Improving outcomes for Idahoans with developmental disabilities and complex needs

December 16, 2022
DHW Director Dave Jeppesen

Most people with developmental disabilities live in their communities. However, when they also have complex needs that results in a crisis, there is currently limited access to effective treatment.

To address these gaps, the department is creating three new crisis system components to add to the existing system: residential, teaming, and capacity building. This new model will allow adults to access a full range of crisis care that supports them and allows them to remain in their communities whenever possible.

Residential: When treatment must be done outside of the person’s community, two new care settings are being implemented.

The first is an assessment, observation, and stabilization unit. This is for people with developmental disabilities who are in crisis and need intensive or urgent behavioral, mental health, and/or medical care.

The second setting, called step-down housing, is for those who are no longer in crisis but are not yet ready to move back into their homes in their local communities. Step-down housing will model community living. Residents will live in apartment-like units with one or two people in each unit.

Significant psychiatric, behavioral, and nursing services would also be available in this setting, but the primary focus would be to help residents grow the skills they need to successfully return home and receive services in their communities. 

This means that the state will transition away from using Southwest Idaho Treatment Center (SWITC) as a long-term residential care setting for people with developmental disabilities and instead the new care settings will focus on short-term crisis and stabilization.

Teaming: This project is creating new specialized clinical teams to support people in the community and in the new care settings when their needs cannot be met using traditional community or crisis services.

These teams will provide cross-systems planning, coordination, and emergency supports with the goal of keeping people in their communities whenever possible. These specialized clinical teams will be nationally certified in best practices and provide expert services to people in all types of care settings.

Capacity building: Increased community capacity to meet the needs of people with developmental disabilities will reduce the need for residential services. Strategies to increase capacity include:

  • Creating support levels for people with exceptional needs
  • Increased access to existing services
  • Higher qualifications and/or training for providers
  • Improved transition processes

What comes next

The department will seek approval from the Centers for Medicare & Medicaid Services (CMS) to allow for Medicaid to pay for the services to support the new model.

The department also will bring a funding request to the Joint Finance-Appropriations Committee (JFAC) for a contract with Center for START Services. The request will fund a national certification to ensure adherence to best practices for the proposed teaming services. 

Then, to implement services needed for the new model, the department will engage in rule promulgation, including stakeholder feedback, and seek legislative approval.

I hope you have a safe and healthy weekend.

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at 

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