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Residential Habilitation and Augmented Plan: the steps to remember

The short step lists from each lesson of Residential Habilitation and the Augmented Plan of Care: prior approvals, on one page. Print it for the station or the break room. Each list points back to its lesson, where the sources are linked.

Open the coursePrint a poster with a QR code

Decision guide

A request for Residential Habilitation or the Augmented Plan: what next?

Has DHCS already made a decision on this request?

  • Yes

    Does the authorization on the ISP match what was requested?

    • Yes

      Give the home the current ISP and the RN assessment, explain what is authorized, and diary the next request: Residential Habilitation needs a new approval every six months.

    • No

      Point the participant or representative to the Notice of Action DHCS mailed: it gives the reason and the hearing steps, within 90 calendar days. The choice is theirs; give no legal advice.

  • No

    Is the request for the CCA's behavior assessment and written behavior plan?

    • Yes

      Is the participant's current tier 4 or 5?

      • Yes

        Do the behavior assessment, write the plan, record the need for added contact in the case file, and request DHCS prior approval to add it to the ISP.

      • No

        Say the Augmented Plan is open only at tiers 4 and 5. If the person's condition has changed, follow your agency's reassessment procedure; the tier follows the score and DHCS review.

    • No

      Has the home or HHA documented treatment goals, timeframes and ongoing daily status?

      • Yes

        Write the service, provider, frequency and duration into the ISP and send it with the assessment and the provider's document to DHCS, following your agency's procedure.

      • No

        Ask the provider for the goals, timeframes and daily status record, and for its staff's documented TBI education. Tell the home that nothing is billed before DHCS approval.

This guide sorts your next step. It does not approve, deny or authorize a service, set hours or decide eligibility: DHCS does.

Step through it one question at a time: alwbeta.com/training/courses/residential-habilitation-augmented-plan#decision-guide

Lesson 1

What the waiver says the two services are

A home calls about a resident whose behavior is getting harder to manage, and asks what ALW can add. Two waiver services may come up. This lesson prepares your first decision: which service fits the need, who provides it, and what each one is not.

  1. Residential Habilitation: added staff focused on one participant's skills and behavior
  2. Its providers: the RCFE, the ARF, or the HHA in public subsidized housing
  3. Augmented Plan: the CCA's behavior assessment, written behavior plan and closer follow-up
  4. Augmented Plan adds mental health coordination and about twice the usual contact
  5. The behavior plan can show a need for Residential Habilitation; it does not approve it

Lesson: alwbeta.com/training/courses/residential-habilitation-augmented-plan#lesson-rhap-two-services

Lesson 2

Who the waiver opens each service to

Before anyone asks DHCS, check that the service is open to this participant. The waiver sets a different door for each service. This lesson prepares you to read the tier, the setting and the need, and to explain that a service being open is not the same as a service being authorized.

  1. Residential Habilitation: any tier, RCFE, ARF or PSH
  2. Augmented Plan: tiers 4 and 5 only
  3. Tier 3 or lower with new behavior needs: consider a reassessment, not the Augmented Plan
  4. Needs, not a diagnosis, drive the request
  5. Open is not authorized: DHCS gives prior approval
  6. The participant decides when, where and how; the Augmented Plan may be by telehealth

Lesson: alwbeta.com/training/courses/residential-habilitation-augmented-plan#lesson-rhap-who-qualifies

Lesson 3

The prior approval DHCS requires

A home wants added staff now, and a family wants an answer today. The waiver puts both services behind a DHCS prior approval. This lesson prepares you to say who approves, for how long, where the approved amount is written, and why no one bills before the approval is in place.

  1. Both services: DHCS prior approval first (DHCS Nurse Evaluators)
  2. Residential Habilitation: a new approval every six months
  3. The authorized amount is outlined on the ISP
  4. Residential Habilitation: 15-minute units, at most 96 a day
  5. No billing before DHCS approval is in place
  6. Above the cost limit: only the DHCS RN authorizes

Lesson: alwbeta.com/training/courses/residential-habilitation-augmented-plan#lesson-rhap-prior-approval

Lesson 4

The documents behind a request

A request is only as strong as its papers. The waiver names what the provider documents, what the CCA keeps and what goes to DHCS. This lesson prepares you to assemble a complete request, so DHCS reviews the real need and nobody waits on a missing page.

  1. Provider: treatment goals, timeframes, ongoing daily status, to DHCS before authorization
  2. Provider staff: two hours of TBI education, two hours of yearly continuing education, documented
  3. ISP: service, provider, frequency and duration; signed
  4. CCA: behavior assessment and need for contact kept in the case file
  5. ISP with the assessment to DHCS; original kept; copies to DHCS and the provider

Lesson: alwbeta.com/training/courses/residential-habilitation-augmented-plan#lesson-rhap-request-documents

Lesson 5

Approval, denial and what you tell people

DHCS has decided, and the home, the participant and the family all want to know what it means. This lesson prepares you to read what was authorized, to send a denial or a cut to the Notice of Action and its hearing steps, and to explain the decision without promising anything more.

  1. Read what was authorized on the ISP; compare it with the request
  2. Denied or not approved as requested: DHCS mails a Notice of Action
  3. Cut or ended after authorization: the doctor and the provider get the NOA too
  4. Hearing: within 90 calendar days of mailing; the participant chooses
  5. Share the current ISP with the home; promise no hours or results

Lesson: alwbeta.com/training/courses/residential-habilitation-augmented-plan#lesson-rhap-decision-and-notice

Beta’s ALW team, course version 2026.10.3, text checked against its sources on October 22, 2026. Educational only. Not continuing-education, licensure or regulatory credit. Follow your employer’s current procedure and the person’s current plan. Call 911 for a medical emergency.

Call the ALW teamFit check