Idaho Independent Living Council tells Health and Welfare Committee housing, workforce and Medicaid case-management gaps threaten community-based care

Mel Levitan, executive director of the Idaho State Independent Living Council (SILC), presented the council's annual update to the Idaho Senate Health and Welfare Committee, outlining the group's statewide needs assessment and the priorities in its current three-year state plan.

Levitan said the council — a volunteer body of about 17 to 24 members that includes four ex officio state-agency representatives — is supported by a staff of four. He said the SILC partners with the Centers for Independent Living (the Disability Action Center Northwest, Living Independence Network Corporation — LINC — and LIFE, a center for independent living in eastern Idaho) and other state agencies to amplify the voices of Idahoans with disabilities.

The 2022–23 statewide needs assessment collected input from 871 Idahoans and included 29 listening sessions; Levitan said the SILC visited roughly 27 communities as part of that work. He told the committee the assessment repeatedly identified housing affordability and accessibility, access to health care and a shortage of direct support professionals as top concerns.

"I use a wheelchair. I think everybody's probably noticed that by now," Levitan said in explaining how simple access changes — removing a podium, ensuring an accessible route or adjusting sound systems to work with cochlear implants — can affect participation. He said the SILC also works on emergency planning, peer mentoring and training for service providers and legislators.

On Medicaid and home- and community-based services (HCBS), Levitan cited a U.S. Department of Justice document from Jan. 16, 2025 and described systemic problems raised by advocacy groups and the DOJ related to remote certified family homes, case management shortages and other barriers. "There has been a lack of case management services," he said, and added that a planned case-management increase of "only 2 hours a month" will not be adequate for people who need help finding housing and community supports.

Levitan also presented comparative cost figures cited in the DOJ report and other sources: he said average HCBS costs are "less than $20,000 a year," while a nursing-home stay he referenced in the report is about $85,800 annually. He warned the committee that workforce shortages — a shortage of direct support professionals and an expected reduction in paid family supports — could lead to more people entering institutional care and higher overall costs. "Medicaid has to pay for nursing home care," he said, adding that federal block grants or per-capita caps would threaten home- and community-based services as currently delivered.

Senator Melissa Wintrow followed with questions about the meaning of "integration, inclusion and equity" in the SILC's goals, and Levitan gave examples ranging from accessible meeting setups to ensuring children with disabilities can fully participate in school activities. Wintrow also asked for further detail on the Department of Justice document; Levitan said he had three physical copies and offered to distribute it electronically to the committee.

Levitan closed by noting that the SILC's current state plan took effect Oct. 1 (year not specified in the presentation) and that the council monitors progress quarterly and adjusts activities as needed. He said the SILC is exploring the establishment of an Idaho ABLE program and is increasing outreach to transition-age youth and young adults with disabilities.

The committee did not take formal action following the presentation. Levitan offered to send the DOJ material to the committee secretary for distribution.