To get YES services, a youth must meet all the following:

• Be a resident of Idaho
• Be under the age of 18
• Have or be at risk for a diagnosis of Serious Emotional Disturbance (SED), which includes a behavioral health diagnosis and at least one (1) functional impairment

Idaho Code 16-2403(13) defines SED as a diagnosis of “an emotional or behavioral disorder, or a neuropsychiatric condition which results in a serious disability, and which requires sustained treatment interventions, and causes the child’s functioning to be impaired in thought, perception, affect or behavior. A disorder shall be considered to ‘result in a serious disability’ if it causes substantial impairment of functioning in family, school or community.” This means that to have a diagnosis of SED, the youth has both a behavioral health diagnosis and a functional impairment.

Providers and assessors use the Comprehensive Diagnostic Assessment (CDA) and Child and Adolescent Needs and Strengths (CANS) assessment tool to see if a youth has Serious Emotional Disturbance. The CDA helps providers understand a youth’s mental state and if they are willing to take part in treatment. It includes a review of the youth’s health history and any family-related issues. The CANS measures a youth’s and family’s needs and strengths. The CANS is used to identify a youth’s level of functioning. Results help guide treatment-planning decisions.
 

The YES system of care is a continuum of services and supports that are organized into a network where:

• Youth and families are empowered to make choices about the youth’s care
• Youth and families partner with providers and public agencies
• Youth and family cultural and linguistic needs are met

The YES website at yes.idaho.gov has information on the YES system of care. It has specific information for youth, families, and providers. Links to resources and YES partner agencies are also on the site.

All YES planning and services adhere to the following YES Principles of Care:

1. Family centered – emphasizes each family’s strengths and resources
2. Family and youth voice and choice – prioritizes the youth’s and family’s preferences in all stages of care
3. Strengths based – identifies and builds on strengths to improve functioning
4. Individualized – customizes care for each youth and family 
5. Team based – brings youth, families, and informal supports together with professionals to identify the youth and family’s strengths and needs, and create, implement, and revise a coordinated care plan 
6. Community-based service array – provides local services chosen by the youth and family
7. Collaboration – brings families, informal supports, providers, and agencies together to meet identified goals
8. Unconditional – commits to achieving the goals of the coordinated care plan
9. Culturally competent – considers the family’s unique needs and preferences
10. Early identification and intervention – identifies mental health concerns and provides access to services and supports as soon as a need is identified
11. Outcome based – contains measurable goals to assess change

The YES system of care includes needs identification, treatment planning and care. The process follows the 6-part YES Practice Model:

1. Engagement – actively involving your child and family in the creation and implementation of their coordinated care plan
2. Assessment – gathering and evaluating information to create your child’s coordinated care plan
3. Care planning and implementation – identifying and providing appropriate services and supports for your child in a coordinated care plan
4. Teaming – collaborating with your child and family, providers, and community partners to create a coordinated care plan
5. Monitoring and adapting – evaluating and updating the services and supports in your child’s coordinated care plan 
6. Transition – altering levels of care and support in your child’s coordinated care plan as needed

For more information, please visit yes.idaho.gov.

The YES system of care includes the following services and supports:

If you are unsure if your youth needs behavioral health services, there are a few things you and your youth can do:

• Complete the YES Screener (Children’s Mental Health Screener). The YES Screener identifies mental health needs your youth may have. Anyone can complete this screener. You can use the one at www.IdahoCMHScreener.com. The results will tell you what to do next. If the results say to call Magellan, call us at 1-855-202-0973 (TTY 711).
• You or your youth can use the Youth Mental Health Checklist for Families. Anyone can use this to see if a youth may benefit from a full mental health assessment from a mental health provider. If you or your youth check one or more boxes on the checklist, call Magellan at 1-855-202-0973 (TTY 711) for help.
• Visit a Magellan network provider for an assessment.
• Call Magellan at 1-855-202-0973 (TTY 711) and we will help you.

Once you learn that your youth needs YES services, your next step will depend on your youth’s needs. Your youth may be able to get services through the Medicaid YES Program or other Medicaid programs.

If your youth already has Medicaid

• Your youth gets YES services through Medicaid. Visit a Magellan network provider for your youth’s care. If you need help finding the right provider for your youth’s needs, call Magellan at 1-855-202-0973 (TTY 711). 
• If your youth needs respite services through Medicaid, they will need to complete an independent assessment with Liberty Idaho Independent Assessment Services (Liberty Idaho IAS). This assessment is needed to qualify for the Medicaid YES Program and to be able to access respite services through Medicaid. See the “Independent Assessments with Liberty Idaho Independent Assessment Services (Liberty Idaho IAS)” section below.

If your youth does not already have Medicaid

Complete an independent assessment with Liberty Idaho IAS to see if your youth can get Medicaid. See the “Independent Assessments with Liberty Idaho Independent Assessment Services (Idaho IAS)” section below.

Your youth only needs to get an independent assessment with Liberty Idaho IAS if:

• They have Medicaid and need respite services
• They need to get Medicaid

If your youth has Medicaid and doesn’t need respite, they do not need an independent assessment with Liberty Idaho IAS. They are free to visit any Magellan network provider for care. You or they can also call Magellan at 1-855-202-0793 (TTY 711).

Independent assessments with Liberty Idaho IAS include a CDA and CANS assessment to see if your youth has SED. To schedule an appointment, contact Liberty Idaho IAS at:

• Email: IdahoYES@LibertyHealth.com
• Phone: 1-877-305-3469 (TTY 711) or 208-258-7980 (TTY 711)
• Web: IdahoIAS.com
• Fax: 208-258-7985

When you first call Liberty, you will talk to a customer service specialist. They will gather basic information about your youth and family. Within one (1) business day, an Independent Assessor will call you to:

• Talk about the assessment process: Take this time to share sensitive information without your youth present.
• Set a date, time, and place for the assessment: Your family will choose a place for the assessment. Choose a place where your youth and family will feel safe and can speak freely. It can be in a home or another community-based location where you can have a private discussion. It can also be virtual.

During the assessment, your youth and family will share your stories. Keep in mind:

• Your youth does not need to be present the whole time.
• Your youth may leave for parts of the discussion.
• Your youth may ask to talk to the Assessor in private.

The Assessor will call you within one (1) business day of the meeting. They will tell you the results of the assessment and if your youth has SED. You can ask any questions about the results or how the SED decision was made.

If the assessor determines that your youth has SED:

• If your youth already has Medicaid, the Independent Assessor will notify the state so that they can update your Medicaid eligibility. Your next step is to have your youth visit a Magellan network provider or call Magellan for help at 1-855-202-0793 (TTY 711).

• If your youth does not already have Medicaid, the next step is to apply for Medicaid for your youth. See the next section on how to apply for Medicaid. You should also call Magellan at 1-855-202-0793 (TTY 711). We can help you while you wait for your youth’s letter of eligibility.

You can apply for Medicaid for your youth through Self-Reliance in one of four (4) ways:

• Online at idalink.idaho.gov. Please ignore any preliminary eligibility determinations displayed online. Instead, wait for your youth’s Notice of Eligibility to arrive in the mail, which takes about five (5) business days.
• By Phone: 1-877-456-1233 (TTY 711)
• By Mail: Download application forms (English or Spanish, in PDF format) at healthandwelfare.idaho.gov/services-programs/medicaid-health/apply-medicaid-0.
• In Person at your local Department of Health and Welfare office.

Remember to tell Self-Reliance that the Independent Assessor determined that your youth has SED and qualifies for the Medicaid YES Program.

• If your youth has benefits through regular Medicaid, CHIP, or Katie Beckett* programs, you will not need to pay for YES services. 
• If your youth has Medicaid through the Medicaid YES Program and your income is below 185% of the Federal Poverty Guidelines (FPG), you will not need to pay for YES services.
• If your youth has Medicaid through the Medicaid YES Program and your income is between 185% and 300% of the FPG, you will need to pay a $15.00 per month premium for Medicaid. You will get a statement each month telling you how to pay. 
  • If your youth is also enrolled in other programs with premiums (CHIP or Katie Beckett), then you will not have to pay the YES premium.
  • Hardship waivers are available if you cannot pay the premium.
• If your income is above 300% of the FPG and your youth is not eligible for Medicaid, call Magellan at 1-855-202-0973 (TTY 711). 

*Katie Beckett is a Medicaid program for children living at home with long-term disabilities or complex medical needs, who may be eligible for Medicaid services even if their family income is above Medicaid federal poverty guidelines.

If your youth has Medicaid through the Medicaid YES program, there are requirements that must be met so that they can continue getting respite and get Medicaid through the Medicaid YES program:

• You and your youth must participate in your youth’s Person-Centered Services Plan within the first 90 days of being enrolled in YES services.
• Your youth must work with Magellan and their provider to complete a Person-Centered Services Plan each year.
• Your youth must use Respite at least once during the year.
• Your youth must complete an independent assessment within 364 days of the previous one.

Liberty Idaho IAS will contact you 60 days before your youth’s yearly assessment due date to repeat the process.

Your youth is free to disenroll from Medicaid YES Program services if:

• They no longer want or need respite services through Medicaid
• They no longer want or need Medicaid at the increased income limits

To disenroll, contact the Division of Self-Reliance at 1-877-456-1233 (TTY 711.)

When you call Magellan after your youth’s assessment and/or they get enrolled in Medicaid, we will ask you a few questions to understand your youth’s and family’s needs. We will help you find a primary mental health provider for your youth if you need one. Then we will talk to you about your Child and Family Team.

Child and Family Team

Youth getting YES services have a formal Child and Family Team (CFT) as a covered service. This means you do not have to pay for your youth’s providers to attend the YES CFT meetings.

At a minimum, the YES CFT includes your youth, your family, and your youth’s primary mental health provider. The YES CFT can also include:

• Other health providers
• A school representative
• Friends
• Neighbors
• Coaches
• Religious leaders
• Other community members the youth and family trust

YES CFTs are formed during the care planning process and continue while the youth is getting services. Your youth’s YES CFT will decide where and how often to hold meetings based on your youth’s and family’s needs. Meetings occur more often during the initial plan development, when there are changes in goals or needs, and during transitions. The team works together to:

• Recognize and encourage the youth’s and family’s strengths
• Identify the needs of the youth and family
• Learn what the youth and family want to accomplish
• Set realistic short- and long-term goals
• Build on the strengths of the youth and family to make needed changes

Each YES CFT works through the six-part YES Practice Model and follows the 11 YES Principles of Care throughout the process. The youth, family, and YES CFT use the results of the CANS and work together to create a person-centered service plan. All person-centered service plans include respite, a crisis plan and a safety plan that help your youth and family:

• Avoid crises
• Address safety concerns during crises
• Predict potential crises
• Identify ways to minimize crises

YES CFTs may operate differently based on the needs of your youth. The frequency of team meetings and intensity of work depends on the needs of your youth and family. It also depends on the type of care coordination your youth may need.

Your youth has care coordination available to them while engaged with YES services. If your youth would like care coordination, their behavioral health provider and Magellan will help determine the right level of support. For more information on care coordination and other services, please see the Care Management section.