Frequently Asked Questions
The Indiana Medicaid waiver allows individuals with disabilities of all ages who choose to live in their own home as opposed to an institution (i.e. nursing facility, group home, etc.) to receive Medicaid-funded services that they otherwise would've received at an institution. These Medicaid-funded services take place both in the individuals home and out in the community, with the intent to assist them in being as independent as possible and live in the least restrictive environment, while maintaining safety and comfort in their own home.
Essentially, the waiver program through Indiana Medicaid "waives" the institution option in order for Medicaid to fully fund home and community-based services, such as recreational therapy and behavior management, while the individual continues to live at home.
While Indiana Medicaid has many waivers that provide services to many people, recreational therapy and behavior management services can be found on the Community Integration and Habilitation Waiver and the Family Supports Waiver, which is under the Division of Disability and Rehabilitative Services.
To be eligible for DDRS Medicaid waiver funding (which is the division of Medicaid that offers recreational therapy and behavior management services), individuals must:
Be diagnosed with an intellectual disability prior to the age of 22.
Reside in or be transitioning into an HCBS-compliant setting (non-institutionalized).
Have income no greater than 300% of the maximum Supplemental Security Income amount (parental income for children under 18 years of age is disregarded).
Meet the Level of Care (LOC) requirements (explained below).
Level of Care (LOC) is the minimum need an individual must have to be considered eligible for waiver services. This is evaluated when you initially apply and annually after approval. For the purposes of LOC, an individual must have a disability that:
Results in impairment of functioning similar to that of a person who has an intellectual disability, including autism, epilepsy, cerebral palsy, or a similar condition (other than mental illness).
Originates before the person is 22 years of age.
Has continued or is expected to continue indefinitely.
Substantially limits the person's ability to engage independently in at least three of six life areas:
Self-care
Receptive/expressive language
Learning
Mobility
Self-direction
Capacity for independent living
Requires access to 24-hour assistance, as needed.
Source: Indiana Medicaid
Applying for the Indiana Medicaid waiver can be done by one of the following options:
Complete an online application.
Print, complete, and mail a paper application to your local BDS office.
For more thorough information regarding the application process, please check out our Waiver Process page, or this document and search for "Application and Start of Waiver Services" in the table of contents.
The waiver is full of acronyms and the vocabulary can be difficult to understand. Below are some of the most common acronyms used amongst Indiana Medicaid waiver providers. If you ever need further clarification, please don't hesitate to contact us!
(Scroll left to right if viewing on a mobile device)
Acronym | Meaning | Description |
BC | Behavior Consultant | Behavior consultant is the title for those who provide behavior management services on the waiver. |
Bureau of Disabilities Services | BDS, commonly pronounced as "beeds," is the hierarchy of FSW & CIH waivers and the services available within those waivers for individuals with disabilities. | |
Behavior Management | An acronym to distinguish behavior management services. | |
BSP | Behavior Support Plan | A BSP is a tool utilized for behavior management services. It is a document that outlines an individual's target behaviors (i.e. the challenging/harmful behaviors that are being targeted to decrease), how to proactively prevent target behaviors, what to do if a target behavior occurs, how to teach an individual positive replacement strategies intended to replace target behaviors, and much more. Consistent use of a BSP by all team members can in time increase positive behaviors and decrease target behaviors. |
Bureau of Quality Improvement Services | BQIS is an extension of BDS that ensures all waiver agencies are providing quality, ethical services by implementing practices in order to maintain accountability. These practices include incident reporting, formal complaints, mortality reviews, and more. | |
Community Integration and Habilitation (Waiver) | The CIH waiver is one of the two waivers that offer recreational therapy and behavior management services, the other is FSW. | |
CM | Case Manager | A case manager is essentially the mediator between you and your waiver services. They are the only service that every waiver recipient is required to have, as they play an integral role in helping you understand the waiver and services available to you, assisting you in maintaining your waiver status, and much more. |
Centers for Medicare & Medicaid | CMS, particularly Medicaid, is the funding source for the waiver. Once an individual becomes an eligible waiver recipient, they become eligible for Medicaid, regardless of their income status. Obtaining Medicaid is a requirement in order to be fully accepted onto the Medicaid waiver. | |
Division of Disability, Aging, & Rehabilitative Services | DDARS, commonly pronounced as "dee-dars", is the division where the CIH & FSW waivers fall under. | |
Family Support Waiver | FSW is one of the two waivers that offer recreational therapy and behavior management services, the other is CIH. | |
Home and Community-Based Services | A term used to describe home and community-based services offered on the waiver, which includes services on the CIH & FSW waivers. | |
HRC | Human Rights Committee | HRC is a volunteer committee of people at New Leaf who review restrictive measures within a behavior support plan, or BSP, in order to protect the rights of individuals and to ensure all human rights are not being violated. |
IDD | Intellectual and Developmental Disabilities | IDD is a simple acronym to distinguish the individuals that are eligible to receive medicaid-funded services on the CIH & FSW waivers. |
IDT or IST | Interdisciplinary Team or Individualized Support Team | This team is a collection of all the individual service providers that you receive waiver services from. |
LOC | Level of Care | Level of care is the minimum level of needs an individual must require to be considered eligible for HCBS waiver services. |
NOA | Notice of Action (also known as an SA or Service Agreement) | A Notice of Action/Service Agreement is a document that outlines the amount of hours per plan year that each service is allotted from an individuals waiver budget. These hours ultimately determine the length and frequency of sessions with each waiver service. |
PCISP | Person-Centered Individualized Support Plan | A PCISP is a document that outlines an individual's vision of a preferred life that reflects their hopes and dreams in order to promote opportunities that exercise choice and self-determination. This document plays a vital role in the creation of goals within each service in order to ensure that all goals are aligned with the individuals preferred life. |
Recreational Therapy | An acronym to distinguish recreational therapy services. | |
RT | Recreational Therapist | Recreational therapist is the title for those who provide recreational therapy services on the waiver. |
SA | Service Agreement (also known as an NOA or Notice of Action) | A Service Agreement/Notice of Action is a document that outlines the amount of hours per plan year that each service is allotted from an individuals waiver budget. These hours ultimately determine the length and frequency of sessions with each waiver service. |