From DDRS
"FSSA is offering an opportunity for feedback on extraordinary care as defined in the provision of attendant care for individuals on the Health & Wellness, Traumatic Brain Injury, and Pathways for Aging waivers as well as for individuals utilizing Participant Assistance and Care on the Family Supports waiver. In order for personal care services to be an allowable option in waiver services, the state must define what types of supports are considered beyond what a parent or spouse would be ordinarily obligated to provide.
The proposed definition is as follows:
"Extraordinary care" means care provided by the parent of a minor child or a spouse that the individual is unable to perform independently to meet his or her intensive nursing care needs under the supervision of an interdisciplinary team. Intensive nursing care needs includes continuous ventilator care, tracheostomy care, Total Parenteral Nutrition (TPN), or other comparable nursing services approved by the Family and Social Services Administration (FSSA). The care must exceed the range of activities that a legally responsible individual would ordinarily perform in the household on behalf of a person of the same age without a disability or chronic illness.
The current definition of extraordinary care in the provision of Structured Family Caregiving on Health & Wellness, Traumatic Brain Injury, and Pathways for Aging waivers will remain unchanged and will not be impacted by the above proposed definition.
As a reminder, when a state provides for the payment to a legally responsible individual for extraordinary care, the service must meet all the waiver criteria required when delivered by a customary provider. Additionally, a state must satisfy some additional policies and oversight activities which include ensuring that the provision of service by the legally responsible individual is in the best interest of the waiver participant and may include safeguards such as limiting the amount of services that a legally responsible individual may provide.
Please send your feedback to BDS.Help@fssa.in.gov or Medicaid@fssa.IN.gov by June 15, 2025, to be considered for inclusion in the upcoming waiver amendment."
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