DBHDS/Medicaid Waiver Group Homes

 

 

 

 

 

🏡 8-Week Program: 

“Launch Your Virginia Medicaid Waiver Group Home Alternative”

 

 

 

Week 1 — Understanding the Virginia Waiver System & Business Model

 

 

• Overview of Medicaid Waivers in Virginia (CL, FIS, CCC+, EDCD).
• Difference between licensed group homes and Medicaid Waiver residential options.
• Business model options (supported living, sponsored residential, in-home support, respite, adult day).
• How BDHDS fits into the provider enrollment process.

 

 

 

Week 2 — Business Formation & Compliance Readiness

 

 

• Choosing the right business structure (LLC vs. PLLC vs. Corp).
• Setting up EIN, NPI, CAQH.
• Understanding liability, insurance, and policy requirements.
• Required background checks & provider qualifications.

 

 

 

Week 3 — DBHDS Medicaid Waiver Provider Application

 

 

• Step-by-step guide for the DBHDS Waiver provider application.
• Service descriptions & program narrative (how to write for approval).
• Policies & procedures you’ll need (safety, staffing, client rights, incident reporting).
• Tips for faster approval & avoiding common denials.

 

 

 

Week 4 — Developing Your Residential Setting & Service Model

 

 

• Using private residences or rental properties for supported living.
• How to avoid zoning/sprinkler challenges by choosing non-licensed waiver services.
• Understanding staffing ratios, overnight coverage, and 24-hour models.
• Sample floor plans & residential documentation.

 

 

 

Week 5 — Marketing & Building Referral Networks

 

 

• Working with Support Coordinators (Case Managers).
• How to connect with Community Services Boards (CSBs) & local agencies.
• Building partnerships with hospitals, social workers, discharge planners.
• Creating your referral & intake packet.

 

 

 

Week 6 — MCO Credentialing & Billing Setup

 

 

• Overview of Virginia’s MCOs (Anthem Healthkeepers, Optima, Aetna Better Health, United Healthcare, Molina, Sentara).
• Step-by-step credentialing process for each plan.
• CAQH tips & provider enrollment portals.
• Billing basics: EVV, claims submission, getting paid correctly.

 

 

 

Week 7 — Staffing, Compliance & Risk Management

 

 

• Hiring & training Direct Support Professionals (DSPs).
• Required trainings: CPR/First Aid, Human Rights, Medication Admin (if needed).
• Incident reporting, client rights, and ongoing compliance with DBHDS.
• Audits & revalidation preparation.

 

 

 

Week 8 — Launch & Scale

 

 

• First client onboarding — how to document & bill your first waiver service.
• Expansion strategies: adding respite, day support, in-home support.
• Creating a pipeline of clients (working with MCO case managers).
• Scaling to multiple homes or service types while staying non-licensed.

 

 

 

 

 

🔑 Key Outcomes for Students

 

 

✅ Launch a Medicaid Waiver-funded residential option in Virginia without the group home licensure headaches.

✅ Get approved as a DBHDS Medicaid Waiver provider and credential with MCOs.

✅ Have policies, forms, and referral materials ready to use.

✅ Learn how to find & onboard clients quickly.

✅ Understand compliance and billing from day one.