- IPUL is Idaho's F2F HIC
- Financing and Eligibility
- Pregnancy / Prenatal Care
- Newborn Screening
- Genetics Resources / Diagnosis Information
- Birth to Three
- School Aged Children with Special Health Care Needs
- Transitioning to Adulthood
- Oral Care
Idaho's Family To Family Health Information Center
Family To Family Health Information Centers (F2F-HIC) are established to provide information and assistance to families of children and youth with special health care needs. Idaho Parents Unlimited is the F2F-HIC for Idaho.
As a parent led organization, we recognize that caring for children with special health care needs is often complex. Like you, we are parents of children and young adults with physical, developmental, and mental health challenges, and we have firsthand experience negotiating the maze of health care services and programs in our state.
We assist families of children with special health care needs to become informed, experienced, and self-sufficient advocates for their children and themselves.
Family Voices aims to achieve family-centered care
IPUL is the Family Voices State Affiliate Organization. for all children and youth with special health care needs and/or disabilities.
We provide families tools to make informed decisions, advocate for improved public and private policies, build partnerships among professionals and families, and serve as a trusted resource on health care.
Financing and Eligibility
- Developmental Disability
- Katie Beckett
- Medicaid for Children
- Children's Mental Health
- Children's Special Health Program
- School-Based Medicaid
The Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) programs provide assistance to people with disabilities.
The SSDI program pays benefits to you and certain family members if you are “insured.” This means that you worked long enough – and recently enough - and paid Social Security taxes on your earnings. The Supplemental Security Income (SSI) program pays benefits to adults and children with disabilities who have limited income and resources.
While these two programs are different, the medical requirements are the same. If you meet the non-medical requirements, monthly benefits are paid if you have a medical condition expected to last at least one year or result in death.
How Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI) and employment can work together.
Here's a series of short, informative videos from the Idaho Department of Labor that go over how SSI, SSDI, and employment can work together. You can view the videos embedded below by clicking the title, or see them in a playlist on youtube by clicking here. (In both English and Spanish)
What is Supplemental Security Income (SSI)?
Supplemental Security Income and Work
Supplemental Security Income (SSI) & Youth Who Work
What is Social Security Disability Insurance (SSDI)?
Social Security Disability Insurance (SSDI) & Planning for Work
Social Security Disability Insurance (SSDI) Work Incentives
Early Periodic Screening, Diagnosis, and Treatment (EPSDT)
The Early, Periodic, Screening, Diagnostic and Treatment (EPSDT) benefit allows a child under 21 to receive medically necessary services that exceed the limits of the Idaho Medicaid plan. The EPSDT benefit is provided to ensure physical conditions or mental illnesses, which can affect a child’s growth or development are found and treated early.
Who can get EPSDT services?
If you are eligible for Children's Medicaid or CHIP, you can qualify for services under EPSDT. There are not different income limits for this program. Children enrolled in Medicaid are eligible for medically necessary screenings, diagnosis, and treatment for physical conditions or mental illnesses. If Idaho Medicaid doesn’t usually cover a service under basic plans, but it is listed in the federal Medicaid law, then it is coverable under EPSDT. Companies who provide these services to children enrolled in Idaho Medicaid must use EPSDT as a guide.
Optum Idaho manages the Idaho Behavioral Health Plan. EPSDT services through Optum are accessed through the following form:
EPSDT Optum (pdf)
The Medicaid program’s benefit for children and adolescents is known as Early and Periodic Screening, Diagnostic and Treatment services, or EPSDT. EPSDT provides a comprehensive array of prevention, diagnostic, and treatment services for low-income infants, children and adolescents under age 21, as specified in Section 1905(r) of the Social Security Act (the Act). The EPSDT benefit is more robust than the Medicaid benefit for adults and is designed to assure that children receive early detection and care, so that health problems are averted or diagnosed and treated as early as possible. The goal of EPSDT is to assure that individual children get the health care they need when they need it – the right care to the right child at the right time in the right setting.
Children’s Developmental Disabilities
The Children’s Developmental Disabilities Program provides a system of care that has a wide array of home and community based services for children including intervention and support services. The system emphasizes evidence-based treatment methods, community integration, and family empowerment.
Children’s Developmental Disabilities Homepage
Apply for Children's Developmental Disabilities Services
Katie Beckett is a Medicaid program for children living at home with long-term disabilities or complex medical needs, who may be eligible for Medicaid services even if their family income is above Medicaid federal poverty guidelines.
For more information about the Katie Beckett program, see the webpage at the Idaho Department of Health and Welfare
Medicaid for Children
Medicaid for Children
Medicaid provides health coverage for children who meet certain eligibility criteria. There are several different Medicaid programs available to address specific circumstances and needs of children.
Children's Behavioral Health
Children’s Mental Health (CMH) has been instrumental in the development of Youth Empowerment Services (YES), the new system of care in the state of Idaho for children with serious emotional disturbance. In addition, CMH Regional Mental Health offices provide connections and services for children and youth without Medicaid.
Children's Special Health Program
The Children's Special Health Program (CSHP) is a statewide financial assistance program for uninsured children with a qualifying medical condition(s) requiring long-term multi-disciplinary medical treatment and rehabilitative measures to improve ability to function. CSHP works with families, providers, and communities to ensure access to care that is family-centered, community-based, and culturally sensitive.
Medicaid School-Based Services
School-based services are health-related and rehabilitative services provided to children with disabilities who receive services under the Individuals with Disabilities Education Act (IDEA)
Full information on this program at the Idaho Health and Welfare School-based Medicaid Services page
Did you know...
- Every year nearly one million American women deliver babies without receiving adequate medical attention.
- Babies born to mothers who received no prenatal care are three times more likely to be born at low birth weight, and five times more likely to die, than those whose mothers received prenatal care.
- If you are pregnant, programs in your State can help you have a healthy baby. These programs offer medical care, support and advice for pregnant women, information about health insurance and other services you and your baby may need.
For more information about prenatal services from the U.S. Department of Health and Human Services click here.
WIC helps families by providing:
- Checks to buy health supplemental foods from local grocery stores ( authorized WIC vendors)
- Nutrition education
- Help finding healthcare and other community services
- Breastfeeding information and support
More information can be found here.
The Office on Women's Health provides national leadership and coordination to improve the health of women and girls through policy, education and model programs. Click here for information from The Office on Women's Health.
Prenatal Care and Screening
Prenatal Screening Links and Resources:
Idaho Perinatal Project - The primary purpose of the Idaho Perinatal Project is to reduce maternal and infant morbidity and mortality and to improve pregnancy outcomes throughout the state of Idaho.
St. Luke's Maternal Fetal Medicine | Genetic Counseling - They help clarify the risks for occurrence or recurrence of a genetic or inherited disorder or condition in specified family members. They help patients and families make sense of complex options for testing and interventions and explain the results of diagnostic tests
Prenatal Care and Testing (Eastern Idaho Regional Medical Center) - Prenatal care is the regular healthcare you will receive during pregnancy from your doctor, midwife, or other healthcare professional.
Kootenai Health Family Birth Center (Coeur d'Alene, Idaho) - Kootenai is one of only about 100 Baby-Friendly hospitals in the nation. This designation represents the highest standard of care for mothers and babies. A dedication to improving infant health through breastfeeding and other maternal-infant care practices in every department of the hospital helped Kootenai earn this distinction.
St. Luke's Clinic - Obstetrics and Gynecology - Obstetrics and gynecology is medical care for women of all ages that includes (but is not limited to):
- High and Low Risk Obstetrics
- TVT Surgery for Urinary Incontinence
- Endometrial Ablations
- Women's Surgery
- Cancer Prevention
- Pelvic Pain
- Family Planning, Tubal Ligations
- 3D/4D Ultrasounds in the Office
- STD Screening
Screening is required by State law:
The Idaho Legislature has instructed the Department of Health and Welfare to require that all babies born in Idaho receive two screening tests for Phenylketonuria (PKU) and other disorders that can result in mental retardation or other serious health problems. This procedure is called the “newborn screen,” or the “newborn blood spot screen.” This test should not be called “The PKU” or the “The PKU Test,” as Idaho now screens for more than 46 conditions. To learn more about the conditions tested for in Idaho, see the Idaho Practitioner's Manual.
This is a list of the conditions that Idaho screens Newborns for.
You can see the entire Idaho Metabolic Screening Panel at this link:
Idaho Metabolic Screening Panel
Newborn screening is just one of many things that happen in the first few days after a baby is born. The information found at http://babysfirsttest.org/ can help prepare expecting parents for the newborn screening process and answer common questions, such as: What should I do Before Birth? What are the Screening Procedures? How should I respond to the Results? What are the Screening Outcomes? What happens to the Blood Samples?
The National Center for Hearing Assessment and Management serves as the National Resource Center for the implementation and improvement of comprehensive and effective Early Hearing Detection and Intervention (EHDI) systems. As a multidisciplinary Center, our goal is to ensure that all infants and toddlers with hearing loss are identified as early as possible and provided with timely and appropriate audiological, educational, and medical intervention.
The Western States Regional Genetics Network is a federally-funded, multi-state project that seeks to improve individual and family health throughout the life course. The participating states and territories are: Alaska, California, Guam, Hawaii, Idaho, Oregon, and Washington.
Their activities aim to increases access to and reduce disparities in newborn screening and clinical genetic and genomic services for individuals with or at risk for heritable disorders. Click here for more information.
Genetics Testing Overview
From the National Oganaization for Rare Diseases - Genetic Testing 101 for Parents Webinar
Do you want to learn more about how genetic testing can be helpful in the diagnosis and management of rare diseases? These topics and more were covered in a NORD RareEDU webinar. In this recording, NORD welcomed Debra Regier, MD, Director of Genetic and Genomic Education at Children's National Hospital in Washington, DC, gives an overview of the different types of genetic tests, indications for their use, and their benefits and limitations. The recording also includes stories from patients and families who have had genetic testing and the impact it has had on their lives.
Idaho Parents Unlimited has an internal tool that we use with families to help you navigate the complicated systems of genetics including trying to get a diagnosis for your child, accessing genetics services, understanding how genetics services may be paid for, and resources for specific diagnoses. Please feel free to contact us for more information. Furthermore, below are some links that may be helpful.
- St. Luke's Clinic – Genetics and Metabolic
- Idaho Department of Health and Welfare Children's Special Health Program
- Genetic Alliance
- Western States Genetic Services Collaborative
- Primary Children's Hospital Genetics
- Providence Medical Group Genetics and Genomics
- Doernbecher Children's Hospital Genetics and Birth Defects
- GEMS Genetic Education Materials for School Success
NORD's Rare Disease Database provides brief introductions for patients and their families to more than 1,200 rare diseases.
Birth to Three
Idaho's Infant Toddler Program (ITP) coordinates a system of early intervention services to assist Idaho children birth to three years of age who have a developmental delay or who have conditions (such as prematurity, Down Syndrome, hearing loss) that may result in a developmental delay.
The ITP links children with services that promote their physical, mental and emotional development and supports the needs of their families. These can include therapeutic, educational, and supportive services, such as:
- Family education
- Speech therapy
- Occupational therapy
- Service coordination
- Family training
- Home visits
- Health services
Children referred to the Infant Toddler Program are assessed to see if they meet program eligibility. If eligible, an Individualized Family Service Plan (IFSP) is written that outlines services for the child and their family. This plan is reviewed every six months. At three years of age, ITP assists with the child's transition to a developmental preschool program or other community services.
Hearing Loss is the most common birth disorder in newborns. It affects how your baby perceives sound and is able to communicate with you and the world. 90% of infants with hearing loss are born to hearing parents. Please don't wait. Much can be done if hearing loss is identified early.
ZERO TO THREE is a national nonprofit organization that provides parents, professional and policy makers the knowledge and the know-how to nurure early development.
Neuroscientists have documented that our earliest days, weeks and months of life are a period of unparalleled growth when trillions of brain cell connections are made. Research and clinical experience also demonstrate that health and development are directly influenced by the quality of care and experiences a child has with his parents and other adults.
That is why at ZERO TO THREE our mission is to ensure that all babies and toddlers have a strong start in life.
We know that as babies, the way we are held, talked to and cared for teache us about who we are and how er are valued. This profuondly shapes who we will become.
Early experiences set a course for a lifelong process of discovery about ourselves and the world around us. Simply put, early experiences matter. We encourage you to learn more about very young children, early development and the work of ZERO TO THREE by exploring our site.
School Aged Children With Special Healthcare NeedsFrom HRSA:
Children and youth with special health care needs (CYSHCN) are those who "have or are at increased risk for chronic physical, developmental, behavioral or emotional conditions and also require health and related services of a type or amount beyond that required by children generally.
- The Health Resources and Services Administration page on CYSHCN
- Centers for Disease Control page on CYSHCN in Emergencies
- National Resource Center For Health and Safety In Child Care and Early Education - Caring for Children With Special Healthcare Needs
- The Child and Adolecent Health Measurement Initiative's Information Sheet on CYSHCN (downloadable PDF)
Transition to Adulthood
Oral Care and Transitioning to Adulthood
This is a lunch and learn IPUL did on May 26, 2021 with Angela Lindig and Stephanie Walters on the topic of Oral Care for children with special healthcare needs in Idaho.
Some of the barriers that families with children and youth with special health needs are facing include:
- Not being able to find a dentist that will accept Idaho Medicaid (families are hearing that Medicaid requires more documentation and denies claims more often that other insurances)
- Dentists that accept Idaho Medicaid are not accepting new patients
- Dentists don’t have the training or experience in handling children and youth with special health needs, their diagnosis or needs (things like how the medications they take effect their dental health, how to provide comprehensive care like needing to do dental treatment under anesthesia, the struggles families face trying in taking care of their children’s dental needs (oral aversion, refusal to brush teeth, not being provided the resources and adaptive equipment to manage their child’s dental health)
- Having to travel long distances to obtain dental care for their special health needs child (Primary Children’s Hospital, UT and Spokane)
- Being denied orthodontic services that are medically necessary
- Transition to adulthood (the challenges that families with children and youth face are even more difficult when they must transition from a pediatric dentistry provider to someone who will accept adult Medicaid)
Resources for families that were discussed included:
- A Provider locater tool that was recently updated on the Idaho Smiles webpage that indicates dental providers who treat special needs
- Member Services as a resource to provide assistance and stay on the phone to ensure that families are provided with excellent customer service and scheduled an appointment with a provider
- If Member Services is unable to provide an acceptable connection, then a Idaho Smiles Case Manager would get involved
- Idaho Smiles is accustomed to working with primary and secondary insurance scenarios (primary private dental insurance with secondary Medicaid (Katie Beckett)
- Idaho Smiles emphasizes network development for providers that are not currently enrolled with Idaho Smiles (for example, if a provider accepts Delta Dental but is not enrolled as an Idaho Smiles provider, Member Services attempts to have that provider enroll and support them through the process to increase the number of Idaho Smiles providers throughout the state)
- Idaho Smiles offers/provides case management services to any member identified with special needs; this is an elective program, not required; they have to obtain consent and will assist to ensure that member is able to obtain dental services that meets the member’s needs
- Case management is available for pregnant women and special needs adults and children
- Idaho Smiles will assist pediatric dental providers to continue to work with their patients as they transition to adulthood or help the member connect with a dental provider who provides adult care
- Idaho Smiles works closely with Dr. Brooke Fukuoka who advocates for expanded access for dental care for adults with special needs; she created an organization that trains dental providers in Idaho to work with patients with special needs; she provides education to dental providers through a HRSA grant; she works out of a FQHC; she works with a special model to train dental providers; has hospital privileges; sees adult special needs patients in special care facilities; she has a website Your Special Smiles PLLC with education/resources for dental providers in working with special needs population; she provides portable dentistry
- Orthodontic care is determined by medical necessity based on specific criteria adopted by administrative code; dental providers can request prior authorization of services as long as the orthodontic work has not already been started; can appeal decisions and provide additional information for review; Idaho Smiles allows for an orthodontic screen once a year as a benefit under the children’s program; dental providers can continue to submit prior authorizations as the child grows as a large majority of the denials for orthodontic treatment is based on requesting services prior to necessary growth of child
- Part of a general dentist’s education and dental residency should cover special needs training but if not they have resources and work with their Dental Director and Executive Director to provide outreach and training
- Idaho currently has 45% of dental provider population that services Idaho Medicaid population
- Idaho Smiles Case Managers provide a dental health assessment, identify needs (such as transportation, translation, difficulty accessing care) and will provide services to the member as long as eligible and family requests services
- Idaho Smiles also has a Member Advocate available to assist
Family Telehealth Advocate Training
This is a link to a telehealth training course for family advocates and others who work with families. This course will give you a foundation of knowledge about telehealth and where to find resources that families can use to connect to services by telehealth.
This project is a collaboration of the Western States Family to Family Health Information Centers and Public Health Maternal and Child Health Programs, Western States Regional Genetics Network, and Pacific Basin Telehealth Resource Center.
What to expect from a Telehealth Visit:
This is a good overview of the process of having a telehealth visit, created by the Hawaii State Department of Health Genomics Section - also in Spanish!
Transition Toolkit for a joint visit with Pediatric and Adult Health Care Clinicians and Transferring Young Adults
This tip sheet offers pediatric and adult clinicians sample content that can be used to facilitate a “warm handoff” to adult care as well as a sample resource for the transferring young adult that explains the telehealth visit.
Family Voices Telehealth Information
Family Voices National has created several resources that can be found on their website including these short webinars for telehealth basics:
The Idaho Caregiver Alliance is a coalition of individuals and organizations focused on expanding opportunities for respite across the lifespan.
Facebook Live with IPUL and the Idaho Family Caregiver Navigator Project
This is a link to a facebook live we did with the Family Caregiver Alliance about their navigator project which is linked above.
Act Early Idaho helps families and professionals monitor children’s development and identify concerns early. Monitoring children’s development is the first and most important step in identifying children who may need additional supports.
Act Early Idaho provides useful tools and materials for families with young children during COVID-19. These resources may help families adapt to changes in their routines and reduce stress, while promoting child and family resiliency.
The Idaho Federation of Families works to develop a coalition of groups and individuals to educate policy makers, professional organizations, legislators, educators, and the public about the needs of children with emotional, behavioral, and mental health challenges and their families. Fundamental to the Idaho Federation of Families is a focus on family participation and support.
Respite Care Options for Children in Idaho
- this is a PDF from the Ohio Department of Education - while the contact information is for Ohio, all the information in it is absolutely useful.