I/DD Waivers in Idaho

All states: Medicaid disability services map

Idaho I/DD services at a glance

Last verified against state sources: 2026-10-23.

Who runs I/DD services in Idaho?

The Idaho Department of Health and Welfare (DHW) runs I/DD services itself, through its Division of Medicaid. There is no separate developmental disabilities department. The Bureau of Developmental Disability Services (BDDS) runs the adult program, and the Children's Developmental Disabilities program, also in the Division of Medicaid, runs services for children.

• Bureau of Developmental Disability Services (BDDS): handles adult DD applications through seven regional offices and prior authorizes each adult's service plan. Details are on DHW's Services for Adults with Developmental Disabilities page.
• Children's Developmental Disabilities program: takes applications through one central intake line (208-334-6500, ChildrensDDIntake@dhw.idaho.gov).
• Front door: adults apply to a regional BDDS office after applying for Medicaid. Children apply through Children's DD central intake.
• Case management: after an adult is found eligible, they choose a paid or unpaid plan developer (for traditional services) or a support broker (for self-direction). Service coordination comes from private service coordination agencies on DHW's Adult DD Provider List. A paid plan developer cannot provide any other service on the plan, except plan development or service coordination, and cannot be the independent assessor. Children get a case manager who leads family-centered planning.

What Medicaid waivers and programs serve people with I/DD in Idaho?

Idaho has one 1915(c) waiver for people with I/DD, the Adult Developmental Disabilities Waiver. A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. Idaho also uses two 1915(i) state plan benefits, which offer home and community services without a waiver: one for adults with developmental disabilities and one for children.

• Adult Developmental Disabilities Waiver (1915(c), control number 0076.R07.00): serves adults 18 and older with autism, intellectual disability or another developmental disability who are financially eligible for home and community based services (HCBS) Medicaid, meet the level of care of an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) and need active treatment. Services, as listed on the CMS waiver fact sheet and DHW's Traditional Support Services page, include residential habilitation (supported living and certified family homes), adult day health, supported employment, respite, behavior consultation and crisis management, community crisis supports, chore, non-medical transportation, home-delivered meals, personal emergency response systems, home and equipment adaptations, skilled nursing and transition services. People can choose traditional services or self-direction through My Voice, My Choice. Enrollment is limited to the number of people CMS approved for the waiver.
• 1915(i) State Plan HCBS for Adults with Developmental Disabilities: covers developmental therapy and service coordination. It serves adults with a qualifying developmental disability who do not meet waiver requirements or do not want waiver services, and waiver participants get it alongside the waiver. CMS approved its latest renewal (ID-22-0022) on June 16, 2023, effective July 1, 2023. Developmental therapy is not self-directed.
• 1915(i) Children's State Plan HCBS (Children's Developmental Disabilities program): serves children from birth through age 17 who have Idaho Medicaid, a qualifying developmental disability diagnosis and limitations in at least three of seven functional areas. It covers respite, community-based supports and family education, delivered by Developmental Disabilities Agencies or independent providers. Families can also choose Family-Directed Services. Idaho's two children's DD 1915(c) waivers (Act Early and Children's DD) ended June 30, 2019.

Idaho also has ICF/IID facilities, an institutional option for four or more people with intellectual disabilities. A person found eligible for the DD waiver may choose ICF/IID admission instead.

Does Idaho pay for I/DD services through managed care?

No. Idaho Medicaid pays for DD services fee-for-service, which means the state pays enrolled providers directly for each service. Private service coordination agencies coordinate services for adults, and case managers do this for children. BDDS prior authorizes the adult plan.

• Dual eligibles: people with both Medicare and Medicaid get DD services through Idaho Medicaid, separately from the Medicare Medicaid Coordinated Plan.
• Planned managed care: DHW plans to move Idaho Medicaid to managed care, but it has not decided whether DD services will be part of that move. See the changes section below.

Is there a waiting list for I/DD services in Idaho?

We could not confirm whether anyone is waiting today. The Adult DD Waiver is limited to the number of people CMS approved, and Idaho Medicaid's provider handbook says applicants who apply after that number is reached go on a waiting list and are processed in the next waiver year. The state does not publish a waiting list or a count.

• How the cap works: the HCBS and LTSS provider handbook (August 17, 2026) ties waiver enrollment to the projected number of users in the approved waiver.
• Priority order: we did not find a published priority order or reserved slots.
• 1915(i) benefits: we did not find a waiting list for the adult or children's 1915(i) state plan benefits.

To ask whether waiver slots are open, contact the regional BDDS office listed on DHW's Apply for Adult with Developmental Disabilities Programs page.

How do people apply for I/DD services in Idaho, and how are budgets set?

Adults apply in two steps: first for Medicaid, then for the Adult DD program at a regional BDDS office. Children apply for Medicaid and the Children's DD program at the same time through central intake. Today Idaho uses the Scales of Independent Behavior-Revised (SIB-R) to decide adult level of care and budgets.

• Adults: apply for HCBS Medicaid through DHW's Self Reliance division (idalink.idaho.gov or 877-456-1233), then send a separate Adult DD application with supporting documents to one of the seven regional BDDS offices. An independent assessment provider then contacts the person about the eligibility assessment.
• Children: apply through Children's DD central intake (208-334-6500, ChildrensDDIntake@dhw.idaho.gov). An independent assessor sets the child's budget, and a case manager helps write the plan.
• Adult eligibility: a developmental disability that is chronic, appeared before age 22 and causes substantial functional limitations. For the waiver, the person must also meet ICF/IID level of care and need active treatment.
• SIB-R: a person meets ICF/IID level of care with a functional age-equivalency score of 8 years 0 months or less, a general maladaptive index of -22 or less, or a combination of the two.
• Budgets: each adult has an individual budget that is redetermined every year. A court settlement in the K.W. v. Armstrong case requires a new way of setting adult budgets, and DHW has chosen the Connecticut Level of Need (LON) assessment to replace the SIB-R. See the changes section below.

What day and residential services can I/DD providers offer in Idaho?

Adult day services in Idaho are developmental therapy, adult day health and supported employment, and they share weekly hour caps. Residential habilitation is offered as supported living in the person's own home or in a certified family home. Developmental Disabilities Agencies (DDAs) and residential habilitation agencies are certified by DHW under IDAPA 16.03.21.

Day services

• Developmental therapy (adult 1915(i), also used by waiver participants): teaches self-care, language, learning, mobility, independent living and work skills, one to one or in groups, at a DDA center, at home or in the community. It must be provided by a certified DDA, and staff need a DHW background check and must qualify as a developmental specialist or paraprofessional. Center groups need at least one qualified staff per 12 participants, and community groups may have no more than three participants per staff. It is capped at 22 hours a week. We did not find the billing unit.
• Adult day health (DD waiver): supervised, structured services outside the home, including health and social services, recreation, safety supervision and help with daily activities. Billed in 15-minute units (S5100) and limited to 30 hours a week. The provider enrolls with Medicaid under the Adult Day Health Additional Terms, and facility-based programs for the DD waiver must meet the IDAPA 16.03.21 building and health rules. Idaho does not license free-standing adult day centers. We did not find a published staff ratio.
• Supported employment (DD waiver): help to work in competitive, integrated jobs for people who need intensive or ongoing support, billed for community settings only. The agency must be accredited by CARF (or meet comparable standards or state Medicaid requirements), enroll with Idaho Medicaid and sign the Supported Employment Additional Terms. It is not available when vocational rehabilitation or special education funding covers it. We did not find a published staff ratio or billing unit.

Combined limits: developmental therapy plus adult day health may not exceed 30 hours a week, and with supported employment added the total may not exceed 40 hours a week.

Residential services (DD waiver)

• Supported living (hourly, high and intense): supports in the participant's own home, with no more than three participants in one setting. High and intense supported living give 24-hour support at a daily rate that includes day services. Intense supported living requires one-to-one staffing and extra criteria, such as serious aggression or complex medical needs. Hourly supported living is billed in 15-minute units. The agency must be certified as a residential habilitation agency by DHW Licensing and Certification and then enroll with Idaho Medicaid.
• Certified family home (CFH): residential habilitation in a family home that holds a Certified Family Home certificate from DHW Licensing and Certification (IDAPA 16.03.19). It is paid at a daily rate (S5140), and a certified family home cannot provide supported living.

How are I/DD provider rates set and how do agencies enroll in Idaho?

Idaho Medicaid pays DD providers their usual and customary charge, up to the maximum in its published Adult Developmental Disabilities Waiver Fee Schedule and Children's DD fee schedules. Payments stay within each person's yearly budget, and rate updates need approval from the Idaho Legislature. Agencies are first certified by DHW and then enroll as Idaho Medicaid providers.

• Billing units: high and intense supported living pay daily rates. Hourly supported living pays in 15-minute units. Hourly supported living, developmental therapy, supported employment and adult day health together are capped at the high supported living daily rate (H2022) unless an exception applies.
• Latest rate change: Information Release MA25-19 (October 16, 2025, amended November 4, 2025) cut non-exempt fee-for-service rates by 4% for dates of service from September 1, 2025. Some HCBS rates were exempt, including certified family home residential habilitation (S5140) at $69.41 a day.
• 2026 legislation: House Bill 863, which changes state law on Medicaid provider payment, was signed March 26, 2026, with one section effective July 1, 2026. We could not confirm what it changes for DD rates. Ask DHW or check its information releases.
• Enrollment: a DDA or residential habilitation agency registers with the Idaho Secretary of State and DHW's Background Check Unit, then applies for certification under IDAPA 16.03.21 through DHW Licensing and Certification (877-457-2815, TRPLicensing@dhw.idaho.gov). After certification it enrolls with Idaho Medicaid through Gainwell (208-373-1424) and signs any required additional terms. A DDA must be certified before it bills, and it must have an administrator and employees; an individual cannot enroll as an agency.
• EVV: electronic visit verification (EVV) does not apply to I/DD services in Idaho. DHW's EVV FAQ says adult and children's DD services are out of EVV scope and residential habilitation is not subject to EVV. Idaho's EVV program, an open model that sends visit data to the Sandata aggregator, covers state plan personal care, home health and three services in the Aged and Disabled (A&D) waiver.

What is changing next for I/DD services in Idaho?

A court settlement requires a new way of setting adult DD budgets. DHW is piloting the Level of Need (LON) assessment with about 800 adults from November 2026 to April 2027, and no go-live date for the new budget model has been set. Idaho's planned move to Medicaid managed care is also still being designed.

• LON pilot: DHW's LON FAQ says the LON will replace the SIB-R for the Adult DD program. The pilot runs November 2026 to April 2027, or until 800 assessments are done. Liberty Healthcare schedules the pilot assessments, and the Human Services Research Institute (HSRI) will use the results to build the new budget method.
• New budgets: DHW's K.W. lawsuit page says adult budgets stay at the highest level a person received on or since July 1, 2011 until the new model is ready, and that everyone will then get a new budget. The state has not given a date for this.
• Managed care: DHW's managed care page describes a plan to move Idaho Medicaid to three managed care organizations, now targeted for January 1, 2030, after an earlier delay. Whether DD services will be included is still an open decision, and the date could change again.

This is Idaho's second try at a new budget model. An earlier plan based on a different assessment, the SIS-A, was put out for comment in late 2021 but stalled. For updates, watch DHW's K.W. lawsuit page or ask a regional BDDS office.

Idaho I/DD sources

• Idaho DHW: Services for Adults with Developmental Disabilities
• Idaho DHW: Apply for Adult with Developmental Disabilities Programs
• Idaho DHW: Traditional Support Services
• Idaho DHW: Apply for Children's Developmental Disabilities Services
• CMS: Idaho waiver fact sheet
• CMS: Idaho 1915(i) State Plan HCBS for Adults with DD renewal (ID-22-0022)
• Idaho Medicaid: HCBS and LTSS provider handbook (August 17, 2026)
• Idaho DHW: Level of Need (LON) assessment FAQ
• Idaho DHW: About the K.W. lawsuit
• Idaho DHW: Residential habilitation agency certification

Related reading

• Disability Services and Independent Living Guide
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Disability Services DayHab has a dilemma - how to solve it
• What is Active Support in Disability Services?
• I/DD services in every state (map)
• Idaho EVV requirements

Page history

• October 23, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.