HomeMy WebLinkAboutAdult DD Application Packet10/2024 JY
Dear Applicant:
Thank you for your interest in adult developmental disability services. The following
forms are included in this application packet:
Eligibility Application for Adults with Developmental Disabilities
Privacy Practices Acknowledgment
How to Access Adult Developmental Disability Program Services
Notice of Privacy Practices
Service and Support Choices for Adults with a Developmental Disability
Complaint Process
Language Assistance Services
Prior to completing the Eligibility Application, please review the documentation
requirements associated with an adult developmental disability diagnosis. Information
about the required diagnosis documentation can be found on the Eligibility
Application.
Once you have completed the Eligibility Application and obtained the required
disability diagnosis documentation, please forward these documents to your local
Department of Health and Welfare Adult Developmental Disability office. Contact
information for each regional office is in this application packet.
NOTE: It is important that you submit the disability diagnosis
documentation requested above at the same time you submit the Eligibility
Application for your application to be processed in a timely manner.
Upon receipt of your Eligibility Application, it will be forwarded on to the Independent
Assessment Contractor (IAC). Once the IAC has received a complete application, they will
schedule an appointment with you to complete the eligibility assessment process.
If you have any questions about the application process or the documents requested
above, please contact the IAC at (208) 258-7980.
Sincerely,
Bureau of Developmental Disability Services (BDDS)
03/2025
ELIGIBILITY APPLICATION FOR ADULTS WITH DEVELOPMENTAL DISABILITIES (DD)
This application is for Medicaid participants turning 18 years or older who have been determined financially eligible for Medicaid. If you do not currently have Enhanced Medicaid, you are still encouraged to apply as you may be eligible if you
meet level of care eligibility for the DD Waiver and financial criteria.
Name Date of Birth Address Phone Current Living Arrangement Enrolled in Medicaid? No Yes If Yes, Medicaid Number
What services are you seeking? Choose one:
DD Waiver- Self Directed Community Supports DD Waiver- Traditional (if eligible, includes State Plan services below)
State Plan Services (Service Coordination, Developmental
Therapy) A&D/State Plan Services (A&D Waiver, Service
Coordination, Developmental Therapy)
Family Member Legal Guardian Contact
Name Address
Phone
Email
Please provide the following documentation with your application:
A history and physical that has been completed within the last 365 calendar days. AND Documentation which verifies that your disability was identified before the age of 22, AND Documentation of your disability:
o For Cerebral Palsy, Epilepsy, or Traumatic Brain Injury: A report from a physician OR
o For Intellectual Disability: Results of an IQ test using the Wechsler Intelligence Scale for Adults – Third Edition (WAIS-III); or Stanford Binet Intelligence Scales, for ages two (2) through adult; or Test of
Nonverbal Intelligence, Fourth Edition (TONI-4), for ages six (6) years through eighty-nine (89) years, eleven (11) months. Tests over one (1) year old must be verified to reflect the current status of the individual by an appropriate professional. OR
o For Autism Spectrum Disorder (ASD): Documentation supporting this diagnosis from a professional working within their scope of practice.
OR
o Other condition found to be closely related to, or similar to, one of these impairments that requires similar treatment or services. Provide documentation that can show the causal relationship between the impairing
condition and the developmental disability. (Does not include mental illness) AND Documentation that guardianship has been transferred to/registered with the state of Idaho (if applicable)
State Plan Eligibility Approved Denied ICF/ID LOC Eligibility Approved Denied
Reason for Denial:
Signature of Authorized Representative of the Department: Date
Rate Code _________
Date received _________
Sent to IAC ___________
03/2025
Return the completed eligibility application for adults with developmental disabilities via email, mail, or to the office nearest you.
Region 1 (Counties served- Benewah, Bonner, Boundary, Kootenai, and Shoshone)
Location- 1120 Ironwood Drive, Suite 102 Fax- (208) 666-6856
Region 2
(Counties served- Clearwater, Idaho, Latah, Lewis, and Nez Perce)
Location- 1118 F Street
Mailing- PO Drawer B Fax- (208) 799-5167
Region 3
(Counties served- Adams, Canyon, Gem, Owyhee, Payette, and Washington)
Location-
1720 Westgate Drive, Suite B Fax- (208) 334-0953
Region 4 (Counties served- Ada, Boise, Elmore, and Valley)
Location- 1720 Westgate Drive, Suite B Fax- (208) 334-0953
Region 5 (Counties served- Blaine, Camas, Cassia, Gooding, Jerome, Lincoln, Minidoka, and Twin Falls)
Location- 601 Pole Line Road, Suite 3 Fax- (208) 736-2116
Region 6
(Counties served- Bannock, Bear Lake, Bingham, Caribou, Franklin, Oneida, and Power) Location- 1070 Hiline Road, Suite 260 Fax- (208) 239-6269
Region 7
(Counties served- Bonneville, Butte, Clark, Custer, Freemont, Jefferson, Lemhi, Madison, and Teton)
Location-
150 Shoup Avenue, Suite 20 Fax- (208) 528-5756
HW 0337 03/03
Acknowledgement of Receipt of the Notice of Privacy Practices
Available in Spanish. We provide interpreter services at no cost. Call 2-1-1 or 1-800-926-2588 for interpretation assistance.
Disponible en espanol. Proveemos servicios de intérprete sin costo alguno. Llame al 2-1-1 ó al 1-800-926-2588 para obtener la ayuda de un intérprete.
Client Name
(Please Print your First Name, Middle Initial and Last Name)
By the signature below, I acknowledge that I have received the Notice of Privacy Practices
provided by the Idaho Department of Health and Welfare.
Your signature Date
Oct 2024
Applying For and Receiving
Adult Developmental Disability (DD) Services
Step 1:
You may apply for Developmental Disability (DD) services by submitting an Eligibility
Application for Adults with Developmental Disabilities to your local Bureau of
Developmental Disability Services (BDDS) office. An application can be mailed to you, or you
may print off a copy of the application from: https://healthandwelfare.idaho.gov/services-
programs/medicaid-health/apply-adult-developmental-disabilities-programs. When an application is
submitted, BDDS staff first verify your financial eligibility for Medicaid. If you do not currently
have Enhanced Medicaid, you are still encouraged to apply as you may be eligible for Enhanced
Medicaid if you meet level of care eligibility for the DD Waiver and financial criteria.
Step 2:
The IAC will review your documents to see if they have enough information to set up an
assessment. If so, they will contact you, your guardian, or other representative to set up an
appointment to meet with them for an interview. If not, they will send you a letter that lets you
know what else is needed.
Step 3:
It is important that you are available for your scheduled interview. Make sure you ask your
guardian, a friend, or another person that knows you very well to be present at the interview.
Step 4:
At the time of your interview:
•The IAC will interview you and the person you bring with you and ask about you and
your needs.
•The IAC will complete the Scales of Independent Behavior—Revised (SIB-R) assessment
tool with a person who knows you very well.
•The IAC may request signatures or that you fill out additional forms.
•The IAC will conduct a needs inventory that will help the IAC to calculate your annual
budget if you qualify for adult DD services.
•The IAC will have already provided you with an Adult DD Medical Care Form that you
can take to your doctor to fill out and return.
After the interview, the IAC will review the information and determine if you’re eligible for DD
services. A notice will be sent to you about the results.
If you are determined eligible for State Plan only services, you can choose from:
•Service Coordination; and
•Developmental Disability Agency (DDA) services
If you are determined ICF/ID Level of Care eligible, you can choose from both State Plan
services and DD Waiver services. DD Waiver services include:
•Residential Habilitation (Certified Family Home or Supported Living)
•Chore Services
•Respite
•Supported Employment
•Transportation
•Environmental Accessibility Adaptations
Oct 2024
• Specialized Equipment and Supplies
• Personal Emergency Response System
• Home Delivered Meals
• Skilled Nursing
• Behavior Consultation or Crisis Management
• Adult Day Health
If you are determined ICF/ID Level of Care eligible, you can choose the Consumer Directed Services option to self-direct your services instead of the services listed above.
Step 5:
If you are determined eligible for DD and/or DD Waiver services, the eligibility notice will
include the amount of your annual budget and a timeline for submission of a plan.
If you are determined not eligible for either one of these services, you can request an appeal
hearing of this decision by submitting an appeal request to Medicaid Appeals. Information
about submitting an appeal is included on the denial notice.
IMPORTANT: The assessment process must be completed EACH YEAR if
you wish to continue to receive services.
Step 6:
You will need to choose a Plan Developer/Support Broker. The IAC can provide you with a list of
Service Coordination Agencies if you need help finding a Plan Developer. If you decide to access
State Plan and Traditional waiver services, you will use a Plan Developer to help you write your
plan. Once you have selected a Plan Developer you will need to fill out the Plan Developer
Choice Form and submit it to the IAC.
If you decide to self-direct your services through the Consumer Directed Services option, you will use a Support Broker to help you write your plan.
For a list of Plan Developers or Support Brokers, go to:
• Plan Developers: https://healthandwelfare.idaho.gov/services-programs/medicaid-
health/traditional-support-services
• Support Brokers: https://healthandwelfare.idaho.gov/services-programs/medicaid-
health/self-directed-services
Step 7:
Once you have chosen a Plan Developer/Support Broker, they will help you to identify family
and/or other individuals who are important to you to be part of a person-centered planning
team.
Step 8:
You and your person-centered planning team will work together to evaluate your needs and
goals and help you to develop a plan. For individuals who choose to access State Plan and
Traditional waiver services, this plan is called an Individual Support Plan (ISP). For individuals
who choose to self-direct their services, this plan is called a Support and Spending Plan (SSP).
Once the plan is written, it is submitted to the Bureau of Developmental Disability Services
(BDDS) for review. A Care Manager in the BDDS office will be responsible for reviewing your
plan.
Step 9:
Oct 2024
The Care Manager will make sure your plan meets your assessed needs, allows for your health
and safety and is within your budget. You and your Plan Developer/Support Broker will be
notified by mail if you plan has been approved.
• If the plan does not meet your assessed needs, allow for your health and safety, and/or is
over budget, the Care Manager will contact your Plan Developer/Support Broker to discuss
the plan. If adjustments are made to your plan so it meets your needs and is within budget,
the Care Manager will be able to authorize the services on the plan.
• However, if your Plan Developer/Support Broker and the Care Manager are not able to agree
on the services needed to meet your needs and/or the plan cost continues to exceed your
calculated budget, the Care Manager will do one of the following:
1. Authorize some of the services on your plan; or
2. Deny all of the services on your plan.
The Care Manager will send a Notice to you, your Plan Developer/Support Broker and your
guardian (if applicable) to let you know what services were approved and/or denied. If you
don’t agree with the Care Manager’s decision to deny some or all of your services, you can
request an appeal through Medicaid Appeals. Information about submitting an appeal is
included on the notice.
Step 10:
If some or all services on your plan are approved, these services will be authorized in the
Medicaid payment system. If you are accessing Traditional DD services, the providers listed on
your plan will also be notified they can provide services and the date you can begin receiving
those services. If you are self-directing your services, you will need to notify your community
support workers when they can begin to provide services.
Step 11:
If your plan needs to be changed during the plan year, this can be done by your Plan
Developer/Support Broker. For State plan or traditional waiver services, a Plan Developer will
complete an addendum and provide any documents that support the requested changes. For
self-directed services, a Support Broker will do a Plan Change Form. An update to a plan must
be submitted in the following circumstances:
For a State Plan or Traditional waiver plan:
• A change in provider
• A change in the amount of time you will be receiving a service
• Adding or deleting a service
• Requesting a restrictive intervention
• Requesting alone time for Certified Family Home services
For a Self-Directed plan:
• Adding or deleting services in a support category
• Moving money from one support category to another
• Requesting a restrictive intervention
• Requesting a Community Support Worker (CSW) with wages above fair market rate
• Requesting alone time for Certified Family Home services
• Requesting a change in the Fiscal Employer Agent (FEA)
Notice of Privacy Practices HW-0320
Effective September 23, 2013 Revised 08/2013
THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
If you have any questions about this Notice, please contact the Idaho Department of Health and
Welfare's Privacy Office at 208-334-6519 or by email at PrivacyOffice@dhw.idaho.gov.
You may request a copy of this Notice at any time. Copies of this Notice are available at the
Department of Health and Welfare offices. This Notice is also available on the Department of
Health and Welfare's website at http://www.healthandwelfare.idaho.gov.
PURPOSE OF THIS NOTICE
This Notice of Privacy Practices describes how the Idaho Department of Health and Welfare (Department)
handles confidential information, following state and federal requirements. All programs in the Department
may share your confidential information with each other as needed to provide you benefits or services, and for
normal business purposes. The Department may also share your confidential information with others outside of
the Department as needed to provide you benefits or services.
We are dedicated to protecting your confidential information. We create records of the benefits or services you
receive from the Department. We need these records to give you quality care and services. We also need these
records to follow various local, state and federal laws.
We are required to:
Use and disclose confidential information as required by law;
Maintain the privacy of your information;
Give you this Notice of our legal duties and privacy practices for your information; and
Follow the terms of the Notice that is currently in effect.
This Notice of Privacy Practices does not affect your eligibility for benefits or services.
YOUR RIGHTS ABOUT YOUR CONFIDENTIAL INFORMATION
1. Right to Review and Copy
You have the right to ask to review and copy your information as allowed by law.
If you would like to ask to review and copy your information, a "Records Request" form is available at
Department offices or its website. You must complete this form and return it to the Department. The
Department will respond to your request according to the Idaho Public Records Act and the federal
HIPAA Laws.
If you ask to receive a copy of the information, we may charge a fee.
You will be told if there is information we are legally prevented from disclosing to you.
Page 1
Effective 09/23/2013
2.Right to Amend
You have the right to ask us to make changes to your information if you feel that the information we have
about you is wrong or not complete.
If you would like to ask the Department to change your information, a "Request to Amend Records" form
is available at Department offices or its website. You must complete this form and return it to the
Department. The Department will respond to your request within 10 days.
We may deny your request if you ask us to change information that:
•Was not created by the Department;
•Is not part of the information kept by or for the Department;
•Is not part of the information which you would be allowed to review and copy; or
•We determine is correct and complete.
3.Right to Restrict Health Information Disclosures
You have the right to ask us not to share your health information for your treatment or services, or normal
business purposes. You must tell us what information you do not want us to share and who we should not
share it with.
If you would like to ask the Department to not share your information, a "Request to Restrict Health
Information Disclosures" form is available at Department offices or its website. You must complete this
form and return it to the Department. The Department will respond to your request in writing.
If we agree to your request, we will comply unless the information is needed to give you emergency
treatment, or until you end the restriction. In situations where you or someone on your behalf pays for an
item or service, and you request that information concerning said item or service not be disclosed to a
health insurer, we will agree to the requested restriction.
4.Right to an Alternate Means of Delivery
You have the right to ask that we communicate with you by alternative means or at alternative locations.
For example, you can ask that we send your information from one program to a different mailing address
from other programs that you receive services or benefits from.
If you would like to ask for an alternate means of delivery for your information, a "Request for Alternate
Means of Delivery" form is available at Department offices or its website. You must complete this form
and return it to the Department. The Department will respond to your request if it is denied for some
reason.
We will not ask you the reason for your request. Reasonable requests will be approved.
5. Right to a Report of Health Information Disclosures
You have the right to ask for a report of the disclosures of your health information. This report of
disclosures will not include when we have shared your health information for treatment, payment for your
treatment or normal business purposes, or the times you authorized us to share your information.
If you would like to ask for a report of your health information disclosures, a "Request to Receive a
Report of Health Information Disclosures" form is available at Department offices or its website. You
must complete this form and return it to the Department. The Department will respond to your request
according to the Idaho Public Records Act and the federal HIPAA Laws.
The first report you ask for and receive within a calendar year will be free of charge. For additional
reports within the same calendar year, we may charge you for the costs of providing the report. We will
tell you the cost and you may choose to remove or change your request at that time before any costs are
charged to you.
Page 2
Effective 09/23/2013
HOW THE DEPARTMENT MAY USE AND SHARE YOUR INFORMATION
Times when your permission is not needed
For Treatment. We may use and share your information to give you benefits, treatment or services.
We may share your information with a nurse, medical professional or other personnel who are giving
you treatment or services. The programs in the Department may also share your information in order to
bring together the services that you may need. We also may share your information with people outside
of the Department who are involved in your care or payment of care, such as family members, informal
or legal representatives, or others that give you services as part of your care.
For Payment. We may use and share your information so that the treatment and services you receive
through the Department can be paid. For example, we may need to give your medical insurance
company information about the treatment or services that you received so that your medical insurance
can pay for the treatment or services.
For Business Operations. We may use and share your information for business operational purposes.
This is necessary for the daily operation of the Department and to make sure that all of our clients
receive quality care. For example, we may use your information to review our provision of treatment
and services and to evaluate the performance of our staff in providing services for you.
Times when your permission is needed
For reasons other than Treatment, Payment or Business Operations. There may be times when the
Department may need to use and share your information for reasons other than for treatment, payment
and business operations as explained above. For example, if the Department is asked for information
from your employer or school that is not part of treatment, payment or business operations, the
Department will ask you for a written authorization permitting us to share that information. If you give
us permission to use or share your information, you may stop that permission at any time, if it is in
writing. If you stop your permission, we will no longer use or share that information. You must
understand that we are unable to take back any information already shared with your permission.
Individuals that are part of your care or payment for your care. We may give your information to a
family member, legal representative, or someone you designate who is part of your care. We may also
give your information to someone who helps pay for your care. If you are unable to say yes or no to
such a release, we may share such information as needed if we determine that it is in your best interest
based on our professional opinion. Also, we may share your information in a disaster so that your
family or legal representative can be told about your condition, status and location.
Other uses and sharing of your information that may be made without your permission
For Appointment Reminders
For Treatment Alternatives
As Required by Law
For Public Health Risks
To Law Enforcement
For Lawsuits and Disputes
To Coroners, Medical Examiners,
Funeral Directors
For Organ and Tissue Donation
For Emergency Treatment
To Prevent a Serious Threat to Health
or Safety
To Military and Veterans Organizations
For Health Oversight Activities
For National Security and Intelligence
Activities
To Correctional Institutions
Page 3
Effective 09/23/2013
SPECIAL REQUIREMENTS
Information that has been received from a federally funded substance abuse treatment program or
through the infant and toddler program will not be released without specific authorization from the
individual or legal representative.
Affected individuals will be notified following a breach of unsecured health information.
CHANGES TO THIS NOTICE
The Department has the right to change this Notice. A copy of this Notice is posted at our Department
offices or at http://www.healthandwelfare.idaho.gov. The effective date of this Notice is shown at the
top of each page. If the Department makes any changes to this Notice of Privacy Practices, the
Department will follow the terms of the Notice that is currently in effect.
COMPLAINTS
If you believe your confidential information privacy rights have been violated, you may file a written
complaint with the Idaho Department of Health and Welfare. All complaints turned in to the
Department must be in writing on the "Privacy Complaint" form that is available at Department offices
or its website. To file a complaint with the Department, submit your completed Privacy Complaint form
to:
Idaho Department of Health and Welfare
Privacy Office
P.O. Box 83720
Boise, ID 83720-0036
If you believe your health information privacy rights have been violated, you may also file a complaint
with the U. S. Department of Health and Human Services. Your complaint must be in writing and you
must name the organization that is the subject of your complaint and describe what you believe was
violated. Send your written complaint to:
Region 10
Office for Civil Rights
U. S. Department of Health and Human Services
2201 Sixth Avenue-Suite 900
Seattle, Washington 98121-1831
For all complaints filed by e-mail send to OCRComplaint@hhs.gov.
A complaint filed with either the Idaho Department of Health and Welfare or the Secretary of Health
and Human Services must be filed within 180 days of when you believe the privacy violation occurred.
This time limit for filing complaints may be waived for good cause.
You will not be punished or retaliated against for filing a complaint.
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Updated 05.2021
MEDICAID ADULT DEVELOPMENTAL
DISABILITY (DD) SERVICES
DD OPTION – TRADITIONAL SERVICES
AVAILABLE TO EVERYONE WHO QUALIFIES
Plan Development/Targeted Service Coordination
Plan Development
•Assists the participant to decide who to invite, the location, and how to run their person-
centered planning meeting
•Assesses participant needs and identifies services to meet those needs
•Completes and submits the participant’s Individual Service Plan (ISP)
Targeted Service Coordination
•Monitors the plan, services, and assists with documentation throughout the plan year
•Meets with the participant to monitor progress
•Links the participant to services and supports as needed
Developmental Therapy
•Provided by a Developmental Disability Agency at a center and/or in the community
•Teaches independent living and social skills
Community Crisis Support
•Assists participants to maintain their health and safety during an emergency, such as loss of
housing or employment, risk of incarceration, and other emergencies
•Crisis Support is linking and collaborating with other resources, not financial assistance
DD WAIVER OPTION - TRADITIONAL SERVICES
AVAILABLE (IN ADDITION TO SERVICES ABOVE) IF WAIVER ELIGIBLE
Residential Habilitation
Certified Family Home
•Participants who reside in a Certified Family Home receive supports in the home and in the
community
•Participants learn independent living skills and receive supervision as necessary
•For more information, visit the Certified Family Home website on
https://healthandwelfare.idaho.gov/
Supported Living Services
•Services are provided by a supported living agency in the participant’s home and in the
community
•Participants learn independent living skills and receive supervision as necessary
•Participants may live with or without roommates
Adult Day Health
•Supervised recreational activities to encourage social interaction
Skilled Nursing
•Professional nursing services or oversight that is within the scope of the Nurse Practice Act
Updated 05.2021
•Develops a plan of care to monitor and address a participant’s medical needs
Supported Employment
•Job coaches help a participant learn job skills and maintain competitive employment in
community work settings
Non-Medical Transportation
•Transportation to activities and resources within the community
Home Delivered Meals
•Delivers nutritious meals to a participant’s home when they are unable to prepare meals
without assistance
•Must be home alone for significant parts of the day without a regular caregiver to assist
Respite Care
•Provides supports to participants to allow non-paid caregivers short term breaks or during
times when non-paid caregivers are not available
Chore Services
•Contracted services provided to help participants maintain a clean and safe environment when
they rent or own their own home
•Participants or others in the home must be unable to provide the services
Specialized Medical Equipment and Supplies
•Medically necessary equipment that is not covered under other insurance plans
Environmental Accessibility Adaptations
•Modifications to the participant’s home to allow greater functional independence
Personal Emergency Response System (PERS)
•Portable unit that alerts emergency services
•Not available if a participant is receiving 24 -hour services
Behavioral Consultation/Crisis Management
•Services designed to prevent psychological, behavioral and emotional crises
•Emergency backup to provide direct support for individuals in crisis
•Oversight provided by a psychologist
DD WAIVER OPTION – SELF DIRECTED SERVICES
AVAILABLE AS A CHOICE INSTEAD OF TRADITIONAL SERVICES
This option gives you more choice and control over the Medicaid funds used to buy your services and
supports. You choose the services and supports that fit your needs.
If you choose self-direction, you will:
•Become the employer and hire, train and manage your workers directly
•Hire a support broker to help you create your plan and monitor your spending
•Hire a Fiscal Employer Agent to help manage your payroll and fiscal responsibilities
•Schedule the type, time, and location you will receive supports
•Be responsible for your choices in the program
Frequently Asked Questions
Certification as a Certified Family Home
Q:When must my home be certified as a Certified Family Home?
A:Idaho Code Title 39, “Health and Safety,” Chapter 35, “Idaho Certified Family Homes,” Section
39-3512 states, “Application of provisions. (1) Any individual providing care and housing
commercially to the elderly, or individuals with mental illness, developmental disabilities, or
physical disabilities shall at a minimum, meet the requirements of this chapter or other provision
of law governing care and housing for the elderly, individuals with mental illness, developmental
disabilities or physical disabilities if those provisions are more restrictive.” This law means that
any person who houses a vulnerable adult and is also being paid to care for that vulnerable
adult must be certified as a Certified Family Home, at minimum. If other, stricter laws require
that a particular living arrangement be licensed or certified in another way, then those more
stringent laws apply instead.
Generally, the following test will inform you of whether your home will need to be certified.
1.Does a vulnerable adult to whom I provide care also live in my home?
2.Am I or my spouse named on the lease, deed, or mortgage of the home?
3.Am I being paid for the care that I am providing to this vulnerable adult?
If the answer to all of the three questions above is “Yes,” then it is likely your home must be
certified as a Certified Family Home. If the answer to any of the questions is “No,” then your
home is not required to be certified. Exceptions to this test are found under IDAPA
16.03.19.001.02.a-e, and include the following:
Individuals who provide only housing, meals, transportation, housekeeping, or
recreational and social activities to the vulnerable adult.
Hospitals, nursing facilities, intermediate care facilities for people with intellectual
disabilities, and residential assisted living facilities.
Payment for care to a vulnerable adult related to the caregiver is not through a publicly-
funded program (e.g., not through Medicaid, but is privately paid instead).
Medical foster homes strictly caring for non-Medicaid veterans.
Q:What is meant by “care?”
A:While not explicitly defined in law or rule, for the purposes of Certified Family Homes, the
intended meaning of “care” can be derived from the following definitions (see underlined text
below):
Section 39-3502(2), Idaho Code:"Activities of daily living" means the performance of
basic self-care activities in meeting an individual’s needs to sustain him in a daily living
environment.
Section 39-3502(8), Idaho Code:"Certified family home" means a family-styled living
environment in which two (2) or fewer adults live who are not able to reside in their
own home and who require care, help in daily living, protection and security,
supervision, personal assistance and encouragement toward independence.
Section 39-3502(18), Idaho Code:"Inadequate care" occurs when a certified family home
fails to provide the services required to meet the terms of the negotiated plan of service
or provide for room, board, activities of daily living, supervision, first aid, assistance and
monitoring of medications, emergency intervention, coordination of outside services or
a safe living environment; or engages in violations of residents’ rights or takes residents
who have been admitted in violation of the provisions of section 39-3507, Idaho Code.
Section 39-3502(20), Idaho Code:"Neglect" means failure to provide food, clothing,
shelter, or medical care necessary to sustain life and health of a resident.
Section 39-3502(22), Idaho Code:"Personal assistance" means the provision by the
certified family home of one (1) or more of the following services:
(a) Assisting the resident with activities of daily living.
(b) Arranging for supportive services.
(c) Being aware of the resident’s general whereabouts.
(d) Monitoring the activities of the resident while on the premises of the facility to
ensure the resident’s health, safety and well-being.
Section 39-3502(25), Idaho Code:“Resident" means an adult who lives in a certified
family home and who requires personal assistance or supervision.
Section 39-3502(29), Idaho Code:"Supervision" means administrative activity which
provides the following: protection, guidance, knowledge of the resident’s whereabouts
and monitoring activities. The care provider is responsible for providing appropriate
supervision based on each resident’s negotiated service agreement.
Q:What if the test above tells me that my home must be certified, but all the care that I am being paid to
provide happens in the community, outside my home…am I still required to have my home certified
as a Certified Family Home?
A:Most likely, yes. The law does not specify that paid care must take place only on the premises of
the home to fall under Section 39-3512, Idaho Code, above. If the vulnerable adult requires
care, help in daily living, protection and security, supervision, personal assistance, and
encouragement towards independence (see Section 39-3502(8), Idaho Code), the living
arrangements and compensation for care trigger whether the caregiver must meet certification
standards, not the location of the services. The services for which the caregiver is paid may
occur entirely in the community, but if the answers to the test described above are “Yes” for all
questions, certification of the home may still be required. The following law specifically refers to
CFH services taking place in the community.
Section 39-3501, Idaho Code:It is the intent of the legislature that certified family homes
be available to meet the needs of those residing in these homes while providing a more
homelike environment focused on integrated community living rather than other more
restrictive environments and by recognizing the capabilities of individuals to direct their
own care.
For example, if a certified family home resident’s plan of service requires 24/7 direct supervision
for the resident, and the resident decides to visit a friend in the community, certified family
home rules require the care provider to ensure adequate and appropriate supervision is given to
the resident while the resident is in the community visiting the friend.
Q:What if I choose not to certify my home when the law says it should be certified?
A:Section 39-3528, Idaho Code, states,“Any person who operates a certified family home
within the state without first obtaining certification as provided in this chapter shall be
guilty of a misdemeanor.” However, the department typically does not refer these matters to
law enforcement when the caregiver demonstrates a willingness to cooperate with certification
requirements within a reasonable timeframe.
Q:How do I start the application process to become a Certified Family Home?
A:The certification process is found online at
https://healthandwelfare.idaho.gov/providers/certified-family-homes/certification-and-
recertification.
The Division of Licensing and Certification also employs certifying agents across the state who
can assist you.
Coeur d’Alene Area: .................. 208-665-8807
Lewiston Area: .......................... 208-799-4438
Nampa Area ............................. 208-455-7120
Boise Area ................................ 208-334-0700
Twin Falls Area ......................... 208-732-1515
Pocatello Area .......................... 208-239-6249
Idaho Falls Area ........................ 208-528-5721
You may also email the Certified Family Home Management Team at cfhcc@dhw.idaho.gov.
Final 8/2022
Participant Complaint Process
What is a complaint?
A complaint is the process of telling someone when another person’s actions or words make you feel
unhappy, upset, or in pain.
If you believe you have a complaint, first:
·Discuss the issue with your staff, provider, and/or agency management according to their
grievance process. A copy of this process may have been given to you when you started
services.
If you feel your complaint is not resolved, follow these guidelines:
·Write down what has happened, when it has happened, and who was involved.If you need
help, ask someone to write down this information for you.Some details you could include are:
§Nature of the complaint or concern
§Provider/agency name
§Names of anyone who may have been a witness
§Is this happening to anyone else?
·Tell your guardian (if applicable),trusted family member,Service Coordinator or Support
Broker about your complaint. They can help you decide who to call for more information or to
file a complaint.
·If your Service Coordinator or Support Broker is the person you have a concern or complaint
about, you can call the Bureau of Developmental Disability Services (BDDS)office yourself
and/or have someone you trust help you file the complaint.
Bureau of Developmental Disability Services (BDDS)
Region 1 (Coeur d’Alene)(208) 769-1567 Select Regional Medicaid
Region 2 (Lewiston)(208) 799-4430 or (877) 799-4430 Select Adult
Developmental Disabilities Program
Region 3 (Nampa/Caldwell)(208)334-0940
Region 4 (Boise, Meridian, Mountain
Home, McCall)
(208) 334-0940
Region 5 (Twin Falls)(208) 736-3024 or (800) 826-1206
Region 6 (Pocatello)(208) 239-6260
Region 7 (Idaho Falls)(208) 528-5750
What will happen with my complaint?
·When you contact BDDS staff to file a complaint, they will need to ask you some questions
about the situation. They will then investigate the complaint according to their rules,and/or
they will forward the information on to another department or agency if it’s important for them
to be involved in the investigation.
There are certain types of complaints that are very serious and need to be reported
immediately:
·Abuse:Someone is causing you physical pain/injury or mental injury on purpose.
·Neglect:Someone who is supposed to be helping you does not give you the food, clothing,
shelter, or medical care you need to stay alive and be healthy or does not allow you to do the
things you normally do to take care of yourself.
Final 8/2022
·Exploitation:Someone is using your money, belongings, or resources for themselves rather
than how you want/need it to be used.
If your concern or complaint is about abuse, neglect, or exploitation, it is very
important that you report what is going on as soon as possible. You can call directly to
Adult Protection Services and let them know what is happening.
Adult Protection Services
Area 1 (Coeur d’Alene area)(208) 667-3179 or 1-800-786-5536
Area 2 (Lewiston area)(208) 743-5580 or 1-800-877-3206
Area 3 (Boise/Caldwell/Nampa/Mountain
Home/McCall areas)
(208)898-7060 or 1-844-850-2883
Area 4 (Twin Falls area)(208) 736-2122 or 1-800-574-8656
Area 5 (Pocatello area)(208) 233-4032 or 1-800-526-8129
Area 6 (Idaho Falls area)(208) 522-5391 or 1-800-632-4813
If you are in immediate danger, have a serious injury, or are experiencing some other
emergency, call local law enforcement/emergency medical services at 9-1-1.
DHW provides language assistance services and appropriate auxiliary aids and services free of charge.
Русский(Russian) Мы предоставляем услуги языковой поддержки и соответствующие вспомогательные средства и услуги бесплатно.
Телетайп
ﺔﯾﺑرﻌﻟا .ﺎًﻧﺎﺟﻣ ﺔﺑﺳﺎﻧﻣﻟا ﺔﻧِوﺎﻌُﻣﻟا تﺎﻣدﺧﻟاو لﺋﺎﺳوﻟاو ﺔﯾوﻐﻠﻟا ةدﻋﺎﺳﻣﻟا تﺎﻣدﺧ مدﻘُﻧ :ﻲﺻﻧﻟا فﺗﺎﮭﻟا)
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українська мова Ми пропонуємо безкоштовний мовний супровід а також відповідні
допоміжні засоби та послуги
ﺳرﺎﻓﯽﮏﻣﮐ و ﮫﻣﺟرﺗ تﺎﻣدﺧ ﺎﻣ ار بﺳﺎﻧﻣ تﺎﻣدﺧ رﯾﺎﺳ و ﺎھ تروﺻ ﮫﺑ ﯽﻣ ﮫﺋارا نﺎﮕﯾار .مﯾھد
وﺗښﭘ ﯥﺑژ د ږوﻣ دا وا ﮫﻧوﺗﻣدﺧ ﯥﺗﺳرﻣﻲﻓﺎﺿا ېدﻧوړ ﮫﻧوﺗﻣدﺧ وا ﯥﺗﺳرﻣ ﮫﭘﺎﯾړوﮫګوﺗ.ووﮐ وﺗﻣﭼ
(French) que des aides et des services auxiliaires appropriés.
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(Karen)
ပဆီၣ်ထွဲမၤစၢၤ ကျိာ်တၢ်ကတိၤ တၢ်မၤစၢၤ ဒီး တၢ်မၤစၢၤဒီးပီးလီတဖၣ်လၢ
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नेपाल�
(Nepali)
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उपलब्ध गराउँछौं । 1-800-926-2588 (TTY: 711)
ế ệ ấ ị ụ ỗ ợ ữ và các phương tiệ ợ
ợ ễ
Revised 1/29/25