Division (CAMHD)
Role: Administers community mental health services and crisis intervention supports
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight ensuring Behavioral Health Services meet Medicaid standards for accessibility, quality, and person-centered care
2. BEHAVIORAL HEALTH SERVICE OVERVIEW
Behavioral Health Services encompass a range of therapeutic, rehabilitative, and crisis support services aimed at improving emotional regulation, managing psychiatric symptoms, and enhancing overall mental wellness.
Approved providers may deliver:
Psychotherapy (individual, group, or family sessions)
Psychiatric evaluation and medication management
Behavioral intervention and crisis de-escalation
Skills training for emotional regulation, coping strategies, and interpersonal communication
Community-based rehabilitative services (CBRS)
Peer support services (where authorized)
Mobile crisis intervention and stabilization (for urgent needs)
All services must align with a participant’s treatment plan or Individualized Service Plan (ISP) and promote recovery-oriented, person-centered goals.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
Obtain EIN from the IRS and NPI (Type 2)
Obtain licensure as a behavioral health agency if operating a facility (through Hawaii DOH)
Employ credentialed professionals (licensed psychologists, psychiatrists, LCSWs, LPCs, LMFTs, APRNs, etc.)
Maintain general liability, professional liability, and malpractice insurance
Enroll as a Medicaid provider with Hawaii’s Med-QUEST Division
4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Submit Provider Enrollment Application for Behavioral Health Services through Hawaii Med-QUEST
Identify services to be provided (therapy, psychiatric services, crisis intervention, rehabilitation, peer supports, etc.)
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, professional licensure verifications, operational and clinical policies, and proof of insurance
Program Readiness Review:
DHS and Med-QUEST review provider readiness including clinical staffing, service models, documentation systems, and participant rights protections
Approval & Medicaid Enrollment:
Upon approval, configure billing codes appropriate to service types (e.g., psychotherapy sessions, psychiatric evaluations, crisis intervention events)
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (Hawaii DCCA)
IRS EIN confirmation
NPI confirmation
Licenses for clinical staff (LCSW, LPC, LMFT, psychologist, psychiatrist, APRN, etc.)
Behavioral Health Agency license (if operating a facility)
Proof of general, professional, and malpractice insurance
HCBS-Compliant and Behavioral Health-Compliant Policy & Procedure Manual including:
Participant intake, assessment, diagnosis, and treatment planning procedures
Clinical service delivery protocols (therapy, crisis response, medication management)
Confidentiality, HIPAA compliance, and participant rights protections
Incident reporting, emergency response, and suicide prevention plans
Staff credentialing, background checks, clinical supervision records
Medicaid billing, service authorization tracking, and quality assurance procedures
6. STAFFING REQUIREMENTS
Role: Clinical Director / Behavioral Health Program Manager
Requirements: Doctorate or Master’s degree in psychology, social work, counseling, or related field; active Hawaii licensure; supervisory experience; background screening clearance
Role: Therapists / Licensed Clinicians (LCSW, LPC, LMFT, Psychologists)
Requirements: Active Hawaii licensure in their discipline; experience with community mental health; background screening clearance
Role: Psychiatrists / Psychiatric Nurse Practitioners (APRNs)
Requirements: Hawaii medical or advanced practice nursing license; DEA registration for prescribing; background screening clearance
Role: Behavioral Health Specialists / Peer Support Workers
Requirements: Certification and/or lived experience where applicable; training in recovery models and crisis de-escalation preferred; background screening clearance
All staff must complete:
HIPAA confidentiality, client rights, and abuse prevention training
Crisis intervention, suicide prevention, and de-escalation training
Emergency preparedness and incident management training
Annual clinical continuing education and Medicaid compliance training
7. MEDICAID PROGRAMS
Behavioral Health Services are authorized under:
Hawaii Medicaid State Plan
Community Care Services (CCS) Program
Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver (for behavioral supports related to disabilities)
QUEST Integration Behavioral Health Programs
Crisis Mobile Outreach Services (separate authorization through AMHD or CAMHD)
Approved providers may deliver:
Therapy sessions (individual, group, family)
Psychiatric evaluations and medication management
Crisis intervention and stabilization services
Skills training and rehabilitative supports
Peer supports and recovery assistance
8. TIMELINE TO LAUNCH
Phase: Business Formation and Licensing Application
Timeline: 1–2 months
Phase: Clinical Program Development and Staff Hiring
Timeline: 2–4 months
Phase: Medicaid Provider Enrollment and Service Readiness Review
Timeline: 60–90 days
Phase: Medicaid Billing System Setup and Claims Testing
Timeline: 30–45 days
9. CONTACT INFORMATION
Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/
Hawaii Department of Health (DOH) — Adult Mental Health Division (AMHD)
Website: https://health.hawaii.gov/amhd/
Hawaii Department of Health (DOH) — Child & Adolescent Mental Health Division (CAMHD)
Website: https://health.hawaii.gov/camhd/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII BEHAVIORAL HEALTH SERVICES PROVIDER
WCG supports behavioral health agencies, private practices, and crisis response organizations in launching Medicaid-compliant Behavioral Health Services under Hawaii’s HCBS and Medicaid State Plan programs.
Scope of Work:
Business registration and EIN/NPI setup
Medicaid provider enrollment and licensing assistance
Development of Behavioral Health Services Policy & Procedure Manual
Staff credentialing templates and participant intake documentation
Medicaid billing system setup and claims management
Website, domain, and email setup
Clinical intake, assessment, treatment planning, and service tracking systems
Crisis response, suicide prevention, and emergency preparedness procedures
Quality assurance and clinical outcome tracking programs
Community networking and referral partnership development
Home Modification
HOME MODIFICATION SERVICES PROVIDER IN HAWAII
ENHANCING SAFETY, ACCESSIBILITY, AND INDEPENDENCE THROUGH CUSTOMIZED HOME ADAPTATIONS
Home Modification Services in Hawaii assist individuals with disabilities, chronic conditions, or aging-related needs by adapting their living environments to promote safe, independent, and community-based living. These services are authorized under Hawaii’s Medicaid Home and Community-Based Services (HCBS) waiver programs and are critical for reducing risks and improving quality of life.
1. GOVERNING AGENCIES
Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Home Modification Services
Agency: Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Role: Administers HCBS waiver Home Modification Services for individuals with intellectual and developmental disabilities (IDD)
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight ensuring Home Modification Services meet Medicaid HCBS standards
2. HOME MODIFICATION SERVICE OVERVIEW
Home Modification Services involve structural changes, installations, or adaptations to a participant’s home to ensure safety, accessibility, and functional independence.
Approved providers may deliver:
Installation of wheelchair ramps, stair lifts, and widened doorways
Bathroom modifications such as roll-in showers, grab bars, and accessible sinks
Kitchen modifications including lowered counters and accessible appliances
Structural adjustments to improve mobility within the home
Installation of handrails, non-slip flooring, and emergency alert systems
Environmental control unit setup (lighting, temperature, entry systems)
All modifications must directly support needs identified in the participant’s Individualized Service Plan (ISP) and may not include general home improvements or repairs unrelated to the participant’s disability.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
Obtain EIN from the IRS and NPI (Type 2)
Hold appropriate contractor’s license in Hawaii (e.g., C-5 Cabinet, Millwork and Finish Carpentry Contractor; C-15 Electronic Systems Contractor; or General Contractor license depending on scope)
Enroll as a Medicaid provider through Hawaii’s Med-QUEST Division
Maintain commercial general liability, professional liability, and workers’ compensation insurance
Develop participant-centered policies for project assessment, execution, and safety
4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Submit Provider Enrollment Application identifying Home Modification Services under Hawaii’s HCBS programs
Provide contractor licensing and insurance verification
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, contractor’s license(s), insurance certificates, and operational policies
Provide examples of project plans, participant intake forms, safety inspection protocols, and warranty plans
Program Readiness Review:
DHS and DOH review provider readiness including project safety standards, participant protection measures, and Medicaid documentation practices
Approval & Medicaid Enrollment:
Upon approval, configure billing codes for Home Modification Assessment, Design, Construction, and Final Inspection
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (Hawaii DCCA)
IRS EIN confirmation
NPI confirmation
Active Hawaii Contractor License (where applicable)
Proof of general liability, professional liability, and worker’s compensation insurance
HCBS-Compliant Policy & Procedure Manual including:
Participant intake, needs assessment, and modification planning protocols
Project safety, ADA compliance, and participant protection standards
Construction procedures, contractor oversight, and final inspection processes
HIPAA confidentiality, participant rights, and grievance handling policies
Staff credentialing, background screening, and competency verification
Medicaid billing, authorization tracking, and audit readiness documentation
6. STAFFING REQUIREMENTS
Role: Home Modification Program Manager / Construction Supervisor
Requirements: Licensed contractor with experience in accessible modifications; background screening clearance
Role: Construction Technicians / Installation Specialists
Requirements: Skilled trades experience; knowledge of ADA accessibility standards preferred; background screening clearance
All staff must complete:
Safety and risk management training
HIPAA confidentiality and participant rights training
Emergency response and incident reporting training
Annual training on building codes, accessibility standards, and Medicaid compliance
7. MEDICAID WAIVER PROGRAMS
The following Hawaii Medicaid Waivers authorize Home Modification Services:
Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver
Community Care Services (CCS) Program (when home modifications are necessary for safe community living)
Approved providers may deliver:
Accessibility-focused home remodeling projects
Safety adaptations for fall prevention, mobility, and emergency response
Environmental control installations supporting participant independence
8. TIMELINE TO LAUNCH
Phase: Business Formation, Licensing, and Insurance Setup
Timeline: 2–4 weeks
Phase: Med-QUEST Provider Application and Readiness Review
Timeline: 60–90 days
Phase: Staff Hiring, Credentialing, and Project Workflow Setup
Timeline: 30–45 days
Phase: Medicaid Enrollment and Billing System Configuration
Timeline: 45–60 days
9. CONTACT INFORMATION
Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/
Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Website: https://health.hawaii.gov/ddd/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
Hawaii Department of Commerce and Consumer Affairs (DCCA) — Contractor Licensing
Website: https://cca.hawaii.gov/pvl/boards/contractor/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII HOME MODIFICATION SERVICES PROVIDER
WCG supports construction firms, accessibility specialists, and human services organizations in launching Medicaid-compliant Home Modification Services under Hawaii’s HCBS waiver programs.
Scope of Work:
Business registration and EIN/NPI setup
Contractor licensing guidance and Medicaid provider enrollment assistance
Development of Home Modification Services Policy & Procedure Manual
Staff credentialing templates and project tracking systems
Medicaid billing configuration and claims management
Website, domain, and email setup
Participant intake, assessment, and home modification planning templates
Safety protocols for construction and participant protection
Quality assurance systems for project delivery and compliance monitoring
Community networking and referral partnership strategies
Specialized Therapies
SPECIALIZED THERAPIES SERVICES PROVIDER IN HAWAII
PROMOTING FUNCTIONAL INDEPENDENCE AND WELL-BEING THROUGH INDIVIDUALIZED THERAPEUTIC INTERVENTIONS
Specialized Therapies Services in Hawaii offer tailored therapeutic interventions to address participants’ physical, cognitive, communication, and behavioral needs. These services are authorized under Hawaii’s Medicaid Home and Community-Based Services (HCBS) waiver programs, aiming to support individuals with disabilities or chronic conditions in achieving greater independence and improving their quality of life.
1. GOVERNING AGENCIES
Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Specialized Therapies
Agency: Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Role: Administers HCBS waiver services, including specialized therapeutic services for individuals with intellectual and developmental disabilities (IDD)
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight ensuring Specialized Therapies meet Medicaid HCBS standards and person-centered planning principles
2. SPECIALIZED THERAPIES SERVICE OVERVIEW
Specialized Therapies encompass a wide range of targeted interventions designed to enhance the functional abilities, communication skills, physical health, and behavioral regulation of participants.
Approved providers may deliver:
Speech-Language Therapy (improving communication and swallowing function)
Occupational Therapy (enhancing daily living skills, sensory integration, adaptive strategies)
Physical Therapy (improving mobility, strength, balance, and physical endurance)
Behavioral Therapy (addressing behavioral challenges through positive supports)
Feeding Therapy (specialized therapy for eating and swallowing disorders)
Music or Art Therapy (where authorized under waiver programs)
All therapies must be recommended by an assessment, authorized in the participant’s Individualized Service Plan (ISP), and tied to measurable, person-centered outcomes.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid provider through the Hawaii Med-QUEST Division
Therapists must hold active Hawaii licenses in their respective disciplines (PT, OT, SLP, Psychology, etc.)
Maintain general and professional liability insurance
Develop clinical policies and protocols for service delivery, participant safety, and documentation
4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Submit Provider Enrollment Application for Specialized Therapies under Hawaii’s HCBS Waiver Services
Indicate therapy disciplines provided and service areas
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, clinical staff credentialing, insurance certificates, and sample service models
Provide participant intake forms, therapy assessment templates, care plans, and service tracking forms
Program Readiness Review:
DHS reviews provider readiness, including staff qualifications, service systems, emergency protocols, and Medicaid compliance documentation
Approval & Medicaid Enrollment:
Upon approval, configure billing codes specific to each specialized therapy service authorized under Medicaid
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (Hawaii DCCA)
IRS EIN confirmation
NPI confirmation
Professional licenses for clinical staff (PT, OT, SLP, psychologist, etc.)
Proof of general and professional liability insurance
HCBS-Compliant Policy & Procedure Manual including:
Participant intake, assessment, and therapy planning protocols
Delivery of therapeutic interventions and outcome measurement
HIPAA confidentiality, participant rights, and grievance procedures
Emergency response protocols and clinical supervision plans
Staff credentialing, background screening, and continuing education documentation
Medicaid billing, service authorization tracking, and audit readiness systems
6. STAFFING REQUIREMENTS
Role: Clinical Supervisor / Lead Therapist
Requirements: Active Hawaii license in applicable therapy discipline; supervisory experience preferred; background screening clearance
Role: Licensed Therapists (PTs, OTs, SLPs, Behavioral Therapists)
Requirements: Active Hawaii professional licensure; CPR certification recommended; background screening clearance
Role: Therapy Assistants (where applicable, such as COTAs, PTAs)
Requirements: Certification and/or licensure as required; background screening clearance
All staff must complete:
HIPAA confidentiality and participant rights training
Emergency response and documentation compliance training
Continuing education in clinical best practices and therapy-specific standards
Annual competency evaluations and Medicaid documentation refreshers
7. MEDICAID WAIVER PROGRAMS
The following Hawaii Medicaid Waivers authorize Specialized Therapies Services:
Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver
Community Care Services (CCS) Program (where authorized for therapies tied to chronic health conditions)
Approved providers may deliver:
Therapy evaluations and individualized therapy planning
Direct delivery of therapy services in homes, centers, or community settings
Coordination with interdisciplinary teams to integrate therapy goals into broader care plans
Progress monitoring and re-assessment services
8. TIMELINE TO LAUNCH
Phase: Business Formation and Initial Credentialing Setup
Timeline: 1–2 weeks
Phase: Med-QUEST Provider Application and Readiness Review
Timeline: 60–90 days
Phase: Staff Hiring, Credentialing, and Clinical System Development
Timeline: 30–45 days
Phase: Medicaid Enrollment and Billing System Setup
Timeline: 45–60 days
9. CONTACT INFORMATION
Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/
Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Website: https://health.hawaii.gov/ddd/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII SPECIALIZED THERAPIES SERVICES PROVIDER
WCG supports therapy providers, rehabilitation centers, and healthcare organizations in launching Medicaid-compliant Specialized Therapies Services under Hawaii’s HCBS waiver programs.
Scope of Work:
Business registration and EIN/NPI setup
Medicaid provider enrollment and DHS service approval support
Development of Specialized Therapies Policy & Procedure Manual
Staff credentialing templates and therapy assessment forms
Medicaid billing configuration and claims management
Website, domain, and email setup
Participant intake, care planning, and therapy outcome tracking templates
Emergency response protocols and clinical documentation systems
Quality assurance programs for therapy service delivery monitoring
Community networking and interdisciplinary team partnership developmental
ent
Community Integration
COMMUNITY INTEGRATION SERVICES PROVIDER IN HAWAII
PROMOTING INCLUSION, PARTICIPATION, AND SOCIAL CONNECTIONS FOR INDIVIDUALS IN THEIR COMMUNITIES
Community Integration Services in Hawaii assist individuals with disabilities, chronic health conditions, or aging-related needs in developing the skills, supports, and opportunities needed to participate fully in community life. These services are authorized under Hawaii’s Medicaid Home and Community-Based Services (HCBS) waiver programs, fostering greater independence, socialization, and quality of life.
1. GOVERNING AGENCIES
Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Community Integration Services
Agency: Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Role: Administers HCBS waiver Community Integration Services for individuals with intellectual and developmental disabilities (IDD)
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight ensuring Community Integration Services meet Medicaid HCBS standards for community-based, person-centered support
2. COMMUNITY INTEGRATION SERVICE OVERVIEW
Community Integration Services focus on helping participants build skills and access opportunities that allow them to live, work, and thrive in their communities.
Approved providers may deliver:
Assistance with locating and participating in community activities (e.g., classes, volunteer opportunities, recreation, religious events)
Skills training in navigating community resources and using public transportation
Development of social skills and peer interactions
Support with joining clubs, hobby groups, sports teams, or civic organizations
Advocacy training to support personal choices and community engagement
Education on public services (e.g., libraries, parks, senior centers)
Services must align with goals identified in the participant’s Individualized Service Plan (ISP) and support meaningful community membership, not just presence in public spaces.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid provider with Hawaii’s Med-QUEST Division
Complete DDD Provider Certification if serving DD/ID Waiver participants
Maintain general liability and professional liability insurance
Develop policies for person-centered planning, safety in community settings, and participant support
4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Submit Provider Enrollment Application for Community Integration Services through Hawaii’s Med-QUEST Division
Identify planned community engagement activities and geographic service areas
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, insurance certificates, operational policies, and participant intake procedures
Provide sample community engagement plans, service tracking forms, and risk management protocols
Program Readiness Review:
DHS and DOH review provider readiness including participant safety systems, community participation strategies, and Medicaid documentation compliance
Approval & Medicaid Enrollment:
Upon approval, configure billing codes for Community Integration Services (typically hourly or session-based billing)
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (Hawaii DCCA)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
HCBS-Compliant Policy & Procedure Manual including:
Participant intake, assessment, and community participation planning
Community activity safety procedures and emergency response plans
Daily documentation and service authorization tracking
HIPAA confidentiality, participant rights, and grievance handling procedures
Staff credentialing, background checks, and competency documentation
Medicaid billing, quality assurance monitoring, and audit readiness documentation
6. STAFFING REQUIREMENTS
Role: Community Integration Program Manager / Supervisor
Requirements: Experience in disability services, social work, recreation therapy, or human services; background screening clearance
Role: Community Support Workers / Direct Support Professionals (DSPs)
Requirements: High school diploma or GED; CPR/First Aid certification preferred; background screening clearance
All staff must complete:
Person-centered planning, community integration, and social inclusion training
HIPAA confidentiality, participant rights, and abuse prevention training
Emergency preparedness and incident management training
Annual training refreshers on Medicaid compliance and community-based support best practices
7. MEDICAID WAIVER PROGRAMS
The following Hawaii Medicaid Waivers authorize Community Integration Services:
Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver
Community Care Services (CCS) Program (where social and community integration goals are identified)
Approved providers may deliver:
Skills training for independent community navigation
Supervised participation in social, recreational, or volunteer activities
Peer support and self-advocacy skill development
Transportation support (if tied to community activity participation)
8. TIMELINE TO LAUNCH
Phase: Business Formation and Initial Credentialing Setup
Timeline: 1–2 weeks
Phase: Med-QUEST Provider Application and Readiness Review
Timeline: 60–90 days
Phase: Staff Hiring, Credentialing, and Community Activity Setup
Timeline: 30–45 days
Phase: Medicaid Enrollment and Billing System Configuration
Timeline: 45–60 days
9. CONTACT INFORMATION
Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/
Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Website: https://health.hawaii.gov/ddd/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII COMMUNITY INTEGRATION SERVICES PROVIDER
WCG supports community-based organizations, direct support agencies, and inclusion-focused programs in launching Medicaid-compliant Community Integration Services under Hawaii’s HCBS waiver programs.
Scope of Work:
Business registration and EIN/NPI setup
Medicaid provider enrollment support
Development of Community Integration Services Policy & Procedure Manual
Staff credentialing templates and participant community assessment forms
Medicaid billing setup and claims management
Website, domain, and email setup
Community activity planning, safety procedures, and service documentation templates
Participant intake, social goal planning, and community partnership development
Quality assurance programs for service delivery and participant satisfaction tracking
Homemaker Services
HOMEMAKER SERVICES PROVIDER IN HAWAII
SUPPORTING INDEPENDENCE BY ASSISTING WITH HOUSEHOLD TASKS ESSENTIAL TO DAILY LIVING
Homemaker Services in Hawaii provide assistance with routine household tasks to individuals with disabilities, chronic health conditions, or aging-related needs, helping them maintain a safe, clean, and healthy home environment. These services are authorized under Hawaii’s Medicaid Home and Community-Based Services (HCBS) waiver programs and are essential for supporting independent living and preventing institutionalization.
1. GOVERNING AGENCIES
Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Homemaker Services
Agency: Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Role: Administers HCBS waiver Homemaker Services for individuals with intellectual and developmental disabilities (IDD)
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight ensuring Homemaker Services meet Medicaid HCBS standards for community-based supports
2. HOMEMAKER SERVICE OVERVIEW
Homemaker Services assist participants with light housekeeping and household management tasks they would otherwise be unable to complete independently.
Approved providers may deliver:
Housekeeping services such as dusting, sweeping, mopping, vacuuming, and trash removal
Laundry and linen changing
Meal preparation assistance (excluding medical-level meal services)
Grocery shopping and other essential errands
Light home organization to promote accessibility and safety
Assistance with household scheduling (e.g., coordinating utility services, basic organization)
Homemaker Services must directly support the individual’s health and well-being and be tied to objectives outlined in the participant’s Individualized Service Plan (ISP).
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid provider through Hawaii’s Med-QUEST Division
Maintain general liability insurance
Develop participant-centered policies and procedures for service delivery, safety, and documentation
4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Submit Provider Enrollment Application for Homemaker Services through Hawaii’s Med-QUEST Division
Identify service areas and scheduling models
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, proof of insurance, operational policies, and staff qualification standards
Provide sample daily service logs, participant intake forms, and emergency contact procedures
Program Readiness Review:
DHS and DOH review provider readiness including documentation systems, safety standards, participant protections, and Medicaid compliance
Approval & Medicaid Enrollment:
Upon approval, configure billing codes specific to Homemaker Services (hourly or per-visit reimbursement models)
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (Hawaii DCCA)
IRS EIN confirmation
NPI confirmation
Proof of general liability insurance
HCBS-Compliant Policy & Procedure Manual including:
Participant intake, needs assessment, and service planning procedures
Housekeeping, meal preparation, and household support protocols
Emergency preparedness and participant safety procedures
HIPAA confidentiality, participant rights, and grievance handling procedures
Staff credentialing, background screening, and competency tracking
Medicaid billing, service authorization tracking, and audit readiness systems
6. STAFFING REQUIREMENTS
Role: Homemaker Services Program Manager / Supervisor
Requirements: Experience managing personal care, home management, or disability support services preferred; background screening clearance
Role: Homemaker Staff / Direct Support Workers
Requirements: High school diploma or GED; CPR/First Aid certification recommended; background screening clearance
All staff must complete:
HIPAA confidentiality and participant rights training
Household safety, emergency response, and infection control training
Abuse prevention and participant safeguarding training
Annual refresher courses on homemaker service standards and Medicaid compliance
7. MEDICAID WAIVER PROGRAMS
The following Hawaii Medicaid Waivers authorize Homemaker Services:
Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver
Community Care Services (CCS) Program (if home management is necessary to prevent institutionalization)
Approved providers may deliver:
Light housekeeping, laundry, and home organization services
Basic meal preparation and shopping assistance
Essential home maintenance to promote participant safety and accessibility
8. TIMELINE TO LAUNCH
Phase: Business Formation and Initial Credentialing Setup
Timeline: 1–2 weeks
Phase: Med-QUEST Provider Application and Readiness Review
Timeline: 60–90 days
Phase: Staff Hiring, Credentialing, and Homemaker Program Setup
Timeline: 30–45 days
Phase: Medicaid Enrollment and Billing System Configuration
Timeline: 45–60 days
9. CONTACT INFORMATION
Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/
Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Website: https://health.hawaii.gov/ddd/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII HOMEMAKER SERVICES PROVIDER
WCG supports homemaker agencies, personal care providers, and community-based organizations in launching Medicaid-compliant Homemaker Services under Hawaii’s HCBS waiver programs.
Scope of Work:
Business registration and EIN/NPI setup
Medicaid provider enrollment support
Development of Homemaker Services Policy & Procedure Manual
Staff credentialing templates and participant intake/service planning documents
Medicaid billing configuration and claims management
Website, domain, and email setup
Participant intake, daily documentation, and service authorization tracking templates
Emergency response procedures and quality assurance systems
Community networking and partnership development strategies
Case Management
CASE MANAGEMENT SERVICES PROVIDER IN HAWAII
COORDINATING SERVICES, SUPPORTS, AND RESOURCES TO PROMOTE HEALTH, SAFETY, AND COMMUNITY INTEGRATION
Case Management Services in Hawaii assist individuals with disabilities, chronic conditions, or aging-related needs by coordinating and monitoring the services and supports necessary for their well-being. These services are authorized under Hawaii’s Medicaid Home and Community-Based Services (HCBS) waiver programs and Medicaid State Plan services, ensuring participants receive person-centered, comprehensive care in community settings.
1. GOVERNING AGENCIES
Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Case Management Services
Agency: Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Role: Administers Case Management under HCBS waivers for individuals with intellectual and developmental disabilities (IDD)
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight ensuring Case Management Services meet Medicaid standards for person-centered planning and service coordination
2. CASE MANAGEMENT SERVICE OVERVIEW
Case Management Services assist participants in planning, accessing, coordinating, monitoring, and evaluating services and supports necessary to achieve and maintain community living goals.
Approved providers may deliver:
Comprehensive assessment of participant needs, strengths, and preferences
Development and updating of the Individualized Service Plan (ISP)
Coordination of service delivery across multiple providers and systems
Referral to community resources, medical services, housing supports, and employment programs
Monitoring of participant progress and service effectiveness
Advocacy for participant rights and service access
Crisis intervention and problem-solving support
Case managers must ensure services are delivered in the most integrated setting possible and that all plans are person-centered.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid provider with Hawaii’s Med-QUEST Division
Ensure case managers meet educational and professional standards (e.g., social work, nursing, human services degrees)
Maintain general liability and professional liability insurance
Develop participant-centered policies and procedures for service planning, documentation, and participant advocacy
4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Submit Provider Enrollment Application for Case Management Services through Hawaii’s Med-QUEST Division
Identify areas of expertise (e.g., IDD supports, long-term services and supports)
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, case manager qualification documentation, operational policies, and insurance certificates
Provide sample ISPs, service monitoring forms, and crisis intervention protocols
Program Readiness Review:
DHS and DOH review provider readiness including participant safeguards, service coordination practices, and Medicaid compliance documentation
Approval & Medicaid Enrollment:
Upon approval, configure billing codes for Targeted Case Management (TCM) and HCBS Case Management
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (Hawaii DCCA)
IRS EIN confirmation
NPI confirmation
Proof of general and professional liability insurance
Staff credentials for case managers (degree certificates, licenses if applicable)
HCBS-Compliant Policy & Procedure Manual including:
Participant intake, assessment, and service planning procedures
Service coordination, monitoring, and crisis intervention protocols
Incident reporting, grievance handling, and participant rights procedures
HIPAA confidentiality, documentation standards, and quality assurance policies
Medicaid billing, authorization tracking, and audit readiness documentation
6. STAFFING REQUIREMENTS
Role: Case Management Program Supervisor
Requirements: Bachelor’s or Master’s degree in social work, nursing, psychology, or a related field; case management or care coordination experience; background screening clearance
Role: Case Managers / Service Coordinators
Requirements: Bachelor’s degree minimum; knowledge of person-centered planning, service coordination, and Medicaid requirements; background screening clearance
All staff must complete:
Person-centered planning and community integration training
HIPAA confidentiality and participant rights training
Abuse prevention, emergency response, and incident management training
Annual continuing education in Medicaid case management best practices
7. MEDICAID WAIVER PROGRAMS
The following Hawaii Medicaid Waivers authorize Case Management Services:
Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver
Community Care Services (CCS) Program
QUEST Integration Long-Term Services and Supports (LTSS) Programs
Approved providers may deliver:
Comprehensive case management and service coordination
Crisis intervention and resource linkage
Advocacy and participant support planning
Ongoing monitoring and reassessment of service needs
8. TIMELINE TO LAUNCH
Phase: Business Formation and Initial Credentialing Setup
Timeline: 1–2 weeks
Phase: Med-QUEST Provider Application and Readiness Review
Timeline: 60–90 days
Phase: Staff Hiring, Credentialing, and Service System Setup
Timeline: 30–45 days
Phase: Medicaid Enrollment and Billing System Configuration
Timeline: 45–60 days
9. CONTACT INFORMATION
Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/
Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Website: https://health.hawaii.gov/ddd/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII CASE MANAGEMENT SERVICES PROVIDER
WCG supports case management agencies, care coordination organizations, and disability support providers in launching Medicaid-compliant Case Management Services under Hawaii’s HCBS and Medicaid programs.
Scope of Work:
Business registration and EIN/NPI setup
Medicaid provider enrollment and DHS case management certification support
Development of Case Management Services Policy & Procedure Manual
Staff credentialing templates and participant service planning documents
Medicaid billing system setup and claims management
Website, domain, and email setup
Participant intake, ISP development, and service monitoring templates
Emergency response and crisis intervention procedures
Quality assurance programs for service coordination and participant outcome tracking
Community networking and referral development strategies
Non Medical Health Transportation
NON-MEDICAL TRANSPORTATION SERVICES PROVIDER IN HAWAII
FACILITATING ACCESS TO EMPLOYMENT, EDUCATION, AND COMMUNITY ACTIVITIES FOR INDIVIDUALS WITH DISABILITIES AND CHRONIC HEALTH CONDITIONS
Non-Medical Transportation (NMT) Services in Hawaii provide individuals with disabilities or chronic conditions access to essential community activities beyond healthcare needs. These services are authorized under Hawaii’s Medicaid Home and Community-Based Services (HCBS) waiver programs, supporting community integration, employment participation, and independent living.
1. GOVERNING AGENCIES
Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Non-Medical Transportation Services
Agency: Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Role: Administers transportation services for participants under the Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight ensuring Non-Medical Transportation Services meet Medicaid HCBS community integration standards
2. NON-MEDICAL TRANSPORTATION SERVICE OVERVIEW
Non-Medical Transportation (NMT) Services enable eligible participants to travel to and from community activities that promote inclusion and independence.
Approved providers may deliver:
Transportation to and from employment sites, volunteer programs, or training facilities
Transportation to educational or post-secondary institutions
Transportation to community activities and services identified in the participant’s Individualized Service Plan (ISP)
Scheduled trips for social, recreational, and civic participation activities
Assistance with boarding, mobility device securement, and supervised travel (if necessary)
These services differ from Non-Emergency Medical Transportation (NEMT) because they are not solely for healthcare appointments — they support broader community integration goals.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid provider through Hawaii’s Med-QUEST Division
Maintain commercial auto insurance and general liability insurance
Ensure vehicles meet safety and accessibility standards (ADA compliance recommended)
Develop policies for participant safety, trip scheduling, emergency response, and transportation documentation
4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Submit Provider Enrollment Application indicating provision of Non-Medical Transportation under the appropriate HCBS waivers
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, proof of insurance, driver credentialing, operational policies, and trip tracking templates
Provide vehicle inspection records, maintenance schedules, and emergency procedures
Program Readiness Review:
DHS and Med-QUEST review provider readiness including vehicle safety compliance, trip documentation systems, and staff training procedures
Approval & Medicaid Enrollment:
Upon approval, configure billing codes for Non-Medical Transportation Services (typically per trip, mileage, or time unit-based reimbursement)
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (Hawaii DCCA)
IRS EIN confirmation
NPI confirmation
Proof of commercial vehicle insurance and general liability insurance
Vehicle inspection and maintenance records
HCBS-Compliant Policy & Procedure Manual including:
Participant intake and transportation needs assessment protocols
Trip scheduling, tracking, and verification systems
Safety procedures, emergency plans, and accessibility protocols
HIPAA confidentiality, participant rights, and grievance policies
Staff credentialing, defensive driving certification, and background screening documentation
Medicaid billing, service authorization tracking, and audit readiness systems
6. STAFFING REQUIREMENTS
Role: Transportation Program Manager / NMT Coordinator
Requirements: Experience in transportation logistics, disability support services, or human services preferred; background screening clearance
Role: Drivers / Transportation Specialists
Requirements: Valid Hawaii driver’s license; defensive driving training recommended; CPR/First Aid certification preferred; background screening clearance
All staff must complete:
Passenger assistance, wheelchair securement, and ADA accessibility training
HIPAA confidentiality, abuse prevention, and participant rights training
Emergency preparedness, evacuation, and incident management training
Annual refresher training on transportation safety and service documentation
7. MEDICAID WAIVER PROGRAMS
The following Hawaii Medicaid Waivers authorize Non-Medical Transportation Services:
Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver
Community Care Services (CCS) Program (where NMT is part of achieving community goals)
Approved providers may deliver:
Trips for employment, education, community engagement, and social activities
Scheduled recurring trips or one-time community event transportation
Service tracking, trip verification, and progress documentation
8. TIMELINE TO LAUNCH
Phase: Business Formation and Vehicle Preparation
Timeline: 1–2 weeks
Phase: Med-QUEST Provider Application and Readiness Review
Timeline: 60–90 days
Phase: Staff Hiring, Credentialing, and Trip Management Setup
Timeline: 30–45 days
Phase: Medicaid Enrollment and Billing System Setup
Timeline: 45–60 days
9. CONTACT INFORMATION
Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/
Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Website: https://health.hawaii.gov/ddd/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII NON-MEDICAL TRANSPORTATION SERVICES PROVIDER
WCG supports transportation companies, disability service organizations, and community outreach programs in launching Medicaid-compliant Non-Medical Transportation Services under Hawaii’s HCBS waiver programs.
Scope of Work:
Business registration and EIN/NPI setup
Medicaid provider enrollment support
Development of Non-Medical Transportation Services Policy & Procedure Manual
Staff credentialing templates and participant trip authorization forms
Medicaid billing setup and claims management
Website, domain, and email setup
Trip scheduling, service verification, and participant intake documentation systems
Emergency preparedness, incident reporting, and vehicle safety procedures
Quality assurance systems for trip delivery and service monitoring
Community networking and partnership strategies with employment, educational and day program providers
Home Health
HOME HEALTH SERVICES PROVIDER IN HAWAII
DELIVERING SKILLED NURSING, THERAPEUTIC, AND PERSONAL SUPPORT SERVICES IN THE COMFORT OF PARTICIPANTS’ HOMES
Home Health Services in Hawaii provide clinical, therapeutic, and supportive care to individuals who require medical oversight but prefer to remain at home rather than receive institutional care. These services are authorized under Hawaii’s Medicaid State Plan, Home and Community-Based Services (HCBS) waiver programs, and Medicare, helping individuals recover, manage chronic conditions, and maintain independence.
1. GOVERNING AGENCIES
Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Home Health Services
Agency: Hawaii Department of Health (DOH) — Office of Health Care Assurance (OHCA)
Role: Licenses and inspects Home Health Agencies for regulatory compliance
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight ensuring Home Health Services meet Medicaid and Medicare standards of care
2. HOME HEALTH SERVICE OVERVIEW
Home Health Services deliver a combination of skilled medical care and personal support directly to the participant’s home.
Approved providers may deliver:
Skilled Nursing (e.g., wound care, medication administration, chronic disease monitoring)
Physical Therapy (PT) services (mobility training, strength rehabilitation)
Occupational Therapy (OT) services (ADL skill-building, adaptive equipment use)
Speech-Language Pathology (SLP) services (speech, swallowing therapy)
Medical Social Work (MSW) services (psychosocial assessments, counseling)
Home Health Aide services (basic personal care under nurse supervision)
All services must be based on a physician’s order and follow an individualized Plan of Care (POC) developed in collaboration with the participant, family, and healthcare team.
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
Obtain EIN from the IRS and NPI (Type 2)
Obtain Home Health Agency License through DOH’s Office of Health Care Assurance (OHCA)
Obtain Medicare certification (optional but strongly recommended for dual Medicaid/Medicare billing)
Maintain general liability, professional liability, and malpractice insurance
Employ licensed clinical staff including RNs, PTs, OTs, SLPs, MSWs, and HHAs
4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Submit application for Home Health Agency licensing through OHCA
Prepare for Pre-Licensure Survey including facility readiness, staffing, policies, and patient care protocols
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, clinical staff credentialing, operational policies, quality assurance plans, and emergency preparedness protocols
Licensure and Certification Surveys:
Undergo OHCA licensure survey
Undergo CMS Certification Survey if Medicare participation is desired
Approval & Medicaid Enrollment:
Upon licensing (and certification if applicable), complete Medicaid enrollment through Hawaii’s Med-QUEST Division
Configure billing codes for Skilled Nursing Visits, Therapy Visits, Home Health Aide Services, and Medical Social Work Services
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (Hawaii DCCA)
IRS EIN confirmation
NPI confirmation
Home Health Agency License (OHCA)
Medicare Certification (optional but encouraged)
Proof of general, professional, and malpractice insurance
HCBS-Compliant Policy & Procedure Manual including:
Participant intake, physician order processing, and care plan development
Skilled nursing, therapy, and personal care delivery protocols
Emergency preparedness, infection control, and incident response procedures
HIPAA confidentiality, participant rights, and grievance handling procedures
Staff credentialing, background screening, and competency verification
Medicaid billing, service authorization tracking, and audit readiness systems
6. STAFFING REQUIREMENTS
Role: Administrator / Director of Nursing (DON)
Requirements: Active Hawaii RN license; experience managing home health operations; background screening clearance
Role: Registered Nurses (RNs) and Licensed Practical Nurses (LPNs)
Requirements: Active Hawaii nursing licensure; CPR certification; home care experience preferred
Role: Physical Therapists (PTs), Occupational Therapists (OTs), Speech-Language Pathologists (SLPs)
Requirements: Active Hawaii professional licensure in applicable disciplines
Role: Medical Social Workers (MSWs)
Requirements: Master’s degree in social work; Hawaii licensure preferred
Role: Certified Home Health Aides (HHAs)
Requirements: Completion of a state-approved Home Health Aide program; CPR certification recommended
All staff must complete:
HIPAA confidentiality and participant rights training
Infection control, emergency response, and abuse prevention training
Annual continuing education in clinical best practices and Medicaid compliance
7. MEDICAID WAIVER PROGRAMS
Home Health Services are authorized under:
Medicaid State Plan (Home Health Benefit)
Community Care Services (CCS) Program
Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver (for specific skilled services)
Approved providers may deliver:
Intermittent skilled nursing care
Short-term therapy services
Personal care support through Home Health Aides under RN supervision
Social work services addressing psychosocial barriers to health
8. TIMELINE TO LAUNCH
Phase: Business Formation, Licensing, and Facility Preparation
Timeline: 2–4 months
Phase: Staff Hiring, Clinical Program Development, and Training
Timeline: 2–3 months
Phase: OHCA Licensing and CMS Certification (optional)
Timeline: 3–6 months
Phase: Med-QUEST Enrollment and Medicaid Readiness Review
Timeline: 60–90 days
9. CONTACT INFORMATION
Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/
Hawaii Department of Health (DOH) — Office of Health Care Assurance (OHCA)
Website: https://health.hawaii.gov/ohca/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII HOME HEALTH SERVICES PROVIDER
WCG supports home health agencies, clinical organizations, and healthcare entrepreneurs in launching Medicaid-compliant Home Health Services under Hawaii’s HCBS waiver programs and Medicaid State Plan benefits.
Scope of Work:
Business registration and EIN/NPI setup
Home Health Agency licensing and Medicare certification support
Medicaid provider enrollment assistance
Development of Home Health Services Policy & Procedure Manual
Staff credentialing templates and participant intake/care planning forms
Medicaid billing setup and claims management
Website, domain, and email setup
Care coordination, clinical documentation, and emergency planning templates
Quality assurance and clinical outcome monitoring systems
Community networking and hospital discharge referral strategies
Meal & Nutrition
MEAL AND NUTRITION SERVICES PROVIDER IN HAWAII
SUPPORTING HEALTH, INDEPENDENCE, AND WELL-BEING THROUGH NUTRITIONAL PLANNING AND MEAL DELIVERY
Meal and Nutrition Services in Hawaii provide individuals with disabilities, chronic health conditions, or aging-related needs access to healthy, nutritionally balanced meals. These services are authorized under Hawaii’s Medicaid Home and Community-Based Services (HCBS) waiver programs, promoting community living, health maintenance, and overall quality of life.
1. GOVERNING AGENCIES
Agency: Hawaii Department of Human Services (DHS) — Med-QUEST Division
Role: Oversees Medicaid provider enrollment, service authorization, and reimbursement for Meal and Nutrition Services
Agency: Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Role: Administers HCBS waiver meal and nutrition support services for individuals with intellectual and developmental disabilities (IDD)
Agency: Centers for Medicare & Medicaid Services (CMS)**
Role: Provides federal oversight ensuring Meal and Nutrition Services meet Medicaid HCBS health and safety standards
2. MEAL AND NUTRITION SERVICE OVERVIEW
Meal and Nutrition Services help ensure that individuals have consistent access to meals that meet their dietary needs, support their health conditions, and enable independent living.
Approved providers may deliver:
Preparation and delivery of nutritious meals (home-delivered or provided at congregate sites)
Menu planning based on participants’ medical and dietary needs
Nutrition education and counseling (where authorized)
Specialized meals for participants with medical conditions such as diabetes, cardiac disease, or swallowing disorders
Culturally appropriate meal planning and adaptations
Monitoring participant nutrition and alerting case managers to concerns
Meals must meet minimum nutritional standards and be tailored to individual dietary preferences and medical needs, as specified in the participant’s Individualized Service Plan (ISP).
3. LICENSING & PROVIDER APPROVAL REQUIREMENTS
Prerequisites:
Register business with the Hawaii Department of Commerce and Consumer Affairs (DCCA)
Obtain EIN from the IRS and NPI (Type 2)
Enroll as a Medicaid provider with Hawaii’s Med-QUEST Division
Maintain general liability and product liability insurance
Follow Hawaii Department of Health (DOH) food safety regulations (obtain a food establishment permit if preparing meals)
Develop policies for meal preparation, delivery safety, food handling, and emergency backup meal services
4. MED-QUEST/DHS PROVIDER ENROLLMENT PROCESS
Initial Interest and Application:
Submit Provider Enrollment Application for Meal and Nutrition Services through Hawaii’s Med-QUEST Division
Identify whether services will include home-delivered meals, congregate meals, or nutritional counseling
Application and Documentation Submission:
Submit Articles of Incorporation, proof of EIN/NPI, food safety certification, proof of insurance, operational policies, and sample menus
Program Readiness Review:
DHS and DOH review provider readiness, including food safety compliance, meal preparation practices, delivery protocols, and service documentation systems
Approval & Medicaid Enrollment:
Upon approval, configure billing codes for Meal Preparation, Meal Delivery, and Nutrition Counseling Services (where authorized)
5. REQUIRED DOCUMENTATION
Articles of Incorporation or Business License (Hawaii DCCA)
IRS EIN confirmation
NPI confirmation
Food establishment permit (if operating a commercial kitchen)
Proof of general and product liability insurance
HCBS-Compliant Policy & Procedure Manual including:
Participant intake and dietary needs assessment procedures
Meal preparation, packaging, and delivery protocols
Food safety and sanitation practices
Emergency meal planning and delivery backup systems
HIPAA confidentiality, participant rights, and grievance handling policies
Staff credentialing, background checks, and food safety training records
Medicaid billing, service authorization tracking, and audit readiness procedures
6. STAFFING REQUIREMENTS
Role: Meal Services Program Manager / Nutrition Coordinator
Requirements: Background in nutrition, dietetics, food service management, or related field preferred; ServSafe certification or equivalent; background screening clearance
Role: Cooks / Food Service Workers / Meal Delivery Drivers
Requirements: Food handler’s card (where required); CPR/First Aid certification recommended for drivers; background screening clearance
All staff must complete:
Food safety and handling training (e.g., ServSafe)
HIPAA confidentiality and participant rights training
Emergency preparedness and incident reporting training
Annual refresher training in food sanitation and participant safety
7. MEDICAID WAIVER PROGRAMS
The following Hawaii Medicaid Waivers authorize Meal and Nutrition Services:
Developmental Disabilities/Intellectual Disabilities (DD/ID) Waiver
Community Care Services (CCS) Program (if meal supports are essential for maintaining health and community living)
Approved providers may deliver:
Home-delivered meals (including specialized diets)
Congregate meals (in authorized community settings)
Nutritional assessments and counseling (where authorized)
8. TIMELINE TO LAUNCH
Phase: Business Formation and Food Service Credentialing Setup
Timeline: 1–2 weeks
Phase: Food Safety Compliance and Facility Setup
Timeline: 1–2 months
Phase: Med-QUEST Provider Application and Readiness Review
Timeline: 60–90 days
Phase: Medicaid Enrollment and Billing System Configuration
Timeline: 45–60 days
9. CONTACT INFORMATION
Hawaii Department of Human Services (DHS) — Med-QUEST Division
Website: https://medquest.hawaii.gov/
Hawaii Department of Health (DOH) — Developmental Disabilities Division (DDD)
Website: https://health.hawaii.gov/ddd/
Hawaii Department of Health (DOH) — Sanitation Branch (for food establishment permits)
Website: https://health.hawaii.gov/san/
Centers for Medicare & Medicaid Services (CMS)
Website: https://www.cms.gov/
WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — HAWAII MEAL AND NUTRITION SERVICES PROVIDER
WCG supports food service companies, home health agencies, and community-based organizations in launching Medicaid-compliant Meal and Nutrition Services under Hawaii’s HCBS waiver programs.
Scope of Work:
Business registration and EIN/NPI setup
Food establishment licensing and Medicaid provider enrollment support
Development of Meal and Nutrition Services Policy & Procedure Manual
Staff credentialing templates and participant dietary assessment forms
Medicaid billing setup and claims management
Website, domain, and email setup
Meal intake tracking, delivery verification, and nutrition monitoring documentation
Food safety systems and emergency meal planning protocols
Quality assurance programs for participant satisfaction and health outcome monitoring
Community networking and case manager referral strategies
Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.