The Idaho Health Care Plan Using State Innovation Waivers to Increase Access to Health Care

The Idaho Health Care Plan (IHCP) is a unique and innovative approach to extending opportunities for affordable health insurance coverage to some Idahoans in the health insurance gap, and to provide Medicaid coverage for Idahoans with certain diagnoses. IHCP requires two State Innovation Waivers, a Medicaid waiver under §1115 of the Social Security Act, and a waiver under §1332 of the Affordable Care Act. The §1115 Waiver would allow Idaho to extend Medicaid coverage to people who have certain conditions which result in very high medical costs. Removing these people from the Idaho health insurance exchange and transferring their coverage … Continue reading The Idaho Health Care Plan Using State Innovation Waivers to Increase Access to Health Care

Comments on Idaho State Innovation Medicaid Waiver (§1115) Application for People with Complex Medical Needs.

DisAbility Rights Idaho is Idaho’s Protection and Advocacy System for people with disabilities.  We provide advocacy, legal assistance and public policy analysis on behalf of Idahoans with disabilities. We recognize that this waiver, in conjunction with a proposed §1332 Affordable Care Act, State Innovation Waiver, seeks to provide health care coverage for about 35,000 Idahoans who are currently without coverage, and to provide Medicaid eligibility for Idahoans with certain diagnoses. We support the waiver application as a significant first step in shrinking the coverage gap and providing an appropriate range of long term services and supports for some Idahoans with … Continue reading Comments on Idaho State Innovation Medicaid Waiver (§1115) Application for People with Complex Medical Needs.

Combining the SILC, the DD Council & TBI Programs into a Single Council is a Bad Idea

DisAbility Rights Idaho, Comments on proposal for the Partnerships for Innovation, Inclusion and Independence (PIII) The PIII proposal is one of those concepts that seems like a good idea to people in Washington D.C. examining the various laws and grants, but is obviously a very bad idea to people with disabilities in the states where the councils actually do their work. I do not believe that there is any way to combine the three councils without diminishing their effectiveness. I do not believe that a single council can have effective representation from all of the affected constituencies. Combining the Councils … Continue reading Combining the SILC, the DD Council & TBI Programs into a Single Council is a Bad Idea

Medicaid Supported Living Rates for People with DD

Comments of DisAbility Rights Idaho on  Medicaid Supported Living Rates for People with Developmental Disabilities. Rate setting assumptions and base wage rate. The rates appear to be based on an assumption that the appropriate average wage for all of the levels of support should be $10.47/hr. This is based on the mean wage for personal care aide in the Bureau of Labor Statistics (BLS), Occupation Code 39-9021, Personal Care Aide. We think this assumption is flawed and that it will lead to undesirable consequences. Although direct support staff for all levels of support may share the same job title, the … Continue reading Medicaid Supported Living Rates for People with DD

OPE Evaluated the Optum Medicaid Behavioral Health Contract, but Not the Outcomes for People with Mental Illness

Idaho’s Office of Performance Evaluation (OPE) just released its report on the Idaho Medicaid managed care contract with Optum Idaho, the Idaho Behavioral Health Plan. (to view full report click here). The report examines some important issues and makes some worthwhile points, but it completely fails to answer the questions that are most important to Idahoans with mental illness and their families. We were hoping that the report would focus on access to treatment and impact on the lives of Idahoans with mental illness, but these outcomes were not addressed. However, if you read carefully, the report contains some serious … Continue reading OPE Evaluated the Optum Medicaid Behavioral Health Contract, but Not the Outcomes for People with Mental Illness

Healthy Idaho Plan Position Paper

Idahoans with Disabilities in the Health Insurance Gap: The Healthy Idaho Plan Contrary to popular opinion, not all Idahoans with disabilities, living in poverty, are eligible for Medicaid, Medicare or any other health insurance program. Many low income Idahoans with serious disabilities fall into the health insurance gap (for information on the gap, http://closethegapidaho.org). Governor Otter’s work group on Medicaid Redesign* recommended that Idaho create our own solution to the health insurance gap by requesting a waiver of federal Medicaid rules. State and private stakeholders designed a plan which could solve the problem. It is called the “Healthy Idaho Plan”. … Continue reading Healthy Idaho Plan Position Paper

Idaho’s Mental Health System and the ADA “Integration Mandate”

DRI was asked to provide testimony to the Idaho Advisory Committee of the U.S. Commission on Civil Rights concerning Idaho’s mental health system and compliance with the U.S. Supreme Court Decision in Olmstead v. L.C. This is what I submitted. Testimony of DisAbility Rights Idaho.     Idaho’s mental health services system is broken. Mental health crisis calls are stretching our law enforcement and emergency responders to the breaking point. Admissions to the state psychiatric hospitals are increasing and the prisons and jails have more inmates with serious mental illness than our hospitals do. Last but not least untreated or inadequately … Continue reading Idaho’s Mental Health System and the ADA “Integration Mandate”

Psychosocial Rehabilitation and the Idaho Medicaid Managed Care Contract

Implementation of Idaho’s Medicaid Managed Mental Health Contract with Optum Health, Inc. has had a rocky start and has resulted in some major changes in the delivery of Medicaid covered mental health services in Idaho. There have been problems encountered by mental health service providers in processing and obtaining authorizations for services, but this article will not address those issues. I intend to focus on the problems being experienced by Idahoans with serious mental illness (SMI) and children with serious emotional disturbance (SED), in obtaining community based mental health services and supports. Most of the controversy revolves around authorization of Community Based … Continue reading Psychosocial Rehabilitation and the Idaho Medicaid Managed Care Contract