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5 lessonsAbout 35 minutesNo CE or licensure credit

Residential Habilitation and the Augmented Plan of Care: prior approvals

Five short lessons for CCA care coordinators and nurses on two ALW services for behavior needs: Residential Habilitation and the Augmented Plan of Care Development and Follow-up. What the waiver says each one is, who it is open to, the DHCS prior approval both need, the documents behind a request, and how a decision or a denial reaches the participant.

Begin the courseSee the sourcesPrint the job aids

Written for

  • CCA professionals
Course version
2026.10.3
Text checked against its sources

Before you begin

What you will be able to do

  • Given a participant's behavior needs, tell Residential Habilitation from the Augmented Plan of Care and name who provides each, as the waiver describes them.
  • Given a participant's tier and setting, say which of the two services the waiver opens to them, without treating an open service as approved.
  • Given a request from a home or a family, explain the DHCS prior approval each service needs, its six-month cycle for Residential Habilitation, and why no one bills before it.
  • Given a request to prepare, list the documents the waiver names and where each one is kept, sent or shared.
  • Given a DHCS decision, explain what was authorized, route a denial or reduction to the Notice of Action and its hearing steps, and promise no outcome.

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In this course

  1. What the waiver says the two services areAbout 7 minutes · Not yet
  2. Who the waiver opens each service toAbout 7 minutes · Not yet
  3. The prior approval DHCS requiresAbout 7 minutes · Not yet
  4. The documents behind a requestAbout 7 minutes · Not yet
  5. Approval, denial and what you tell peopleAbout 8 minutes · Not yet
  6. Course check · 10 questions0 of 5 lessons done

Sources

Sources behind this course

Each lesson lists the sources it uses. Open the original for the exact rule, form or instruction that applies to your work. The source library describes each one in more detail.

California DHCS, approved by CMS

ALW waiver application CA.0431.R04.01, 2024 to 2029, as amended March 1, 2025

The Residential Habilitation and Augmented Plan of Care Development and Follow-up service definitions, who each is open to, their providers, DHCS prior approval and the six-month cycle, the documents the provider and the CCA keep, the authorization on the ISP, added services above the cost limit, the rate method, and the Notice of Action and State Fair Hearing.

Where to look: Brief description (p. 6); telehealth assurances (p. 16); B-2 (pp. 26 to 27); Care Coordination (p. 47); Residential Habilitation (pp. 50 to 54); Assisted Living Services and Tier 5 (p. 56); Augmented Plan of Care (pp. 60 to 61); D-1-g and D-1-i (p. 83); D-2-a (p. 84); F-1 (pp. 98 to 99); I-2 (pp. 132 to 133).

Open the current ALW waiver (PDF)
California DHCS

Assisted Living Waiver Individual Service Plan Desk Guide (August 2024)

The Tier 5 fields on the ISP, and the signatures the ISP needs from the participant and the providers who carry it out.

Where to look: Individual's Information (pages 5 to 6) and the Patient's Rights Form instructions (page 33).

Open the DHCS ISP Desk Guide (PDF)
California DHCS

Assisted Living Waiver Reimbursement Rates (updated 12/2025)

The Residential Habilitation and Augmented Plan of Care entries: their service codes, their descriptions, and the rule that DHCS approval comes before billing for the Augmented Plan.

Where to look: The Residential Habilitation entry (page 1) and the Augmented Plan of Care entry (page 2). Read on 2026-10-22 from the Internet Archive copy captured March 14, 2026; the DHCS page refused scripted reads.

Open the DHCS ALW rate sheet (PDF)
Call the ALW teamFit check