A&D and TBI Waiver Update

From FSSA 

A&D and TBI Waiver  Update A communication to Hoosiers who receive services on the Aged & Disabled or the Traumatic Brain Injury waivers Week of June 17, 2024

Welcome to the update For members and families The Family and Social Services Administration will provide this regular update to members and their families during this period of transition. Checklist What to watch for You may have received a letter from the Division of Disability and Rehabilitative Services – Bureau of Disabilities Services if you are under age 60. This is because the Aged and Disabled Waiver and the Traumatic Brain Injury Waivers are transitioning to be administered by DDRS on July 1. The A & D Waiver is becoming the Health and Wellness Waiver for members under 60. You may have received a phone call from a representative of FSSA in an effort to support you if you need to transition to Structured Family Caregiving or find a new attendant care provider. The calls have ended at this time. Contact Information Area Agencies on Aging Find your AAA: Call 800-713-9023 or visit www.in.gov/fssa/inconnectalliance/ Division of Aging Call 888-673-0002 or email FSSA.Daresponseteam@fssa.IN.gov Bureau of Disabilities Services Call 800-545-7763 or email BDS.Help@fssa.in.gov Apply for Medicaid Visit www.in.gov/medicaid/members

Member webinars Did you miss it? The June 12 family webinar covered topics including integrated supports, Medicaid state plan and waiver services, and person-centered service plans. You can watch it on the FSSA Indiana (@FSSAIndianavideos) YouTube channel. Additional topics Another webinar covering additional topics is scheduled. Date: Wednesday, June 26, 2024. Time: 3-3:30 p.m. EDT Participate live in Microsoft Teams. Your questions answered Frequently Asked Questions Additional FAQs were posted on June 18. You can find them on the Medicaid Strategies webpage. Below is an excerpt. Question: Can Prior Authorization Home Health services and Structured Family Caregiving be provided concurrently to a Medicaid recipient? Answer: Yes. A waiver recipient can be authorized to receive Structured Family Caregiving and PA for Home Health. The services can be delivered on the same day but cannot be delivered at the same time. In addition, the services cannot be delivered by the same paid caregiver. Question: Can an individual be both the paid principal caregiver of Structured Family Caregiving and paid to provide PA for Home Health services for the same Medicaid recipient? Answer: No. To be eligible for PA for Home Health services (both Nursing and Home Health Aide), an individual’s primary caregiver must be unavailable to provide care for one or more reasons (IHCP Home Health Services module, pg. 3). The primary caregiver cannot be unavailable so that the individual is eligible for PA for Home Health services, while also being paid to deliver those same services. Question: If I am the paid principal caregiver for a waiver recipient receiving Structured Family Caregiving, can another member of our household be a Home Health Aide for them, assuming they are qualified to do so? Answer: Yes, Structured Family Caregiving and PA for Home Health services can both be authorized as long as they are not provided by the same individual and not provided at the same moment in time. Additional FAQs are available on the FSSA Medicaid Strategies webpage. Send your questions to Medicaid@fssa.in.gov. Waiver transition A&D Waiver will split on July 1 On July 1, the Aged and Disabled Waiver will split into two waivers. These waivers have been approved by CMS. You can read more here. Members 59 and under This waiver is being renamed the Health & Wellness Waiver and is transitioning to the Division of Disability and Rehabilitative Services. You should continue to work with your care manager for any waiver-related needs. Members over 60 The Indiana PathWays for Aging program begins July 1. The Office of Medicaid Policy and Planning is committed to providing continuity of care for members as they transition. Managed care entities will provide continuity of care for the authorization of services and choice of providers for 90 days after PathWays begins. Members may call 87-PathWay-4 (877-284-9294) to change their plan. TBI Waiver to transition on July 1 On July 1, the Traumatic Brain Injury Waiver will transition to the Division of Disability and Rehabilitative Services.