Chis: Procedural Requirements

All CHIS identified on a participant's ACTP must be prior authorized by the Department and maintained in each participant's file. CHIS providers are responsible for documenting and submitting the ACTP and obtain PA before delivering any CHIS. (7-1-26) 01. Prior Authorization (PA) Request. Must be submitted to the Department. The provider, and parent or legal guardian will be notified of the decision. (7-1-26) a. Once the initial request for PA is submitted, CHIS may be delivered for a maximum of twenty-four (24) hours and up to thirty (30) calendar days or until the PA is approved. (7-1-26) b. Initial PA requests must include: (7-1-26) i. An order from a provider; and (7-1-26) ii. The ACTP. (7-1-26) c. Ongoing PA requests must include: (7-1-26) i. A list of the participant's goals and objectives; (7-1-26) ii. A written summary of data regarding progress or lack of progress to meeting each objective, including graphs showing change lines; (7-1-26) iii. A list of all CHIS hours being requested and the qualification of the individual(s) who will provide them; and (7-1-26) iv. An updated annual ACTP, if applicable. (7-1-26) d. The following services may be requested retroactively: (7-1-26) i. The initial ACTP; (7-1-26) ii. The screening tool; and (7-1-26) iii. Crisis intervention within seventy-two (72) hours of the service initiation. (7-1-26) 02. Implementation Plan(s). A qualified provider will complete and sign an implementation plan with details on how intervention will be implemented. All implementation plan objectives must be related to a need identified on the ACTP. The provider must document that a copy of the participant’s implementation plan(s) was offered to the participant’s parent or legal guardian. Any restrictive or aversive interventions being implemented must be reviewed and approved by a licensed or certified individual working within the scope of their practice. (7-1-26) 03. Documentation. For each participant, the following program documentation is required for each visit made or service provided: (7-1-26) a. Date, time, and duration; (7-1-26) b. Summary of session or service provided, and if interdisciplinary training is provided, who the service was delivered to, and the content covered; (7-1-26) c. Data documentation that corresponds to the implementation plans for habilitative skill building or behavioral intervention; (7-1-26) d. Location of service delivery; and (7-1-26) e. Signature of the individual providing the service, date signed, and credential. (7-1-26) IDAHO ADMINISTRATIVE CODE IDAPA 16.03.26 Department of Health & Welfare Medicaid Plan Benefits Section 184 Page 57 04. Supervision. Supervision includes both face-to-face observation and direction to the staff regarding developmental and behavioral techniques, progress measurement, data collection, function of behaviors, and generalization of acquired skills for a participant. Supervision must be provided under the requirements of the EBM or each provider qualification. Intervention specialists providing services to children birth to three (3) years old must be supervised by a specialist or professional who also meets the birth to three (3) years old requirements. (7-1-26)