Idaho Medicaid disability Resource Allocation Model

The Resource Allocation Model is a system used by Idaho's Department of Health and Welfare (IDHW) to determine Medicaid in-home care and service budgets for developmentally and intellectually disabled people. 

System 🤖

Operator: Idaho Department of Health and Welfare
Developer: Idaho Department of Health and Welfare
Country: USA
Sector: Govt - health; Govt - welfare
Purpose: Assess care resource requirements
Technology: Resource allocation algorithm
Issue: Accuracy/reliability; Fairness
Transparency: Governance; Black box; Complaints/appeals

Risks and harms 🛑

Idaho's Medicaid Disability Resource Allocation Model has been criticised for unfair and discriminatory benefits/entitlements loss, leading to disparities in access to essential services and support, and poor transparency.

Idaho's Resource Allocation Model hit the headlines in 2012 when the local branch of the American Civil Liberties Union filed a class-action lawsuit after it became clear that the algorithm had severely cut funding for thousands of people who had qualified for the state's Developmental Disability Waiver ('DD Waiver'), without explanation. 

The court determined the formula was 'unconstitutionally arbitrary,' forcing the Medicaid programme to reconfigure its system so that the patients received the proper dollar value services, and restore the dollar value services the patients previously received. 

As part of the 2016 legal settlement (pdf), Idaho's Department of Health and Welfare agreed to work with the Human Services Research Institute ('HSRI') to develop a new resource allocation model by January 2020. Idaho subsequently asked for an extension to 2024 so that it could work with adults with developmental disabilities and their families to develop the new model.

As noted in George Washington University's ETI AI Litigation Database, the settlement provided that the public would have the right to inspect and copy the data 'about the IDHW’s budget setting methodologies, models, and tools,' and DD Waiver programme participants would have the right to inspect past, present, and future information, with redactions involved only when necessary to protect personal information.

Transparency 🙈

Idaho refused access to its tool, and information about its workings, on the basis that acknowledged this was a result of ait was a protected 'trade secret.'

News, commentary, analysis 🗞️

Page info
Type: System
Published: March 2023
Last updated: May 2024