id-16-0321-2501: Developmental Disabilities Agencies (DDA) (Chapter Rewrite)
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The government is updating rules for agencies that support people with developmental disabilities to ensure they receive better care and services. These changes aim to improve how these agencies operate and make it easier for individuals and their families to access help.
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Dear Senators VANORDEN, Bjerke, Wintrow, and Representatives VANDER WOUDE, Erickson, Rubel: The Legislative Services Office, Research and Legislation, has received the enclosed rules of the Department of Health and Welfare: IDAPA 16.03.21 - Developmental Disabilities Agencies (DDA) (Chapter Rewrite)-Proposed Rule (Docket No. 16-0321-2501). Pursuant to Section 67-454, Idaho Code, a meeting on the enclosed rules may be called by the cochairmen or by two (2) or more members of the subcommittee giving oral or written notice to Research and Legislation no later than fourteen (14) days after receipt of the rules' analysis from Legislative Services. The final date to call a meeting on the enclosed rules is no later than 08/01/2025. If a meeting is called, the subcommittee must hold the meeting within forty-two (42) days of receipt of the rules' analysis from Legislative Services. The final date to hold a meeting on the enclosed rules is 08/29/2025. The germane joint subcommittee may request a statement of economic impact with respect to a proposed rule by notifying Research and Legislation. There is no time limit on requesting this statement, and it may be requested whether or not a meeting on the proposed rule is called or after a meeting has been held. To notify Research and Legislation, call 334-4854, or send a written request to the address on the memorandum attached below. Page 1 of 1 Terri Kondeff Director MEMORANDUM TO: Rules Review Subcommittee of the Senate Health & Welfare Committee and the House Health & Welfare Committee FROM: Legislative Drafter - Kyle Slominski DATE: July 15, 2025 SUBJECT: Department of Health and Welfare IDAPA 16.03.21 - Developmental Disabilities Agencies (DDA) (Chapter Rewrite)-Proposed Rule (Docket No. 16-0321-2501) Summary and Stated Reasons for the Rule The Idaho Department of Health and Welfare submits notice for proposed rulemaking for developmen- tal disabilities agencies, IDAPA 16.03.21. The Department states that the proposed rulemaking consolidates IDAPA 16.04.17 (Residential Habilitation Agencies) with this IDAPA 16.03.21 (Developmental Disabilities Agencies. The Department states that consolidating these two chapters will promote efficiency and consis- tency while reducing regulatory burden and ensure the health and safety of vulnerable individuals. Negotiated Rulemaking / Fiscal Impact The Department states that negotiated rulemaking was conducted and that notice was published in the April 2, 2025, Administrative Bulletin, Volume 25-4, pages 27-28. The Department also states that there is no anticipated negative fiscal impact to the general fund. Statutory Authority The Department appears to have authority to promulgate this rule pursuant to section 39-4605, Idaho Code. cc: Department of Health and Welfare Adam Jones *** PLEASE NOTE *** Per the Idaho Constitution, all administrative rules may be reviewed by the Legislature during the next legisla- tive session. The Legislature has 3 options with this rulemaking docket: 1) Approve the docket in its entirety; 2) Reject the docket in its entirety; or 3) Reject the docket in part. Paul Headlee, Deputy DirecMatt Drake, Manager Keith Bybee, ManagerApril Renfro, Manager Norma Clark, Manager Legislative Services OffResearch & Legislation Budget & Policy AnalLegislative AuditsInformation Technology Statehouse, P.O. Box 83720 Tel: 208–334–2475 Boise, Idaho 83720–0054 legislature.idaho.gov IDAPA 16 – DEPARTMENT OF HEALTH AND WELFARE 16.03.21 – DEVELOPMENTAL DISABILITIES AGENCIES (DDA) DOCKET NO. 16-0321-2501 (CHAPTER REWRITE) NOTICE OF RULEMAKING – PROPOSED RULE initiated proposed rulemaking procedures. The action is authorized pursuant to Section(s) 39-4605, Idaho Code. PUBLIC HEARING SCHEDULE: Public hearings concerning this rulemaking will be held as follows: VIRTUALTELECONFERENCES Via WebEx Monday, June 9, 2025 2:00 PM (MT) Join from the meeting link https://idhw.webex.com/idhw/j.php?MTID=m3b53e9aad0b5c7a8406b205b66d2e692 Join by meeting number Meeting number (access code): 2820 182 3802 Meeting password: TpZmsjq2e86 Meeting password when dialing from a phone or video system: 87967572 Join by phone +1-415-527-5035 United States Toll +1-303-498-7536 United States Toll (Denver) Friday, June 20, 2025 2:00 PM (MT) Join from the meeting link https://idhw.webex.com/idhw/j.php?MTID=m909cd0ca85fdb797c81a68a9b3ffbee3 Join by meeting number Meeting number (access code): 2830 045 5205 Meeting password: YBpf4VRZe83 Meeting password when dialing from a phone or video system: 92734879 Join by phone +1-415-527-5035 United States Toll +1-303-498-7536 United States Toll (Denver) The hearing site(s) will be accessible to persons with disabilities. Requests for accommodation must be made not later than five (5) days prior to the hearing, to the agency address below. DESCRIPTIVE SUMMARY: The following is a nontechnical explanation of the substance and purpose of the proposed rulemaking: IdahoAdministrative Bulletin Page 101 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking This chapter is a consolidation of IDAPA 16.03.21 (Developmental Disabilities Agencies) and IDAPA 16.04.17 (Residential Habilitation Agencies). Consolidating these two chapters will assist the Department and providers with efficiency and consistency while reducing regulatory burden and ensure the health and safety of the vulnerable individuals these organizations serve. This chapter includes requirements for Adult Residential Care Facilities that provides residential services to adult individuals with developmental disabilities. FEE SUMMARY: The following is a specific description of the fee or charge imposed or increased: Fees will not be increased as a result of this rulemaking. FISCAL IMPACT: The following is a specific description, if applicable, of any negative fiscal impact on the state general fund greater than ten thousand dollars ($10,000) during the fiscal year as a result of this rulemaking: There is not anticipated to be a negative fiscal impact exceeding $10,000. NEGOTIATED RULEMAKING: Pursuant to Section 67-5220(1), Idaho Code, negotiated rulemaking was conducted for the consolidated document of both 16.04.17 and 16.03.21. Stakeholders were provided with the draft document showing the proposal to repeal 16.04.17 and insert components into 16.03.21. The Notice of Intent to Promulgate Rules - Negotiated Rulemaking was published in the April 2nd, 2025 Idaho Administrative Bulletin, Volume 25-4, pages 27 and 28. INCORPORATION BY REFERENCE: Pursuant to Section 67-5229(2)(a), Idaho Code, the following is a brief synopsis of why the materials cited are being incorporated by reference into this rule: N/A. ASSISTANCE ON TECHNICAL QUESTIONS, SUBMISSION OF WRITTEN COMMENTS: For assistance on technical questions concerning the proposed rule, contact Jared Larsen at DHWRules@dhw.idaho.gov. Anyone may submit written comments regarding this proposed rulemaking. All written comments must be directed to the undersigned and must be delivered on or before June 25th, 2025. DATED this 2nd day of May, 2025. Jared Larsen Chief, Legislative and RegulatoryAffairs Idaho Department of Health & Welfare 450 W. State Street, 10th Floor P.O. Box 83720 Boise, ID 83720-0036 (208) 334-5500 phone; (208) 334-6558 fax DHWRules@dhw.idaho.gov THE FOLLOWING IS THE PROPOSED TEXT OF DOCKET NO. 16-0321-2501 (Chapter Rewrite) 16.03.21 – DEVELOPMENTAL DISABILITIES AGENCIES (DDA), RESIDENTIAL HABILITATION AGENCIES, AND ADULT RESIDENTIAL CARE FACILITES 000. LEGALAUTHORITY. Section 39-4605, Idaho Code, authorizes the Idaho Board of Health and Welfare to adopt rules and standards of IdahoAdministrative Bulletin Page 102 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking certification for Developmental Disabilities Agencies, Residential Habilitation Agencies, and Adult Residential Care Facilities, to promote the health and safety of participants. These entities will be referred to as an organization for this rule chapter. (3-17-22)( ) 001. SCOPE. These rules govern developmental disabilities agencies, residential rehabilitation agencies, and adult residential care facilities.: (3-17-22)( )
01. Certification. The granting, denial, or revocation of certification is based on whether agencies are
adequate for the health, safety, and the care, treatment, maintenance, training, and support of participants under these rules. (3-17-22)
02. Application. Any person, corporation, or association may apply to the Department for approval
and certification of the applicant's DDA. (3-17-22) 002. -- 008. (RESERVED) 009. CRIMINAL HISTORYAND BACKGROUND CHECK REQUIREMENTS.
01. Verification of Compliance. The agency organization must verify that all employees,
subcontractors, agents of the agency organization, and volunteers delivering DDA services have complied with IDAPA 16.05.06, “Criminal History and Background Checks.” (3-17-22)( )
02. Reporting Criminal Convictions, Pending Investigations, or Pending Charges. Once an
employee, subcontractor, agent of the agency, or volunteer delivering DDA services has received a criminal history clearance, any additional criminal convictions, pending investigations, or pending charges must be reported to the Department as listed in IDAPA16.05.06, “Criminal History and Background Checks,” Subsections 210.01 and 02 by the close of the next business day when the agency learns of the convictions, investigations, or changes. (3-17-22) 010. DEFINITIONS --ATHROUGH Z. For the purposes of this chapter of rules, the following terms apply. (3-17-22)
01. ADA. The “Americans with Disabilities Act Accessibility Guidelines,” under 28 CFR Part 36,
AppendixA. (3-17-22)
02. Center-Based Services. Services provided in a location under control of the agency through
ownership or lease agreement that meets requirements under Section 400 of these rules. (3-17-22)
01. Abuse. The non-accidental act of sexual, physical, verbal, or mental mistreatment, or injury of a
participant through the action or inaction of another individual. ( )
02. Adult Residential Care Facility. A facility that provides any service or group of services which
provide care to the developmentally disabled on an inpatient or residential basis. ( )
03. Advocate. An authorized or designated representative of a program or organization operating
under federal or state mandate to represent the interests of developmentally disabled, mentally ill, or elderly participants. ( ) 034. Communicable Disease. A disease that may be transmitted from one (1) person or animal to another person either by direct contact or through an intermediate host, vector, inanimate object, or other means that may result in infection, illness, disability, or death. (3-17-22) 045. Deficiency.Adetermination of non-compliance with a specific rule or part of rule. (3-17-22) 056. Department. The Idaho Department of Health and Welfare. (3-17-22) 06. Developmental Disability.A developmental disability, defined in Section 66-402, Idaho Code. IdahoAdministrative Bulletin Page 103 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking (3-17-22) 07. Developmental Disability Agency (DDA). A business entity, also known as “agency,” that meets the definition of a developmental disabilities facility provided in Section 39-4604(3), Idaho Code, that is certified by the Department to provide services to eligible individuals with developmental disabilities under these rules. (3-17-22)( ) 08. Exploitation. An action that may include, but is not limited to, the unjust or improper use of a vulnerable participant’s financial power of attorney, funds, property, or resources by another person for profit or advantage. ( ) 089. Health Care Professional. An individual licensed to provide health care within their respective discipline and scope of practice. (3-17-22) 09. Implementation Plan.Aplan that details how goals from the plan of service will be accomplished. (3-17-22) 10. Natural Setting. The environment where an activity or behavior naturally occurs that is typical for peers of the participant's age, such as the home and community, where the participant lives or participates in activities, and in the service environment indicated. (3-17-22) 10. Immediate Jeopardy.Alevel of non-compliance with one (1) or more requirements in this chapter that has caused, or is likely to cause, serious injury, harm, impairment, or death to a participant that requires an immediate response. ( ) 11. Maladaptive Behavior.Any behavior that significantly interferes with participant care or presents a danger to self or others. ( ) 12. Medication. Any substance or drug used to treat a disease, condition, or symptoms that may be taken orally, injected, or used externally, and is available through prescription or over the counter. ( ) 13. Neglect. The failure to provide food, clothing, shelter, or medical care reasonably necessary to sustain the life and health of a vulnerable adult as defined in Section 18-1505, Idaho Code. ( ) 114. Participant. An individual receiving services through a DDA, Residential Habilitation Agency or Adult Residential Care Facility. (3-17-22)( ) 15. Residential Habilitation. Services consisting of an integrated array of individually tailored services and supports furnished to an eligible participant that are designed to assist them to reside successfully in their own home. Services include personal care services, and skill training. Individuals who provide residential habilitation services must be employed by a residential habilitation agency. ( ) 16. Physical Restraint. Any manual hold or mechanical device that the participant cannot remove easily, and which restricts the free movement of or normal functioning of any portions of a participant’s body. ( ) 127. Plan of Service. An initial plan, annual plan, or addendum that identifies all services, supports, or both, if applicable offered. (3-17-22)( ) 138. Repeat Deficiency.Aviolation or deficiency found on a resurvey or revisit to a DDAthat was also found during the previous survey or visit The Department has found an organization is out of compliance with a rule and received a citation on two (2) consecutive surveys. (3-17-22)( ) 19. Substantial Compliance. A level of compliance that has not or will not cause significant injury that requires medical attention to a participant. ( ) 1420. Survey.Areview conducted by the Department to determine compliance with statutes and rules. IdahoAdministrative Bulletin Page 104 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking (3-17-22) 21. Time Out. A separate unlocked room or location, that is supervised, that is used to remove a participant from stimulation that may be triggering or reinforcing maladaptive behavior. ( ) 011. -- 074. (RESERVED) SERVICES PROVIDED BY DEVELOPMENTALDISABILITIESAGENCIES Sections 075-099 075. DDASERVICES. A DDA provides services that include evaluation, diagnostics, skill development, intervention, and support services that are provided in the community, home, or center to individuals eligible to receive services. (3-17-22) 076. -- 099. (RESERVED) CERTIFICATION REQUIREMENTS FOR DEVELOPMENTAL DISABILITIESAGENCIES Sections 100-299 100. TYPES OF CERTIFICATES ISSUEDCERTIFICATION REQUIREMENTS FOR DDA, RESIDENTIAL HABILITATIONAGENCIES, ANDADULT RESIDENTIAL CARE FACILITIES. The Department issues certificates in effect for a period no longer than three (3) years. The types of certificates issued are as follows: (3-17-22)
01. Initial Certificate. When the Department determines application requirements have been met, an
initial certificate is issued for a period of up to six (6) months from the initiation of services. The Department will survey the agency prior to the certificate expiration date to ensure substantial compliance with these rules. When the agency is determined to be in substantial compliance, a one (1) year certificate will be granted. (3-17-22)
02. One-Year Certificate. A one (1) year certificate is issued by the Department when it determines
the agency is in substantial compliance with these rules, following an initial or provisional certificate, or when there may be areas of deficient practice that would impact the agency's ability to provide adequate care. An agency is prohibited from receiving consecutive one (1) year certificates. (3-17-22)
03. Three-Year Certificate. A three (3) year certificate is issued by the Department when it
determines the agency requesting certification is in substantial compliance with these rules. (3-17-22)
04. Provisional Certificate. When an agency is found to be out of substantial compliance with these
rules but does not have deficiencies that jeopardize the health or safety of participants, a provisional certificate may be issued by the Department for up to a six (6) month period. (3-17-22) a. A provisional certificate is issued contingent upon the correction of deficiencies under a plan developed by the agency and approved by the Department. (3-17-22) b. Before the end of the provisional certification period, the Department will determine whether areas of concern have been corrected and whether the agency is in substantial compliance with these rules. (3-17-22) c. If the Department determines the agency is in compliance, a one (1) year certificate will be issued. If the agency is determined to be out of compliance, the certificate will be revoked. (3-17-22) 101. APPLICATION FOR INITIAL CERTIFICATION.
01. Certification Required. Before any agency can operate and provide services as a DDA, it must
apply for, obtain, and maintain DDAcertification from the Department. (3-17-22)
02. Department Review Not Guaranteed. The Department may choose not to consider the
IdahoAdministrative Bulletin Page 105 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking application of any operator, administrator, or owner of an agency whose license or certification has been revoked until five (5) years have lapsed from the date of revocation. (3-17-22)
03. Open Application. An applicant may apply up to three (3) times within a three hundred sixty-five
(365) day period starting on the date of the first submission. If the application is incomplete upon a third submission, the application will be denied. The applicant may not resubmit an application for six (6) months from the date of the denial notice. (3-17-22)
01. Application for Initial Certification. Certification will be issued to any organization upon
completing an application demonstrating compliance with these rules ( ) 042. Content of Application for Certification. TheAapplication for certification must be submitted to the Department on the Department-approved form with the following information and supporting documents at least sixty (60) days prior to the planned opening must include: (3-17-22)( ) a. An application form that contains name, address, and telephone number of the agency, type of services to be provided, the geographic service area of the agencies, and the anticipated date for the initiation of services; (3-17-22) ba. An accurate and complete statement of all bBusiness names of the agency organization as filed with the Secretary of State, whether it is an assumed business name, partnership, corporation, limited liability company, or other entity that identifies each owner and the management structure of the agency; (3-17-22)( ) c. A statement that the agency will comply with these rules and all other applicable local, state, and federal requirements, including an assurance that the agency complies with pertinent state and federal requirements governing equal opportunity and nondiscrimination; (3-17-22) db. Acopy of the proposed oOrganizational chart or plan for staffing of the agency; (3-17-22)( ) c. The following Policies and Procedures; ( ) ei. Written policies and procedures addressing qualifications to meet service delivery requirements including resumes, job descriptions, verification of criminal history clearance, and copies of state licenses and certificates, when applicableStaff and volunteer qualifications including, roles, responsibilities and organization expectations; (3-17-22)( ) fii. Written policies and procedures for the development and implementation of personnel training to meet the requirements of Section 302 of these rulesStaff training that is specific and appropriate to the population served; (3-17-22)( ) giii. Personnel and participant illness policy, communicable disease policy, and other health-related policies and proceduresInfection prevention measures to mitigate the spread of communicable diseases; (3-17-22)( ) iv. General health care services including assessment and treatment of acute and chronic complaints or situations. ( ) hv. Written tTransportation safety policies and procedures required in Section 402 of these rules, including the organization’s preventive maintenance program, inspection intervals, insurance coverage, and licensed driver requirements for organization owned vehicles, and a policy for staff owned vehicles, if applicable; (3-17-22) ( ) vi. Written participant grievance policies and procedures to meet requirements in Section 406 of these rulesThe organization must ensure the participant and the guardian, if applicable, has been informed of how to file a grievance. The organization must respond to the grievance within fourteen (14) days or less; (3-17-22)( ) jvii. Written medication policies and procedures to address medication standards to meet requirements IdahoAdministrative Bulletin Page 106 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking in Section 405 of these rulesMedication standards; (3-17-22)( ) kviii. Written policies and procedures that address the development of positive behavior supports to meet requirements in Section 510 of these rulesBehavior Management, including approved interventions to manage inappropriate or maladaptive behaviors, and restraints if applicable; (3-17-22)( ) lix. Written policies and procedures for reporting incidents to the adult protection, child protection authority, or both, and to the Department to meet requirements in Section 404 of these rulesReporting incidents of abuse, neglect and exploitation including notifying the proper authorities; (3-17-22)( ) x. Incident Reports for all events that occur during service delivery that interfere with the participants’ safety or ability to participate; ( ) m. A written code of ethics policy reflecting nationally recognized professional standards of practice. The policy must articulate basic values, ethical principles and standards for confidentiality, conflict of interest, exploitation, and inappropriate boundaries in an agency's relationship with participants, relatives, or with other agencies; (3-17-22) n. Complete administrator and supervisor records as required in Subsection 301.04 of these rules; (3-17-22) o. Sample of the following documents: (3-17-22) i. Complete participant record as required in Subsection 301.05 of these rules; (3-17-22) ii. Program billing; (3-17-22) iii. Quality assurance program developed to meet requirements in Section 500 of these rules;(3-17-22) iv. All documents referenced in the application. (3-17-22) p. Any other information requested by the Department for determining the agency's compliance of these rules or the agency's ability to provide the services for which certification is requested; (3-17-22) xi. Termination of services that ensures the safety of the participant and notifies all relevant parties; ( ) xii. The organization will only accept and retain participants for whom the organization has the appropriate staff and skills to provide the services; and ( ) xiii. Each organization must ensure the rights provided under Section 66-412, Idaho Code, and will ensure the participant’s privacy and confidentially, promote independence in the community and allow participants to refuse services. ( ) qd. When center-based services are to be provided, the agency must include the following and meet requirements under Section 400 of these rulesDDA center and Adult Residential Care Facilities must include the following: (3-17-22)( ) i. Address and telephone number for each service location; (3-17-22) ii. Supporting documentation requirements including the ADA checklist, local fire safety inspection, and local building and zoning compliance“Americans with Disabilities Act Accessibility Guidelines,” under 28 CFR Part 36,Appendix checklist, local fire safety inspection, and Certificate of Occupancy; and; (3-17-22)( ) iii. Written pPolicies and procedures covering the protection of all individuals in the event of fire and other emergencies to include emergency evacuation procedures; andfor responding to fire, emergencies, including emergency evacuation plans. (3-17-22)( ) IdahoAdministrative Bulletin Page 107 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking iv. Asite review completed by the Department prior to the initiation of center-based services verifying compliance with these rules. (3-17-22) 03. Denial of anApplication. The Department may deny any application for the following reasons; ( ) a. The applicant is not in substantial compliance with these rules; ( ) b. The applicant has willfully misrepresented or omitted information on the application; or ( ) c. The administrator or owner of an organization whose certification has been revoked within the last five (5) years. ( ) 04. Certificate. The Department will issue an initial six (6) month certificate when it is determined the organization is in substantial compliance. Following the initial or a provisional certificate the Department will issue a one year (1-year) certificate, or as needed to determine compliance with rules. A three (3) year certificate is issued when it is determined the organization is in substantial compliance. ( ) a. Application of renewal. An organization must apply to renew its certificate no less than sixty (60) days before the expiration date. ( ) b. Expiration. Expiration of a certificate without a timely request for renewal rescinds the organization’s certificate. ( ) c. DDA Center and Adult Residential Care Facility, the certificate must be posted and visible to the public. ( ) 05. Survey and Investigations. ( ) a. Investigation Survey. The Department will investigate complaints of alleged rule violations. Complainant information is kept confidential. ( ) b. Method of Investigation. The Department will determine the method used to investigate the complaint. ( ) c. Notification to Complainant. The Department will provide a written response to the complainant upon completion of the investigation. ( ) d. Licensing and Certification will conduct survey and investigation at specified intervals to determine compliance with this chapter of rules and Title 66, Chapter 4, Idaho Code and Section 39-4605, Idaho Code. ( ) 06. Notification To the Department. ( ) a. The Department must be notified when the organization's owner, administrator, service area, or address changes; and ( ) b. New ownership, certificates are not transferable. ( ) 1021. -- 10916. (RESERVED) 110. DEPARTMENT’S WRITTEN DECISION REGARDINGAPPLICATION FOR CERTIFICATION. The Department will provide to the agency, within thirty (30) days of the date the completed application packet is received, a written decision regarding certification. An application is considered completed when all required documents are received and comply with these rules. (3-17-22) IdahoAdministrative Bulletin Page 108 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking 111. DENIAL OFANAPPLICATION. The Department may deny any application. (3-17-22)
01. Causes for Denial. Causes for denial of an application may include: (3-17-22)
a. The application does not meet rule requirements in Subsection 101.04 of these rules; (3-17-22) b. The applicant, owner, operator, or provider has: (3-17-22) i. Willfully misrepresented or omitted information on the application or other documents pertinent to obtaining a certificate; (3-17-22) ii. Been denied or has had revoked any license or certificate for a DDA, facility, certified family home, or residential habilitation agency; or (3-17-22) iii. Been convicted of operating an unlicensed or uncertified DDA, facility, certified family home, or residential habilitation agency; (3-17-22) iv. A court order that mandates the applicant must not operate a DDA, facility, certified family home, or residential habilitation agency; (3-17-22) v. An action, either current or in process, against a certificate held by the applicant either in Idaho or any other state or jurisdiction. (3-17-22)
02. Before Denial is Final. The Department will advise the individual or provider in writing of the
denial and their right and method to appeal. Contested case hearings, including denial and revocation, must be conducted under IDAPA16.05.03, “Contested Case Proceedings and Declaratory Rulings.” (3-17-22) 112. -- 114. (RESERVED) 115. CHANGES THAT REQUIRE REPORTING.
01. Notification To The Department. (3-17-22)
a. When a change of a certified agency's ownership, administrator, geographic service area, or address is contemplated, the owner or designee must notify the Division of Licensing and Certification in writing through the Department-approved process. (3-17-22)
02. Center-Based Services. When an agency plans to provide center-based services in a new physical
location, on a temporary or permanent basis, the Department will conduct a site review within thirty (30) days after the agency has relocated. Included with the notification required under this rule, the agency must provide: (3-17-22) a. Evidence of review and approval by the local fire and building authorities, including issuance of occupancy permit; (3-17-22) b. A checklist that verifies compliance with the ADA requirements and Subsection 400.01 of these rules.; and (3-17-22) c. Written policies and procedures covering the protection of all individuals in the event of fire and other emergencies to include emergency evacuation procedures. (3-17-22)
03. Updated Certificate Necessary. To continue operation after any such anticipated change, the DDA
must receive an updated certificate from the Department that reflects the change(s).An agency that fails to notify the Department of such changes is operating without a certificate. (3-17-22)
04. New Ownership. For new ownership, the new owner must submit a new application to the
Division of Licensing and Certification through the approved process at least sixty (60) days prior to the proposed IdahoAdministrative Bulletin Page 109 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking date of change under Section 101 of these rules. (3-17-22) 116. CERTIFICATE NOT TRANSFERABLE. The certificate is issued only to the agency named in the application, for the period specified, and for the location indicated in the application, and to the owners or operators as expressed on the application submitted to the Department. The certificate may not be transferred or assigned to any other person or entity. The certificate is nontransferable from one (1) location to another. (3-17-22) 117. RESTRICTION ON CERTIFICATION. Abusiness entity established by a parent for the sole purpose of providing DDAservices to their own child cannot be certified as a DDA. (3-17-22) 118. AVAILABILITY OF CERTIFICATE. The certificate must be posted in a conspicuous location in the DDA where it may be seen readily by the participants and members of the public. (3-17-22) 1197. AGENCIES ORGANIZATIONS APPROVED THROUGH NATIONALACCREDITATION. Agencies approved by national accrediting bodies must maintain Department certification requirements in the followingOrganizations that are accredited are required to produce the following records to renew a certificate: (3-17-22)( )
05. Facility Standards for Agencies Providing Center-Based Services. See Section 400 of these
rules. (3-17-22) 120. RENEWALAND EXPIRATION OF THE CERTIFICATE.
01. Renewal Request. An agency must request renewal of its certificate no less than ninety (90) days
before the expiration date of the certificate, to ensure there is no lapse in certification. (3-17-22)
02. Expiration Without Timely Request for Renewal. Expiration of a certificate without a timely
request for renewal automatically rescinds the agency’s certificate to deliver services under these rules. If an agency's certificate is rescinded, a new application for certification must be submitted to deliver services under these rules. (3-17-22) 12118. -- 299. (RESERVED) GENERALAGENCY ORGANIZATION QUALIFICATIONS AND REQUIREMENTS Sections 300-399 300. GENERAL STAFFING REQUIREMENTS FORAGENCIES . Each DDA is accountable for all operations, policy, procedures, and service elements of the agencyThe organization must have a qualified administrator, supervisor and direct service provider (DSP) to meet the needs of participants served. The organization administrator and supervisor can be the same individual if the organization can meet requirements of each duty. (3-17-22)( )
01. Agency Administrator Qualifications and Duties. The agency administrator must have two (2)
years of supervisory experience with the population served in an administrative role. On a temporary basis, Aan administrator may designate a qualified individual to perform delegate administrative functions on their behalf. The IdahoAdministrative Bulletin Page 110 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking administrator or their designee is responsible for the overall operations of the organization, including compliance with these rules. (3-17-22)( )
02. Agency Administrator Duties. An agency administrator is accountable for the overall operations
of the agency, including ensuring compliance with these rules, overseeing and managing personnel, developing and implementing written policies and procedures, and overseeing the agency's quality assurance program. (3-17-22)
03. Supervisor Qualifications. The agency must have documentation that ensures personnel acting in
a supervisory capacity meets qualifications as required by the payer source for the service provided. The agency administrator and supervisor can be the same individual if the agency can meet requirements of each duty. (3-17-22) 042. Supervisor Duties. Complete or obtain the plan of service, supervise DSP, including at least quarterly supervision, and coordinate other service providers to ensure continuity of service delivery. (3-17-22)( ) a. Complete or obtain participant assessments and plans according to the authorized plan of service. (3-17-22) b. Provide personnel initial direction, procedural guidance, and monthly supervision of work performed to ensure programs are implemented as written and demonstrate the necessary skills to provide the services. (3-17-22) 05. Direct Service Provider (DSP) Qualifications. A person qualified to provide services must meet the qualifications prescribed for the type of services to be rendered and training requirements of Section 302 of these rules. (3-17-22) 063. DSP Duties. Perform tasks as assigned under the direction of a supervisor. Tasks may not be assigned that require specific certification or licensure. (3-17-22) 074. Parent or Legal Guardian of Participant. A DDA may not hire the parent or legal guardian of a participant to provide services to the parent’s or legal guardian's child. (3-17-22) 08. Volunteer Workers in a DDA. If volunteers are utilized, the agency must establish written policies and procedures governing the screening, training, and utilization of volunteer workers. If a volunteer is working directly with participants, they must meet the qualifications, training, and record requirements of a DSP. (3-17-22) 301. AGENCY ORGANIZATION RECORD REQUIREMENTS.
01. Accessibility ofAgency Records. The agencyAn organization’s records required under these rules
must be accessible available to the Department during normal operations of the agency for the purpose of inspection and copying, with or without prior notification, under Section 39-4605(4), Idaho Code, with or without prior notification. (3-17-22)( )
02. General Record Requirements. Each agency certified under these rules The organization must
maintain accurate, current, and complete administrative, personnel, and participant records for at least a minimum of five (5) years. (3-17-22)( )
03. Administrative Records. Records must include: (3-17-22)
a. An organizational chart; (3-17-22) b. Legal authority identified in organizational bylaws or other documentation of legal authority of ownership; and (3-17-22) c. Fiscal records verifying service delivery prior to request for payment. (3-17-22) 043. Personnel Staff Records. Records must include contain the following: (3-17-22)( ) IdahoAdministrative Bulletin Page 111 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking a. Name, current address, and phone number of the employee, date of hire and termination, if applicable; (3-17-22)( ) b. Documentation supporting qualifications to carry out assigned duties; (3-17-22) c. Verification of satisfactory completion of criminal history checks under IDAPA 16.05.06, “Criminal History and Background Checks.” (3-17-22) d. Date of Employment; (3-17-22) e. Documentation of training under Section 302 of these rules; (3-17-22) f. Evidence of current age-appropriate CPR and first aid certifications; (3-17-22) g. Current assistance with medications certification, if applicable; (3-17-22) h. Other current certifications, as applicable; (3-17-22) ic. Obtain and maintain documentation of licenses and certifications for drivers and vehicles under public transportation laws, regulations, and ordinances that apply to the agency to conduct business and to operate the types of vehicles used to transport participantsCurrent driver’s license and automobile liability insurance for staff who transport participants; (3-17-22)( ) j. Continuously maintain liability insurance that covers all passengers and meets the minimum liability insurance requirements under Idaho law. The agency will ensure that liability insurance coverage is carried to cover circumstances when an employee transports participants in their personal vehicle; and (3-17-22) k. Date and reason for termination, if applicable. (3-17-22) 054. Participant Records Requirements. Each agency must have an organized participant records system to provide past and current information and to safeguard participant confidentiality under these rules thatRecords must contain the following: (3-17-22)( ) a. Clear documentation of the date, time, duration, and type of service with credentialed signature and corresponding initials of the individual providing the service, for each service provided.Documentation of type and duration of services delivered, including the date, time, and name of person providing the service; (3-17-22)( ) b. Profile sheet containing the following information: (3-17-22) ib. Current living arrangementName, address, phone number, and contact information of guardian (if applicable) or emergency contact; (3-17-22)( ) ii. Complete address and contact information for the participant, guardian (if applicable), emergency contacts, and physician; (3-17-22) iii. Current medications and allergies; and (3-17-22) ivc. SpecialGeneral health information including specific dietary or medical needs., and health care providers; (3-17-22)( ) cd. Signed Nnotification of participant rights, access to grievance procedures, and the names, addresses, and telephone numbers of contact information for protection and advocacy services that is clear and understandable; and; (3-17-22)( ) de. Authorized pPlan of service for the participant; and incident reports. (3-17-22)( ) IdahoAdministrative Bulletin Page 112 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking e. Assessments from a health care professional, if relevant or needed for service provision due to medical or behavioral condition; (3-17-22) f. An evaluation to be completed by a qualified supervisor or obtained by the agency, if applicable; (3-17-22) g. Implementation plans, as applicable; (3-17-22) h. Written documentation that identifies the participant's progress toward goals defined on their plan of service; and (3-17-22) i. Incident reports under Section 404 of these rules. (3-17-22) 302. GENERALTRAINING REQUIREMENTS. Each DDA must ensure that all training of staff is completed as followsThe organization must document all staff training, including the date, description of training, and name of the person conducting the training. Staff must be trained on the following: (3-17-22)( )
01. Initial and Annual Training. Prior to working with participants and annually thereafter, direct
service providers are to staff must complete: (3-17-22)( ) a. Safety training to include location based structural and environmental risks, and on natural disasters; (3-17-22)( ) b. Abuse, neglect, and exploitation training covering definitions and reporting requirements; (3-17-22) c. Agency adopted ethical standardsOrganization’s policy and procedures; (3-17-22)( ) d. Participant's rights, advocacy resources, and confidentiality; and (3-17-22) e. Behavior intervention strategies and techniques including appropriate responses to maladaptive behaviors; ( ) ef. For center-based services, fire training to include policies and procedures, fire drills, and emergency evacuation plansFor DDA centers and Adult Residential Care Facility services, fire safety training, fire drills, and emergency evacuation plans. (3-17-22)( )
02. CPR and First Aid Training. Staff must be certified in CPR and first aid prior to working alone
with participants and ongoing thereafter. ( ) 023. Participant-Sufficient Specific Training. Prior to delivering services, DSPs must be trained on the specific needs of the participant including medical, or health requirements, and the use of assistive devices if applicable; (3-17-22)( ) a. Prior to working alone with participants, DSPs will receive basic introductory review of participant information to provide services and supports, to include the following: (3-17-22) i. Participant's profile sheet; (3-17-22) ii. Correct and appropriate use of assistive technology used by participants; and (3-17-22) iii. Special, medical, or health requirements. (3-17-22) b. Supervisor will provide or ensure training provided by a designee on the following, as applicable: (3-17-22) IdahoAdministrative Bulletin Page 113 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking i. Instructional techniques including correct and consistent implementation of the participant's implementation plan or plan of service; (3-17-22) ii. Managing behaviors including techniques and strategies for teaching adaptive behaviors; and (3-17-22) iii. Accurate record keeping and data collection procedures; (3-17-22)
03. Certification Training. (3-17-22)
a. Prior to working alone with participants, personnel receive age-appropriate certification in CPR and first aid, and maintain current certification thereafter; and (3-17-22) b. Personnel assisting with participant medications successfully complete the assistance with medications training course available through an Idaho college or university; (3-17-22) c. Personnel that implement physical restraints receive and maintain certification in a nationally recognized physical intervention strategy. (3-17-22)
04. Ongoing Training. The supervisor provides and ensures ongoing training of DSPs must be trained
when there are changes that impact services or supports including: (3-17-22)( ) a. Participant’s plan of service and corresponding implementation plans, as applicable; and (3-17-22) b. Participant’s physical, medical, and behavioral status. (3-17-22) 303. -- 399403. (RESERVED) FACILITY, SAFETY, AND HEALTH STANDARDS Sections 400-499 400. FACILITY STANDARDS FORAGENCIES PROVIDING CENTER-BASED SERVICES. When an agency is providing center-based services they must meet the following: (3-17-22)
01. Accessibility.Agencies designated under these rules must be responsive to the needs of individuals
receiving services and accessible to individuals with disabilities as defined in Section 504 of the federal Rehabilitation Act, the ADA, and the uniform federal accessibility standard. The DDA must submit a completed checklist to the Department with the application for certification to verify compliance with theADArequirements. (3-17-22)
02. Environment. The facilities of the agency must be designed and equipped to meet the needs of
each participant including factors such as sufficient space, equipment, lighting, and noise control. (3-17-22)
03. Fire and Safety Standards. Center-based locations must: (3-17-22)
a. Meet all local and state codes concerning fire and life safety that are applicable to a DDA through annual inspection by the local fire authority or Idaho State Fire Marshal's office as required by local, city, or county ordinances, documented with inspection results and corrective actions taken on violations cited; (3-17-22) b. Provide suitable fences, guards, or railings to protect participants on the premises where natural or man-made hazards are present; (3-17-22) c. Remove the accumulation of weeds, trash, and rubbish; (3-17-22) d. Limit and use of portable heating devices that have heating elements to not more than two hundred twelve degrees Fahrenheit (212°F), certified by Underwriters Laboratories, and approved by the local fire or building authority; (3-17-22) IdahoAdministrative Bulletin Page 114 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking e. Properly label and store all hazardous or toxic substances under lock and key; (3-17-22) f. Maintain water temperatures in areas accessed by participants at one hundred twenty degrees Fahrenheit (120°F) or below; and (3-17-22) g. Have a telephone available on the premises with emergency numbers near the telephone for use in the event of an emergency. (3-17-22)
04. Evacuation Plans. Evacuation plans must be posted throughout the center and indicate point of
orientation, location of all fire extinguishers, location of all fire exits, and designated meeting area outside of the building. (3-17-22)
05. Fire Drills. The DDAmust conduct and document quarterly fire drills. and meet the following:
(3-17-22) a. At least two (2) times each year these fire drills will include complete evacuation of the building; and (3-17-22) b. A brief summary of each fire drill conducted, written, and maintained on file indicating the date, time, and duration the drill occurred, participants and personnel participating, problems encountered, and corrective action(s) taken. (3-17-22)
06. Food Safety and Storage. (3-17-22)
a. When the agency provides food service for participants and meets the definition of a “food establishment,” in Section 39-1602, Idaho Code, the agency must comply with IDAPA16.02.19, “Idaho Food Code.” Compliance is verified through inspection by the local District Health Department. (3-17-22) b. Refrigerators and freezers used to store participant foods will be maintained at or below forty-one degrees Fahrenheit (41°F), and ten degrees Fahrenheit (10°F) respectively, and in good repair. (3-17-22) c. When medicines requiring refrigeration are stored in a food refrigerator, medicines must be stored in a package and kept inside a covered, leak-proof container that is clearly identified as a container for the storage of medicines. (3-17-22)
07. Housekeeping and Maintenance Services. The agency must meet the following: (3-17-22)
a. Maintain the interior and exterior of the center be maintained in a clean, safe, and orderly manner and kept in good repair; (3-17-22) b. Not use deodorizers to cover odors caused by poor housekeeping or unsanitary conditions; (3-17- 22) c. Ensure the agency is free from infestations of insects, rodents, and other pests; and (3-17-22) d. Maintain the temperature and humidity of the agency within a normal comfort range by heating, air conditioning, or other means. (3-17-22) 401. SETTING REQUIREMENTS. The service setting must meet the needs of the participant as follows: (3-17-22)
02. Environment. Be assessed to meet the needs of each participant including factors such as
sufficient space, equipment, lighting, and noise control. (3-17-22) IdahoAdministrative Bulletin Page 115 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking
03. Promote Inclusion. Promote the participant’s inclusion in the natural setting. (3-17-22)
402. TRANSPORTATION POLICY. Each agency must develop and implement transportation policies that include the following: (3-17-22)
01. Preventative Maintenance Program. Establish a preventive maintenance program for each
agency-owned or leased vehicle, including vehicle inspections and other regular maintenance to ensure participant safety. (3-17-22)
02. Adequate Staffing. Ensure adequate staffing for participants who require additional supervision
during transportation for the safety of all vehicle occupants. (3-17-22)
03. Licenses, Certifications, and Insurance for Drivers and Vehicles. Ensure adequate insurance
coverage to protect the individuals utilizing agency transportation. This may include commercial vehicle insurance and employee vehicle insurance coverage. Obtain and maintain licenses, certifications, and insurance for drivers and vehicles required by public transportation laws, regulations, and ordinances. (3-17-22)
04. Laws, Rules, and Regulations.Adhere to all laws, rules, and regulations applicable to drivers and
types of vehicles used. (3-17-22) 403. HEALTH POLICY. Each DDA must develop and implement policies and procedures that: (3-17-22)
01. Ensure Personnel are Disease-Free. Describe how the agency will ensure that personnel are free
from communicable disease; (3-17-22)
02. Protect Participants. Describe how the agency will protect participants from exposure to
individuals exhibiting symptoms of illness. (3-17-22)
04. Address Needs of Participants. Address any special medical or health care needs of participants
as relevant to service delivery. (3-17-22) 404. AGENCY ORGANIZATION REPORTING POLICY. Each agency must develop and implement written policies and procedures outlining how the agency will document reporting and other communications for the following requirements: (3-17-22)
01. Incident Reports. Document all participant incidents that occur during service delivery and affect
the ability to participate in services. Each report will document that the participant's legal guardian has been notified within twenty-four (24) hours. A documented review by the agency of all incident reports will be completed at least annually with written recommendations and retained by the agency for five (5) years. (3-17-22) 021. Reporting Requirements.Any agency employee, contractor, or volunteer will report all suspected incidents and allegations of mistreatment, abuse, neglect, or exploitation to the administrator, adult or child protection authorities, or law enforcement underThe organization will follow Sections 39-5303 and 16-1605, Idaho Code when there are allegations of abuse, neglect, or exploitation. The agency organization will protect the participant from the possibility of abuse during services while the investigation is in progress. The administrator will ensure the events and the agency response to the events are documented in the participant record organization will document their investigation of all alleged violations. (3-17-22)( ) 032. Reporting Incidents to the Department. Through a Department-approved process, the agency administrator or designee The organization must notify the Division of Licensing and Certification by the close of the next business day of any significant the following incidents that occur to the participant during service hours including: (3-17-22)( ) IdahoAdministrative Bulletin Page 116 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking a. Death; (3-17-22) b. Hospitalization; (3-17-22) c. Participant’s arrest or incarceration; or (3-17-22) d. When staff actions result in a report to protective or legal authorities. (3-17-22) 405. MEDICATION POLICY . Each agency organization must develop and implement written medication policies and procedures that outline in detail how the agency will ensure appropriate handling and safeguarding of medications. If the agency chooses to assist participants with medications, the agency must also develop and implement specific policies and procedures to ensure assistance is safe and delivered by qualified, fully-trained personnel Staff assisting participants with medications must complete the assistance with medications training course available through a Department-approved training. (3-17-22)( )
01. Handling of Participant's Medication. The agency organization must: (3-17-22)( )
a. Maintain that the medication is in the original pharmacy-dispensed container, original over-the- counter container, or placed in a unit container (by a licensed nurse or pharmacy staff) appropriately labeled with the name of the medication, dosage, time to be taken, route of administration, and any special instructions. Each medication will be packaged separately, unless in a Mediset, blister pack, or similar system.; (3-17-22)( ) b. Maintain evidence of the written or verbal order for the medication from the health care professional in the participant's record. MedisetsMedication and treatment must be provided per the health care professional’s orders. DDA’s and residential habilitation agencies may use Medi sets filled and labeled by a pharmacist pharmacy staff or licensed nurse can serve as written evidence of the order.An original prescription bottle labeled by a pharmacist describing the order and instructions for use can also serve as written evidence of an order from the health care professional.; and (3-17-22)( ) c. Be responsible to safeguard the participant's medications while the participant is at the agency or in the community. (3-17-22) c. The organization must store medications under the proper conditions and according to manufacturer’s recommendations. ( ) d. Not retain medications that are no longer used by the participant for longer thanDiscontinued or outdated medications must be removed from the participant’s medication supply within thirty (30) calendar days. (3-17-22)( )
02. Self-Administration of Medication. Written approval is required when the participant is
responsible for administering their own medication without assistance, stating the participant's health care professional has evaluated the participant's ability to self-administer medication, and has found that the participant:A participant can self-administer medication when there is written approval from a health care professional supporting the participant is capable of completing this task safely. (3-17-22)( ) a. Understands the purpose of the medication; (3-17-22) b. Knows the appropriate dosage and times to take the medication; (3-17-22) c. Understands expected effects, adverse reactions or side effects, and action to take in an emergency; and (3-17-22) d. Is capable of taking the medication without assistance. (3-17-22)
03. Assistance with Medication.An agency may assist participants with medications; however, only a
health care professional may administer medications. Prior to unlicensed agency personnel assisting participants with IdahoAdministrative Bulletin Page 117 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking medication, Staff must follow policy and procedures for assisting participants with medications, and the following conditions must be in place: (3-17-22)( ) a. Personnel assisting with participant medications successfully complete the assistance with medications training course available through an Idaho college or university; (3-17-22) ba. The participant's health condition is stable; and (3-17-22)( ) cb. The participant's health status does not require nursing assessment before receiving the medication or nursing assessment of the therapeutic or side effects after the medication is taken; (3-17-22)
04. Medication Record. Record must contain the following: ( )
d. The medication is in the original pharmacy-dispensed container with proper label and directions, in an original over-the-counter container, or the medication has been placed in a unit container by a licensed nurse. Proper measuring devices will be available for liquid medication that is poured from a pharmacy-dispensed container; (3-17-22) e. Written and oral instructions from a physician, practitioner of the healing arts, health care professional, pharmacist, or nurse concerning the reason(s) for the medication, the dosage, expected effects, adverse reactions, side effects, and action to take in an emergency have been reviewed. (3-17-22) f. Written instructions are in place that outline required documentation of assistance including the following: (3-17-22) ia. Name of the participant; (3-17-22) iib. Name and dosage of the medication given; (3-17-22) iii. Time and date the medication was given; (3-17-22) ivd. Initials of individual assisting with medication that can be verified with matching signature; (3-17-22) ve. Documentation of medication errors to, includeing any missed doses, not taken, incorrect medication taken, doses, overdose occurrence, or side effects observed or adverse side effects; (3-17-22)( ) vif. Health care professional contacted to determine the level of threat to the individual's health and determine the treatment required, if any; andDocumentation that a health care professional was contacted for adverse events; and (3-17-22)( ) viig. Documentation of corrective action taken and results for adverse events or incidents of repeated medication errors. (3-17-22)( ) g05. Disposal of Medications. Procedures for Documentation of disposal or destruction of medications must be documented and consistent with procedures outlined in the assistance with medication training course. (3-17-22)( ) 406. GRIEVANCE POLICY. Each DDA must develop and implement written grievance policies and procedures that outline in detail the agency’s grievance policy. The policy must include how the agency will ensure participant and guardian are aware of the process, how to file a grievance, and receive a response from the agency in fourteen (14) days or less. (3-17-22) 4076. – 499. (RESERVED) QUALITYASSURANCE, PARTICIPANT RIGHTS, REQUIRED POLICIES, ETC BEHAVIOR IdahoAdministrative Bulletin Page 118 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking MANAGEMENT, AND SPECIFIC PROGRAM REQUIREMENTS . Sections 500-599 500. REQUIREMENTS FOR AN AGENCY’S ORGANIZATION’S QUALITY ASSURANCE PROGRAM. Each agency organization must develop and implement a quality assurance program that improves the quality of services, identifies any corrections needed, a time frame for those corrections, and ensures the following: non- compliance or safety issues including corrective measures and timeframes. This review must include; (3-17-22)( )
01. Measurable Outcomes. Produces high quality services that maintain interests, needs, and current
standards of practice consistent with individual choices. This includes: (3-17-22) a01. Review of pParticipant rRecords,. for content and effectiveness of programs; and Assess for accurate content and effectiveness of service delivery; (3-17-22)( ) b. Amethod for gathering and assessing participant satisfaction; (3-17-22)
02. Available Personnel and ResourcesStaff Records. Sufficient personnel and material resources
are available to meet the needs of each individual served to include a review of: Assess that staff have the necessary skills and training to provide adequate service delivery; and (3-17-22)( ) a. Personnel records for content. (3-17-22) b. Supervision and training data to ensure there are personnel who have the skills necessary to provide the service. (3-17-22) c. Work scheduled to assure coverage. (3-17-22)
03. Health and Safety Supports. The overall agency practices are within rule and support participant
health and safety to include a review of: (3-17-22) a. Code of ethics, identification of violations, and implementation of an internal plan of correction; (3-17-22) b03. Policyies and pProcedures. manual to specify date and content of revisions made; Review to ensure content meets the needs of participants served. (3-17-22)( ) c. Center-based facilities, if applicable, to ensure compliance with these rules. (3-17-22) 501. -- 504. (RESERVED) 505. PARTICIPANT RIGHTS. Each agency must ensure the rights provided under Section 66-412, Idaho Code, as well as the additional rights listed below for each participant receiving DDAservices. (3-17-22)
01. Participant Rights Provided Under Idaho Code. Provide the following rights for participants:
(3-17-22) a. Humane care and treatment; (3-17-22) b. Not be put in isolation; (3-17-22) c. Be free of restraints, unless necessary for the safety of that individual or for the safety of others; (3-17-22) d. Be free of mental and physical abuse; (3-17-22) IdahoAdministrative Bulletin Page 119 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking e. Voice grievances and recommend changes in policies or services being offered; (3-17-22) f. Practice their own religion; (3-17-22) g. Wear their own clothing and retain and use personal possessions; (3-17-22) h. Be informed of their medical and habilitative condition, of services available at the agency, and the charges for the services; (3-17-22) i. Reasonable access to all records concerning themselves; (3-17-22) j. Refuse services; (3-17-22) k. Exercise all civil and all other rights established by law, unless limited by prior court order; (3-17-22) l. Privacy and confidentiality; (3-17-22) m. Receive a response from the agency to any request made within fourteen (14) business days; (3-17-22) n. Receive services that enhance the participant’s social image, personal competencies, and whenever possible, promote inclusion in the community; (3-17-22) o. Refuse to perform services for the agency. If the participant is hired to perform services for the agency the wage paid must be consistent with state and federal law; and (3-17-22) p. Review the results of the most recent survey conducted by the Department and the accompanying plan of correction. (3-17-22)
02. Method of Informing Participants of Their Rights. Each agency must ensure and document that
each participant receiving services is informed of their rights in the following manner: (3-17-22) a. Upon initiation of services, provide each participant and their parent or guardian, where applicable, with a packet of information that outlines rights, access to grievance procedures, and the names, addresses, and telephone numbers of protection and advocacy services. This packet must be written in easily understood terms. (3-17-22) b. When providing center-based services, prominently post a list of the rights contained in this chapter. (3-17-22) c. Provide each participant and their parent or guardian, where applicable, with a verbal explanation of their rights in a manner that will best promote individual understanding of these rights. (3-17-22) 506. -- 509. (RESERVED) 510. POLICIES AND PROCEDURES REGARDING DEVELOPMENT OF RESTRICTIVE INTERVENTIONSMANAGING PARTICIPANT BEHAVIOR. Each agency must develop and implement written policies and procedures that address restrictive interventions to include the following:The use of systematic interventions to manage inappropriate or maladaptive participant behaviors must follow facility policy and be incorporated into the participant’s individual service plan. (3-17-22)( )
01. Protected Rights. Ensure the safety, welfare, and human and civil rights of participants are
adequately protected. (3-17-22) IdahoAdministrative Bulletin Page 120 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking 02 1. Appropriate Use of InterventionsTechniques to Manage Maladaptive Behavior. Ensure interventions used to manage participants’ maladaptive behavior are never Interventions to manage behaviors must never be used: (3-17-22)( ) a. For disciplinary purposes; (3-17-22) b. For the convenience of personnel or lack of staff; or (3-17-22)( ) c. As a substitute for a needed training an active treatment program; or or needed training. (3-17-22)( ) d. By untrained or unqualified personnel. (3-17-22) 032. Use of Restraint on ParticipantsPhysical Restraints and Time Out Requirements. No restraints, other than physical restraint in an emergency, must be used on participants prior to the use of positive behavior interventions. The following requirements apply to the use of physical restraint on participants by qualified personnel. Physical restraints and time out must be: (3-17-22)( ) a. Physical restraint may be used in an isolated emergency to prevent injury to the participant or others and must be documented and reviewed by the DSP and the supervisor. Documentation must include a debrief with the participant, guardian, and DSP involved focusing on strategies to avoid the occurrence of future physical restraints.Used as an emergency measure when other lesser restrictive interventions have failed and there is substantial risk for harm to self or others; or (3-17-22)( ) b. Physical restraint may be used in a non-emergency setting when a written behavior program is developed by a supervisor, the participant, and their guardian, if applicable, and approved by a health care professional. Informed consent is required by the participant and parent or legal guardianPart of an integral service plan that is intended to lead to less restrictive means of managing or eliminating the behavior for which the restraint is applied. (3-17-22)( ) c. Utilized by staff that have been certified in a nationally recognized behavior management program approved by the Department. ( ) d. Used only until the participant has regained control. ( ) e. Documented in the participant record including date, time, duration, staff involved and description of behaviors. ( ) 043. Written Informed Consent. If the program contains restrictive or aversive components, an individual working within the scope of their license or certification must also review and approve, in writing, the plan prior to implementation. The participant, parent or legal guardian, if applicable, must also consent prior to implementation. When programs implemented by the agency are developed by another service provider, the agency must obtain a copy of these reviews and approvals If an organization uses physical restraints as part of their behavior management program, participants, and their legal guardian, if applicable, must provide written informed consent. (3-17-22) ( ) 511. STANDARDS FOR ADDA CENTER ANDADULT RESIDENTIAL CARE FACILITY.
01. Environment. The facility must be designed and equipped to meet the needs of each participant
including sufficient space, adaptive equipment, lighting, and noise control. Facilities providing residential care must provide participants with sleeping rooms including furnishings, such as a dresser and bed, and be safe and in good repair. ( )
02. Construction Changes. For changes of occupancy, modifications, additions, or renovations to
existing buildings, the facility must submit certificate of occupancy to the Department for approval prior to admitting participants. ( ) IdahoAdministrative Bulletin Page 121 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking 0 3. Fire Safety Standards. Locations must maintain the following records: ( ) a. Acopy of an annual local fire authority inspection including any necessary corrective actions; ( ) b. Documentation of quarterly fire drills, including date, time, duration, names of participants and staff involved, and any resulting corrective action(s); and ( ) c. Documentation that at least two (2) times each year fire drills included a complete evacuation of the building. ( ) 04. Environment Safety Standards. ( ) a. Provide fences, guards, or railings to protect participants on the premises where natural or man- made hazards are present; ( ) b. Portable heating devices must be approved by the local fire authority; ( ) c. Properly label and store all hazardous or toxic substances under lock and key; ( ) d. Maintain water temperatures in areas accessed by participants at one hundred twenty degrees Fahrenheit (120°F) or below; ( ) e. Have a telephone on the premises with emergency numbers available; and ( ) f. Evacuation plans must be posted throughout the center and indicate point of orientation, location of all fire extinguishers, location of all fire exits, and designated meeting area outside of the building. ( ) 05. Food Safety and Nutrition. ( ) a. Organizations that provide food services must: ( ) i. Meet the standards in IDAPA 16.02.19, “Idaho Food Code.” Compliance is verified through inspection by the local District Health Department. ( ) ii. Provide three (3) daily balanced meals in appropriate intervals. ( ) iii. Menu must be planned, approved, signed and dated by a registered dietician. Menus must be maintained on file for sixty (60) days and include any substitutions. ( ) iv. Accommodations must be made to a participant with special medical or religious dietary needs. ( ) b. Refrigerators and freezers used to store participant foods will be maintained at or below forty-one degrees Fahrenheit (41°F), and ten degrees Fahrenheit (10°F) respectively; and ( ) c. When medicines requiring refrigeration are stored in a food refrigerator, medicines must be stored in a package and kept inside a covered, leak-proof container that is identified as a container for the storage of medicines. ( ) 06. Housekeeping and Maintenance Services. The organization must meet the following: ( ) a. The center must be clean, safe, and kept in good repair; ( ) b. Ensure the building is free from infestations of insects, rodents, and other pests; and ( ) c. Maintain the temperature and humidity of the building within a normal comfort range by heating, IdahoAdministrative Bulletin Page 122 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking air conditioning, or other means. ( ) 512. RESIDENTIAL HABILITATIONAGENCIES TERMINATION PROCEDURES.
01. Emergency Termination. Emergency conditions warranting immediate termination of services
include: ( ) a. A change in the participant’s condition resulting in an increased level of care beyond the scope of the organization’s ability to provide care for the participant; or ( ) b. Significant behavior concerns including physical aggression by the participant that puts the health and safety of the organization’s staff or other participants in jeopardy and behavior management techniques have failed to reduce the risk to staff or others. ( )
02. Termination with Notice. The organization must provide written notice of no less than thirty (30)
days for termination, include a transition plan, and a copy of the organization grievance policy.Atransition plan is an interim plan defining activities to facilitate the transition out of residential habilitation services. ( )
03. Termination with Agreement. Services may be terminated prior to thirty (30) days if both parties
agree in writing. ( ) 5113. -- 599. (RESERVED) RULE ENFORCEMENT PROCESS AND REMEDIES SECTIONS 600-699 600. ENFORCEMENT PROCESS. The Department may impose a remedy an enforcement action when it determines an agency has not met the requirements in these rules organization is not in compliance with these rules. The Department may monitor the organization on an as-needed basis, until it has been established the organization is in substantial compliance. (3-17-22)( )
01. Determination of Remedy. In determining which remedy to impose, the Department will consider
the agency's organization’s compliance history, change of ownership, the number of deficiencies, the scope and severity of the deficiencies, and the potential risk to participants. Subject to these considerations, any one or combination of the following remedies, is subject under these rules for notice and appeal: (3-17-22)( ) a. Require the agency organization to submit a plan of correction approved in writing by the Department; (3-17-22)( ) b. Issue a provisional certificate with a specific date for correcting deficient practices; (3-17-22))_ c. Ban enrollment of all participants with specified diagnoses; (3-17-22) dc. Ban any new enrollment of participants; (3-17-22)( ) ed. Summarily suspend the certificate and transfer participants; or (3-17-22) fe. Revoke the agency’s organization’s certificate. (3-17-22)( )
02. Immediate Jeopardy. If the Department finds it is determined an agency’s deficiency
organization’s non-compliance with these rules immediately jeopardizes the health or safety of its a participants, the Department may certificate may be summarily suspend the agency’s certificateed. (3-17-22)( )
03. Repeat Deficiency. If the Department finds a repeat deficiency in an agency, it may impose any of
the remedies listed in Subsection 600.01 of this rule, The Department may monitor the agency on an as-needed basis, until the agency has demonstrated to the Department's satisfaction that it is in compliance with these rules. If so, then IdahoAdministrative Bulletin Page 123 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking certification will be granted. If not, the certificate will be denied or revokedRepeat deficiency may result in any of the remedies listed in this section. (3-17-22)( )
04. Failure to Comply. The Department may impose one (1) or more of the remedies specified in
Subsection 600.01 of this rule if this section: (3-17-22) a. The if the agency organization has not complied with any requirement in these rules returned to compliance within three (3) months after the date it was notified of its failure to comply with such requirement; or of implementing a plan of correction. (3-17-22)( ) b. The agency has failed to correct the deficiencies stated in the agency's accepted plan of correction and as verified by the Department, via resurveys. (3-17-22) 601. REVOCATION OF CERTIFICATE.
01. Revocation of the Agency’s Organizations Certificate. The Department may revoke a agency's
certificate when persuaded by the preponderance of the evidence that the agency organization is not in substantial compliance with the requirements in these rules. The certificate is the property of the state and must be returned to the state if it is revoked or suspended. (3-17-22)( )
02. Causes for Revocation of the Certificate. The Department may revoke any agency's
organization’s certificate for any of the following causes: (3-17-22)( ) a. The certificate holder has willfully misrepresented or omitted information on the application for certification or other documents pertinent to obtaining a certificate; (3-17-22) b. Conditions exist in the agency organization that endanger the health or safety of any participant; (3-17-22)( ) c. Any act adversely affecting the welfare of participants is being permitted, performed, or aided and abetted by the person(s) supervising the provision of services in the agency organization. Such acts include neglect, physical abuse, mental abuse, emotional abuse, violation of civil rights, or exploitation; (3-17-22)( ) d. The provider has demonstrated or exhibited a lack of sound judgment that jeopardizes the health, safety, or well-being of participants; (3-17-22) ed. The agency organization has failed to comply with any of the conditions of a provisional certificate; (3-17-22)( ) f. The agency has one (1) or more major deficiencies. A major deficiency is a deficiency that endangers the health, safety, or welfare of any participant; (3-17-22) g. An accumulation of minor deficiencies that, when considered as a whole, indicate the agency is not in substantial compliance with these rules; (3-17-22) h. Repeat deficiencies by the agency of any requirement of these rules or of the Idaho Code; (3-17-22) ie. The agency organization lacks adequate personnel staff, as required by these rules or as directed by the Department, to properly care for the number and type of participants served at the agency organization; or (3-17-22)( ) j. The agency is not in substantial compliance with the provisions for services required in these rules or with the participants' rights under Section 505 of these rules; (3-17-22) kf. The certificate holder refuses to allow the Department or protection and advocacy agencies full access to the agency organization environment, agency organization records, or the participants. (3-17-22)( ) IdahoAdministrative Bulletin Page 124 June 4, 2025 – Vol. 25-6 DEPARTMENT OF HEALTH AND WELFARE Docket No. 16-0321-2501 Developmental Disabilities Agencies (DDA) Proposed Rulemaking 602. NOTICE OF ENFORCEMENT REMEDY. The Department will notify the following of the imposition of any enforcement remedy on a agency: (3-17-22)
01. Notice to Agency. The Department will notify the agency in writing, transmitted in a manner that
will reasonably ensure timely receipt. (3-17-22)
02. Notice to Public. The Department will notify the public by sending the agency printed notices to
post. The agency must post all the notices on the premises of the agency in plain sight in public areas where they will readily be seen by participants and their representatives, including exits and common areas and with the notices remaining in place until all enforcement remedies have been officially removed by the Department. (3-17-22) 602. INJUNCTION TO PREVENT OPERATION WITHOUT CERTIFICATE. Notwithstanding the existence or pursuit of any other remedy, the Department may in the manner provided by law, maintain an action in the name of the state for injunction or other process against any person or governmental unit to restrain or prevent the establishment, conduct, management, or operation of an organization without a certificate required under this chapter. For the purposes of these rules, a governmental unit is the state, or any county, municipality, or other political subdivision, or any department, division, board, or other organization thereof. ( ) 603. WAIVERS. Waivers to these rules may be granted through the Department-approved process under Section 67-5230, Idaho Code. ( ) 6034. -- 999. (RESERVED) IdahoAdministrative Bulletin Page 125 June 4, 2025 – Vol. 25-6
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