Family Supports Waiver Journey
Part 1: Beginning The JourneyBegin the journey by applying for the Family Supports Waiver. Application can be made in one of two ways.
Contact the local Bureau of Disabilities Services (BDS) field office. The contact information for each of these offices is listed here or call 800-545-7763 to find the local office. Simply call the BDS office and tell the Intake Specialist that you’d like to apply for the Family Supports Waiver for an individual. The specialist will ask for some basic information and subsequently mail a packet of information to complete. The packet will include the following forms:
Individuals may also print these forms at this link: https://www.in.gov/fssa/ddars/resources/individuals/forms/
An online application for the Family Supports Waiver can be filled out and submitted. It is available at the BDS Gateway: https://bddsgateway.fssa.in.gov/. The online application requests the same information as the paper application. The Confirmation of Diagnosis form will be filled out separately and can be mailed or delivered to the local BDS office. For more information about the online application or for additional instructions, guidance, application tutorial, and application FAQ, visit https://www.in.gov/fssa/ddars/bds/developmental-disabilities/ *Note that the online application must be completed in one sitting if not applying through Access Indiana. Applications are received by date, and the program operates on a first-come/first-served basis.
Once the application has been received by BDS, an individual or parent/guardian will hear from an Intake Specialist, who will schedule a time to meet with the individual or parent/guardian. This appointment may take place at the regional BDS office, or the BDS intake specialist can come to the individual's home upon request. At that appointment, the Intake Specialist will ask a series of questions to determine if the individual meets level of care (LOC). The LOC is determined by the presence of a developmental disability, or closely related disability, which results in substantial functional limitations in at least 3 of the following areas of major life activities:
In addition to the LOC, the BDS intake specialist will also support the individual or parent/guardian in filling out an “Authorization for Disclosure of Personal and Health Information” form. Other forms may need to be included, as well, depending on the individual’s diagnosis and/or situation. The BDS intake specialist will advise of any additional information or forms needed. Using the information gathered, it will be determined if the individual meets LOC. Upon determination, a letter of eligibility will be mailed to the individual. This letter includes a review of the individual’s information (Eligible Conditions, Duration, Age of Onset, Care Treatment and Limitations), as well as if the individual meets criteria for Developmental Disabilities Services. If the individual meets LOC (eligibility criteria), a supporting letter of placement onto the waiver waiting list will be included. Directions for appealing the decision will also be included. Note that for children under the age of 6, provisional eligibility may apply, and LOC will be determined upon when a waiver slot is available. It is important to keep copies of all documents that are submitted and received regarding the waiver, along with notes of contact with the BDS office (or other agency).
The individual’s information can be confirmed by logging onto the BDS Waitlist Portal. If there are questions or concerns, can contact the BDS office at any time. Be sure to contact them with any changes or updates in contact information, like a change in address or phone number. An individual or their parent/guardian may want to apply for Medicaid or Medicaid Disability at this time. Household income and assets are considered for eligibility at this point. If the individual meets the requirements for Medicaid, they may qualify for Medicaid Prior Authorization (PA) services, which are support services that may be used while waiting for the waiver. Part 2: Completing The JourneyThe wait is over and now the “Invitation Letter” has been received– that is a letter stating that the individual has now been “invited” to receive a waiver slot.
A response is required to complete the process. Call the Bureau of Disabilities Services (BDS) office and say “YES” or return the letter to BDS within 30 days, after checking “YES” that the individual is interested in receiving the waiver. Once BDS has received the response, an Intake Specialist will make contact. Along with the invitation letter will be a Confirmation of Diagnosis (COD) form that needs to be completed by a physician (MD or DO) involved in the individual’s care if the current COD was completed more than 12 months prior to being invited to the waiver. Those who meet priority criteria would not have to go through this process again. The physician needs to return the letter to the BDS office within 21 days of the invitation letter date.
The assigned Intake Specialist from BDS will contact the individual or the parent/guardian for any needed information during the waiver invitation process and occasionally check on progress. The Intake Specialist will assist with any problems that may be encountered until a case manager begins working with the individual. BDS may ask for supporting medical information, school records, and request additional testing through one of their contracted providers. The individual or parent/guardian will not need to pay for any evaluations that may be needed to determine Level of Care (LOC). Although LOC was determined at the time of application, the individual will be assessed for LOC again upon invitation if the current LOC was completed more than 12 months ago. Once BDS has received the information needed and the individual has been determined eligible (meets LOC criteria), the individual or parent/guardian will be given a list of case management companies to choose from. The individual or parent/guardian must choose a case management company and return the completed form to BDS If an individual doesn’t currently have Medicaid, the BDS intake specialist will notify the individual or parent/guardian when the system is updated and ready for them to apply. If the individual has Medicaid, the recipient’s category may need to be changed to one that is compatible with the waiver. For children under 18, this may include going through Indiana Medicaid’s Medical Review Team (MRT) to determine eligibility for Indiana Health Coverage Programs (IHCP) based on disability. For those 18 and older, they will need to apply for and be approved for Supplemental Security Income (SSI). 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
To apply for Medicaid:
Within approximately a week of applying for Medicaid, a representative from the DFR will make contact and request an interview. A choice should be given to conduct the interview at the local DFR office or by phone. The individual or parent/guardian will be given a specific time for the interview, and it is very important to attend the appointment at the specified time. Expect the appointment to last from 30-45 minutes. The individual being invited does not need to attend this meeting unless they are 18. Note that if the invited individual is under the age of 18, only the income of the individual is counted in applying for Medicaid. Senate Bill 30 states that parental income is disregarded in determining eligibility for children under 18 years old who are waiver recipients. Because of this, parents and other household members' incomes are not counted when determining eligibility for Medicaid.
If problems are encountered during the Medicaid application process, contact the BDS Intake Specialist. Once Medicaid is in place, BDS will send the referral to the chosen case management company for intake. A case manager from the chosen case management company will schedule a time to meet to develop a Person-Centered Individualized Service Plan (PCISP). This plan will guide the individual or parent/guardian and their case manager in determining appropriate services and support. Once waiver service(s) have been chosen, the case manager will give the individual a “Choice List” of providers to choose from. Individuals may interview provider companies and staff to see who might best fit the individual’s needs. It is important to remember that individuals and families have a choice of services, providers, and staff. The case management company, case manager, or other providers can be changed at any time for any reason. The individual or their parent/guardian can utilize or “purchase” any of the below services for a total yearly budget of $26,482. Keep in mind that case management is a billable service paid for out of this budget. Case Management is the only required service to keep the waiver active. It is also important to remember that each service has a standard rate. When selecting a service, every provider will bill the same amount for a unit of service provided
The case manager will submit the PCISP, which includes the service plan, to the Division of Disability, Aging, and Rehabilitative Services (DDARS). Once the service plan is approved by DDARS, a Notice of Action (NOA) will be sent to chosen providers to begin services. The provider agency will then arrange training and care for the individual, and services can begin.
There are several safeguards in place to ensure that the individual receives safe and appropriate care. Be sure to make note of these as they are explained by the case manager and provider company. Congratulations! The Destination Has Been Reached!If you receive information that differs from the above information, please contact us so we can see if you were given misinformation, or if there have been changes to the process. Phone: 844-323-4636 or email: [email protected]
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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.
