​​Home Health Agencies Provider Enrollment​

Assisted Living Waiver Program 

Home Health Agencies (HHA) ar​e licensed and regulated by the California Department of Public Health (CDPH), Licensing and Certification Division (L&C). The HHA renders Assisted Living Waiver (ALW) services in the Public Subsidized Housing (PSH) setting. The HHA is responsible for meeting the needs of the participant equivalent to the services delivered by Residential Care Facility providers. 

Basic HHA Requirements

  • The PSH-HHA must possess a State of California business license, be licensed as a HHA in California to be considered for certification as a Medi-Cal provider of home health and ALW services.
  • HHAs will be expected to open a branch office on the PSH premises. The office must have sufficient space, lockable doors, and a landline telephone. The office must have the ability to provide a care plan for ALW participants, provide staff access 24/7, and have secured onsite record keeping capabilities.
  • Participant quarters may be private or semi-private (housemate or roommate) with doors that lock, a full bathroom, a kitchenette equipped with a refrigerator, a microwave or cooking appliance, and storage space for utensils and supplies.
  • In the PSH setting, an Individual Response System (IRS) is required. An IRS is a 24-hour call system that enables participants to secure immediate assistance.
  • Be in substantial compliance with all licensing regulations and in good standing with the licensing agency. NOTE: CDPH will survey the branch office site on an annual basis.

HHA provide the following services services:

  • Provide personal care and assistance with Activities of Daily Living Support sufficient to meet both the scheduled and unscheduled needs of the participant. 
  • Prepare or, in conjunction with the public housing site, coordinate the delivery of three meals plus the provision of snacks.
  • Perform all necessary housekeeping tasks.
  • Provide intermittent skilled nursing services as required by participants. 
  • In accordance with State law, provide assistance with the self-administration of medication or, if necessary, administer medication by licensed staff.
  • Provide or coordinate transportation.
  • Provide or coordinate daily recreational activities.
  • Provide social services.
  • Assist in developing and updating ALW participants' ISP, detailing at minimum the frequency and timing of assistance.

Refer to the HCBS Waiver for the complete ALW requirements.

HHA Provider Enrollment Steps

1.  In order to participate in the ALW program, the following application packet is required:

For a Change of Ownership or Change of Location contact: ProFacWAIVER@dhcs.ca.gov

2. Enrolling providers are required to have a National Provider Identifier (NPI). For more information and to apply for your NPI number, visit the NPI Overview webpage. The unique 10-digit number allows universal recognition of individual health care providers. Once enrolled as a Medi-Cal provider in the ALW program, the NPI number is used in administrative and financial (billing) transactions.

3. Upon review and approval of the ALW/HHA application, an onsite visit will be completed by DHCS to verify the applicant's qualifications.

4. Upon DHCS approval of the branch office site, the applicant submits a completed Branch Application to CDPH Central Applications Unit (CAU) with a cover letter requesting participation as an “ALW branch office only" (CDPH Branch Application).

  • No application fee is required for the CDPH enrollment of a branch office.
  • Following completion of the Branch Application process, CDPH/CAU will inform their District Office (DO) that the site is ready for the CDPH branch office survey.
  • The DO conducts licensing inspection of the ALW branch site according to CDPH survey protocols. Upon completion of the DO inspection, CDPH will inform DHCS of the results and/or issues related to the survey. DHCS will also be notified of the Branch Application site approval/denial.

Application Submission

Send all applications to:

Provider and Facility Site Review Unit
Integrated Systems of Care Division
Department of Health Care Services
1501 Capitol Avenue, MS 4502
P.O. Box 997437
Sacramento, CA 95899-7437

Important note: Do not send applications to the Provider Enrollment Division

Resources

Last modified date: 12/23/2019 9:29 AM