Important Documents

Suitable Representative Plan / Plan adecuado para representantes

Medicaid has a new plan to make sure people can get a representative to help them. This is called the “suitable representative” plan (only in English). New Suitable Representative Plan Q&A.

Medicaid tiene un nuevo plan para asegurarse de que las personas puedan obtener un representante que les ayude. Esto se denomina plan “representativo adecuado” (sólo en inglés). Nuevo plan adecuado para representantes Preguntas y Respuestas.

Budget Notices

Medicaid wants your input. These are new notices (like letters) to let you know your budget and rights. These notices might change. For example, do not count on keeping your old budget after the new system starts this summer. There are five groups of notices. They are only in English, as far as we know. These links take you to folders for each group:

Budget notices: These tell you what your new budget will be. Some of these say that you may be able to keep your old budget after the new system starts this summer. This is not approved yet. So do not count on keeping your old budget after you get a new one.

Verification notices: These tell you about qualifying for a higher budget because of medical needs of behaviors.

Change in condition notices: these tell you whether you get a new assessment because something changed in your life

Denial notices: These tell you that you were denied for DD services.

Other notices: These are about other things that can come up.

Avisos presupuestarios

Medicaid quiere su opinión. Estos son nuevos avisos (como cartas) para que usted conozca su presupuesto y sus derechos. Estos avisos pueden cambiar. Por ejemplo, no cuente con mantener su antiguo presupuesto después de que el nuevo sistema comience este verano. Hay cinco grupos de avisos. Sólo están en inglés, por lo que sabemos. Estos vínculos le llevan a las carpetas de cada grupo:

Avisos sobre el presupuesto: Estos le dicen cual será su nuevo presupuesto. Algunos de estos dicen que usted puede ser capaz de mantener su antiguo presupuesto después de que el nuevo sistema comience este verano. Aun no se ha aprobado. Así que no cuente en mantener su viejo presupuesto después de que usted consiga uno nuevo.

Avisos de verificación: Esos le informan sobre cómo calificar para un presupuesto más alto debido a las necesidades médicas de los comportamientos.

Avisos de cambio en la condición: estos le dicen si recibe una nueva evaluación porque algo cambio en su vida

Avisos de denegación: Avisos de denegación: Estos le informan que se le negaron los servicios de DD.

Otros avisos: Se trata de otras cosas que pueden surgir.

Budget Tool Documents / Documentos de la Herramienta de Presupuesto

Medicaid waiver changes: These are the changes that Idaho Medicaid wants to make to the DD program “waiver.” The federal government has to approve these changes. Your can give your feedback in December 2021.

Fall 2021 draft rules: These are the draft rules Idaho Medicaid wants feedback about in November 2021, through the “negotiated rulemaking” process.

Pre-Implementation Review Report: This document explains the Pre-Implementation Review process used to see whether the new budget tool is working right. It also has recommendations to make sure the tool is fair.

NEW Service Mix Packet: Latest version of the service mixes and budget ranges (released 4/5/2021).

Budget Level Scores (Puntuaciones de Nivel Presupuestario): This document lists the actual SIS scores for each budget level (Este documento enumera las puntuaciones reales del SIS para cada nivel presupuestario.)

M and B Level Verification Process (Proceso de Verificación de los Niveles M y B): This document explains the process IDHW may use to determine who is in budget levels M and B. (Este documento explica el proceso que el IDHW puede utilizar para determinar quién está en los niveles de presupuesto M y B.)

Original Service Mix Packet: First draft of the service mixes, released February 2021.

Paquete con Mezcla de Servicios: Paquete con el primer borrador de mezcla de servicios.

2/23/2021 Community NOW! packet: This is the packet for the Community NOW! meeting on 2/23/2021, explaining the first draft service mixes.

23/2/2021 Paquete ¡Comunidad AHORA!: Este es el paquete para la ¡Comunidad AHORA! Reunión el 23/2/2021, explicando el primer borrador de la mezcla de servicios.

2/26/2021 Community NOW! packet: This is the packet for the Community NOW! meeting on 2/26/2021, getting feedback on the first draft service mixes.

26/2/2021 Paquete ¡Comunidad AHORA!: Este es el paquete para la ¡Comunidad AHORA! Reunión el 26/2/2021, obteniendo comentarios sobre el primer borrador de la mezcla de servicios.

Settlement Agreement Documents

Settlement Agreement: The class action settlement agreement is a long document that has all the details about the settlement. All of the changes that the Idaho Department and Health and Welfare has agreed to for the Idaho adult DD program are explained here.

New model development plan: This document explains the work that the outside expert will do to help the Idaho Department of Health and Welfare develop a new model for setting personal supports budgets. The outside expert is John Agosta, who works for the Human Services Research Institute.

Health and Safety standards: The health and safety standards define what you will need to show to get a higher budget. The standards also spell out what documents you need to have to get a higher budget.

SIB-R form: This is the form that you will have to sign to get copies of your SIB-R scoring booklets.

New budget notice form: This is the format of the new budget notice that the Idaho Department of Health and Welfare will start sending out.

Class action settlement notice: This notice is mailed to everyone in the Idaho adult DD program and many others. This notice explains how you can let the Court know if you have concerns about the settlement.

Court Orders

Preliminary settlement approval: This is the first step toward final approval for the settlement agreement. Now that the court has granted preliminary approval, a notice will be sent to everyone in the adult DD program. The court will hold a hearing on January 12, 2017, to decide whether to finally approve the settlement.

Partial declaratory judgment: This court order protects your right to know how the Idaho Department of Health and Welfare decided your budget. This order requires the Department to give you copies of your budget calculations and to show you how they came up with the formulas they use.

Summary judgment decision: This is the court decision that said that the Idaho Department of Health and Welfare would have to make big changes to the Idaho adult DD program.

New Model Documents

New Assessment Tool

November 2, 2016, Assessment Tool Work Group Meeting

Community NOW! Work Group

January 3 and 4, 2017, Meeting (and Pre-Meeting) Materials: this is the packet of documents from the January 3, 2017, pre-meeting of people with developmental disabilities and family members and the January 4, 2017, whole group meeting.

Court Notice

Notice about attorney fees (June 28, 2021)

Document Gallery

Recommendation report about assessment tools

Community NOW! January 3 and 4, 2017, meeting packet