DD Program Information

Home- and community-based settings (HCBS) include all locations where participants who receive HCBS live or receive their services. HCBS settings are required to have the following qualities:

• Integration and access - The setting is integrated in and supports full access to the greater community for participants receiving HCBS. Typical, age-appropriate activities include opportunities to seek employment and work in competitive integrated settings, engage in community life, control personal resources, and receive services in the community in the same manner as people who do not require supports or services to remain in their home or community.
• Selection of setting - Home- and community-based settings are selected by the participant’s decision-making authority from among disability-specific and non-disability-specific settings and are based on the participant’s needs and preferences, including consideration of the participant’s safety and the safety of those around the participant.
• Participant rights - The setting ensures a participant’s rights of privacy, dignity, and respect, and freedom from coercion and unauthorized restraint are honored.
• Autonomy and independence - The setting optimizes but does not regiment an individual's initiative, autonomy, and independence in making life choices, including daily activities, physical environment, and with whom to interact.
• Choice - The setting promotes opportunities for participant choice regarding the services and supports provided in the setting.

For HCBS Information, guidance and documents, visit HCBS Information.

Providers of the services below must submit to the semiannual and annual status reviews reflecting the status of behavioral objectives or services identified in the plan of service. For more information, visit Provider Status Review Forms

• Residential habilitation-supported living or certified family home
• Supported employment
• Developmental disabilities agency providing individual or group developmental therapy
• Adult day health
• Behavior consultation or crisis management
• DD waiver nursing

Health & safety exception review

The department will complete an exception review of plans or addendums requesting services that exceed the assigned budget authorized by the assessor if services are needed to assure the health or safety of participants and the services requested are medically necessary.

For more information on how to request a health or safety exception review and additional documents, visit Exception Review Information

Supported employment exception review

The department will complete an exception review of plans or addendums requesting services that exceed the assigned budget authorized by the assessor if services are needed for the participant to obtain or maintain employment.

For more information on how to request a health or safety exception review and additional documents, visit Exception Review Information for Supported Employment

Any participant or legal guardian who would like to request additional budget dollars based on a change in condition may submit a change in condition request if they believe they have met both of the following requirements:

• Documented changes in the participant's condition resulting in a need for services that meet medical necessity criteria
• The change in condition results in a change in a response on the current inventory of individual needs

For more information and forms on submitting a change in condition request, see Change in Condition

If the participant disagrees with the eligibility determination or budget established by the independent assessment provider, they have the right to appeal that decision.

View Requesting a Budget Appeal Instructions

To view the no-cost suitable representative training, visit the Our Health and Welfare website developed by ACLU of Idaho. The link is listed as “TSC Training” but anyone can be an advocate for an individual.

For more information on the appeal process for department eligibility determinations, visit Your Rights to Appeal or Request a Fair Hearing