The goal of the Children’s System Redesign is to implement a system of care that has an improved array of Medicaid benefits for children with developmental disabilities. The new benefits are based on the individual needs of the child and include interventions, supports and collaboration services. 

The new system emphasizes evidence-based treatment methods, community integration, and family empowerment. The Children’s Redesign Rules were approved by the Idaho Legislature in early February 2011. The transition to the new benefits will be a gradual process.

Beginning July 1, 2011, children will be phased into the new system according to their birth dates.

Families will have the choice to use their budgets to access Medicaid services through two options:

Traditional Model - Families who want to access services through the traditional model will continue to receive services from DD agencies who are paid for providing defined Medicaid benefits.

Family-Directed Services Model - Families who want to access services through the new family-directed services model will have the ability to purchase services and supports defined by the family from persons and businesses of their choice. Visit www.familydirected.dhw.idaho.gov for more information.

 

Effective January 1, 2012, all families must follow the Department’s transition plan defined in IDAPA 16.03.10.523.  This plan requires children to transition into redesign benefits on their birthday.  The temporary option to continue with current benefits is no longer needed.  The Department is resourced to support full implementation of the Children’s Redesign.

 

Children whose eligibility was determined prior to January 1, 2012, and have chosen to remain with DT or IBI will transition to redesign benefits at their annual eligibility re-determination.

For more information on the Eligibility and Enrollment process, please see the updated Frequently Asked Questions on this Website and the January MedicAide newsletter. 

The fee schedule was recently updated on December 16, 2011, to correct an error.  The billing code H2015 must be billed with a TJ modifier when habilitative support is billed in a group setting, not with the HQ modifier that was listed previously.

Individuals on our direct email list will receive notification when the Website is updated. If you would like to be put on our direct email list, please send your email address to Redesign@dhw.idaho.gov