Indiana Waiver Changes Are Coming

BY DAROLYN “LYN” JONES AND TENDRA DUFF

Introduction

The following article is a synopsis of critical information from the Ask the Arc Webinar Series titled “Waiver Transition and Redesign Update” with Director of Arc Advocacy Karly Sciortino-Poulter and Cathy Robinson, Associate Director of the Division of Disability and Rehabilitative Services (DDRS).

In this webinar, Robinson explained how the end of the Covid public health emergency (PHE) impacts flexibilities to the Indiana Medicaid Waivers enacted during the PHE and also discusses changes and updates to the Aged and Disabled (A&D) waiver, and administrative reclassification of the Traumatic Brain Injury (TBI) waiver.

You can watch the entire webinar, “Waiver Transition and Redesign Update” at https/www.youtube. com/watch?v=3ciedI6Lwk4.

If you want more general information about the Indiana Medicaid Waivers, you can learn more about what those waivers are, who qualifies, and how to apply here: https/insource.org/files/pages/0093Medicaid_Waiver_Guide_2013.pdf

In Indiana, the Division of Disability and Rehabilitative Services, or DDRS, is under the Family and Social Services Administration (FSSA). The DDRS oversees the Bureau of Disability Services (BDS), Vocational Rehab Services, and First Steps, among other disability services. Learn more about the DDRS and its programs and services here https/www.in.gov/fssa/ddrs/

Public Health Emergency (PHE) Ends

In January of 2020, during the COVID-19 pandemic, the federal government declared a public health emergency (PHE), which allowed for critical services, including free Covid home tests, telemedicine, and flexibility for Medicaid Waiver services. The PHE officially ended May 11, 2023.

Some emergency services, such as free Covid home tests, ended immediately. States have six months, or until November 11, 2023, to transition out of other changes made during the PHE. The transition process is informed by what the state has learned during the PHE and from listening to families and individuals who receive those services. The end date was determined by the federal government.

During the PHE, a limited time flexibility was granted to parents and legal guardians of minor dependent children enrolled in the:

• Family Support

Waiver (FSW)

• Community Integration and Habitation (CIH) waiver.

The parent/guardian could be compensated for support provided to their dependent for up to 30 days when the minor child or their direct support professional had tested positive for COVID-19.

The services to which the flexibilities applied were:

• participant assistance and care

• community based rehabilitation

• residential habilitation

A common question is whether parents will continue to get paid to care for their minor children under these two waivers. The answer is no. This PHE flexibility will end by November 11, 2023.

Note that parents of adult children under these two waivers will continue to be paid for 40 hours of care per week, as was true before the pandemic.

Waivers NOT impacted by the end of the PHE flexibilities are the:

• Aged & Disabled (A&D) waiver

• Traumatic Brain Injury (TBI) waiver

Parents and legal guardians may be paid caregivers of minor, dependent children through two A&D and TBI waiver services in approved waiver service plans:

• attendant care

• home and community assistance services

Some families may be familiar with this guidance as “medically complex warriors” guidance.

If you want more information about how to be paid to be your child’s caregiver, reach out to Tendra Duff at Guardian Care: tendra.duff@myguardian.care

Waiver Transition, Renaming, and Future Changes Coming

Individuals who are age 59 and under and currently have the A&D waiver will now be covered under the Health and Wellness Waiver. This waiver will be moved from the Division of Aging to the DDRS.

Individuals who currently have the A&D waiver and who are 60 and over, will now be covered by the Pathways for Aging Waiver. Learn more about these changes here https/www.in.gov/fssa/indianapathways-for-aging/managed-longterm-services-and-supports/

Note that the TBI waiver will not undergo changes at this time, other than to be administratively moved to DDRS. FSSA has a FAQ publication for waiver transition questions. Find that document here: https/www.in.gov/fssa/ddrs/files/ FamilyWaiverTransitionFAQ.pdf To learn more about considerations, feedback, and recommendations, check out these two important publications:

• The Indiana Waiver Redesign Concept Paper was written in 2020 and explores the changes the state was considering to the waivers. https/www.in.gov/fssa/ddrs/files/ IndianaConceptPaper_FINAL.pdf

• The Path Forward publication is a follow-up to the Indiana Waiver Redesign Concept Paper and explains updates and recommendations for changes to the FSW and CIH waivers. https/ www.in.gov/fssa/ddrs/files/IN_ Path_Forward-July-22.pdf

DDRS will continue to solicit feedback from families and individuals at waiver transition stakeholder engagements, virtual listening sessions, and quarterly building bridges meetings. Find information about those opportunities here https/ www.in.gov/fssa/indiana-pathwaysfor-aging/stakeholder-engagement/

How are services impacted by the changes to the A&D waiver? For families transitioning from the A&D to the Health and Wellness Waiver, you can remain with your same case management and your services and budgets will remain the same. The wait lists should not necessarily be impacted by these changes because the qualifiers are not changing for the new waiver.

I need help or I still have questions! We encourage individuals and families to reach out to other individuals or families they know, to their Medicaid case managers, to the ARC of Indiana https/www. arcind.org and to parent support organizations like Family to Family https/www.inf2f.org/ and INSource https/insource.org to learn more.

As parents ourselves, we would encourage families to consult MORE than one source for best clarification of questions.