Idaho DD Waiver vs. private-pay sitter — a plain comparison

The DD Waiver — full name 'My Voice, My Choice' — is a Medicaid-funded program in Idaho for individuals 18 and older with a qualifying intellectual or developmental disability. It allows self-direction: the participant or their family chooses and hires direct-care staff through a fiscal-management agent.

The Waiver pays for things like daily routines, community access, supported employment, and respite. The hourly rates are set by Idaho Medicaid and the staff are W-2 employees of a fiscal agent, not contractors of the family.

Individuals 18 or older with a qualifying IDD diagnosis (intellectual disability, autism spectrum, cerebral palsy, epilepsy diagnosed before age 22 with significant cognitive limitations, or other developmental disability). Initial eligibility goes through the Idaho Department of Health and Welfare. There is an application process, paperwork, and sometimes a wait list.

Children under 18 do not qualify for the DD Waiver specifically — different programs apply, including the Children's Developmental Disabilities Waiver and the BPA Health Vouchered Respite Program for kids with a Serious Emotional Disturbance (SED) diagnosis.

Once a participant is on the Waiver and elects self-direction, the family becomes responsible for hiring, supervising, and managing direct-care staff. The family identifies who they want to work with, the fiscal agent handles payroll and HR formalities, and Medicaid pays the bill at the Waiver rate.

This is genuinely empowering for families who know who they want — a specific DSP from the community, a trusted family friend, or a former paraeducator who already knows their adult child. The family has hiring control.

Our platform is private-pay only. No insurance billing. No Medicaid. The sitter is paid by the family directly.

We are built for the gaps:

• • Date nights, weddings, family events — the kinds of bookings that do not fit a routine Waiver schedule.
• • Last-minute needs. Waiver scheduling is built around enrolled staff with cleared paperwork. We can match same-day.
• • Families who do not qualify for the Waiver. Kids under 18, adults whose diagnosis is not on the qualifying list, families who do not want the paperwork.
• • Specific credentials. If you want a Registered Behavior Technician for a specific evening because your adult son is most at ease with someone from that background, our platform surfaces RBTs.

Not through our platform. We do not bill Medicaid and our sitters are not enrolled as Waiver staff while they are sitting through us.

If a sitter from our platform is willing to also work as your Waiver-direct-hire staff outside our platform — through your fiscal agent, on the Waiver's terms — that is a private employment arrangement between you and them. We do not facilitate it, supervise it, or take a cut. Different work, different rules, different rate.

If you qualify for the Waiver and the Waiver covers what you need, the Waiver is almost always cheaper than private pay. Use it.

If you do not qualify, or if you have used your monthly Waiver hours and still need an evening, or if you want occasional flexibility that the Waiver structure does not provide — private pay is what we are for.

Many families use both. Waiver hours for routine weekday support, private-pay sitting for the wedding and the dentist appointment.