Public Policy

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

The Governor’s Work Group on Medicaid Redesign made a new recommendation on November 14th, 2014 to support a “hybrid” version of Medicaid expansion. They called this recommendation “Option 3.5”. It provides Medicaid eligibility for qualifying families below the Federal Poverty Level (FPL), and uses Medicaid funding to purchase coverage on the state insurance exchange for qualifying families between 100% and 138% of the FPL. Implementing this recommendation, or any other option for Medicaid expansion, will be of significant benefit to many Idahoans with disabilities. Contrary to popular opinion, not all Idahoans with disabilities, who are living in poverty, are eligible … Continue reading Idaho Medicaid Redesign and People with Disabilities: “Option 3.5”

  Comments of DisAbility Rights Idaho Idaho Medicaid Transition Plan for Compliance with CMS/HCBS Community Integration Regulations     Introduction DisAbility Rights Idaho (DRI) is the Protection and Advocacy Agency for the State of Idaho under 42 USC §§ 15041-15045, 42 U.S.C.A. §§ 10801-10807, 10821-10827, and 29 USC § 794e. We are deeply concerned with the implementation of these Federal regulations and with the rights of people with disabilities generally. Insuring that Idahoans with disabilities have full access to their communities, and control over their lives and homes, is a high priority for DRI. We believe that the approach to … Continue reading DRI Comments on Home and Community Based Services Transition Plan

Opportunities for Medicaid funded job training and support services are opening up in the next few weeks. It is important for people to know how to get access to them. Community Supported Employment (CSE) is a Medicaid Home and Community Based Waiver service (HCBS). Adults who qualify for either the Developmental Disability (DD) waiver or the “Aged and Disabled” (A&D) waiver may be able to benefit from the service. CSE provides intense, usually one to one, on the job training and support from a “job coach”. 1.   The Court Decision: The Idaho Federal District Court has certified a class action … Continue reading Supported Employment Opportunities Open Up for People with Disabilities in Idaho: A Court Decision, a State Law Change, and a Little Known Opportunity

  I am including the Comments form The National Disability Rights Network on the safety and effectiveness of electroshock devices as a supposed “treatment” for autism and other developmental disabilities.  Please submit a comment if you have experience with this awful practice. April 14, 2014   Avena RussellCenter for Devices and Radiological HealthFood and Drug Administration10903 New Hampshire Ave., Bldg. 66, Rm. 1535Silver Spring MD 20993-0002 Re: Written Testimony for Neurological Devices Panel of the FDA Medical Devices Advisory Committee, Docket No. FDA-2014-N-0238, Schedule for public meeting on April 24, 2014  Dear Ms. Russell, The National Disability Rights Network (NDRN) appreciates … Continue reading Shocking Behavioral Therapy – The Safety and Effectiveness of Using Electric Shock Devices for Behavior Management

For Most of the twentieth century it was assumed that people with significant developmental disabilities could not be employed in regular jobs at reasonable wages. In recent decades, we have demonstrated that people with developmental disabilities can be productive and valuable employees if they have specialized training and workplace supports. Community Supported Employment (CSE) services are intense, often one to one, on the job training and workplace assistance that can create real employment opportunities. CSE is the only Medicaid funded service that promotes employment for people with disabilities. It is available to people who qualify for the Developmental Disabilities Home … Continue reading Community Supported Employment – H476

Idaho Medicaid Redesign:   Promoting Independence for People with Disabilities Medicaid Redesign is a proposal for major changes in Idaho’s health care financing system for people who cannot afford the cost of health care, including mental health care.   There are five components to Idaho Medicaid redesign: Accept the federal Medicaid Coverage Option Add Medicaid requirements to increase consumer responsibility  Eliminate the County Indigent Health Care Programs  Eliminate the State Catastrophic Care Fund  Shift state funded Community Mental Health Care to Medicaid. Others have documented how these changes will save about $480 Million in Idaho costs over the next 10 … Continue reading Idaho Medicaid Redesign

If accepted by the legislature, the new definition reads as follows: Medically necessary services for eligible Medicaid participants under the age of twenty-one (21) are health care, diagnostic services, treatment, and other measures described in Section 1905(a) of the Social Security Act (SSA) necessary to correct or ameliorate defects, physical and mental illness, and conditions discovered by the screening services as defined in Section 1905(r) of the SSA, whether or not such services are covered under the State Plan.   Services must be considered safe, effective, and meet acceptable standards of medical practice. On July 20, 2012, Centers for Medicare and … Continue reading On October 3, 2012, Idaho Department of Health and Welfare (IDHW) gave notice that it had proposed a new medical necessity definition for use in children’s cases.

There is a trend in some states, including Idaho, to use some combination of assessment tools to arrive at a number (usually a dollar amount) which is supposed to reflect a measurement of the person’s “need” for services.  If we assume that such needs can be adequately expressed by a number, it  would make the difficult task of allocating an individual budget for services much simpler. In fact the dream of having an objective, quantifiable measurement of a person’s need would make everything so easy, straightforward, fair, and justifiable that it is irresistible. However, like so many beautiful dreams, the … Continue reading Measuring a Person’s “Need” for Developmental Disability Services

DisAbility Rights Idaho’s Comments on Idaho Proposal to Contract with a Managed Care Organization (MCO) for Medicaid Services for People Who are Eligible for Both Medicaid and Medicare. Introduction: The Idaho Department of Health and Welfare (IDHW) has requested public comment on their proposal to contract with a Managed Care Organization (MCO) to provide Medicaid services to people who are eligible for both Medicaid and Medicare (Dual Eligible). This contract is intended to cover not only the types of medical services typically handled by health insurance companies, but also mental health services including psychiatric rehabilitation services, home and community based, … Continue reading Idaho Medicaid Managed Care Proposal