1. GOVERNING AGENCIES

Agency: Colorado Department of Health Care Policy and Financing (HCPF)
Role: Administers HCBS waivers and sets standards for Day Habilitation services and provider participation

Agency: Centers for Medicare & Medicaid Services (CMS)
Role: Provides federal oversight to ensure services meet person-centered HCBS requirements

2. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Day Habilitation Services are community-based or site-based programs that offer structured activities to help individuals with IDD acquire, improve, and retain self-help, socialization, and adaptive skills.

Approved providers may deliver:

• Life skills training (e.g., hygiene, cooking, communication)
• Community integration activities (e.g., volunteering, recreation)
• Self-advocacy and personal goal-setting support
• Safety training and behavioral support (if authorized)
• Social and peer interaction opportunities
• Documentation of daily attendance and progress toward goals

Service delivery models may include:

• Specialized Habilitation (SH): Structured support in a facility-based setting
• Supported Community Connections (SCC): Services delivered in integrated, community-based settings

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register your business with the Colorado Secretary of State
• Obtain EIN from the IRS and NPI (Type 2)
• Enroll as a Medicaid Day Habilitation Provider through the Gainwell Technologies Provider Portal
• Ensure facility meets accessibility and safety standards (for site-based programs)
• Comply with HCBS Settings Rule for community inclusion and individual choice
• Maintain liability insurance and a secure documentation system

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4. PROVIDER ENROLLMENT PROCESS

Step 1: Business registration and NPI setup
Step 2: Apply for Medicaid enrollment through the Gainwell Provider Portal

Select HCBS waiver program and Day Habilitation as service type
Step 3: Submit policy manual, resumes, service descriptions, and training materials
Step 4: Coordinate with Case Management Agencies (CMAs) for participant referrals

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or proof of business registration
• IRS EIN Letter
• NPI confirmation
• Medicaid provider ID

Policy & procedure manual including:

• Intake procedures and individual profile forms
• Person-centered activity planning templates
• Daily logs, attendance tracking, and goal documentation
• Community access safety protocols
• Staff-to-participant ratio policy
• Emergency preparedness and incident response plans
• Participant rights and grievance procedures
• Staff training records and background checks

6. STAFFING REQUIREMENTS

Role: Direct Support Professional (DSP)
Requirements:

• High school diploma or equivalent
• Background check, CPR/First Aid certification
• Experience supporting individuals with disabilities preferred

Role: Program Coordinator / Site Supervisor
Requirements:

• Supervisory or program management experience
• Familiarity with HCBS regulations and community-based programming

Training Requirements for All Staff:

• Person-centered planning and service delivery
• Community safety and transportation protocols
• HIPAA and client rights
• Abuse prevention and mandated reporting
• Documentation and data collection procedures
• Annual refreshers and continuing education tracking

7. MEDICAID WAIVER SERVICES

Day Habilitation is reimbursed under:

• HCBS-DD (Developmental Disabilities) Waiver
• HCBS-SLS (Supported Living Services) Waiver

Approved providers may deliver:

• Specialized Habilitation (SH) — structured, facility-based services
• Supported Community Connections (SCC) — integrated, community-based skill-building
• Customized programming aligned with the participant’s Individualized Service Plan (ISP)
• Transportation services (if included in authorization)

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8. TIMELINE TO LAUNCH

Phase: Business Formation
Timeline: 1–2 weeks

Phase: Medicaid Enrollment via Gainwell
Timeline: 30–60 days

Phase: Staff Hiring and Facility Preparation (if applicable)
Timeline: 2–4 weeks

Phase: Referral Activation and Program Launch
Timeline: Ongoing

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9. CONTACT INFORMATION

Colorado Department of Health Care Policy and Financing (HCPF)
Email: hcpf_hcbs_questions@state.co.us
Website: https://hcpf.colorado.gov

Colorado Medicaid Provider Enrollment (Gainwell Technologies)
Website: https://portal.co.gov

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10. SCOPE OF WORK

• Business registration (LLC, EIN, NPI)
• Medicaid provider enrollment and waiver program setup
• Policy & procedure manual for activity planning, documentation, and compliance
• Templates for goal tracking, daily logs, and incident reports
• Website, domain, and email setup
• Staff credentialing trackers and training documentation
• Client intake packet, consent forms, and service agreements
• Incident reporting systems and audit preparation tools
• Referral networking with CMAs, schools, and day program partners

WAIVER CONSULTING GROUP'S START-UP ASSISTANCE SERVICE — COLORADO DAY HABILITATION SERVICES PROVIDER

We help disability professionals and organizations launch Medicaid-compliant Day Habilitation programs that promote independence and community access across Colorado.

​​​​​​​​​​​​​​​​​​​​To get started, click the link to request portal access.