5 EHR Options for IDD Agencies: What to Check Beyond a Generic EHR

Generic EHR software tends to break down exactly where IDD service delivery differs from a routine clinic visit. Person-centered planning, residential and day program documentation, EVV, and Medicaid waiver billing all need workflows a record built for clinical encounters was never designed to carry. This page compares five IDD-focused platforms, iCareManager among them, against the dimensions that matter for group-home and DSP staffing so you can judge fit before you sign a contract.

This is written for IDD service providers and case management agencies choosing or replacing an EHR, from single-site residential programs to multi-county day and community services. According to the Institute on Community Integration, 8.53 million people in the United States had an intellectual and/or developmental disability in 2022. Picking the wrong platform costs staff hours in workarounds and raises the risk of billing errors and compliance gaps.

Quick guide: IDD EHR options for IDD service providers and case management agencies

• iCareManager: all 50+ modules, training, implementation, customizations, and updates included in one fixed monthly fee.
• According to Therap, its billing tools convert attendance, documentation, schedules, and EVV data into billable units automatically.
• According to SETWorks, it connects client records, service plans, and authorizations with service documentation and reporting; its integrated staffing and time-attendance features simplify payroll and billing.
• Core Solutions: state-specific Medicaid payer configuration reflected directly rather than managed through staff workarounds.
• According to Foothold Technology, it offers configurable service plans that link staff documentation to the relevant plan, and BillingBuilder links service documentation to billing claims, beginning with authorizations.

Each option is covered below with its own entry, features, and trade-offs, followed by a side-by-side table on EVV, eMAR, and Medicaid billing.

How we chose IDD EHR options for IDD service providers and case management agencies

These criteria follow the operational points an IDD agency has to get right once service delivery moves off paper, not a generic software checklist. Each one maps to a column in the comparison table below, and to a question worth asking before you sign anything.

• Integrated EVV: Does the platform capture visit verification directly, or does it depend on a separate add-on to meet state mandates?
• eMAR included: Is medication administration tracked inside the same record your care teams already use, or in a connected module?
• Medicaid billing: Does documentation flow into billing without a second system, and who handles the claim-submission step?

1. iCareManager: 50+ integrated modules in one connected EHR

iCareManager is a cloud-based EHR and service management platform built specifically for IDD providers and human services organizations. It centralizes person-centered planning, service documentation, medication management, goal tracking, and compliance reporting in one system. Its In-Home Supports offering includes EVV, mobile documentation, and Medicaid waiver billing built for teams delivering support in the home.

iCareManager features

• Business intelligence reporting: BIRT transforms raw EHR data into real-time dashboards, custom reports, and visual analytics for smarter decisions.
• eMAR: eMAR, CareTracker, billing, training, and compliance work together in real time on one connected platform.
• Mobile, offline documentation: DSPs can access client information and document care at the point of service, even offline, so field teams have current data during in-home visits.
• Medicaid and HCBS billing: The platform combines person-centered planning, goal tracking, attendance logging, and Medicaid or HCBS billing in one compliant EHR platform.
• Claims validation: iCareManager validates Medicaid claims before submission.

iCareManager pros and cons

Pros:

• iCareManager offers 50+ modules.
• Training, implementation, customizations, and future updates are included in a fixed monthly fee.

Cons:

• The overnight Medicaid claims review flags denial risks before submission.

2. Therap: converts EVV and documentation data into billable units automatically

According to Therap, it provides a documentation and EHR platform built specifically for I/DD, HCBS, and LTSS providers and government agencies. The company says its platform brings together over 70 integrated tools. Direct support staff use a mobile app to log Daily Notes, ISP data, and medication administration in the field, on Apple and Android devices.

Its integrated billing platform also tracks service authorizations and automates remittance reconciliation. Its person-centered planning tools connect daily documentation to each individual's goals.

Therap features

• Mobile documentation: A mobile app for Apple and Android lets support staff log Daily Notes, ISP data, and medication administration from the field, in real time.
• EVV and scheduling: The EVV tools build schedules, track staff hours, and are built to meet federal EVV requirements.
• Medicaid and payer billing: Claims go directly to Medicaid, managed care organizations, and third-party payers, using standard 837P and 837I formats.
• Billing automation: Daily service documentation converts into submission-ready claims without manual re-entry, moving from documentation through claim reconciliation.

Therap pros and cons

Pros:

• Training and support are included in every subscription, starting with implementation assistance.
• Its EHR lets users track health data and create detailed reports.

Cons:

• With over 70 integrated tools in one platform, ask how much of that breadth your team's workflows actually need.

3. SETWorks: manages records, billing, and compliance in one connected system

According to SETWorks, the platform is built to manage client records, billing, and compliance in one connected system, with eMAR handled through its Carasolva EMAR+ integration. SETWorks describes its software as purpose-built specifically for disability services.

That complexity includes Medicaid waiver requirements, EVV mandates, state-specific documentation standards, and incident reporting typologies. It notes that agencies may face changing requirements, different billing systems for each funder, and the need to submit EVV data.

SETWorks features

• Mobile-first documentation: Staff record services, notes, and signatures from any device, and it lands in the same record billing runs on.
• Billing built for disability services: SETWorks says integrated billing software designed for disability service agencies is a better and more affordable option.
• System integrations: SETWorks integrates with other systems that support interfacing.
• Specialist support: SETWorks pairs its platform with specialists who know disability services and have onboarded hundreds of mission-driven organizations.

SETWorks pros and cons

Pros:

• It centralizes client records, billing, and compliance in one system.
• It bills 1,000+ funding sources, including waivers, counties, DVR contracts, and MCOs.

Cons:

• Does its billing reach the full mix of funders your agency manages, given it reports billing 1,000+ sources across waivers, counties, DVR contracts, and MCOs?
• Does it integrate with the internal systems your agency already runs, given it integrates with any system that supports interfacing?

4. Core Solutions: documentation workflows built into the platform from the start

Core Solutions says Cx360 Intelligence: The Intelligent Care Record was designed for IDD providers from the start, with state-specific payer configuration, native EVV integration, and service-specific documentation workflows part of its foundation. Those documentation requirements are built into the workflows that generate documentation.

An individual’s identified needs flow through as valued outcomes to a person-centered life plan or service plan. Automated task triggering ensures next-step task development and routing, minimizing the likelihood of service gaps occurring. Managers can assign staff to specific actions associated with quality outcomes, and mobile access with EVV enables DSPs to deliver services and record updates wherever care takes them.

Core Solutions features

• Native EVV integration: EVV data flows into the billing record without manual reconciliation.
• State-specific Medicaid billing: Payer configuration reflects state-specific Medicaid rules, so billing isn't managed through staff workarounds.
• Automated task triggering: Next-step tasks are generated and routed automatically, reducing the likelihood of service gaps occurring.
• Plan and goal visibility: Staff get immediate visibility into active plan status, goal progress, at-risk indicators, and upcoming review timelines, with plan creation, documentation, and evaluations in one place.

Core Solutions pros and cons

Pros:

• Service-specific documentation workflows are part of the platform's foundation rather than added on afterward.
• A Revenue Cycle Command Center gives financial and operations leaders visibility into where billing is breaking down across programs, service types, and authorizations from one environment.

Cons:

• Its Rcopia integration supports e-prescribing and medication administration record (MAR) management for authorized practitioners.

5. Foothold Technology: configurable builder tools spanning planning, forms, and billing

On its own pages, Foothold Technology describes developmental disabilities software built to track and manage data across the services an IDD agency delivers. The platform groups configurable tools under named builders: FormBuilder for data collection, PlanBuilder for service plans, and BillingBuilder for claims. Foothold also describes person-centered planning features that connect individuals to housing, employment, and transportation, alongside an EVV integration and a centralized eMAR.

Foothold Technology features

• FormBuilder: Agencies create configurable forms to track data in the format that fits their program and workflow.
• PlanBuilder: Custom service plans track individual goals, with documentation linked directly to the related plan goals.
• BillingBuilder: Community-based I/DD billing covers authorizations and several billing types, linking service-plan documentation to claims.
• eMAR: A centralized medical-information location includes e-prescribing, medication administration, immunizations, diet, and vital signs.
• EVV integration: Direct service providers can easily and securely document visits through Foothold's Electronic Visit Verification integration.

Foothold Technology pros and cons

Pros:

• Person-centered planning features support planning around housing, employment, and transportation, and connect individuals with communities.
• Configurable service plans track personalized outcomes for each individual.
• The software is flexible and configurable, allowing agencies to track and manage data related to services supporting people with IDD.

Cons:

• Since BillingBuilder generates claims beginning from authorizations, does your team have a process for keeping authorization statuses current across every funder you bill?
• Its transportation tracking creates claims for billable transportation services, so check whether those claims use the same waiver codes your agency applies to other IDD services.

Why do IDD agencies struggle with generic EHR software?

Federal rules set a high bar for how support plans get built. The person-centered planning process must be led by the individual wherever possible, according to the Centers for Medicaid and CHIP Services. The Legal Information Institute describes the process as individual-driven, with participation by people chosen by the individual, accessible information, choices, and a method to request updates as needed. A generic EHR built for clinical encounters has no structured place for that. It tracks visits and diagnoses, not a goal an individual chose and the daily notes that should connect back to it.

The gap shows up in day-to-day workflow more than in any single missing field. Staff end up re-entering the same service details into separate billing, scheduling, and compliance tools, because the record wasn't built around IDD service delivery in the first place. That workaround, not any one missing feature, is what makes a generic system feel like it's fighting the team instead of supporting them.

Comparison table: IDD EHR options for IDD service providers and case management agencies

Option	Integrated EVV	eMAR included	Medicaid billing
iCareManager	Yes	Yes	Yes
Therap	Yes	Yes	Yes
SETWorks	Yes	Yes, via Carasolva EMAR+	Yes
Core Solutions	Yes	Yes, via Rcopia	Yes
Foothold Technology	Yes, via Electronic Visit Verification	Yes	Yes

Compiled by iCareManager from the vendors' own pages (7 publishers), published research (2 publishers) and government pages (1 publisher), and the sources listed below, as of October 2026.

What makes an EHR a good fit for IDD agencies?

A good fit starts with how the software maps to your service settings, not how many features it lists. Residential, day program, and community-based work each generate different documentation at different moments, and the system should follow that shape rather than force every service into one generic encounter form.

Fit also shows up in whether a person's plan stays connected to what staff record day to day, so goals do not sit in a separate binder from the notes meant to support them. Ask how directly a vendor's planning tools link to daily documentation, and compare that against the five entries below.

Which capabilities should IDD agencies check first?

Start with the three areas that cause the most rework when they are missing: visit verification, medication administration, and billing. Electronic Visit Verification needs to capture a direct support professional's location and time without a separate login or a second export step. eMAR should sit inside the same record used for documentation, not a bolt-on tool staff have to reconcile by hand. Medicaid billing should pull from the service notes already entered, so a claim reflects what was actually delivered.

Beyond those three, check how goals and progress notes connect: a plan that updates separately from daily documentation is a compliance gap waiting to surface at audit. The comparison table below lines up each option against these capabilities, and the entries above it walk through what each one's own pages show.

Matching the comparison above to your next contract

The quick guide, the five entries, and the comparison table above lay out where each platform's own pages show strength, from EVV and eMAR to Medicaid billing. Use the criteria list to decide which columns matter most for your agency's service mix, then weigh the entries against your own residential, day program, or in-home workflows. The right fit is the platform whose own documentation already matches the services you deliver, not the one with the longest feature list.

FAQs about IDD EHR options

What does Medicaid claims validation look like before submission?

Validation that happens before submission catches errors while there's still time to fix them, instead of after a payer rejects the claim weeks later. Ask whether a platform's review step runs automatically with every batch or only when someone remembers to trigger it.

How does person-centered planning fit into day-to-day documentation, not just the ISP file?

A plan only stays useful if the notes staff write each day map back to its goals, not just sit in a separate ISP file. Look for a platform that lets a direct support worker log progress against a specific goal in the moment, rather than reconstructing it later from memory.

Can a day program and a residential program share one EHR record?

iCareManager’s own page refers to IDD service providers offering residential, day programs, and supported living. That matters for agencies running more than one service line under the same roster of individuals.

What happens to a service plan already created in another system if you switch EHRs?

On its own pages, Core Solutions describes a life plan import feature that generates draft action plans or individual support plans from uploaded person-centered plans or state-generated documents. That kind of import can shorten the data entry work of a transition, though the draft still needs staff review before it becomes the live plan.