Idaho DD Waiver Budget and Authorized Hours Explained

How Idaho Determines the Annual Budget

Idaho's DD waiver budget is not a number the family chooses or negotiates in the traditional sense. It flows from the functional assessment conducted by Liberty Healthcare, Idaho's contracted independent assessment provider. The assessor administers the Scales of Independent Behavior–Revised (SIB-R) tool, which scores the individual across adaptive behavior domains — motor skills, social interaction, communication, personal living, and community living.

That score feeds into a budget formula maintained by BDDS. Higher support needs produce a higher annual dollar allocation. The budget covers all waiver services for the year: residential habilitation, supported employment, day habilitation, respite, environmental modifications, and specialized equipment.

One important caveat: Idaho's budget methodology has been subject to ongoing litigation under K.W. v. Armstrong. Under court-ordered protections, existing participants' budgets are protected as "Injunction Budgets" while the state and the Human Services Research Institute (HSRI) develop a replacement assessment tool. This means the state cannot arbitrarily reduce a participant's budget below their established level without transparent mathematical justification.

What "Authorized Hours" Actually Means

The annual budget converts into authorized service hours based on the provider rates for each service type. For example, if residential habilitation is reimbursed at a specific hourly rate and the individual's plan allocates a certain dollar amount to that service, the authorized hours are simply the dollar allocation divided by the rate.

Authorized hours are not a fixed entitlement to a specific number of hours per week. They're a spending authorization — the plan developer or support broker distributes the total annual budget across service categories, and the authorized hours in each category reflect that distribution.

If the family needs more hours in one category (say, additional respite during a medical crisis), the plan developer or support broker can request a reallocation within the existing budget without changing the total dollar amount. Moving dollars between service categories requires a plan amendment submitted to BDDS, but it does not require a new Liberty Healthcare assessment.

When the Budget Falls Short

If the allocated budget genuinely cannot cover the individual's health and safety needs in the community, the plan developer or support broker can initiate an exception review. This process requests funding above the standard budget model. Two types exist:

• Traditional exception review: For participants on the traditional waiver track, where the plan developer documents why agency-delivered services at the current budget level are insufficient.
• Self-directed exception review: For participants on the self-directed track, where the support broker documents why the SSP budget cannot secure adequate community support workers.

The exception review requires clinical documentation — behavioral incident reports, emergency room visits, changes in medical status — that demonstrates the current budget creates an unacceptable safety risk.

Requesting a Reassessment

If the individual's functional needs have changed significantly since the last Liberty Healthcare assessment (a medical event, a behavioral regression, loss of a major support), the plan developer or TSC should submit a "Change in Condition" request. This triggers a new SIB-R assessment, and if the scores reflect higher support needs, the annual budget increases accordingly.

Annual reassessments happen automatically — Liberty Healthcare conducts a new SIB-R each year. But families should not wait for the annual cycle if a significant change has occurred. The sooner the reassessment captures the change, the sooner the budget adjusts.

The Idaho SSI at 18 & Adult Disability Benefits Guide includes a Liberty Assessment Preparation Worksheet that helps families document functional limitations before the SIB-R interview, plus appeal templates for challenging budget reductions.

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