Aged and Disabled Waiver Waiting List FAQs for Providers
From The Division of Aging, a program of the Indiana Family and Social Services Administration
"On April 24, 2024, FSSA implemented a waiting list for the Aged and Disabled Waiver, which had been announced earlier in April. This FAQ is being provided in response to questions from providers.
- When did FSSA announce there would be a future A&D Waiver Waiting List?
- What is the effective date of the Aged and Disabled Waiver Waiting list?
- April 24, 2024. The State evaluated the current list of all individuals who were not active on the Aged and Disabled Waiver based on the priority criteria established in the waiver. Based on the remaining waiver capacity and prioritization, some of the individuals who are not active will move forward with the A&D Waiver while other will be moving to the waiting list. Individuals who are being placed on the on the waiting list should receive notification by mail.
- Any new applicants will be placed on the waiting until additional slots become available July 1.
- What are the Aged and Disabled Waiver priority categories?
- The waiver defines the categories and order in which an individual is offered access to the waiver. These categories include individuals transitioning from the Money Follows the Person (MFP-AD) program, discharging from a nursing facility, utilizing state-funded services (e.g. CHOICE), and discharging from a hospital.
- The waiver reserves capacity for individuals who are in the Money Follows the Person (MFP-AD) program. This means the state must ensure the Aged and Disabled Waiver has the capacity to seamlessly transition these individuals to the waiver. The state will hold or reserve slots for individuals who are transitioning from the MFP-AD program.
- In the remaining categories, the state does not reserve a slot, but individuals in these circumstances must be offered access to the waiver before others who do not fall into these categories. The order of access defined in the Aged and Disabled Waiver is individuals discharging from a nursing facility and state-funded services (e.g. CHOICE program) followed by individuals discharging from a hospital, and then all other applicants.
- An individual has applied for the Aged and Disabled Waiver but has not had their Nursing Facility Level of Care completed. Will they be on the waiting list?
- Individuals who meet the Nursing Facility Level of Care and wish to pursue the Aged and Disabled Waiver will be added to the waiting list.
- An individual has applied for the waiver and met the Nursing Facility Level of Care, but their Medicaid eligibility is still pending. Will they be on the Aged and Disabled Waiver Waiting list?
- Individuals who have met the Nursing Facility Level of Care criteria for the Aged and Disabled Waiver but still have Medicaid eligibility pending will be added to the waiting list.
- An individual has applied for the waiver and met the Nursing Facility Level of Care and they have approved Medicaid. Will they be on the Aged and Disabled Waiver Waiting list?
- The State is evaluating the current list of all individuals who are not active on the Aged and Disabled Waiver based on the priority criteria established in the waiver. Based on the remaining waiver capacity and prioritization, some of the individuals who are not active will move forward with the Aged and Disabled Waiver while others will be moving to the waiting list. This should be determined by end of April.
- What are the expectations of the Area Agency on Aging when an individual is seeking services while the Aged and Disabled Waiver Waiting list in effect?
- The Area Agency on Aging is responsible to support and assist individuals beyond placing an individual on the waiting list. Area Agencies on Aging are embedded in communities to better serve, engage, network, and refer individuals to community resources. Area Agencies on Aging are expected to support individuals with the following activities that include, but are not limited to:
- Provide assistance with navigating the Medicaid application.
- Explore the individual’s needs holistically through person centered practices.
- Refer the individual to community resources.
- Support the individual with information necessary for them to make the best-informed decision about services and supports.
- It is FSSA’s expectation Area Agency on Aging continue to process applications as they do today and do so as expeditiously as possible.
- What are the expectations of the waiver provider while the individual is on the Aged and Disabled Waiver Waiting list?
- If an individual is on the Aged and Disabled Waiver Waiting list, the individual would not be receiving services from a waiver provider. When the individual is invited to continue the process to access the Aged and Disabled Waiver, the care manager will offer the individual choice of waiver providers.
- Can an individual who needs Assisted Living (AL) care, but has been placed on the Aged and Disabled Waiver Waiting list, go to a Nursing Facility (NF) in the short term until an Aged and Disabled Waiver slot opens?
- The individual will need to be assessed by the AAA/ADRC to assist in this determination. The AAA/ADRC will complete a new Nursing Facility Level of Care to establish eligibility and discuss options with the individual.
- If an individual is currently spending down in an Assisted Living (AL) facility via private pay, will they no longer get an Aged and Disabled Waiver slot if the spend down occurs within the waitlist period?
- When the waiver has the capacity to invite individuals, the individual on the waiting list will be prioritized based on the criteria defined in the waiver. Individuals in the situation above do not meet any of the priority criteria outlined in the Aged and Disabled Waiver.
- Will people be put on the Aged and Disabled Waiver Waiting list after being approved or transitioned over to traditional Medicaid or prior to being approved for Medicaid?
- An individual may be placed on the Aged and Disabled Waiver Waiting list with or without having Medicaid eligibility established. Medicaid eligibility does not have an impact on an individual’s placement on the waiting list.
- What happens in July at the beginning of the new waiver year and launch of the PathWays program?
- More information will be released in the coming weeks, before the July 1 PathWays and Health and Wellness Waiver launch.
- Where is more information for individuals and families?
- Additional FAQs, a process flow, and a resource list are available on FSSA’s webpage."
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