I am a Medicaid I/DD Waiver Provider
Approved waiver providers are paid by Medicaid to deliver direct services to Medicaid I/DD Waiver participants in compliance with all waiver requirements, federal and state laws, and waiver standards. Providers incorporate principles of person centered planning into the delivery of services and supports.
DDD holds at least two (2) HCBS Medicaid I/DD Waiver Provider Trainings each year to update waiver providers on the activities of the division, any changes to state and federal regulations, and information about the Medicaid I/DD Waiver, as well as to provide technical assistance.
All available past training material, videos, or webinars can be accessed through Archive: Training for Providers.
- DDD is responsible for monitoring compliance with the Medicaid Waiver Standards Manual B-3.
- To ensure the quality and effectiveness of waiver services, DDD monitors all waiver providers and validates staff qualifications.
- Through the monitoring process, DDD works with providers to remediate areas of concern.
Home and Community-Based Services (HCBS) Final Rule for Community Integration
Current providers that were delivering services before the final rule was issued in 2014 must work toward meeting the Centers for Medicare and Medicaid (CMS) HCBS Final Rule for Community Integration to deliver services in fully integrated community settings. Providers will complete remediation activities as described in Hawaii’s state transition plan, My Choice My Way.
New provider applicants must meet the final rule requirements prior to approval to become a Medicaid I/DD Waiver provider. There is no transition period for a new provider applicant.
Adding a New Service
A waiver provider in good standing may request to add services to its service array. “Good standing” means the provider has:
- a current signed Medicaid Provider Agreement with the Department of Human Services, Med-QUEST Division (MQD);
- meets the Medicaid waiver requirements as determined through the monitoring process and;
- has received approval from DDD for its corrective action plan, if applicable.
To request adding a service, complete and submit a DDD Medicaid I/DD Waiver Provider Service Expansion Application (*coming soon*).
DDD will review the provider’s application and responses to supplemental service-specific questions. The Provider must demonstrate the capacity and qualified staff to deliver the additional services requested and the additional services are delivered in compliance with the CMS HCBS Final Rule for Community Integration. DDD will also review the provider’s recent monitoring results in making a final determination.
Changing Waiver Provider Information
It is important that all waiver providers update the DDD Community Resources Branch (CRB) of any changes in provider information. Changes in provider information may include:
- Waiver provider name
- Primary waiver contact person
- Contact information: phone number, fax number, email address, mailing and physical address, etc.
- Adding geographical locations or service addresses
All changes in provider information should be emailed to CRB immediately at [email protected].
If you are a current Medicaid I/DD Waiver provider and have questions, you may contact the DDD CRB at 808-733-2133 or [email protected]
- CMS-Approved 1915(c) I/DD Waiver Technical Amendment
- CMS-Approved 1915(c) I/DD Waiver Amendment #02
- Summary of Public Comments for Waiver Amendment #02
- Highlights of I/DD Waiver Changes
- Medicaid Waiver Standards Manual B-3
- Medicaid Waiver Standards Manual B-2
- Appendices & Resources for Waiver Standards
- Final Rate Models 5/23/18 from Burns & Associates
- Final Rate Models 6/13/17 from Burns & Associates
- Phase-in Timing for New Rates
- Agency I/DD Medicaid Waiver Services Schedule of Rates
- Billing Manual (Coming soon)
- FAQs (Coming soon)
- Administrative Hearing for Medicaid I/DD Waiver Providers
Policies and Procedures (PDF Format)
- Positive Behavior Supports Policy #2.01
- Restrictive Interventions Policy #2.02
- Mandatory Reporting for Abuse & Neglect Policy #2.05
- Adverse Events Report Policy #3.07
Provider Monitoring Tool
- DDD Medicaid I/DD Waiver Provider Expansion Application (Coming soon)
- Medicaid Application/Change Request Form (DHS 1139) with Instructions
- Adverse Events Report Form Instructions
- Adverse Events Report Form (AER) – Docx Format