Methodology

How this data is collected, the framework behind the questions, and what it does and does not claim.

Framework

The survey instrument is structured around the four-quadrant system-stress framework set out in the April 2026 Potentia Public Policy Institute white paper, Strategic Responses to Idaho Medicaid Rate Reductions (Cook, Villegas-Grubbs, Deshaies). Recommendation nine of that paper calls for coordinated tracking of provider closures, service reductions, workforce stress, waitlist growth, denied referrals, and crisis-system utilization. This site implements that recommendation.

Quadrant one — Provider stabilityClosures, downsizing, intake freezes, county or service-line exits.

Quadrant two — Workforce stressVacancy, turnover, overtime, wage levels, agency staffing reliance.

Quadrant three — Access pressureWaitlists, declined referrals, high-acuity refusal, reduced service hours.

Quadrant four — Crisis spilloverER visits, hospitalizations, law enforcement involvement, placement disruptions, crisis episodes attributed to service gaps.

A fifth section captures financial position and direct attribution of changes to the March 2026 rate cuts. A sixth section captures narrative.

Relationship to H.B. 863 cost-survey audits

House Bill 863 directs the Department of Health and Welfare to cost-survey several HCBS service categories annually, with at least 15 percent of responses audited and used to develop future payment rates. The first publicly available audit report is due December 31, 2027.

Services subject to mandatory annual cost survey under H.B. 863

Residential habilitation
Personal care services
Developmental disability agency services
Community-supported employment
Targeted service coordination

Providers must annually expend the appropriated amount allocated to direct care worker wages and employee-related expenses.

This coalition tracks operational impact today; H.B. 863 audits will eventually drive payment rates. The two are complementary and independent.

Who reports

Idaho HCBS providers — residential habilitation, developmental disability agencies, targeted service coordination, certified family homes, behavioral-health and crisis providers, community-supported employment, day habilitation, personal care services, nursing support, and related categories. Participation is voluntary and unpaid. No login is required.

Aggregation and suppression

A reporting period publishes aggregate values only when at least five included submissions exist. Provider categories with fewer than three reporters are suppressed. Counties with fewer than five reporters roll up to their IDHW region. Individual provider responses are never displayed publicly.

A coalition analyst reviews each submission for duplicates and obvious data entry errors before marking it included. The threshold and suppression rules are not configurable through the public site.

What we don't claim

The reporting sample is self-selected, not random. Aggregate values describe what participating providers reported in a given quarter — not the total Idaho HCBS system. Trends across reporting periods are more meaningful than absolute values from any single period.

Definitions

DSP vacancy rateVacant direct support positions divided by total budgeted positions, as a percentage.

Stability changeAny closure, downsizing, intake freeze, beds taken offline, county exit, or service-category exit in the last 90 days.

Crisis spillover eventAn ER visit, hospitalization, law-enforcement contact, placement disruption, or crisis stabilization episode the provider believes was tied to service gaps, staffing shortages, or capacity constraints.

Reporting periodA calendar quarter during which submissions are open. Submissions arriving after a period closes are routed to the next period.