FAQs

An appeal is a written or verbal request to the State or its contractors, such as Medicaid or the Idaho Behavioral Health Plan, to review and change a decision made about your youth’s care.

An Adverse Benefit Determination (ABD) letter is sent by Magellan Healthcare when they:

• Denies (turns down) services or approves fewer services than you or your provider wanted
• Reduces, suspends, or terminates a previously approved service
• Denies part of or all of a payment to your provider

The ABD letter also explains the decision that was made, your right to appeal, and your right receive information used in making the decision.

An ABD letter may also be called a notice of decision or notice of action.

• A denial or termination of Medicaid eligibility
• A denial, reduction, or termination of Medicaid funded services or supports (including EPSDT determinations)
• A Medicaid benefit determination made by the Idaho Department of Health and Welfare or the independent assessment contractor, Liberty Healthcare, that a youth does not meet the following criteria for serious emotional disturbance (SED):

                 ◦ A functional impairment identified by the Child and Adolescent Needs and Strengths (CANS) assessment

                 ◦ A mental health diagnosis identified by a Comprehensive Diagnostic Assessment (CDA)

• Failure to provide YES services or supports the youth is entitled to under Appendix C of the Jeff D. Settlement Agreement: Objective-C-IAP.pdf (idaho.gov)
• When requests for eligibility or services are not acted upon with reasonable promptness

Individuals who disagree or are not satisfied with a written notice of decision made by the Department of Health and Welfare or its contractors. If an individual has not received a written notice of decision following a verbal notice of decision within a reasonable time, an appeal can be submitted. The Department of Health and Welfare’s contractors include the Idaho Behavioral Health Plan, Liberty (Independent Assessments), and MTM (Non-Emergency Medical Transportation).

Yes, an attorney, community advocate, or any person you choose that has your permission may represent you at any point in an appeal. You are responsible for any fees charged by the person representing you.

A family member, a provider, or someone else who has permission from the youth and/or family to act on their behalf.

You can submit an appeal in person, via a website, fax, telephone, mail, or e-mail. Contact information for submitting an appeal can be found on your Notice of Decision or in the Appeals Contacts section of the YES website appeals webpage. The appeal form can be found here: Fair Hearing Request (idaho.gov)

Youth and their families have the right to request a copy of all documentation used in making decisions and/or their entire record on file.

• You can request any records the Department of Health and Welfare’s contractor used in making a decision by contacting them directly and requesting it. Contact information will be on the decision letter you received.
• You can also submit a public records request to the Department of Health and Welfare by emailing PRR@dhw.idaho.gov. A youth that is 14 years old or older must sign the request in addition to their guardians. Please note, the Public Records Request unit tracks all requests for personal records, but they are not public records requests. More information about how to request records can be found at the Public Records Request webpage: https://healthandwelfare.idaho.gov/news-notices/public-records-requests.
• You may also request records from your providers. If you are having difficulty requesting this information, the Department or its Contractors may be able to help you.

You can submit information to support why you think the decision should be changed. It is not required to submit this information. Examples include:

• A copy of the “notice of decision” or “adverse benefits determination” letter – although it is not necessary or required for an appeal
• Medical/behavioral health provider records and hospital records
• An explanation of why you disagree with the decision and what services you insist are medically necessary to address the needs of the youth
• Medical referrals
• Letters from the treating providers
• Emails

• If you are on Medicaid and are already receiving services that have been reduced or denied, you may request to continue to receive these services while you are waiting for an appeal decision. This is called “Continuation of Benefits.”
• You must submit an expedited or urgent appeal within 10 days from the date on the notice of decision. If the denial you are appealing is upheld, you may be responsible for the cost of the services.

• You have 60 days from the date Magellan Healthcare makes a decision on a requested service to submit an appeal to them.
• If you are not satisfied with Magellan’s appeal decision, you have 120 days from the date Magellan Healthcare makes an appeal decision to submit an appeal to the Department of Health and Welfare.

• You have 28 days from the postmark date of the notice of decision to submit an appeal for denial of medical services and supports, transportation, independent assessment, hospital or residential behavioral health care, pharmacy, and any other medical decisions.

• You have 30 days from the postmarked date of the notice of decision to submit an appeal for a denial for or change to your youth’s Medicaid eligibility (for example, losing Medicaid coverage).

• You can request an Expedited or Urgent appeal with Magellan Healthcare if you feel that waiting up to 30 days for an appeal decision could jeopardize the youth’s life, health, or ability to regain maximum functioning. Magellan Healthcare will decide if your appeal meets urgent criteria. If your provider supports the urgent request Magellan Healthcare will automatically grant the urgent appeal. If the urgent appeal is not granted, Magellan Healthcare will notify you and give you a decision within 30 calendar days.
• You can submit letters from treating providers and other information to establish the need for an Expedited or Urgent appeal.
• When you submit your expedited/urgent appeal use the contact information on the notice of decision letter.

• You can use the Medicaid Appeal Request Form in the Resources section of this page, check the box in Section 3 to indicate that you are requesting an expedited appeal. If you are submitting your appeal in any other way, be clear that you are asking for an expedited, urgent, or fast appeal.
• When you submit your expedited/urgent appeal follow the instructions on the Medicaid Appeal Request Form.

• For a standard appeal submitted to Magellan Healthcare, a decision will be made within 30 calendar days.
• For an expedited/urgent (fast) appeal, a decision will be made within 72 hours.
• If you submitted a standard appeal to the Department and the appeal goes to a State Fair Hearing, the time to make a decision may be longer. Once the hearing is held, the Hearing Officer will make a decision within 30 calendar days for a standard appeal and as soon as possible for an expedited appeal.

• For an appeal submitted to a contractor, the contractor will review the documents submitted to support your appeal, all documents in your case that were used to make the decision that you are appealing, and criteria for the service that was requested. A different person than the one who made the original decision will conduct this review. The contractor will communicate the outcome to you in writing within 30 days. If you disagree with the outcome of this appeal, you can follow instructions on your appeal resolution letter to submit an appeal to the Department and request a State Fair Hearing.
• For an appeal submitted to the Department, the Department will first conduct an internal review (sometimes called an “informal review”) of the appeal. The internal review includes reviewing all the documents submitted to support your appeal, all documents in your case file that were used to make the decision you are appealing, and criteria for the service that was requested. A different person than the one who made the original decision will conduct this review. The Department will communicate with you about the preliminary outcome of the internal review within the 30 days. 
• If you disagree with the Department’s internal review, a State Fair Hearing will be scheduled with the Office of Administrative Hearings (OAH) at the earliest available date. State Fair Hearings are all telephonic (over the phone). The date of the hearing is selected by the Hearing Officer and sent to you via mail or email with a date, time, and call-in information. If the date or time do not work for you, please follow the instructions on your Notice of Scheduling to request a new date. The Notice of Scheduling will also include information on how to submit supporting documentation (called ‘exhibits’) and how to have people to support you at the hearing (called ‘witnesses’).
• At the hearing you will have the right to present witnesses and documents to support your appeal and to ask the Department’s witness questions about the decision. After the hearing, the Hearing Officer will issue a decision in no more than 30 calendar days. More information on the hearing process is available in the YES Practice Manual Guide to YES: A Practice Manual.
• If you would like copies of any of the information and documentation used in the internal review or used in making the decision, you may request them from the Department or the contractor. Please see the Frequently Asked Question titled, “How do I request records used in making the decision that I want to appeal?”

• If you submitted an appeal to Magellan Healthcare and you have not received a notice of decision on your appeal within 30 days, you may submit an appeal to the Department without waiting for a decision from Magellan Healthcare.
• If you submitted an appeal to the Department or another contractor (Liberty, MTM, etc.), please reach out directly to the contact you filed your appeal with to inquire about the status of your appeal. Contact information can be found on your notice of decision letter or in the Appeals Contacts section this webpage.

Please reach out directly to the contact you filed your appeal with and inquire about the status of your appeal. Contact information can be found on your Notice of Decision or in the Appeals Contacts section of this webpage.

• If the deadline for submitting for an appeal is coming up and you do not have information you requested from your provider, you can file your appeal without it. The documentation can be submitted after you request an appeal.
• If you are having trouble getting the supporting documents you requested from your provider, notify the Department of Health and Welfare and they can request that documentation for you.
• If the date for a State Fair Hearing is coming up and you do not have the paperwork or documentation you need to submit to support you during the hearing, contact the Office of Administrative Hearings (OAH) by emailing them at: health.filings@oah.idaho.gov or call them at: (208) 690-2242. They may suggest you work with the Department of Health and Welfare to reschedule the hearing to a later date. When rescheduling a hearing, the Office of Administrative Hearings (OAH) will request you and the Department of Health and Welfare submit three dates and times that you agree work for both of you. They will select one time out of those and reschedule the hearing.

• To ensure your standard appeal request was received, please wait five (5) business days to allow the agency you filed the appeal with to document and begin the appeal process.
• To ensure your expedited appeal request was received, please contact the agency you filed the appeal with the next business day.

• No. An appeal cannot be submitted due to inability to locate a provider for services.
• If you can’t find a provider or access a recommended service, please contact Magellan Healthcare to help you locate a service provider or alternative service.
• If Magellan Healthcare cannot find you a provider or alternative service, you can file a complaint with Medicaid using the form on the YES website at Youth Empowerment Services Concern and Complaint Form (keysurvey.com) or by emailing YES@dhw.idaho.gov.  

The complete appeal and fair hearing process can be found in the YES Practice Manual Guide to YES: A Practice Manual | YOUTH EMPOWERMENT SERVICES (idaho.gov)

• If you feel you are being retaliated against or if you have any other concerns, you are free to submit your questions or file a complaint directly by using this link: Youth Empowerment Services Concern and Complaint Form (keysurvey.com) or by emailing YES@dhw.idaho.gov. You can submit your questions or complaint anonymously.
• Idaho Parents Unlimited (IPUL) – State-contracted YES Advocacy, Education, and Support: parents@ipulidaho.org.

• Any of the contacts in the Appeals Contacts section of this webpage.
• These contacts include the Department of Health and Welfare’s divisions of Medicaid, Behavioral Health, and Welfare/Self-Reliance, and Magellan Healthcare.
• Idaho Parents Unlimited (IPUL) – State-contracted YES Advocacy, Education, and Support: parents@ipulidaho.org.

• The Department of Health and Welfare ‘s Contested Case Rules: IDAPA 16.05.03

IDAPA 62 – Office of Administrative Hearings

• The federal Managed Care Organization grievances & Appeals: eCFR :: 42 CFR Part 438 Subpart F — Grievance and Appeal System
• The federal Medicaid Regulations: 42 U.S.C. section 431.200 Fair Hearings

 eCFR :: 42 CFR 431.200 — Basis and scope. 

• The Jeff D YES Due Process Protocol: YES Due Process Protocol (idaho.gov)

The Youth Empowerment Services (YES) system of care is a comprehensive array of mental health services and supports that are organized into a coordinated network to meet the changing needs of youth who are at risk for or have serious emotional disturbance (SED), and their families. 

YES is a strengths-based and family-centered system of care that incorporates a teaming approach to provide individualized care for youth. This means the youth and their family drive the decisions for their care and work with a team to develop a plan that is designed to meet the child’s and family’s needs with appropriate services and supports located in the youth’s community.

Some of the most important concepts in YES include:

• Child and Family Teams
• Principles of Care
• Practice Model
• Coordinated Care Plans

You can learn more about these concepts in the Guide to YES: A Practice Manual.

The following partners developed the YES system of care:

• The Idaho Department of Health and Welfare including the Divisions of Behavioral Health, Child, Youth, and Family Services (CYFS), and Medicaid.
• The Idaho Department of Education
• The Idaho Department of Juvenile Corrections
• Parent and Youth Partners
• Mental health providers

YES provides access to mental health services and supports for youth under the age of 18 who who are at risk for or have serious emotional disturbance (SED). SED is a mental health diagnosis combined with a functional impairment.

Youth and families are the primary decision makers in their care. They, along with their mental health provider and the rest of their Child and Family Team (CFT), set goals, develop plans, and determine services and supports.

The Idaho Children’s Mental Health Screener is an online tool that can be used to help identify youth with unmet mental health needs. 

This screener was developed from the Child and Adolescent Needs and Strengths (CANS) tool. CANS certification is not required to use the screener and the Idaho Children’s Mental Health Screener cannot be used in place of a complete CANS assessment. It is one of many tools a provider can use to identify unmet needs.

The screener was specifically designed for practitioners in a non-mental health setting. Family doctors, probation officers, human services, education providers, and others may use the screener if there is an indication that the youth may need help with their mental health.

Learn more from the resources listed below.

• CMH Screener Manual
• CMH Screener 
• How to use the CANS Screener

Serious emotional disturbance (SED) is a legal term used when youth under the age of 18 have both a mental health diagnosis and a functional impairment as identified by the Child and Adolescent Needs and Strengths (CANS) tool.

Idaho’s legal code* uses this definition:
“Serious emotional disturbance” means 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…”

A youth has SED if they have both a DSM diagnosis and a functional impairment as identified by the Child and Adolescent Needs and Strengths (CANS) tool.

* Idaho Code,16-2403(15)

• Engagement – Youth and families are actively involved in the creation and implementation of their coordinated care plan.
• Assessment – Information about the youth and family is gathered to create a meaningful coordinated care plan.
• Care Planning & Implementation – The coordinated care plan identifies appropriate services and supports and how families and youth access them.
• Teaming – Youth and families are able to collaborate with providers and community partners to create their coordinated care plan.
• Monitoring & Adapting – The services and supports in the coordinated care plan are evaluated and updated as needed.
• Transition – Type of services, frequency of use, and levels of care change as the youth and family’s needs change.

The YES system of care prioritizes the following values throughout treatment planning, implementation, and evaluation:

• Family and Youth Voice and Choice – Prioritizes the preferences of youth and their families in all stages of care.
• Individualized Care – Customizes care specifically for each youth and family.
• Community-Based Service Array – Provides local services to help families reach the goals identified in their coordinated care plan.
• Unconditional – Commits to achieving the goals of the coordinated care plan.
• Early Identification and Intervention – Assesses mental health and provides access to services and support.

To be eligible to administer the Idaho CANS, providers must be certified.  Recertification is required annually. Providers can register for CANS certification trainings at the Idaho TCOM Institute website.    

Schools do not directly provide services as part of the YES system of care, but school staff may participate on a Child and Family Team (CFT), help a family complete the CANS with the family’s mental health provider, or support the goals identified on the coordinated care plan. How schools choose to get involved varies between districts, and families are encouraged to discuss involvement with their local school staff.

A Child and Family Team (CFT) is a group of caring and invested people who are invited by the youth and family to work together to help create a coordinated care plan. Members of the CFT include the youth, the family, and the mental health provider, but may also include extended family, friends, individuals from child-serving agencies, and community members.

The youth and family are essential Child and Family Team members, and a CFT may not meet without them. Families and youth are supported, valued, and respected by other members of the team. They lead the team in identifying short and long-term goals for the coordinated care plan.

Child and Family Teams meet as needed to create the coordinated care plan and then update it as treatment progresses and the needs of the youth and family change. The length of time that a CFT may meet depends on the needs of the youth and family. Members of the CFT may change over time.

Serious emotional disturbance (SED) is a legal term used when youth under the age of 18 have both a mental health diagnosis and a functional impairment as identified by the Child and Adolescent Needs and Strengths (CANS) tool.

Idaho’s legal code* uses this definition:
“Serious emotional disturbance” means 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…”

A person has SED if they have both a DSM diagnosis and a functional impairment as identified by the Child and Adolescent Needs and Strengths (CANS) tool.

* Idaho Code,16-2403(15)

The Child and Adolescent Needs and Strengths (CANS) tool is used in Idaho to identify a youth’s strengths and needs, including a functional impairment. The CANS uses the youth and families story to recognize strengths that can help during treatment, as well as needs that may require intervention. The results of the CANS are used to help identify appropriate services and then help monitor progress towards goals.

The CANS looks at different areas of your child’s life, such as:

• Their past experiences.
• Individual strengths.
• Social and family interactions.
• Their emotional needs.
• Their activities.

The CANS results provide a common language for everyone working with your child to communicate about their treatment goals. The CANS also considers the family’s needs and strengths as an important part of developing the treatment plan.

Along with a diagnosis from the current version of the Diagnostic & Statistical Manual of Mental Disorders (DSM), the CANS helps to determine if a youth has serious emotional disturbance (SED) and meets the criteria for YES services and supports.

If you would like to learn more about the CANS, visit the Praed Foundation website.

Coordinated care plans are created by Child and Family Teams (CFT) and identify services and supports in the community that may help the youth and family reach their treatment goals.

If a youth has gone to the Independent Assessor and they are eligible for Medicaid, they will create a coordinated care plan that includes a person-centered service plan.

Treatment goals in coordinated care plans are measurable, assess change (but not compliance) and encourage the youth and family to work towards wellness and self-sufficiency. All types of coordinated care plans also include mental health crisis and safety plans.

The YES system of care prioritizes the following values throughout treatment planning, implementation, and evaluation:

• Family-Centered – Emphasizes each family’s strengths and resources.
• Family and Youth Voice and Choice – Prioritizes the preferences of youth and their families in all stages of care.
• Strengths-Based – Identifies and builds on strengths to improve functioning.
• Individualized Care – Customizes care specifically for each youth and family.
• Team-Based – Brings families together with professionals and others to create a coordinated care plan.
• Community-Based Service Array – Provides local services to help families reach the goals identified in their coordinated care plan.
• Collaboration – Partners families, informal supports, providers, and agencies together to meet identified goals.
• Unconditional – Commits to achieving the goals of the coordinated care plan.
• Culturally Competent – Considers the family’s unique cultural needs and preferences.
• Early Identification and Intervention – Assesses mental health and provides access to services and supports.
• Outcome-Based – Contains measurable goals to assess change.

• Engagement – Youth and families are actively involved in the creation and implementation of their coordinated care plan.
• Assessment – Information about the youth and family is gathered to create a meaningful coordinated care plan.
• Care Planning & Implementation – The coordinated care plan identifies appropriate services and supports and how families and youth access them.
• Teaming – Youth and families are able to collaborate with providers and community partners to create their coordinated care plan.
• Monitoring & Adapting – The services and supports in the coordinated care plan are evaluated and updated as needed.
• Transition – Type of services, frequency of use, and levels of care change as the youth and family’s needs change.

There are multiple tools available to help you determine if your child may benefit from a full mental health assessment.

• Mental Health Checklist for Youth — Designed to be used by families.
• Youth Mental Health Checklist— Designed to be used by the youth.
• Child and Adolescent Needs and Strengths (CANS) screener — Designed for use by medical professionals and families.
• Speak with your child’s medical provider.

A mental health assessment, sometimes called a comprehensive diagnostic assessment (CDA), is a process where a licensed clinician reviews the history of the person seeking care, conducts a clinical interview, and evaluates any available data to identify mental health issues and service needs. A completed CDA includes background information, the results of a mental status exam, and a mental health diagnosis, if appropriate.

The Child and Adolescent Needs and Strengths (CANS) tool is often used at the same time as a CDA, as it helps the family share their story with the mental health provider. While the CDA identifies a mental health diagnosis, the CANS helps to identify specific needs that may benefit from treatment.

Not everyone who has a mental health concern has serious emotional disturbance (SED), but other types of mental health issues can also benefit from treatment. Completing a mental health assessment can help you decide if mental health care could help your child.

Contact the Idaho Behavioral Health Plan Managed Care Contractor, Magellan Healthcare, www.magellanofIdaho.com (if your child is currently eligible for Medicaid), or your private insurance company for local resources.

Access to the YES system of care is available to all Idaho youth under the age of 18 who have a mental health diagnosis and a functional impairment. For Medicaid eligible youth, Medicaid covers many of the services that are part of the YES system of care. For youth who do not qualify for Medicaid, services may be accessed for a fee through Idaho Behavioral Health Plan Managed Care Organization Magellan Healthcare.

Beginning January 1, 2018, the Idaho Legislature raised the qualifying federal poverty guideline (FPG) for Medicaid to 300% for children with serious emotional disturbance (SED). This means there are higher household income limits for children with SED to qualify for Medicaid coverage.

To see if your family may be eligible under these new limits, please take a look at the current Federal Health and Human Services Poverty Guidelines.

Please note: The information provided on this site represents 100% of the FPG and does not take into account allowable income exceptions. The only way to know if a child with SED will qualify for Medicaid under these higher income limits is to apply. Because of the increased income eligibility, the automated system may issue a preliminary denial. A final Medicaid eligibility determination is manually reviewed and a letter is sent in the mail.

Before you apply for Medicaid under the 300% FPG, your child will need to have an independent assessment. Please call the Independent Assessor to schedule an in-home appointment.

Youth who have SED and qualify for Medicaid with a household income over 185% and below 300% of the FPG are responsible for paying a monthly premium of $15.00.

If a youth is eligible for Medicaid and/or respite coverage after visiting the Independent Assessor, annual independent assessments and eligibility redeterminations are required to maintain Medicaid eligibility. In addition to annual reviews, youth who visit the Independent Assessor will complete a person-centered service plan as part of their coordinated care planning process.

Coordinated care plans are created by the Child and Family Team (CFT) to coordinate the care being given by all providers. Treatment plans explain only the service or support being offered by that specific provider.

Each provider creates an individualized treatment plan to explain how they plan to help the youth reach the goals identified in the coordinated care plan. They also identify the strength being built or the need being addressed with measurable goals.

The YES system of care looks a little different when a youth is in the custody of a county detention facility or the Idaho Department of Juvenile Corrections. In those cases, the Child and Family Team (CFT), which may be called a treatment team, has members from county or state child-serving agencies, and the services and supports may not be community-based or voluntary. While every effort is made to include families on these teams, court orders must be followed, and that may impact the ability for the family to participate. The services identified by the treatment team reflect the services available in the facility and may include different services than are available in the community.

The answer to that question depends on how your child accesses the YES system of care.

If your child needs a service that isn’t available in your community, you may contact the Idaho Behavioral Health Plan managed care organization, Magellan Healthcare,  and ask them to find a provider in your area. If the service you need (or the requested amount of the service) is not a part of the Idaho Behavioral Health Plan (IBHP) you may apply for Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services to help your child access the service. Families will still be responsible for the cost of premiums and co-pays up to 5% of the household’s modified adjusted gross income (MAGI).

Most schools do not directly provide services as part of the YES system of care, but school staff may participate on a Child and Family Team (CFT), help a family complete the CANS with the family’s mental health provider, support the goals identified on the coordinated care plan, or provide in-school supports. How schools choose to get involved and the resources available vary between districts, and families are encouraged to discuss involvement with their local school staff.

The Child and Adolescent Needs and Strengths (CANS) is a tool that looks at different areas of your life, such as:

• Your past experiences.
• Individual strengths.
• Social and family interactions.
• Your emotional needs.
• Your activities.

The CANS identifies areas where you show strength and areas where you need support. You can then use this information to create a plan to improve your mental health.

One benefit of using the CANS to create your plan is that it gives everyone a common language when talking about your care. This means that everyone involved in helping you will know what goals you are working on and what strengths you have to help you along the way. Youth Empowerment Services (YES) is based on a youth-involved team approach to planning, so this common language with common goals will help you design a plan that works for you.

There is a Youth Mental Health Checklist to help you decide if you need help with your mental health. After using the checklist, take a look at your answers. If you answered yes to any of the statements, then you may benefit from a full mental health assessment. 

Completing a mental health assessment will help you decide if behavioral health care may be helpful.

If you are comfortable, ask your parents or guardians to contact a local behavioral health provider to schedule an assessment. If you or your parents need help locating a behavioral health provider for an assessment, you can contact the Idaho Behavioral Health Plan, Magellan Healthcare, 1-855-202-0973. Magellan Healthcare can help you if you have Medicaid, no insurance, or private insurance. If you have private insurance, you can also contact your insurance company for local resources.”

If you are not comfortable talking to your parents, you can talk to another responsible adult such as a friend’s parent, a teacher, school nurse, guidance counselor, a doctor, or a leader at your church. If they have questions about the process or Youth Empowerment Services (YES), show them this website, YES 101 or YES for Youth.

If you have family or friends who may benefit from the Youth Empowerment Services (YES) system of care, you can share this website, give them the YES 101, or talk to them about finding a mental health provider. You can also be supportive of their mental health goals and join their Child and Family Team (CFT) if they ask you.

If you are worried about the safety of a friend or family member who may struggle with mental health concerns, you can:

• Call (24 hours a day, 365 days a year) or text the Idaho Crisis and Suicide Hotline at 988.

Call 9-1-1 if they need immediate help to be safe.

If you are new to the mental health system and would like more information on how to get started, visit the YES Publications page or read the YES 101 guide. It can help you find information about:

• Mental health assessments.
• Serious Emotional Disturbance (SED)
• Finding out if you have Medicaid or are eligible, and how to get services even if you don’t qualify for Medicaid.
• How a group of people dedicated to working with you can help as your “Child and Family Team”

That is a hard question to answer because everyone has a different story. 

What we do know is that having a diagnosis and the results from a Child and Adolescent Needs and Strengths (CANS) can give you valuable information about yourself. Knowing what your strengths are can help you focus on what works for you. Knowing what your needs are can help you find supports. Having a diagnosis can help your doctor understand your medical needs. Together, those things can help you.

If you need to speak to someone about your mental health you have options.

If you are looking for a counselor or other behavioral health care provider you can speak with your regular doctor.

Or, if you or your parents need help locating a behavioral health provider for an assessment, you can contact the Idaho Behavioral Health Plan (Magellan Healthcare, MagellanofIdaho.com). Magellan Healthcare can help you if you have Medicaid, no insurance, or private insurance. If you have private insurance, you can also contact your insurance company for local resources.

Some services require a parent or guardian to be involved, while others do not.

If you are having a mental health emergency, or you think you are in danger, please contact 911 or go to your local emergency room.

If you are considering suicide, or just need to talk to someone, please call or text the Idaho Crisis and Suicide Hotline at 988 (24 hours a day, 365 days a year). You can call or text even if you are not considering suicide, but just need to talk to someone about how you feel. If you currently have Medicaid you can also call Idaho Behavioral Health Plan managed care provider and speak to someone 24 hours a day, 365 days a year.

With the introduction of the Youth Empowerment Services (YES) system of care, new and updated mental health services and supports are being introduced in Idaho. The system of care uses a practice model and specific principles of care to guide how those services are provided to children and their families.

It is important to remember that while YES is a system of care developed in Idaho, not all behavioral health providers and private insurance companies participate. If you want to access the YES system of care, it is important to know if your provider is part of the YES system of care. This means they have been trained to follow the principles of care and use the Child and Adolescent Needs and Strengths (CANS) tool. Providers who are part of the Idaho Behavioral Health Plan managed care network that serve youth are YES providers.

Youth Empowerment Services (YES) is a system of care* that helps children and youth under the age of 18 who who are at risk for or have serious emotional disturbance (SED).

The goal of YES is to give children and youth who have SED access to the services and supports that will help them improve their mental health.

*The YES system of care is a spectrum of services and supports for children and youth with serious emotional disturbance and their families. The YES system of care creates meaningful partnerships between families, youth, providers, and government agencies to address the specific needs of the youth and family to help them function better at home, in school, in the community and throughout life.

If you are under 18 and a resident of Idaho, you will be able to get mental health care.

If you or your parents need help locating a behavioral health provider for an assessment, you can contact the Idaho Behavioral Health Plan (Magellan Healthcare). Magellan Healthcare, MagellanofIdaho.com, can help you if you have Medicaid, no insurance, or private insurance. If you have private insurance, you can also contact your insurance company for local resources.

Serious emotional disturbance (SED) is a term that refers to children and youth under age 18 who have a mental, behavioral, or emotional issue that limits their ability to participate in family, school, or community activities.

A person is considered to have SED if they have both a Diagnostic Statistical Manual (DSM) diagnosis and a functional impairment as identified by the Child and Adolescent Needs and Strengths (CANS) tool.

The legal definition of SED is defined in Idaho Code,16-2403(15).

With the introduction of the Youth Empowerment Services (YES) system of care, new and updated mental health services and supports are available in Idaho.

If you or your parents need help locating a behavioral health provider for an assessment, you can contact the Idaho Behavioral Health Plan (Magellan Healthcare). Magellan Healthcare, www.MagellanofIdaho.com, can help you if you have Medicaid, no insurance, or private insurance. If you have private insurance, you can also contact your insurance company for local resources.

If your family does not know about Youth Empowerment Services (YES), you can have them read YES 101. You can also have them look at the parent section of this website to find more information.

Your family can help you decide if you may benefit from a mental health assessment, and if so, help you find a behavioral health provider.

A big part of YES is the Child and Family Team (CFT), which is a way to set goals, plan, and coordinate treatment, and evaluate progress. Your family can participate on your CFT to help you identify your strengths, set short and long-term goals, and help you celebrate your successes in treatment.