The Medicaid Program has special provisions for people with developmental disabilities. Individuals with developmental disabilities need to first complete a Medicaid application and be determined eligible for Medicaid and then the individual will need to complete an application for the developmental disabilities program.
To meet financial eligibility criteria, you must be determined financially eligible for Medicaid. After your financial eligibility for Medicaid is verified, DHW will also review your application for adult developmental disability (DD) services.
In addition to financial eligibility, you must also meet medical disability criteria in order to be eligible for DD services. To meet medical disability criteria, your disability must:
- Be chronic
- Appear before the age of twenty-two (22)
- Be caused by impairments such as intellectual disability, cerebral palsy, epilepsy, autism, or another condition found to be closely related to, or similar to one of these impairments that requires similar treatment or services; or be caused by dyslexia resulting from one or more of the above described impairments; and
- Substantially limit your ability to function in at least three (3) of the following major life activities;
- Self care
- Receptive and expressive language
- Learning
- Mobility
- Self direction
- Capacity of independent living
- Economic self-sufficiency
- Reflect the need for a combination and sequence of special, interdisciplinary, or generic care, treatment or other services
- Require services which are of lifelong or extended duration
- Require services that must be individually planned and coordinated
All Medicaid participants receive the services and supports that best meet their individualized needs and fit within their Medicaid budget. The following services and supports are available for adults with developmental disabilities:
- Targeted service coordination – A service for individuals who can’t access, coordinate, or maintain services on their own.
- Developmental therapy – Skill development services provided through individual or group therapy in the home, community or a center.
- Community crisis supports – Interventions for individuals who are at risk of losing housing, employment or income, or who are at risk of incarceration, physical harm, family altercations, or other emergencies.
- Intermediate Care Facility for Persons with Intellectual Disabilities (ICF/ID) Services – An ICF/ID is a home for up to eight individuals. The home has shared dining, living, and cooking areas. Each individual can have a private bedroom or share a bedroom with another individual. Services provided by the ICF/ID are designed to meet the needs of individuals requiring in-home care, and provide services 24 hours a day
The application process for the adult with developmental disabilities program has two steps.
- Apply for Medicaid
- Complete the developmental disabilities application
- Apply: Online using idalink
- Be prepared to provide this information with the application:
- Verification of identity (e.g. driver's license)
- Household income
- Household resources
- Current monthly expenses
- If applicable, immigration status
- Interview
- Call: 1-877-456-1233 (toll free)
- Visit: Closest field office
- Be prepared to provide this information with the application:
- Verification of identity (e.g driver's license)
- Household income
- Household resources
- Current monthly expenses
- If applicable, immigration status
- Download and complete an application
- Then Apply by either:
- Email: MyBenefits@dhw.idaho.gov
- Fax: 1-866-434-8278 (toll free)
- Mail: Self Reliance Programs, PO Box 83720, Boise, ID 83720-0026
- Be prepared to provide this information with the application:
- Verification of identity (e.g. driver's license)
- Household income
- Household resources
- Current monthly expenses
- If applicable, immigration status
Submit your completed application to an office in your area
| Area | Location | phone/fax | |
|---|---|---|---|
|
Region 1: Benewah, Bonner, Boundary, Kootenai, Shoshone |
1120 Ironwood Drive, Suite 102 Coeur d’Alene, ID 83814 |
(P) 1-208-769-1567 (F) 1-208-666-6856 |
BDDSQA1@dhw.idaho.gov |
|
Region 2: Clearwater, Idaho, Latah, Lewis, Nez Perce |
1118 F Street PO Drawer B Lewiston, ID 83501 |
(P) 1-208-799-4430 (F) 1-208-799-5167 |
BDDSQA2@dhw.idaho.gov |
|
Region 3: Adams, Canyon, Gem, Owyhee, Payette, Washington |
3402 Franklin Road Caldwell, ID 83501 |
(F) 1-208-334-0953 |
BDDSQA3@dhw.idaho.gov |
|
Region 4: Ada, Boise, Elmore, Valley |
1720 Westgate Drive, Suite B Boise, ID 83704 |
(F) 1-208-334-0953 |
BDDSQA4@dhw.idaho.gov |
|
Region 5: Blaine, Camas, Cassia, Gooding, Jerome, Lincoln, Minidoka, Twin Falls |
601 Pole Line Road, Suite 3 Twin Falls, ID 83301 |
(P) 1-208-736-3024 (F) 1-208-736-2116 |
BDDSQA5@dhw.idaho.gov |
|
Region 6: Bannock, Bear Lake, Bingham, Caribou, Franklin, Oneida, Power |
1070 Hiline Road, Suite 260 Pocatello, ID 83201 |
(P) 1-208-239-6269 (F) 1-208-239-6260 |
BDDSQA6@dhw.idaho.gov |
|
Region 7: Bonneville, Butte, Clark, Custer, Freemont, Jefferson, Lemhi, Madison, Teton |
150 Shoup Avenue, Suite 20 Idaho Falls, ID 83402 |
(P) 1-208-528-5750 (F) 1-208-528-5756 |
BDDSQA7@dhw.idaho.gov |
The independent assessment provider will send you a notice informing you of your eligibility.
After you have been determined eligible for DD and/or DD Waiver services, you will need to choose a plan developer/support broker. If you decide to access state plan and traditional waiver services, you will use a plan developer to help you write your plan. After you have selected a plan developer you will need to fill out the plan developer choice form and submit it to Liberty Health. Liberty Health can provide you with a list of service coordination agencies if you need help finding a plan developer.
If you decide to self-direct your services through the consumer-directed services option, you will use a support broker to help you write your plan. Liberty Health can provide you with a list of approved support brokers if you need help finding a support broker.
File an appeal
This page explains how to file an appeal for an eligibility decision for public assistance programs.