IDAHO
A new process to assess people with disabilities before delivering services was put into practice through a pilot program in Idaho in 2002 to address concerns about Medicaid caseload increases. Another long-term care development involved legislation governing the transfer of assets prior to qualifying for Medicaid coverage of services.
Developmental Disabilities and Mental Health
Idaho has experienced significant caseload increases in its Medicaid home and community-based waiver program for people with developmental disabilities in recent years. The program served an average of 1,028 people monthly during FY 2002, up 68 percent from FY 2000. This growth led to legislation enacted in 2001 that directs the Department of Health and Welfare to initiate a project intended to manage the growth in Medicaid spending on services for people with developmental disabilities and also to improve the quality of those services. The Developmental Disabilities and Mental Health Service Delivery Project involves several phases, the first of which is to serve adults with developmental disabilities, to be followed by serving adults with mental health issues.
The process requires review and authorization of services for each consumer before services are delivered. The Department began a seven-month pilot program (beginning in October 2001) for adults with developmental disabilities in Region 2 of the state. The project involved 11 developmental disabilities service provider agencies and the care management of 114 consumers receiving services. The department reported that. " ... data shows the pilot was able to slow the growth of expenditures to 1 percent for the seven-month trial period and still maintain a high level of service."
Transfer of Assets
The 2002 Legislature endeavored to plug a loophole in the rules governing the transfer of assets to qualify for Medicaid assistance for nursing home care. The Idaho law provides that any transfer of assets not otherwise permitted by federal law is presumed to be for the purpose of sheltering assets to qualify for Medicaid. The transferred assets will be counted as available in determining eligibility and will subject the applicant to civil penalties, unless the applicant can demonstrate by clear and convincing evidence that the transfer was intended for another purpose.
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