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How to apply for the Idaho adult DD Waiver

A plain-language walkthrough for Treasure Valley families: who qualifies, the two applications you file, the assessment, choosing your services, and what it costs. Every step is sourced.

  • Emily, adult daughter
  • Karen, mom
  • Greg, dad
  • Tasha, DSP (someday)
  • Maya, DSP guide

Written by Cass Neilson, founder and administrator of GemState · Published June 24, 2026 · Last reviewed August 14, 2026

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Getting an adult onto Idaho's Developmental Disabilities Medicaid Waiver can feel like a maze. This guide lays out the whole path in order, in plain language, so you know what to expect and what to gather. We link to the official Idaho sources at each step so you can verify everything yourself.

This guide follows the Hansen family. Emily, about 21, lives at home with her parents, Karen and Greg, while the three of them work through the applications together. No DSP works in their house. A home of Emily's own is a someday goal, and you will see it at the end.

Maya explains Hi, I'm Maya, a direct support professional. I'll walk beside the Hansens with short, plain-language notes, so you can skim the big picture first and read the details when you need them.
Illustration: Karen Hansen sits at her kitchen table among blank papers and a laptop, rubbing her forehead, while her husband Greg sets a mug of coffee beside her.

1 The maze

Karen at the kitchen table

Karen has a laptop open and papers everywhere, and the application feels like a maze. Greg brings her coffee. They decide to take the path in order, one step at a time.

One honest heads-up: dollar limits, the assessment tool, the assessment contractor, and whether there is a waitlist all change over time. We note the current details and link straight to the live Idaho Department of Health and Welfare (DHW) pages so you are always working from today's numbers, not last year's.

The whole path

Application, assessment, budget, services

Six stops, in the order this guide walks through them.

  1. Check eligibility

    Every requirement below has to be met. A diagnosis by itself is not enough.

  2. Apply for HCBS Medicaid

    The financial application: online through idalink, by phone, at a DHW field office, or by mail.

  3. Submit the Adult DD packet

    The program application. Return it with your records to your regional DHW developmental-disabilities office. One application does not cover the other.

  4. Complete the functional assessment

    The assessment confirms eligibility and sets the individualized budget. The assessor sets the budget, not the family. You get a written Notice of Decision and can appeal a denial or the budget. The waiver is capped, so ask whether slots are open. Do not assume immediate enrollment.

  5. Choose Traditional or self-directed

    A plan developer writes the plan, or a support broker helps you direct it. The person-centered plan has to fit inside the budget the assessment set.

  6. Choose a certified provider

    At the planning meeting. When an agency delivers residential habilitation, it must be DHW-certified.

For an enrolled, Medicaid-eligible participant, covered services cost nothing out of pocket. Medicaid pays the provider. Room and board (rent, utilities, and food) is not covered. This visual summary does not add requirements beyond the sections below.

Maya’s tip Start one folder, paper or digital, for both applications before you begin. Keep a copy of everything you send, and write the date you sent it on the front.

1. Are you eligible?

Illustration: Emily Hansen sits between her parents, Karen and Greg, at the kitchen table and points to a line on a printed checklist.

2 Who qualifies

Emily reads the list herself

Emily sits between her parents and reads each requirement out loud. All of them must be met, so the family goes line by line instead of guessing.

Maya explains Here's the eligibility list in plain words: every line has to be true, not just one. A diagnosis by itself is not enough.

The adult DD Waiver (federal 1915(c) waiver #0076) requires all of these:

  • Age 18 or older. No maximum age. Children under 18 use a separate program.
  • A qualifying developmental disability that began before age 22 and is expected to continue: intellectual disability, cerebral palsy, epilepsy, autism, or a closely related condition needing similar care.
  • Substantial limits in 3 or more of 7 life areas (listed in the box below).
  • An ICF/IID level of support: the level an institution would provide, received at home or in the community instead.
  • HCBS Medicaid, financially. As of January 2026: about $3,002 a month in income and $2,000 in resources. These change every year.

Sources: Idaho Code 66-402 (the legal DD definition), DHW: Apply for Adult DD Programs, and the live DHW Medicaid income limits.

All required

The eligibility gates

Meeting one of these is not enough. Children under 18 use a separate program.

  • Age 18 or olderThere is no maximum age.
  • A qualifying disability before age 22A chronic condition expected to continue indefinitely: intellectual disability, cerebral palsy, epilepsy, autism, or a closely related condition needing similar care.
  • ICF/IID level of supportThe level an institution would provide, received at home or in the community instead.
  • HCBS Medicaid, financiallyAs of January 2026, about $3,002 a month in income and $2,000 in resources. These change every year.
  • Substantial limits in 3 or more of 7 life areas
    • Self-care
    • Receptive and expressive language
    • Learning
    • Mobility
    • Self-direction
    • Capacity for independent living
    • Economic self-sufficiency

Check the live DHW Medicaid income limits, linked above, before you plan around a dollar figure.

Maya’s tip Go through the list together, like the Hansens did, and jot down which records show each item, such as the diagnosis and when it began. That becomes your proof list for the DD packet.

2. How to apply: two applications, started together

Illustration: Greg Hansen types at a laptop at the kitchen table while Karen hands him a document from her folder.

3 Application one

Greg files the Medicaid side

Greg types the HCBS Medicaid application while Karen hands him the proof from her folder. This is the financial side.

This trips up almost everyone: Idaho needs two separate applications, and one does not cover the other. Start both.

Step 1: Apply for HCBS Medicaid (the financial side)

  • Online through idalink, Idaho's benefits portal (the easiest way).
  • By phone at 877-456-1233, in person at a DHW field office, or by mail.
  • Have ready: proof of identity, household income, resources or assets, and immigration status if it applies.
Maya’s tip Gather the proof before you sit down, the way Karen had her folder ready for Greg. Save a copy or screenshot of the finished application and the date you filed it.

Every method: DHW's Medicaid application page.

Illustration: Emily Hansen slides a manila envelope into a blue mailbox on a tree-lined Boise street while her dad Greg stands beside her, smiling.

4 Application two

Emily mails the DD packet

Emily drops the program application in the mailbox herself, with Greg beside her. They confirmed the regional office first. Both applications are now started.

Step 2: Submit the DD application packet (the program side)

  • Get the packet: download the Adult DD Application Packet and the "Applying for DD Services Step-By-Step" guide from the DHW adult DD page, or ask your regional office to mail one.
  • Fill it out and return it with your proof to your regional DHW developmental-disabilities office.

What to include as proof:

  • The qualifying diagnosis with onset before age 22 (for intellectual disability, an IQ score around 70 or below).
  • A current health or physical exam and a current medication list.
  • Names of treatment providers, and any relevant records such as seizure logs.

Where it goes: the regional Bureau of Developmental Disability Services office for your county. Ada and the surrounding counties are served from 1720 Westgate Dr, Suite B, Boise, phone 208-334-0940.

Maya’s tip Check your exact office on the DHW office locator before you mail anything, like the Hansens did. Copy every page first, and note the date you mailed it.

Start both

Two applications, not one

A Medicaid approval does not file the DD packet, and the DD packet does not apply for Medicaid.

HCBS Medicaid (financial)

  • File through idalink, by phone, at a DHW field office, or by mail.
  • Have proof of identity, household income, and resources or assets.
  • Include immigration status if it applies.

Adult DD packet (program)

  • Download it from DHW, or ask your regional office to mail one.
  • Include the qualifying diagnosis with onset before age 22.
  • Add a current health or physical exam, a current medication list, treatment providers, and records such as seizure logs.
  • Return it to your regional DHW developmental-disabilities office. Confirm the office before you mail it.

One application does not cover the other. Start both.

Sources: DHW Apply for Adult DD Programs, idalink.

3. The assessment, the decision, and the waitlist

Illustration: an independent assessor in a gray cardigan holds a plain clipboard at the Hansens' kitchen table while Emily answers for herself and Karen and Greg listen.

5 The assessment

Emily answers for herself

The independent assessor talks with the family. Emily answers in her own words. Karen and Greg sit beside her and let her lead. The assessor sets the budget, not the family.

Maya explains Here's what happens after the packet, in plain words: an independent assessor meets with you, the assessment sets a budget, and you get the decision in writing.
  • Who calls you: once your packet is complete, Idaho's contracted independent assessor schedules a functional assessment. The current contractor is Liberty Healthcare. The DHW page does not name the contractor, so confirm with DHW.
  • The tool: Idaho currently uses the SIB-R (Scales of Independent Behavior-Revised). A move to the SIS-A has been announced but is uncertain, so verify with DHW.
  • The budget: the assessment sets an individualized budget tied to functional, behavioral, and medical needs. The assessor sets it, not the family. Higher need means a higher budget.
  • The decision: a written Notice of Decision says whether you are eligible and how to appeal. You can appeal a denial and the budget amount. Eligibility is reviewed at least once a year.

About waitlists: the adult DD Waiver is a capped program, not an open entitlement, so it can have a waitlist when slots are full. Status is not always posted. Do not assume immediate enrollment. Apply early and ask your regional DHW office whether slots are open.

Maya’s tip When the Notice of Decision arrives, read it right away and put it in your folder. If the eligibility answer or the budget looks wrong, follow the appeal steps it lists without waiting.

The assessment is the highest-stakes hour of the whole process, so we wrote it a guide of its own: preparing for the DD eligibility assessment, covering respondents, records, and how to answer accurately.

Sources: DHW Apply for Adult DD Programs, Liberty Healthcare Idaho.

4. Your plan of service: Traditional or Self-Directed

Illustration: Emily Hansen leads her planning meeting at a round table, pointing to a board of sticky notes with drawings of a cooking pot, a bus, a piggy bank, and a key, as her parents and a plan developer with a laptop listen.

6 Her plan

Emily leads her planning meeting

Emily points to her goals: cooking, riding the bus, handling her money, and a key to a home of her own someday. Her parents listen. The plan developer writes it down. The plan has to fit the budget the assessment set.

Maya explains Here's the choice in plain words. Once you're found eligible, you pick one of two ways to run services. Traditional: an agency provides the services, and a plan developer writes the plan. Self-directed: you're the boss of your own workers, and a support broker helps you. Either way, you still choose your providers.

Pick one

Traditional or self-directed, side by side

You record your choice on a Plan Developer or Support Broker Choice Form.

Traditional services

An agency, with a Plan Developer
  • Who provides services: an agency you choose.
  • Who helps you plan: a Plan Developer hosts the planning meeting, writes the Individual Support Plan (ISP), and submits it to the state.
  • Built-in check: a paid plan developer cannot also be paid to provide other services on that plan, so their advice stays independent.

Self-Directed ("My Voice, My Choice")

You hire, with a Support Broker
  • Who provides services: Community Support Workers you hire yourself.
  • Who helps you plan: a Support Broker helps you manage your budget. You set your workers' schedule.
  • Payroll: a Fiscal Employer Agent handles payroll and taxes.

Either way, you keep the right to choose your own providers.

The person-centered planning meeting

  • This is where you choose the goals, the services, and the provider who delivers them.
  • Those choices are written into the plan.
  • The plan has to fit inside the budget the assessment set.
Maya’s tip Before the meeting, help your loved one list a few goals in their own words, like Emily's sticky notes: cooking, the bus, money, a key. Bring your questions about providers written down, too.

Sources: DHW: Traditional services, DHW: Self-Directed services.

5. Choosing a certified residential habilitation provider

Maya explains Here's provider choice in plain words: pick a DHW-certified agency, ask where and how its staff actually work, and make the choice at your planning meeting.
  • Where, under Idaho rule: the rule allows residential habilitation in a person's own home, a family home, or a certified family home, and excludes institutions such as nursing facilities, hospitals, and ICF/IID settings.
  • Certified: an agency that delivers it must be certified by DHW and must employ and supervise the direct-care staff.
  • No public directory: ask your assessor, plan developer, or regional DHW office for the current list serving your area.

How GemState does it: we support adults who live in their own home or apartment, with a DSP in the home 24 hours a day, one DSP for up to 3 participants sharing a home.

It is not drop-in or hourly care, and we do not provide services in a family member's home.

Maya’s tip When you talk with an agency, ask where its staff work and how many hours a DSP is in the home. Our walkthrough on how to choose a residential habilitation provider covers checking certification, questions to ask, and red flags.

Source: IDAPA 16.03.10.703.

6. What it costs your family

Maya explains Here's the money part in plain words: Medicaid pays for the services. The home itself (rent, utilities, food) is still the participant's to pay.
  • Services: for an enrolled, Medicaid-eligible participant, covered services cost nothing out of pocket. Medicaid pays the provider.
  • Room and board is not covered: rent or mortgage, utilities, and food stay the participant's responsibility, usually paid from SSI or personal income. This is standard for every Idaho HCBS waiver.
  • A ceiling: total waiver services cannot cost more than the average Medicaid cost of institutional (ICF/IID) care.
Maya’s tip When you picture a home of their own someday, sketch a simple monthly budget for rent, utilities, and food next to your loved one's income, so the room-and-board part is not a surprise.

Sources: IDAPA 16.03.10.703, DHW income limits.

How GemState helps

Illustration: Karen Hansen holds a closed folder at the kitchen table and smiles while Emily and Greg share a family side hug in golden light.

7 The folder closes

One step at a time, together

Karen closes the folder and exhales. Emily and Greg pull her into a side hug. Emily still lives at home with her parents, and no DSP works in their house.

This process is exactly the "red tape" we help families through. GemState is a DHW-certified Treasure Valley residential-habilitation agency (Certificate No. RHA-6337), and we will walk you and your loved one through every step above, from your first question to the day services start. The fastest first move is our quick eligibility check or simply sending us a note.

Maya’s tip Not sure which step you're on? Bring your folder and call GemState at (208) 247-9010. We can look at where you are together.
Illustration, a someday scene: Emily stirs a mixing bowl in her own apartment kitchen while Tasha, a DSP in a mint polo, coaches beside her, and her parents Karen and Greg wave as visitors.

8 Someday

A home of Emily's own

This is a someday picture, not today. At GemState, residential habilitation happens in the participant's own home or apartment, with a DSP like Tasha in the home 24 hours a day, one DSP for up to 3 participants. It is not drop-in care.

Emily stirs, Tasha coaches, and Karen and Greg come by as visitors.

Common questions

Do I have to apply for Medicaid and DD services separately?
Yes. Idaho requires two applications: a financial Medicaid application for Home and Community-Based Services, and a separate developmental-disabilities application and functional assessment. One does not cover the other, so start both.
Is there a waitlist for the Idaho adult DD Waiver?
The adult DD Waiver is a capped 1915(c) waiver rather than an open entitlement, so it can have limited slots and a waitlist when full. Current status is not always published, so do not assume immediate enrollment. Apply as early as possible and ask your regional DHW office whether slots are open.
Does residential habilitation mean my loved one moves into a facility?
No. Idaho rule IDAPA 16.03.10.703 excludes institutional settings such as nursing facilities, hospitals, and ICF/IID. The rule allows the service in a person's own home, a family home, or a certified family home. At GemState, residential habilitation happens in the participant's own home or apartment, with a DSP in the home 24 hours a day (one DSP for up to 3 participants sharing a home). It is not drop-in or hourly care.

Emily, Karen, Greg, Tasha, and Maya are illustrated characters. Fictional. Facts on this page cite Idaho sources. Confirm details for your situation with your regional DHW office. GemState ResHab explainer series.

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