In 2011, the Division of Disability and Rehabilitative Services (DDRS) was charged by the Indiana General Assembly with responding to six categories identified as important in Section 144 of the 2011 House Enrolled Act (HEA) 1001, otherwise known as the budget bill. The Division’s task was to consider how to reduce the aggregate and per capita spending of its Waiver programs.
DDRS convened a stakeholder workgroup to discuss the topics defined in Section 144 of HEA 1001, as well as a broader scope of program areas administered by the Division. Goals and objectives were designed to better serve individuals with disabilities and help them to lead more independent lives in their homes, workplaces, and communities.
Recommendations outlined in this report address three priorities of the Division: employment development, family unity, and appropriate and cost-effective services for persons with complex support needs. Further, these recommendations are methods by which the Division plans to eliminate the DDRS Medicaid Waiver Wait List over the course of the new few years.
Frequently Asked Questions
Why does DDRS have to amend the Supports Services Waiver?
The Centers for Medicare & Medicaid Services (CMS) requires that states submit a request to amend or make changes to any of its Waiver programs. CMS will review the proposed changes, and provide feedback to the submitting state, including clarifying questions, suggestions, etc. No changes to any of DDRS’ Medicaid Waivers can be made without CMS’ approval.
What changes are being made to the Support Services Waiver?
Changes to the Support Services Waiver are designed to support preservation of the family unit. Proposed changes include:
- Changing the name of the Waiver to “Family Supports Waiver”
- Adding a residential service option to the waiver; Participant Assistance and Care (PAC) service
- Providing services on an as-needed basis, as needs dictate certain services are critical for achieving successful outcomes for the individual
- A new Case Management service, which will allow a seamless transition from contracted case management to waiver funded case management services with more choice for individuals
- Increasing the annual reimbursement cap above the current amount of $13,500 to enable families currently using the Support Services Waiver to utilize these new services without migrating to the DD Waiver. As more families seek waiver services, this waiver will also provide them more comprehensive supports.
What is the new residential service being added to the new Family Supports Waiver?
The Participant Assistance and Care (PAC) Service will be added as an option to the Family Supports Waiver. Participant Assistance and Care (PAC) Services are provided to allow participants (consumers) with developmental disabilities to remain and live successfully in their own homes, function and participate in their communities and avoid institutionalization. PAC services support and enable the participant in activities of daily living, self-care, and mobility with the hands-on assistance, prompting, reminders, supervision and monitoring needed to ensure the health, safety and welfare of the participant. Activities may include any task or tasks of direct benefit to the participant that would generally be performed independently by persons without developmental disabilities or by family members for or on behalf of persons with developmental disabilities.
To what amount will the spending cap be raised on the new Family Supports Waiver?
In the first year of implementation, the cap will be raised from $13,500 to $16,250, which must include the cost of case management services. This will enable families using the current Support Services Waiver to utilize new services without migrating to the Developmental Disabilities Waiver, and provide more comprehensive supports to new families seeking services.
Why is DDRS making these changes?
DDRS is making these changes so that people can transition from the Medicaid Waiver Wait List to Medicaid Waiver services more quickly. As people incrementally transition onto this waiver, which is designed to better meet their needs, it is anticipated that the wait list will be eliminated by 2017.
When will all of these changes take effect?
DDRS submitted its SSW Waiver amendment to CMS on April 16, 2012. CMS may take up to 90 days to review DDRS’ request and provide feedback. Upon approval, which is anticipated for July 2012, DDRS will begin implementing these changes.