Aged & Disabled Waiver approval
The Centers for Medicare and Medicaid Services has approved Indiana’s Home and Community-Based Services Aged & Disabled Waiver, effective July 1, 2018. With this approval Indiana will continue to provide an array of home and community-based services that assist Medicaid beneficiaries to live in their homes and communities.
Please visit the Division of Aging web page, available by clicking here, to review the Aged & Disabled Waiver amendments and approved waiver.
Please direct any questions and/or concerns to Darcy Tower, director of provider relations, via email at darcy.tower@fssa.in.gov or (317) 234-2944.
Of interest to our families:
• Respite—Updated service definition for conciseness and person centered language and removed the requirement that respite take place in the caregiver or participant home, clarified differences between the service definition and the service standard, split documentation standards between provider and care manager.
Home Modification Assessment—Changed name from Environmental Modification Assessment to Home Modification Assessment; required home modification assessment if assessor available in the county the participant resides if the expected amount of home modification is greater than $5,000.00, clarified the amount for the assessment is not part of the cap on home modifications, and added a possibility for a DA to pay $250.00 to the assessor to make a third trip to a home modification to help the DA mediate disputes.
• Home Modification—changed name from Environmental Modification; updated service definition to only require two (2) bids but if the bids meet minimum specifications the lowest bid is the only one that can be chosen, if it is family owned then a signature from the family owner is required, added bids are required if amount is to be more than $1000, added including but not limited to language for the types of activities and added kitchen as possible type of activity; for service standards added PCA for care manager’s and a one year minimum warranty work for providers; for activities not allowed removed ceiling track systems, elevators, installation of standard fixtures, and modified structural repair to include incidental structural repair.
Specialized Medical Equipment—Removed medical necessary sentence B., removed communication devices, manual wheelchairs, generators, and posture chairs, added lift chairs and option for approval by the DA if item not listed; for documentation standards split care manager and Provider requirements, require 2 bids if amount over $1,000 and for the care manager to explain if only 1 bid; added manual wheelchairs to activities not allowed and removed activity streamers and adaptive switches
Vehicle Modifications—Removed ten (10) year and 100,000 mile maximums for vehicle, updated for conciseness and PCA, requiring two (2) bids if amount expected to be over $500 or for the care manager to document why only one (1) bid received, removed lowered floor and communication devices from activities not allowed and removed AFC and AL services from activities not allowed.
Of interest to our families:
• Respite—Updated service definition for conciseness and person centered language and removed the requirement that respite take place in the caregiver or participant home, clarified differences between the service definition and the service standard, split documentation standards between provider and care manager.
Home Modification Assessment—Changed name from Environmental Modification Assessment to Home Modification Assessment; required home modification assessment if assessor available in the county the participant resides if the expected amount of home modification is greater than $5,000.00, clarified the amount for the assessment is not part of the cap on home modifications, and added a possibility for a DA to pay $250.00 to the assessor to make a third trip to a home modification to help the DA mediate disputes.
• Home Modification—changed name from Environmental Modification; updated service definition to only require two (2) bids but if the bids meet minimum specifications the lowest bid is the only one that can be chosen, if it is family owned then a signature from the family owner is required, added bids are required if amount is to be more than $1000, added including but not limited to language for the types of activities and added kitchen as possible type of activity; for service standards added PCA for care manager’s and a one year minimum warranty work for providers; for activities not allowed removed ceiling track systems, elevators, installation of standard fixtures, and modified structural repair to include incidental structural repair.
Specialized Medical Equipment—Removed medical necessary sentence B., removed communication devices, manual wheelchairs, generators, and posture chairs, added lift chairs and option for approval by the DA if item not listed; for documentation standards split care manager and Provider requirements, require 2 bids if amount over $1,000 and for the care manager to explain if only 1 bid; added manual wheelchairs to activities not allowed and removed activity streamers and adaptive switches
Vehicle Modifications—Removed ten (10) year and 100,000 mile maximums for vehicle, updated for conciseness and PCA, requiring two (2) bids if amount expected to be over $500 or for the care manager to document why only one (1) bid received, removed lowered floor and communication devices from activities not allowed and removed AFC and AL services from activities not allowed.
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