April 7, 2006

 

 

 

 

 

TO:                  Residential Habilitation Agencies and DD Service Coordination Agencies

 

FROM:            Leslie M. Clement, Deputy Administrator

 

 

 

The Department will consider requests to exceed the $190.00 per day limitation for hourly Residential Habilitation in combination with developmental therapy, community supported employment, and adult day care when all of the following conditions are met:

 

·         The participant is eligible to receive the High Support daily rate for Residential Habilitation (Supported Living).

 

·         Community supported employment is included in the plan and is causing the combination of services to exceed $190.00 per day.

 

·         There is documentation that the Person Centered Planning team has explored other options including utilizing lower cost services and natural supports.

 

·         The participant’s health and safety needs will be met using hourly services despite having been assessed to qualify for 24 hour care.

 

Please submit documentation of above to the Independent Assessment Provider (IAP) to request an exception to the $190.00 per day limitation.  The IAP will review the request for appropriateness and pend to the regional care manager for final review and authorization.  If you have any questions concerning the information contained in this release, please contact David Simnitt, in the Bureau of Behavioral Health, at (208) 364-1992.

 

Thank you for your continued participation in the Idaho Medicaid Program.

 

This Information Release does not replace information in your Idaho Medicaid Provider Handbook.

 

LMC/ds/sw