Information for providers of personal care services and home- and community-based waivers.
The Bureau of Long Term Care (BLTC) works with multiple healthcare providers that help members maintain independence in their home through authorized services. Periodic quality assurance reviews make sure that members receive safe and quality care and services.
The Bureau of Long Term Care has oversight of the following services and programs:
- State Plan Personal Care Services (PCS):
- Grooming, bathing, toileting, dressing, food and nutrition, and incidental housekeeping.
- Aged and Disabled Waiver Services (A&D):
- Adult day health, adult residential care, specialized medical equipment and supplies, non-medical transportation, attendant care, chore services, companion services, consultation, home-delivered meals, homemaker services, environmental accessibility adaptations, personal emergency response system, respite care, skilled nursing, supported employment, and habilitation.
Personal Assistance Agency Prospective Provider Enrollment
If you are a prospective Personal Assistance Agency (PAA), you must complete the Prospective Home and Community Based Services (HCBS) Provider Toolkit as part of the enrollment application with the department’s provider enrollment vendor. This toolkit provides important information to assist you in the application process to ensure compliance to all rules, regulations, and contractual obligations.
Prospective HCBS Provider Toolkit
Prospective Provider Resources
If you are interested in becoming a Medicaid provider please visit the prospective provider resource library to find frequently asked questions, enrollment resource guide, and other documents that may be helpful.
If you are a new provider, you must be trained by the Quality Assurance Specialist prior to application approval and before providing any services for the Aged & Disabled Waiver or State Plan Personal Care Services. This includes Certified Family Home, Residential Assisted Living Facility, Home Delivered Meals, and Personal Emergency Response System prospective providers.
To schedule a training, please call 877-799-4430 or email the quality assurance team directly at BLTCQA@dhw.idaho.gov.
Home and Community Based Setting Compliance
Idaho received final approval in 2019 for its Statewide Transition Plan (STP) to ensure all Idaho HCBS settings are compliant with federally required setting qualities.You can review the Statewide Transition Plan here.
If you have a member on the Aged & Disabled (A&D) Waiver who lives in their own home or in a community setting (i.e. nursing facility), they may qualify for A&D Waiver Case Management for Home- and Community-Based Services. This service will help them manage the benefits they qualify for under this program.
The goal is to ensure that members with chronic conditions, disabilities, or aging-related needs can access a range of services that promote independence, safety, and well-being in the least restrictive environment possible.
Helpful Documents
Operational materials related to the Family Personal Care Services (FPCS) benefit, which allows for a parent of a minor child or spouse to provide Personal Care Services and Attendant Care to eligible members, are below. Please note that the department has submitted material to CMS requesting to end this program (see the Idaho 1115 Family Personal Care Services Waiver document library).
Helpful Documents
- Agency RN Supervisory Visit Form
- Family PCS Request Help Aid
- FPCS FAQs
- FPCS Request Form
- FPCS Workgroup Meeting Agendas and Minutes
- FPCS Termination FAQs
The General BLTC Staff Directory has been removed from this website. If you have questions or concerns, please call the statewide toll-free BLTC phone number at 877-799-4430 or send an email to BLTCCentral@dhw.idaho.gov.
If you have an inquiry about a new Family Personal Care Services or Aged and Disabled Waiver assessment that has already been referred to our team for scheduling, the assigned nurse reviewer will call you when he or she is able to do so. Our team schedules assessments in the order received. Repeated calls, messages, or emails will not expedite scheduling. Due to the extremely high volume of referred assessments and inquiries, the BLTC will not be taking action on messages related to initial assessment status.
The Bureau of Long Term Care hosts an online Complaint Submission System. This system is available to all stakeholders and allows you to enter a complaint and provide us with all the details to help us investigate and resolve your concerns. Once the complaint is received, it is routed directly to our triage team and our Complaint Intake Managers who are responsible to prioritize and manage all submitted complaints.
Dual eligible providers with questions about UAI assessment, service plan, authorizations, or any anything related to the A&D Waiver, Personal Care Services, or Behavioral Health Services should contact the health plans Utilization Management Teams by email:
- Molina Healthcare of Idaho: MHIDPriorAuthorizations@MolinaHealthCare.Com
- Blue Cross of Idaho: mmcp-mqm@bcidaho.com
For more information about duals' programs, please visit the Medicare/Medicaid webpage.