What is happening with the new budget tool?
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Last month, we had a court hearing about the SIS-A (the “Supports Intensity Scale – Adult”). The SIS-A is a new assessment that Idaho Medicaid wanted to use. Idaho Medicaid wanted to replace the SIB-R and Inventory of Individual Needs with the SIS-A.
At the court hearing, Idaho Medicaid argued that adults with developmental disabilities and their families and advocates should not be allowed to see the SIS-A manual. The manual that explains how the SIS-A assessment works. We argued that adults with developmental disabilities have constitutional
rights to understand how the SIS-A works and access the SIS-A manual.
On April 27, Medicaid told the judge not to make a decision. Medicaid said that the SIS-A will not be available in Idaho. The people who sell the SIS-A also do not want adults with developmental disabilities or their families and advocates to see the manual. The SIS-A people say they will not work with Idaho if people with developmental disabilities are able to fully understand how the SIS-A works. What happens now?
Idaho Medicaid agreed to launch a new, fair budget tool by 2020. It did not meet that deadline. So the Court ordered it to launch the new tool by June 2022. It did not meet that deadline either. Idaho Medicaid has violated the K.W. v. Armstrong settlement agreement and the Court’s order. The Court
may have to decide what to do about Medicaid’s violations. We will share updates here as we learn more.
Why is the SIS-A manual so important?
The new budget tool was built around the SIS-A. For most people, your SIS-A score would set your budget. A change by just one point on the SIS-A could change your budget by thousands of dollars. The SIS-A manual is the only place you can learn all about how the SIS-A assessment works. The manual tells assessors what to do and what not to do. The manual is also the only place to find the tables for figuring out your score. And the manual has statistics about how much higher your score could be. The SIS-A people don’t want you to know that information. Idaho Medicaid asked the court to ban you from getting that information.
How did the SIS-A get picked if it had this problem?
We don’t know. Idaho Medicaid tried before to hide how the budget tool worked. It also fought in court to keep adults with developmental disabilities from seeing their SIB-R booklets. The court ruled against them both times.
After that, Medicaid asked Idaho advocates what was important in a new assessment tool. We told them that transparency—being able to understand all about how the assessment works—was so important that it ranked a “10” on a scale of 1 to 5. We told them lack of transparency was a “deal breaker.” Idaho Medicaid should have made sure that the SIS-A was transparent. We first learned in 2021 that the SIS-A people wanted to keep parts of it secret. We kept telling Idaho Medicaid how important this was, but nothing changed.
How can I learn more?
We will hold a meeting for adults with developmental disabilities and their families on May 30, 2023, at 6:30 pm MT / 5:30 pm PT. The meeting will be online, by Zoom. You can register here. And if you have questions, just contact us.
