I. Paying for Memory Care in Idaho

The Cost of Memory Care in Idaho

Because of the specialized staff training and resources required to provide high-quality memory care, memory care typically costs more than other types of residential care. On average, memory care will cost 20-30% more than assisted living.

Assisted living in Idaho costs a statewide average of $3,728 a month, according to the 2019 Genworth Cost of Care Survey. This is well under the $4,051 a month seniors pay for assisted living nationwide. Prices within Idaho vary considerably between urban areas. The state capital of Boise, for example, averages $3,952 a month for assisted living, while the least expensive major city in the state, Idaho Falls, averages $602 a month less, at $3,350. Other cities in the state fall somewhere between the two in average monthly price. Keep in mind that these costs will be about $1,000 higher for memory care.

   

Idaho Medicaid Programs for Memory Care

HCBS Aged & Disabled Medicaid Waiver

The HCBS Aged & Disabled Medicaid Waiver pays for caregiver support and medical supplies for seniors with disabilities. Services are available for seniors who live on their own at home, or for residents of adult foster care, assisted living communities and other residential care facilities. Program benefits include adult day care costs, homemaker services and both durable and disposable medical supplies. Respite care is also available to program beneficiaries.

Who is Eligible: Beneficiaries of the HCBS Waiver must be seniors aged 65 and over or other adults who have been designated as disabled by the Social Security Administration. Individuals are restricted to earning less than $2,349 a month, or 300% of the Federal Benefits Rate.

How to Apply: Seniors and loved ones who are interested in applying for the HCBS Waiver may download an application online, or contact the Idaho Department of Health and Welfare by calling 800-926-2588, or by mail at 1720 Westgate Drive, Boise, Idaho 83704.

Personal Care Services Program (PCSP)

The Idaho Personal Care Services Program pays the cost of a personal caregiver for eligible seniors. This program is available for seniors who live at home or in assisted living and adult foster homes, including residential memory care facilities. Program funds pay the caregiver of choice, including family or friends of the beneficiary, to assist with activities of daily living and other personal needs.

Who is Eligible: Seniors and adults with disabilities are eligible for PCSP if they are enrolled in Medicaid and reside at home or in an assisted living or adult foster home. Single adults are limited to a monthly income of $836 a month, while married couples are allowed up to $1,195 a month. Countable assets are limited to $2,000 or less for singles or $3,000 for married couples.

How to Apply: Applicants can request enrollment in PCSP online at the Idaho Medicaid web portal. In-person applications may be submitted at any local Idaho Department of Health & Welfare office in the state.

Medicare Medicaid Coordinated Plan (MMCP)

The Medicare Medicaid Coordinated Plan (MMCP) is an all-inclusive coverage option for seniors in Idaho who are eligible for both Medicare and Medicaid. The program streamlines all service options into a single policy that pays many of the costs of memory care, caregiver assistance and medical supplies. MMCP coverage is available to seniors in all living situations, from private homes to assisted living, memory care facilities and nursing care homes. Plan benefits include personal care services, behavioral and mental health care, inpatient services and medical supplies. Dental care and other supplemental coverage is provided, along with benefits from any private insurance beneficiaries may also carry.

Who is Eligible: MMCP is open to Idaho seniors and adults aged 21 and over who have been diagnosed with a disability. Applicants must meet Medicaid eligibility criteria, including income and asset limitations, as well as reside in a participating county.

How to Apply: Seniors and their caregivers can apply in person for MMCP at any Idaho Department of Health & Welfare office in the state. Phone applications may be submitted via Blue Cross of Idaho at 888-495-2585, or by calling Molina Healthcare of Idaho at 866-403-8293.

More Ways to Pay for Memory Care

In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:

  • Long-Term Care Insurance: Depending on the policy details, long-term care insurance may be used to pay for memory care services. It’s best to sign up for a policy early, as coverage will likely be denied if one already has long-term care needs. More information about the intricacies of long-term care insurance can be found at longtermcare.acl.gov.
  • Reverse Mortgages: Reverse mortgages allow some homeowners to take out a loan as an advance from the eventual sale of their primary residence. This can be a good way to fund memory care in the short-term, but the loans will need to be paid back after the sale of the home. The most commonly used type of reverse mortgages for seniors is the Home Equity Conversion Mortgage, which is the only reverse mortgage insured by the federal government.
  • Veterans Benefits: The Department of Veterans Affairs offers several programs that veterans and their spouses may use to cover health care needs such as memory care. More information about these programs can be found on the VA website.
  • Life Insurance: Some life insurance policies allow policyholders to cash out their policy before a qualifying death. There may be some downsides to accessing a life insurance benefit early, so be sure to read more about the process.

II. Memory Care Laws and Regulations in Idaho

Memory Care Regulation

Memory care facilities in Idaho are regulated as residential care facilities for the elderly by the Idaho Department of Health & Welfare. The department has the authority to license, inspect and regulate all facilities in the state that provide memory care services in a residential care setting. The department conducts both scheduled and surprise inspections to enforce health and safety guidelines for licensed facilities.

Facility Scope of Care

Residential care facilities in Idaho are allowed by the state to provide non-medical care consistent with the needs of seniors with Alzheimer’s disease and other adults with disabilities. Beyond that, licensed staff at memory care facilities can administer medications within their scope of practice, such as registered nurses administering insulin injections. Trained staff members may assist residents with managing catheters, colostomies, incontinence issues and other daily needs.

Facility caregivers may also assist residents with activities of daily living and other needs unrelated to medical issues. Permitted activities include providing transportation off-site, meal preparation and physically and mentally stimulating group activities.

Admission Requirements

All licensed memory care facilities in Idaho must develop a written admissions policy that goes over the specific purpose, quantity and characteristics of the services provided by the facility. Included in the written statement must be an explanation of:

  • Any restrictions imposed by the facility management’s philosophical or religious reasons
  • Limitations on staff services imposed by gender
  • Disclosure of any residents who are registered as sex offenders
Residents Who May Be AdmittedResidents may be admitted when all of their vital needs can be met by the facility’s staff and equipment. Common conditions among new admissions to memory care facilities include:

  • Alzheimer’s disease and other forms of dementia
  • Physical limitations, including limitations on mobility
  • Developmental disabilities
  • HIV/AIDS
  • Traumatic brain injury
  • Age-related conditions that require assistance with activities of daily living
Residents Who May NOT Be AdmittedResidents who require care beyond the scope of the facility, including those who:

  • Need continuous IV or TPN therapy
  • Require nursing services for longer than 30 days
  • Have had a gastrostomy tube, arterial-venous (AV) shunts, or supra-pubic catheter inserted within the previous 21 days
  • Must be confined by restraints, not including locking wheelchairs
  • Are in a comatose state, other than hospice care admissions where a doctor has assessed a likely end of life within 14 to 30 days
  • Have a stage III or IV pressure ulcer or other open wound that is not visibly improving
  • Have a tracheotomy or other complex medical device necessary for life
  • Are currently in the active phase of a MRSA infection
  • Have behavioral issues not compatible with other residents of the facility
  • Are not capable of self-evacuation in the event of an emergency

Care Plan Requirements

Facilities providing memory care must develop and maintain a written care plan for all new admissions. The care plan must include the identity of any outside agency that helped develop it, as well as the identities of any authorized parties who have decision-making authority for the resident. Care notes must be included in the plan that go over needed treatments, medical office visit schedule and physical or mental therapy needs.

Medication Management Requirements

Facilities may keep and dispense medications in accordance with Idaho standards for pharmacy medication management. All prescription medications stored onsite must be dispensed by a licensed pharmacist and kept in a secure and locked container. Nurses on staff may prepare blister packs of medication for residents and assist with taking them within the scope of nursing care. Residents who are capable of self-management may do so, but in all cases facilities are required to log and report missed doses of prescribed medications.

Facility Requirements

All facilities providing memory care in the state of Idaho must obtain and display a current license issued by the state. Rooms may be private or contain a maximum of two residents. Facilities must have at least one toilet for every six residents and one shower with an ADA-accessible bathtub for every eight residents. Bathrooms must be accessible without having to pass through a private room. All common areas of a facility must be accessible to wheelchair traffic, and fixtures in bathrooms must be equipped with grab bars and other safety devices. Shared closet spaces must have internal dividers and a door that closes. Every resident must have access to an emergency call system that is in proper working order.

Staffing Requirements

Facilities licensed for 15 or fewer residents must have at least one staff member present at all times who can assist residents as needed, including those identified as needing night care. Larger facilities must have a staff member who is awake and able to respond immediately 24 hours a day.

Medicaid Policy

Idaho Medicaid can pay for some of the costs related to residential care in a nursing care home or adult day care. Medicaid does not directly pay for the costs of memory care in Idaho, though several waivers are available for seniors who need help managing their activities. One waiver, the HCBS Aged & Disabled Medicaid Waiver, pays for services and other support for seniors in an adult foster home. Another waiver, the Medicare Medicaid Coordinated Plan (MMCP), is open to seniors who are “dual-eligible” for both Medicare and Medicaid.

Reporting Abuse

Suspected cases of senior abuse or neglect can be reported to law enforcement or online via the Idaho Adult Protective Services online reporting tool. APS is a division of the Idaho Commission on Aging, which may be reached by phone at 877-471-2777, or by mail at:

6305 W. Overland Rd.
Ste. 110
Boise, Idaho 83709

III. Free Memory Care and Alzheimer's Resources in Idaho

ResourceContactDescription
Alzheimer’s Association Greater Idaho Chapter800-272-3900The Alzheimer’s Association Greater Idaho Chapter assists with funding long-term care and caregiver support for families of seniors with Alzheimer’s disease. The association operates a 24/7 helpline for referrals and crisis intervention. Seniors with dementia can get referrals to participate in medical trials through the association’s Idaho branch office.
Advanced Clinical Research (ACR) Idaho208-955-9030ACR provides free Alzheimer’s and dementia screening services throughout the state of Idaho. Seniors may be offered placement in a paid research study that offers screening, medical exams and other services for study participants.
Alzheimer’s Idaho208-914-4719Alzheimer’s Idaho provides multiple free services for seniors with Alzheimer’s and dementia. Volunteers accompany seniors with dementia on scheduled outings and nature walks, no-cost meal services and assistance with residential care placement. Alzheimer’s Idaho also supports caregivers with training and subsidized respite care services.
Idaho Commission on AgingContact a local Area Agency on AgingThe Idaho Commission on Aging offers several programs to help care for seniors with Alzheimer’s and dementia. One program offers congregate meals at locations across the state. Meals are provided at local senior centers at no cost to guests. Caregivers and family members are welcome to attend.