Division of Disability and Rehabilitative Services Home-and Community-Based Services Spend Plan update

In July, the Indiana Family and Social Services Administration submitted its proposed spending plan for implementation of Home-and Community-Based Services Enhanced Federal Medical Assistance Percentage to the Centers for Medicare and Medicaid Services for approval. The opportunity for enhanced FMAP was a part of the American Rescue Plan Act and allows for an additional 10% federal match on Medicaid HCBS expenditures from April 1, 2021, through March 31, 2022. The additional resources must be expended by March 2024. Based on stakeholder feedback, FSSA prioritized the use of the dollars as follows: 

Plan component	Percent of total
Stabilization (provider, workforce and caregiver)	20%
Workforce (Support and expand the HCBS provider workforce)	25%
Enhance HCBS (Includes Increasing competitive employment opportunities)	20%
Build provider capacity (Increase access to services/promote self-direction)	30%
Caregiver training and support	5%

Phase 1 of the FSSA HCBS Spend Plan launched in January 2022, with stabilization grant opportunities for Division of Disability and Rehabilitative Services, Division of Mental Health and Addiction and Division of Aging providers of home and community-based services. Eligible providers will receive a one-time grant calculated as a flat percentage (7-8%) of the provider’s highest annual claims total across calendar years 2019, 2020, and 2021. FSSA’s commitment to recruiting and retaining a qualified workforce is a key emphasis of the funding as providers are required to spend 75% of the funds on direct support workforce compensation and benefits.  

Divisions within FSSA developed proposals aligned with the aforementioned priorities. Within the overall spend plan, DDRS identified projects in alignment with person-first philosophy, 1102 Task Force recommendations, Indiana’s Employment First plan, waiver redesign and stakeholder feedback.  Those projects include grants to pilot innovative employment approaches, support for voluntary efforts to transition individuals from sub-minimum wage employment/sheltered work, and support for creative approaches to pre-vocational and employment services for providers who have closed sheltered workshops within the last 24 months. These activities will be utilized to inform waiver redesign, policy and procedure and the design of a value-based payment model to support quality outcomes for individuals with intellectual and developmental disabilities.  

DDRS seeks to enhance home and community-based services through projects aimed at improving outcomes for individuals with intellectual and developmental disabilities, systems access and navigation, individual access to resources, provider approval process, quality monitoring and tracking systems, and enhanced training in person-centered approaches for providers, case managers, individuals and families.

Funds are also allocated to improve outcomes for individuals and family members through expanded peer mentoring/support, self-advocacy training, and tools to support establishing expectations for a full and meaningful life. Additionally, the funds will be leveraged for identification of other promising service delivery approaches or models that may further enhance and support outcomes for individuals and families and could be incorporated into the service array offerings in the future.

DDRS is now preparing to initiate Phase 2 of the HCBS Spend Plan. As we develop our implementation plans, stakeholders should anticipate communication from DDRS over the next few weeks as follows:

Quarter 1 2022:

• Increased amount of quality on-site provider reviews as well as additional consultation
• Opportunities for participation in Charting the LifeCourse Innovation Collaboratives and Employment Network Cohorts
• Opportunities for Open Future Learning and Provider Engagement for Enhanced Training

Quarter 2 2022:

• Release of request for funding for employment innovation pilots
• Launch of 14c Transition Learning Collaborative
• Announcement of 14c Pre and Post Transition Grant Opportunities to support voluntary conversion, innovative pre-vocational supports and improved competitive employment outcomes
• Grants to build and strengthen the network of self-advocates
• Pilots and grant opportunities for innovative approaches to community support, such as creative use of technology and other services, that address system resource needs and family caregiver supports
• Begin the development of a behavioral services technical guide

Quarter 3 2022:

• Begin update and enhancement of the incident reporting system
• Begin update and enhancement of the provider application process and experience
• Begin research as well as strategize on how to improve communication and marketing
• Announcement of state hospital transition pilots

 

The DDRS is a program of the Indiana Family & Social Services Administration. If you have questions about DDRS programs and services, visit us online at www.DDRS.In.gov.