Indiana Home and Community-Based Services Waivers

The following programs allow Indiana Medicaid programs to pay for services that are provided in a person’s home or other community setting, rather than a Medicaid funded facility or institution. Persons must qualify for institutional care (nursing facility level of care) in order to be eligible for home and community-based services. Waiver refers to the waiving of certain federal requirements that otherwise apply to Medicaid program services. The Division of Aging oversees two waivers; they are the Aged and Disabled Waiver (A&D), and the Traumatic Brain Injury Waiver (TBI).

LifeSpan Resources’ case managers assist program participants by coordinating and integrating services that are required in the participant’s service plan.

  • Aged and Disabled Medicaid Waiver – Serves individuals who meet Medicaid eligibility (special income limits are taken into consideration for waiver eligible individuals) and who would otherwise need to receive care in a nursing facility without in-home services. Individuals must be elderly, disabled or have skilled medical needs. The Aged and Disabled waiver is designed to provide services to supplement informal supports and meet critical needs. Waiver services can be used to help people remain independent in their homes, as well as assist those living in nursing facilities to return to community settings, including their own homes, apartments, assisted living facilities or adult foster care homes. Please see available services list below.
  • Traumatic Brain Injury Waiver – Serves persons who have suffered injuries to the brain from an outside cause, including closed or open head injuries, toxic chemical reactions, anoxia, near drowning and focal brain injuries. Traumatic Brain Injury Waiver does not include injuries that are vascular in origin (cerebral vascular accident or aneurysm), alcoholism, Alzheimer’s disease or the infirmities of aging.

 

Money Follows the Person Program

The Money Follows the Person Program is designed to move individuals from institutional settings such as nursing facilities to home and community-based settings. It is funded through a federal grant from the Centers for Medicare and Medicaid Services (CMS). Eligible individuals must be a current resident of a qualifying institution (nursing facility); must have been a resident for the past 90 consecutive days (not counting Medicare days); must have needs that can be safely met through services in the community; must be an Indiana Medicaid eligible recipient at least one day prior to discharge from institution and must meet nursing facility level of care.

Case management services are provided to assess needs and assist with the transition to home or other community-based setting. Limited funds can be provided to help with establishing a new home.

Available Services

Adult Day Services: Community-based group programs designed to meet the needs of adults with impairments through individual service plans.

Adult Family Care:  Adult family care (AFC) is a comprehensive service in which a participant resides with an unrelated caregiver so the participant may receive personal assistance.

Assisted Living: Assisted living service is defined as personal care and services, homemaker services, chores, attendant care and companion services, medication oversight (to the extent permitted under State law), and therapeutic social and recreational programming provided in a home-like environment in a residential facility that is licensed by the Indiana State Department of Health (ISDH), in conjunction with residing in the facility.

Attendant CareAttendant care services primarily involve hands-on assistance for aging adults and persons with disabilities.

Behavior Management (TBI only): training, supervision or assistance in appropriate expression of emotions and desires, assertiveness, acquisition of socially appropriate behaviors and the reduction of inappropriate behaviors.

Case Management: Medicaid waiver case managers coordinate and integrate all services required in a participant’s person centered plan, link participants to needed services, and ensure that participants continue to receive and benefit from services. Waiver case managers enable participants to receive a full range of services needed due to a medical condition in a planned, coordinated, efficient and effective manner.

Community Transition: Community transition services include reasonable setup expenses for individuals who make the transition from an institution to their own home.

Environmental Modifications: Environmental modifications are minor physical adaptations to the home that are necessary to ensure the health, welfare, and safety of the individual.

Healthcare Coordination: Healthcare coordination includes medical coordination provided by an RN to manage the healthcare of the individual including physician consults, medication ordering, and development and nursing oversight of a healthcare support plan.

Home-Delivered Meals: A home delivered meal is a nutritionally balanced meal. “Meals To Go”; Diabetic Meals, Soft Foods, Puree and breakfast boxes prepared by a caterer. Homebound meals are delivered weekly and include 7 complete meals.

Homemaker Services: Homemaker services offer direct and practical assistance consisting of household tasks and related activities.

Nutritional Supplements: Nutritional (dietary) supplements include liquid supplements, such as Boost or Ensure, to maintain an individual’s health in order to remain in the community.

Personal Emergency Response System: An electronic device that enables the person to secure help in case of any emergency.

Pest Control: Services that are designed to prevent, suppress, or eradicate anything that competes with humans for food and water, injures humans, spreads disease to humans, or annoys humans, and is causing or is expected to cause more harm that is reasonable to accept. Pests include things such as roaches, mosquitoes, fleas, ticks and mice.

Residential-Based Habilitation (TBI only): Service provides training to regain skills that were lost secondary to the traumatic brain injury.

Respite Services: Periodic, short-term care to a person when the family member or the primary caregiver cannot be there or needs a rest from his/her care responsibilities. Does not include “child care” to enable caregiver to work or attend school.

Self-Directed Attendant CareEnables Medicaid Waiver participants to hire their own personal attendant.

Specialized Medical Equipment and Supplies: Specialized medical equipment and supplies are medically prescribed items which are necessary to assure the health, welfare, and safety of the individual.

Structured Family Caregiving: A living arrangement in which a participant lives in his or her private home or the private home of a principal caregiver who may be a non-family member or a family member who is not the legal guardian of the participant.

Supported Employment (TBI only): services consist of paid employment for persons for whom competitive employment at or above the minimum wage is unlikely, and who, because of their disabilities, need intensive ongoing support to perform in a work setting.

Transportation: Non-medical transportation services are services offered to enable individuals served under the waiver to gain access to waiver and other community services, activities, and resources as specified in the service plan.

Vehicle Modifications: The addition of adaptive equipment or structural changes to a motor vehicle that permit and individual with a disability to safely transport in a motor vehicle. Vehicle modifications, as specified in the service plan, may be authorized when necessary to increase an individual’s ability to function in a home and community-based setting and to ensure accessibility of the individual with mobility impairments.