Bridget Shannahan, a young woman who utilizes the traditional system to meet her needs will help you understand.  She describes her feelings on the current system. Not everyone who relies on these types of services will feel the same way; however, you can benefit from hearing how some people feel about the services rather than the supports they receive.

WHAT IS CARE MANAGEMENT?

Care Management: Care Management for Adults with Developmental Disabilities is a Medicaid program. The goal of the Adult Developmental Disabilities Care Management Program is to assist adults with developmental disabilities to get the right care at the right place at the right cost with the right outcomes. Through Care Management, Adults with Developmental Disabilities will apply for eligibility and access to Community Based Waiver options (Traditional or My Voice, My Choice).  Participants must meet eligibility based on having a developmental disability as defined by State of Idaho code:

• Participants in Care Management must be eligible for Medicaid.
• Participant needs for services are reviewed and determined through an objective assessment process.
• Participants are given a budget range which is developed using the past three years of Medicaid costs from the participant's profile, assessment information, and level of support as defined by a current SIB-R score.
• Services are prior authorized and cannot be accessed until they are authorized.
• Services are reviewed to ensure that participants are getting the right care, at the right place, for the right price and with the right outcomes.

TRADITIONAL WAIVER OPTIONS

Waiver Services: Waiver services are a part of the "de-institutionalization" plan. Waiver programs were designed to provide an institutional level of care for people with developmental disabilities who meet the eligibility requirements. Waiver services allow people with severe disabilities to live in community settings and still have access to the services and supports that allow them to live Self-Determined lives while meeting their particular needs.

Although not originally intended to provide bundled services, waivers are sometimes implemented as a bundle of services that an eligible participant must accept--whether or not they need the services. Challenges to waiver programs include having enough providers available, getting participants to services, and adapting group programs to meet individual needs. Providers have attempted to design programs that meet the needs of individuals, communities and funding streams, yet they continue to struggle with these challenges.

HCBS/DD Waiver: Home and Community Based Waiver-Developmental Disability.  This program is a community based, supported living concept within a person's home or in a certified family home. This program can provide supervision, care, training, some vocational training, and other needed environmental and therapy needs. Those who apply for this program must meet a higher level of need ­ comparable to an Intermediate Care Facility for those with Mental Retardation (ICF-MR) level of care. A program coordinator oversees consumer training and services within the person's residence. The most common providers of service of developmental disability waiver services Developmental Disability Agencies (DDA's). DDA's offer a wide variety of services, and can serve both adults and children.

HCBS/A&D Waiver: Home and Community Based Waiver-Aged & Disabled. This program is a community based supported living concept within a person's home or Residential Assisted Care Facility (RALF), or in a certified family home. The level of care and services available are determined by the consumer's needs and can include supervision, care, and other needed environmental and therapy needs. Eligible persons must meet nursing facility level of care and have identified needs beyond a developmental disability. A nurse oversees consumer care and services within the person's residence.

Waiver Services: Waiver services is a menu of programs that people with disabilities can access through any of the waiver program options offered in Idaho. Click to enlarge the list of menu services currently available.  This is an excellent resource that you should print and save as a future resource.   

Click here and print the attachment for a resource.

click to enlarge

top