Title V MCH – Title XIX Medicaid Inter-Agency Agreement (IAA)

The Idaho Divisions of Public Health and Medicaid are both located within the Idaho Department of Health and Welfare (DHW), which enhances shared opportunities for systems-building and policy development. The current Memorandum of Understanding between the Divisions of Public Health, Medicaid, and Welfare (see Attachment) seeks to improve public health service delivery and public health outcomes for low-income populations. Specifically, the divisions share available data; coordinate administration of programs designed to improve the health of women of child-bearing age, infants, children, and children and youth with special health care needs (CSHCN); and coordinate implementation of policies that affect shared populations. In addition, the MCH Program coordinates with Medicaid to promote awareness of programs, promote healthy behaviors, and facilitate referrals to appropriate benefit programs, with an emphasis on CSHCN. Meaningful collaboration between Title V and Medicaid has ebbed and flowed over recent years due to staff turnover, which results in a continuous need for re-education about Title V and relationship-building efforts. The MCH Program aims to increase communication and partnership opportunities with Medicaid in the coming year to improve coordination of services and systems-building efforts.

Idaho Medicaid utilizes a managed care approach through the Idaho Behavioral Health Plan which provides services for children with serious emotional disturbance and adults with serious mental illness or serious and persistent mental illness, as well as any adults or children who manifest symptoms indicative of behavioral health issues. The plan is administered by Optum Idaho, which is accredited by the National Committee for Quality Assurance (NCQA).

In 2020, Idaho Medicaid had proposed state plan amendments for children’s enhancement services related to behavioral intervention, crisis intervention, family directed services, community-based supports, and respite. Idaho Medicaid has the following approved waivers that are relevant to MCH populations:

• Idaho Behavioral Health Plan
• Act Early Waiver
• Children’s Disabilities Waiver
• Dual-eligibility Waiver
• Dental Waiver (1915b)
• Home visiting

During the 2020 legislative session, the Idaho Legislature passed an appropriations bill directing Medicaid to submit a State Plan Amendment (SPA) to allow for home visiting services as part of Medicaid services. The SPA was submitted in August 2020 and approved in November 2020 with a retroactive reimbursement date of July 1, 2020. Initially, Medicaid reimbursement is limited to two home visiting models: Parents as Teachers (PAT) and Nurse Family Partnership (NFP). The MCH Program, MIECHV Program, and the Division of Medicaid are working together to operationalize the new reimbursement benefit and standardize reporting requirements.

In 2020, the MCH Program was invited to work with Idaho Medicaid, the Division of Behavioral Health, and the Center for Drug Overdose and Suicide Prevention on an application for technical assistance through the National Academy for State Health Policy (NASHP) MCH Policy Innovation Program. The Idaho Team applied to focus primarily on Medicaid-eligible pregnant women who are struggling with substance use disorders. The policy academy will span two years and provide teams with technical assistance to implement policies and improve health care delivery systems and related supports for Medicaid-eligible pregnant and parenting women.