The PathWays Waiver for individuals aged 60 and older and the Health and Wellness Waiver for individuals 59 and younger provide home and community-based services to eligible Hoosiers who need nursing facility level of care. Per the federal approvals, both waivers have a designated number of slots available. A slot can only be used by one person during the July 1, 2024, through June 30, 2025, waiver year and cannot be re-used by a different person if a member no longer needs services, for example if the individual moved out of state. Family and Social Services Administration reached its approved capacity for the prior waiver year in April 2024 and implemented a waiting list.
When the new waiver year began on July 1, FSSA began inviting a group of individuals from the Health and Wellness Waiver and PathWays Waiver waiting lists each month to continue the process to begin receiving home and community-based services as long as capacity remains. Based on the number of slots, the number of people on the waiting list, and the steps that must be taken, FSSA plans to invite individuals as follows:
- 125 individuals per month to Health and Wellness Waiver
- 800 individuals per month to PathWays Waiver
These estimates are based on the steps that must be taken following invitation, with the goal of allowing eligible members to access services as quickly as possible. For example, face-to-face level of care assessments must be completed, and functional eligibility and Medicaid eligibility must be determined. Individuals invited to proceed will receive a letter with further details.
The information below shows the number of individuals invited each month from waiting list. For informational checklist and additional resources about the waiting lists please visit the Medicaid Strategies page here.
Health and Wellness Waiver
Priority Status | |||||
---|---|---|---|---|---|
Month | Transition from Nursing Facility | Discharge from Hospital | Transition from CHOICE | Invited Based on Date of Application | Total Invitations Sent* |
July 2024 | 42 | 17 | 18 | 58 | 135 |
August 2024 | 6 | 11 | 13 | 101 | 131 |
Total for Waiver Year (July 1, 2024 - June 30, 2025) | 48 | 28 | 31 | 159 | 266 |
* Total invitations sent each month include the 125 slots planned for release plus slots that were declined or otherwise not utilized.
PathWays Waiver
Note: No waiting list exists for the overall PathWays program, only individuals eligible for waiver services under PathWays are placed on the waiting list.
Priority Status | |||||
---|---|---|---|---|---|
Month | Transition from Nursing Facility | Discharge from Hospital | Transition from CHOICE | Invited Based on Date of Application | Total Invitations Sent* |
July 2024 | 161 | 19 | 103 | 573 | 856 |
August 2024 | 13 | 16 | 24 | 819 | 872 |
Total for Waiver Year (July 1, 2024 - June 30, 2025) | 174 | 35 | 127 | 1,392 | 1,728 |
* Total invitations sent each month include the 800 slots planned for release plus slots that were declined or otherwise not utilized.
Last updated: 8/20/2024