Medicaid Waivers Indiana’s Family Supports Waiver & Community Integration Habilitation Waivers
What are Medicaid Waivers?Indiana has four Home and Community Based Services (HCBS) waiver programs that are administered by the Indiana Division of Disability Aging and Rehabilitative Services (DDARS): two medical waivers (see our fact sheet Medicaid Waivers: H&W and TBI) and two waivers serving individuals intellectual/developmental disabilities (I/DD) - the Family Supports Waiver (FSW) and the Community Integration & Habilitation (CIH) Waiver.
These Medicaid programs provide federal and state funds for children and adults with disabilities to receive support and services in their home and community rather than in an institutional setting. A child may apply and qualify for more than one type of waiver, but they may only be served by one waiver program at a time. How is Eligibility Determined?To qualify for the FSW or CIH Waiver, an individual must have an I/DD or related condition with proven onset prior to age of 22 (and expected to continue indefinitely) and must also meet the level of care needed for admission to an Intermediate Care Facility (ICF) for those with an intellectual disability, known as ICF/IID Level of Care. This Level of Care means that the person has substantial functional limitations in at least three of six major areas of life, which are: self-care, learning, self-direction, capacity for independent living, understanding and use of language, and mobility.
The Bureau of Disabilities Services (BDS) District Office uses the Confirmation of Diagnosis (COD) form to determine whether the applicant has a qualifying DD diagnosis as defined by the State. If so, the district office completes the Level of Care Screening Instrument to determine eligibility for the FSW and CIH waivers. Information gathered from the COD, Screening Instrument, as well as other supporting documentation that is provided as part of the application process (this might include an IEP, etc.) are all part of determining eligibility. BDS can also request an evaluation of the applicant, if needed. The CIH waiver is a needs-based waiver. The individual must meet the eligibility requirements described above and at least one priority criteria. Some examples include: the death of or an aging primary care giver when no other caregiver is available, transition out of a Department of Education residential placement, Department of Child Services residential placement or Supervised Group Living setting, or an extraordinary health or safety risk. Medicaid eligibility determination for a child under the age of 18 who is applying for a waiver is based on only the income/assets of the child (NOT the parental/household income or assets). A child must be approved for Medicaid before waiver services can begin. If your child already has Medicaid, the category of Medicaid may be changed once they are invited to the waiver. Learn more about the different Medicaid categories and which ones are compatible with HCBS Waivers here: https://www.in.gov/fssa/ompp/files/Aid-Category.pdf How to Apply:Applications for BDS services, including the FSW and CIH Waiver can be completed and submitted online using the BDS Gateway: https://bddsgateway.fssa.in.gov/. Paper applications request the same information and can be downloaded and printed using this link: https://www.in.gov/fssa/ddars/bds/medicaid-hcbs-waivers/. BDS District Offices can provide applications upon request. Local District Office information including contact information is found here: https://www.in.gov/fssa/ddars/bds/bureau-of-developmental-disabilities-services/ or by calling 1-800-545-7763.
When applying for a CIH Waiver, it is important to specify that the request is for the CIH waiver. A CIH Needs Based Access Request form is provided by BDS as a required part of this process. For an individual who meets the eligibility and needs requirements to be granted a CIH waiver, there must be a funded slot available and BDS must have determined that other service options are not appropriate or not available. Provisional Eligibility:Once an individual has submitted a waiver application and been deemed eligible, s/he is either placed on a waiting list for a waiver or deemed “provisionally eligible.” Applicants may apply for services and be placed on a waiting list under the FSW at any age.
The FSW currently operates on a waiting list based on application date; families are encouraged to apply for waiver services as soon as they suspect the waiver will be needed, regardless of the child’s age. There are three priority criteria categories which may reduce the time between application and invitation to the FSW.
How to stay on the Waiting List?Contact information must be current including phone number or address changes. It is best to contact the BDS office annually to update or confirm correct information. The BDS Waitlist Web Portal can also be accessed to verify correct information. https://www.in.gov/fssa/ddars/resources/individuals/bds-waitlist-portal/)
What Documentation to Maintain?Keep a copy of the dated waiver application and any other correspondence records such as detailed notes from phone conversations with BDS representatives including times, dates, and names. Additionally, if the application is submitted in person or by postal mail, request receipt confirmation upon initial delivery of the application.
Where to get More Information:
Additional Community Resources:
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Programs and systems change often. It is important to ensure that you are using the most current information. Please check https://www.inf2f.org/fact-sheets.html for the most recent edition.
This fact sheet was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $96,750 with 89% percent financed with nongovernmental sources. The contents are those of INF2F and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.
This fact sheet was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $96,750 with 89% percent financed with nongovernmental sources. The contents are those of INF2F and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.
