DD / IDD waiver · MUI · DSP credentialing · EVV · auth units
Finally — an EHR
that handles waiver.
DD/IDD agencies run their waiver programs across four disconnected systems— Excel for MUI tracking, a state portal for waiver auth, paper binders for DSP credentialing, and a generic BH EHR for notes that don't understand person-centered planning. AgenciesForge collapses all four into one platform with state-specific paths for the 7 largest IDD authorities.
Ohio DODDNY OPWDDCA DDSFL APDPA ODPTX HHSC IDDOR BHDDA
What a DD/IDD agency actually juggles today
If your team is logging into four systems just to discharge one DSP shift, you're paying the "generic EHR + spreadsheet" tax. Here's what that looks like — and what AgenciesForge ships in its place.
Today
Excel for MUI tracking
Per-state incident category memorized by your QI lead. A separate spreadsheet for the 24h / 72h / 30d windows. Hand-typed reports re-keyed into the state portal.
With AgenciesForge
Native MUI workflow per state
Pick incident category from your state's list. Reporting-window timers fire automatically. Structured fields extract via AI from clinician narrative. Export to your state portal in the format it expects.
Today
Paper binders for DSP credentialing
Hire-date-anchored training hours tracked on a clipboard. Expired certifications discovered during a state survey, not before. No way to prove DSP-X had training-Y by date-Z.
With AgenciesForge
DSP credentialing dashboard
Per-DSP training-hour log, expiration alerts at 90 / 30 / 0 days, certificate uploads. One-click Audit Packet export per staff for the state surveyor's USB stick.
Today
State portal for waiver auth
Auth units checked manually before each shift. Bills land on denied claims weeks later when you find out the auth ran out 12 days ago. Sometimes you're working free.
With AgenciesForge
Real-time auth-unit drawdown
Each visit deducts units from the patient's auth on check-out. Low-balance alerts fire before you bill against a depleted auth. Re-auth requests get drafted automatically when units fall under your threshold.
Today
EVV vendor on a separate login
Sandata / HHAeXchange / state-portal — your DSPs check in on one app, write the visit note in another, and your billing team reconciles between them. Missed EVV check-ins = retroactive claim denials.
With AgenciesForge
One check-in, EVV synced
DSP checks in once. GPS + timestamp + activity list + signature post through your state's EVV adapter (Sandata, HHAeXchange, state-direct, or self-hosted). Visit note + EVV event are the same workflow, not two.
Native paths for 7 state authorities
Each state ships with its specific waiver program names, MUI categories, and EVV vendor wired in. Don't see your state? The generic DD scope handles HCBS Settings Rule + ISP + DSP credentialing for any authority — we add states based on customer demand.
| State | Authority | Waiver program(s) | MUI / incident system | EVV vendor |
|---|---|---|---|---|
| Ohio | DODD | Level One / IO / SELF | DODD MUI portal | Sandata |
| New York | OPWDD | HCBS Comprehensive / OPWDD | OPWDD incident system | HHAeXchange |
| California | DDS | HCBS-DD / Self-Determination | SIR (Special Incident) | State direct |
| Florida | APD | iBudget | APD incident reporting | Tellus / Sandata |
| Pennsylvania | ODP | Consolidated / P/FDS / CL | EIM / HCSIS | Sandata |
| Texas | HHSC IDD | HCS / TxHmL / CLASS | HHSC incident reporting | HHAeXchange |
| Oregon | BHDDA | K-Plan / DD waiver | ORCA | OR-PTC DCI |
EVV vendor adapters are pluggable — if your state uses one we don't list yet, the agency-native EVV path captures the same event shape (GPS + timestamp + activity list + signature) for state aggregator polling.
What you actually get
Five workflows DD/IDD agencies need that generic BH EHRs don't ship — and aren't going to.
Workflow 1
MUI / incident reporting
State-specific incident categories. 24h / 72h / 30d reporting-window timers. AI extracts structured fields from clinician narrative. Export-ready format for DODD / OPWDD / SIR / APD / EIM / HHSC / ORCA.
Workflow 2
Person-Centered Planning
ISP / PCP development with active goals, progress tracking, annual renewal flags. Goals reference auto-prefill into clinician progress notes. Multi-stakeholder review + signature workflow.
Workflow 3
DSP credentialing
Hire-date-anchored training-hour log per staff. Certificate uploads. Expiration alerts at 90 / 30 days. Audit Packet export per DSP for survey-day prep.
Workflow 4
EVV (electronic visit verification)
GPS check-in / check-out with geofence + activity-list capture + signature. Vendor adapters: Sandata, HHAeXchange, state-direct, agency-native. Visit note + EVV event are one workflow, not two.
Workflow 5
Waiver auth-unit drawdown
Units deducted from the patient's auth on each visit close-out. Low-balance alerts before you bill against a depleted auth. Re-auth request drafts when units fall under your threshold.
Plus everything else
Full EHR + clearinghouse
Stedi 270/271 eligibility + 837P billing + 277CA/835 ERA. AI Forge SOAP/BIRP/DAP drafting. HIPAA fax. WENO eRx for prescribing DSPs. Patient portal. All bundled, no add-on fees.
Common waiver questions
Which states have native waiver paths built in?
Seven authorities ship with state-specific workflows out of the box: Ohio DODD, New York OPWDD, California DDS, Florida APD, Pennsylvania ODP, Texas HHSC IDD, and Oregon BHDDA. Each one covers the state's MUI / incident reporting categories, waiver program names (e.g. Ohio's Level One / IO / SELF; California's HCBS-DD; Florida's iBudget; Pennsylvania's Consolidated / P/FDS / Community Living), and the portal handoff path for billing. If your state isn't listed yet, you can still run on AgenciesForge — the generic DD scope handles HCBS Settings Rule compliance, ISP / PCP, and DSP credentialing for any state — we just don't have your authority's specific incident categories pre-mapped. Tell us what you need and we add states based on customer demand.
What waiver workflows are actually supported?
The five load-bearing ones for a DD/IDD agency: (1) MUI / major-unusual-incident reporting with the right state categories + reporting windows + escalation rules baked in; (2) Person-Centered Planning / ISP development with active goals + progress tracking + annual renewal flags; (3) DSP credentialing — training-hour tracking by hire date, expiration alerts at 90/30 days, an audit-ready credential packet exportable per staff member; (4) EVV (Electronic Visit Verification) check-in / check-out with geofence + activity-list capture, routed through your state's EVV vendor (Sandata / HHAeXchange / state-direct / agency-native); (5) Waiver auth-unit drawdown — units consumed per visit deduct from the patient's authorization in real time, with low-balance alerts before you bill against a depleted auth.
What if I run a multi-program agency — DD plus BH or DD plus home health?
That's a first-class config. Agencies declare a service mix during onboarding (any combination of BH, DD/IDD, and HHC). The certification roadmap, AI Forge agent's clinical knowledge, and per-patient workflows all branch off that mix — a DD+BH agency gets ISP + waiver units AND PHQ-9 + safety planning; a DD+HHC agency gets MUI + DSP credentialing AND OASIS-E + 485 PoC + PDGM. Same login, same dashboard, same billing. Patients flagged with both scopes show the right charting surface based on what service they're getting that day.
Will this handle the EVV mandate in my state?
EVV is configured per agency in Settings. Pick your vendor (Sandata, HHAeXchange, state-direct, or agency-native) and the EVV check-in route adapts. The agency-native path is a HIPAA-compliant fallback for states that allow self-hosted EVV solutions; it writes the same EVV event payload (GPS + timestamp + activity list + signature) to Firestore and surfaces it for state aggregator polling. For Sandata / HHAeXchange states, we push the event to your aggregator on check-out so claims don't bounce for missing EVV.
Does this work for self-directed or family-directed waivers?
Yes. Family / self-directed waivers (Ohio SELF, California Participant Choice, Texas CDS, etc.) follow the same waiver-unit + ISP + EVV machinery — the only difference is the budget / employer-of-record role, which lives on the patient's coverage config. The patient portal supports family-member sign-in on a patient's behalf so a family-employer can review their DSP's check-ins and sign off on monthly summaries from home.
How do I prove DSP training compliance to my state?
Settings → Team has a credentialing dashboard per staff member with hire-date-anchored training requirements, hours logged, certificate uploads, and expiration tracking. The auto-credential-decoder fills in state-board metadata (renewal cycle, CEU hours, verification URL) when a license is added. For survey prep, export an Audit Packet per staff member — the ZIP contains every certificate + training log + license verification screenshot organized to the state survey checklist. The same Audit Packet is what your QI lead drops on a state inspector's USB stick when they arrive.
What's it cost — and is it the same price as the rest of AgenciesForge?
Same flat tiers: EHR Starter $199/mo (50 patients), EHR Professional $499/mo (200 patients), EHR Enterprise $1,099/mo (500 patients). Unlimited clinicians and unlimited DSPs at every tier — DSP staff are not billed as additional seats. All waiver workflows (MUI, ISP, DSP credentialing, EVV, auth-unit drawdown) are included at every tier, not gated to Enterprise. Above 500 active waiver clients, talk to us — sales@agenciesforge.com.
Run waiver — without four logins.
Book a 30-min waiver-specific demo. Bring a current MUI scenario from your agency — we'll walk through how it would get reported, EVV'd, and billed inside AgenciesForge end-to-end. No Stripe card, no commitment.
Questions? sales@agenciesforge.com