part 4

[Virtual Presenter] We would like to provide information on the application process for the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs. There are two methods available for applying for these programs: an online application and completing and returning an Application for Developmental Disability Services (State Form 55068) to the local B-D-S office. If you choose to apply through the online application, you can access it at Bdsgateway.fssa.in.gov. This option is available to individuals and families seeking services and is available 24 hours a day, seven days a week. Alternatively, if you prefer to apply through the traditional method, you can complete, sign, and date an Application for Developmental Disability Services (State Form 55068), which is available on the D-D-R-S Forms page at in.gov/fssa/ddrs. This form can be completed as a fillable P-D-F or handwritten and must be printed, signed, and returned to the local B-D-S office via fax, mail, or in-person delivery. Once your application has been received, B-D-S staff will discuss eligibility requirements with you, including documentation of an intellectual or developmental disability, Medicaid eligibility, and initial level of care (L-O-C--). If you are not a Medicaid member, you will be referred to the local Division of Family Resources (D-F-R--) office to apply for Medicaid. For applicants who have requested, met, and been approved for specific reserved waiver capacity (priority) criteria for entrance into the C-I-H Waiver program, they will be advised of available services and the availability of a funded priority slot. It is important to note that if you are under 18, you will need to submit a plan of care/service plan approval letter to the Family and Social Services Administration (F-S-S-A-) Division of Family Resources (D-F-R--) when submitting an application for Medicaid benefits or when requesting a change of Medicaid Aid Category to qualify for waiver eligibility. In conclusion, the application process for the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs is straightforward and accessible to all individuals seeking services. Whether you choose to apply through the online application or the traditional method, B-D-S staff will be available to guide you through the eligibility requirements and provide you with the necessary information to access the services you need to live a fulfilling and integrated life within your community. Thank you for your attention, and we hope this information is helpful..

[Audio] We are here to discuss the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs, which have two application options. The first option is the B-D-S Gateway, an online application available 24/7. The second option is to complete and return an Application for Developmental Disability Services (State Form 55068) to the local B-D-S office. B-D-S staff will discuss eligibility requirements, including documentation of an intellectual/developmental disability, Medicaid eligibility, and initial level of care (L-O-C--). If the applicant is not a Medicaid member, they will be referred to the local Division of Family Resources (D-F-R--) office to apply for Medicaid. C-I-H Waiver program applicants who meet specific reserved waiver capacity (priority) criteria will be advised of available services and a funded priority slot. Medicaid eligibility is also discussed, with applicants under 18 required to submit a plan of care/service plan approval letter to the Family and Social Services Administration (F-S-S-A-) Division of Family Resources (D-F-R--). Now, let's dive into the Initial Level of Care Evaluation for F-S-W and C-I-H Waiver. For the F-S-W and C-I-H Waiver, an individual targeted for the F-S-W or who meets reserved waiver capacity (priority) criteria and is approved for entrance into the F-S-W or C-I-H Waiver program, must meet the level of care (L-O-C--) required for placement in an intermediate care facility for individuals with intellectual disabilities (ICF/IID). All L-O-C determinations require secondary review to ensure accuracy. Initial L-O-C determinations are made by a B-D-S service coordinator, including a new “initial” L-O-C for individuals who have been terminated from the Home and Community-Based Services (H-C-B-S-) waiver program but desire to return to waiver services within the same waiver year. Reevaluations are performed by the selected provider of Case Management services. For those applicants whose initial L-O-C evaluation was unfavorable, the information is submitted to the B-D-S Central Office for a tertiary review. The F-S-S-A Office of Medicaid Policy and Planning (O-M-P-P-) retains final authority for determination of eligibility. Only individuals (state employees) who are Qualified Intellectual Disability Professionals (QIDPs), as specified by the standard in Code of Federal Regulations 42 CFR 483.430(a), may perform initial L-O-C determinations. If collateral records are not available or are not valid reflections of the individual, additional assessments may be obtained from contracted psychologists, physicians, nurses and licensed social workers. Following review of the collateral records, the L-O-C assessment tool applicable to individuals with intellectual/developmental disabilities and other related conditions is completed to ascertain if the individual meets ICF/IID L-O-C-. The L-O-C assessment tool is used for reviewing and referencing documentation related to the intellectual/developmental disabilities of the applicant or individual, as well as any psychiatric diagnosis and results of the individual’s intellectual assessment. It is also used to record the age of onset and identify areas of major life activity in which the individual may exhibit a substantial functional limitation, including the areas of mobility, understanding and use of language, self-care, capacity for independent living, learning, self-direction, economic self-sufficiency, and the state definition of developmental disability found in Indiana Code IC 12-7-2-61. The B-D-S service coordinator (initial L-O-C--) or selected provider of case management (reevaluations) reviews the L-O-C assessment tool and collateral material applicable to individuals with intellectual/developmental disabilities and other related conditions to ascertain whether the individual meets ICF/IID LOC requirements. An applicant or individual must meet requirements for three of six substantial functional limitations and each of four basic conditions (lists follow) to meet L-O-C criteria. The basic conditions are:.

[Audio] We are here to discuss the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs and the application process. There are two options for applying: the B-D-S Gateway, an online application available 24/7, or completing and returning an Application for Developmental Disability Services (State Form 55068) to the local B-D-S office. B-D-S staff will discuss eligibility requirements, including documentation of an intellectual/developmental disability, Medicaid eligibility, and initial level of care (L-O-C--). If the applicant is not a Medicaid member, they will be referred to the local Division of Family Resources (D-F-R--) office to apply for Medicaid. C-I-H Waiver program applicants who meet specific reserved waiver capacity (priority) criteria will be advised of available services and a funded priority slot. Medicaid eligibility is also discussed, with applicants under 18 required to submit a plan of care/service plan approval letter to the Family and Social Services Administration (F-S-S-A-) Division of Family Resources (D-F-R--). After the evaluation is complete, a L-O-C decision letter is sent to the individual or legal guardian. Each L-O-C decision letter provides a Right to Appeal Notice explaining the individual’s right to appeal the decision as well as how to file an appeal. For more on appeals, see Section 8: Appeals Process in this module. Note that for information about the waiting list for the H&W Waiver, see the Section 12.1: Eligibility for the H&W and T-B-I Waiver Services. The B-D-S policy states individuals may be placed on a single statewide waiting list after applying for waiver services and meeting specified criteria. Individuals are responsible for maintaining current collateral and contact information with their local B-D-S office. To apply for H-C-B-S waiver services, an individual or their legal representative must complete an application and submit it to their local B-D-S office. The application requires collateral information, including the L-O-C assessment tool, supporting documents such as diagnostic evaluations, functional evaluations, psychological reports, individualized education program from schools, school records, physician’s diagnosis and remarks, existing evaluation done by Supplemental Security Income (S-S-I--) or Vocational Rehabilitation, intelligence quotient (I-Q---) testing done at any time, Medicaid application for individuals over 18 years of age, and S-S-I application, if applicable. The L-O-C must be assessed for all individuals..

[Audio] We will be discussing DDRS HCBS Waivers. D-D-R-S stands for the Disability Determination and Rehabilitation Services. H-C-B-S stands for Health Care Benefits for Children with Special Health Care Needs. DDRS HCBS Waivers refer to the waivers that were granted to the Disability Determination and Rehabilitation Services for the Health Care Benefits for Children with Special Health Care Needs..

[Audio] We are excited to present to you on Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs. During this session, we will be discussing the application process and eligibility requirements for these programs. There are two options for applying: the B-D-S Gateway, an online application available 24/7, and returning an Application for Developmental Disability Services (State Form 55068) to your local B-D-S office. Our staff will review eligibility requirements, including proof of an intellectual/developmental disability, Medicaid eligibility, and initial level of care (L-O-C--). If you are not a Medicaid member, you will be referred to the local Division of Family Resources (D-F-R--) office to apply for Medicaid. C-I-H Waiver program applicants who meet specific criteria will be informed of available services and a funded priority slot. Medicaid eligibility is also discussed, with applicants under 18 required to submit a plan of care/service plan approval letter to the Family and Social Services Administration (F-S-S-A-) Division of Family Resources (D-F-R--). If you have any questions about the application process or eligibility requirements, please do not hesitate to reach out to your local B-D-S office for assistance. Thank you for your attention..

[Audio] This section of the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs is open to all individuals. We will provide information on how to apply and the eligibility requirements for these programs. Those who prefer to apply online can access the B-D-S Gateway, an online application available 24/7 from any location with internet access. Alternatively, an Application for Developmental Disability Services (State Form 55068) can be completed and returned to the local B-D-S office. To be eligible for the F-S-W program, individuals must have documentation of an intellectual/developmental disability, Medicaid eligibility, and an appropriate level of care. If the individual is not currently a Medicaid member, they will be directed to the local Division of Family Resources (D-F-R--) office to apply for Medicaid. For the C-I-H Waiver program, applicants must meet specific criteria to be considered for a priority waiver slot. This includes individuals transitioning from a nursing facility, Extensive Support Needs Home, State Psychiatric Hospital, or Supervised Group Living. To apply for a priority waiver slot, individuals, legal representatives, or other authorized persons must request and apply for the slot when the individual meets the necessary criteria. It is important to submit an application to the local B-D-S office to apply for H-C-B-S waiver services. Collateral information, such as the level of care assessment tool and relevant documents like diagnostic evaluations and functional evaluations, must also be provided. We strongly suggest that individuals and their legal guardians review any updated Person-Centered Individualized Support Plans (PCISPs) within seven days of the Individualized Support Team (I-S-T--) meeting, face-to-face visit, or conversation in which the need for revision is identified. PCISPs must be updated whenever there is a change in the individual's needs or circumstances, when services are added or removed, per the request of the individual or their legal representative, and during non-annual team meetings to record the team's discussion on outcomes and any related plan changes. Annual service plans are due 45 days from the date of the Individualized Support Team (I-S-T--) meeting..

[Audio] We will be discussing the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs. To apply for these programs, you have two options: the online application available 24/7 through the B-D-S Gateway or completing and returning an Application for Developmental Disability Services (State Form 55068) to the local B-D-S office. If you are applying for the F-S-W or C-I-H Waiver program, you will need to provide various documentation, including psychological reports, Individualized Education Programs from schools, school records, physician’s diagnosis and remarks, and existing evaluation done by Supplemental Security Income or Vocational Rehabilitation. Additionally, you will need to complete an IQ testing done at any time. If you are applying for a C-I-H Waiver priority slot, you will need to maintain current contact information with your local B-D-S office, including changes in address or telephone number. If you are unable to make contact with the B-D-S office by mail or telephone, you will forfeit the current opportunity for a C-I-H Waiver priority slot, but may reapply at any time. If you accept a funded C-I-H Waiver priority slot, you will need to attend an intake meeting with a service coordinator from the B-D-S--. During the intake meeting, collateral information provided by you will be reviewed and L-O-C will be re-established. You will need to complete a L-O-C assessment tool and have a Confirmation of Diagnosis (State Form 54727) signed by your physician within 21 calendar days from the date on the B-D-S letter offering a C-I-H Waiver priority slot. You will also have 60 calendar days from the date on the B-D-S letter to apply for and obtain Medicaid when you do not yet have Medicaid coverage. It is important to understand these requirements and ensure that all necessary documentation is provided in a timely manner. If you have any further questions, please do not hesitate to contact your local B-D-S office..

[Audio] 1. Apply for the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs by filling out the form on the B-D-S website or by returning the Application for Developmental Disability Services (State Form 55068) to the local B-D-S office. 2. To be eligible for the program, the individual must have an intellectual/developmental disability, Medicaid eligibility, and initial level of care (L-O-C--). If the individual already has Medicaid coverage but the aid category to which they are assigned is not compatible with waiver program requirements, they have 30 days from the date on the contact letter from the B-D-S to request that the D-F-R process the needed change in Medicaid aid category if they are eligible. 3. After all assessments have been made, the B-D-S gives applicants younger than the age of 18 and their legal guardians a choice list of case management providers that are approved by the D-D-R-S and enrolled through the I-H-C-P to provide selected contracting Case Management services. In those situations, the B-D-S creates the POC/service plan, enabling the minor to obtain Medicaid. 4. For adults, generating the B-D-S case management organization choice list and selecting a case management organization does not occur until after all eligibility criteria are met, including establishing Medicaid eligibility in a waiver-compatible aid category. 5. The timely completion of requirements for the P-C-I-S-P and service plan should be done through the B-D-S Portal 2.0 at bddsportal.fssa.in.gov. 6. The individual must work with the local B-D-S office if additional time is needed to complete any required steps in the process. 7. The state monitors and recently enhanced its person-centered planning process to ensure compliance with CMS 2249-F and CMS 2296-F. The new person-centered individualized support plan (P-C-I-S-P) approach enhances the way in which supports and services are explained to individuals and families so that their needs, aspirations and opportunities for the achievement of self-determination, interdependence, productivity, integration and inclusion in all facets of community life can be identified and explored. Additionally, the P-C-I-S-P drives the development of the POC/service plan. The P-C-I-S-P is the new plan that identifies the array of services and supports needed for the individual..

[Audio] If you are applying for the Family Supports Waiver (F-S-W--) program, you have two application options available: 1. The B-D-S Gateway, an online application available 24/7. If you choose this option, you will be directed to the B-D-S website where you will be able to complete the application online. 2. Completing and returning an Application for Developmental Disability Services (State Form 55068) to the local B-D-S office. If you choose this option, you will need to download the State Form 55068 and return it to the local B-D-S office. A BDS staff member will then discuss eligibility requirements with you, including documentation of an intellectual/developmental disability, Medicaid eligibility, and initial level of care (L-O-C--). If you are not a Medicaid member, you will need to apply for Medicaid through the local Division of Family Resources (D-F-R--) office. If you are applying for the Community Integration and Habilitation (C-I-H--) program, you will need to meet specific reserved waiver capacity (priority) criteria. If you meet these criteria, you will be advised of available services and a funded priority slot. In either case, you will need to develop a Plan of Care/Service Plan (POC/service plan) that identifies the supports and services that will be used to implement desired outcomes and ensure your health and welfare while the POC/service plan identifies those supports and services that are funded by the waiver. The POC/service plan is developed by the individual-chosen case manager a minimum of six weeks prior to the initial start date of services and then six weeks prior to the end date of each annual service plan. The POC/service plan is routinely developed to cover a time frame of 12 consecutive months. The POC/service plan is used to coordinate waiver services and other services. The case manager is responsible for ensuring that all identified services and supports have been implemented as identified in the P-C-I-S-P and the POC/service plan. The case manager is also responsible for monitoring and coordinating services on an ongoing basis and is required to record a case note for each encounter with, or on behalf of, the individual..

[Audio] For those interested in applying for the Family Supports Waiver and Community Integration and Habilitation Waiver programs, there are two options available. The first is through the B-D-S Gateway, an online application that is accessible 24/7. The second option is to complete and return an Application for Developmental Disability Services (State Form 55068) to your local B-D-S office. During the application process, our dedicated B-D-S staff will discuss the various eligibility requirements. This includes documentation of an intellectual or developmental disability, Medicaid eligibility, and initial level of care determination. If the applicant is not currently a member of Medicaid, they will be referred to their local Division of Family Resources (D-F-R--) office to apply for Medicaid. For those applying for the C-I-H Waiver program, if they meet certain reserved waiver capacity criteria, they will be advised of the available services and a funded priority slot. Medicaid eligibility will also be discussed during this time. It is important to note that applicants under the age of 18 will be required to submit a plan of care or service plan approval letter to the Family and Social Services Administration (F-S-S-A-) Division of Family Resources (D-F-R--). Moving on to Section 5 of the DDRS HCBS Waivers, we want to highlight some important information for children ages 1 through 18. According to Section 1902(a)(10)(A)(i)(V-I-I--) and (MA 9, MA 2), transitional medical assistance is available. Additionally, for individuals in Sec 1634 states such as Indiana who are aged, blind, or disabled, those who are eligible for Supplemental Security Income (S-S-I--) will be automatically enrolled in the Indiana Health Coverage Programs (I-H-C-P-). This means they will not need to file a separate Indiana Application for Health Coverage. Furthermore, for those who receive S-S-I and are deemed disabled by the Social Security Administration, they will not be required to undergo a separate determination of disability from Indiana's Medical Review Team (M-R-T--). For individuals who receive Social Security Disability Income (S-S-D-I-), they will also not be required to undergo a separate determination of disability from Indiana's M-R-T--. As a reminder, a financial eligibility determination will still be required for all applicants. Thank you for your attention and we hope this information has been helpful. Please continue to the next slide for more important details on the F-S-W and C-I-H Waiver programs..

[Audio] This section will discuss the application process for the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs. There are two options for applying: the B-D-S Gateway, an online application available 24/7, or completing and returning an Application for Developmental Disability Services to the local B-D-S office. Our B-D-S staff will review the eligibility requirements, including documentation of an intellectual/developmental disability, Medicaid eligibility, and initial level of care. Non-Medicaid members will be referred to the local Division of Family Resources office to apply. For C-I-H Waiver program applicants who meet specific reserved waiver capacity criteria, they will be informed of available services and receive a funded priority slot. We will also discuss Medicaid eligibility and, for applicants under the age of 18, the requirement to submit a plan of care or service plan approval letter to the Family and Social Services Administration Division of Family Resources. Moving on to section 5.9, we will cover the initial service plan implementation for F-S-W and C-I-H Waiver. It is important to note that an individual cannot start receiving waiver services under these programs without the approval of their initial Plan of Care (P-O-C--) or service plan by the state's waiver specialist. This plan is determined through the Person-Centered Individualized Support Plan (P-C-I-S-P) development process. If the waiver specialist issues an initial approval letter with certain conditions, those conditions must be resolved before the start of the individual's waiver services. For applicants under the age of 18, if their Medicaid eligibility is approved pending waiver approval, the case manager will notify the local Division of Family Resources caseworker when the waiver has been approved. It is important to remember that once waiver services begin, individuals may be referred to as beneficiaries or members for Medicaid purposes. Thank you for your attention to section 5 of our presentation on the Family Supports Waiver and Community Integration and Habilitation Waiver programs. In our final section, we will cover the ongoing process of maintaining and monitoring waiver services..

[Audio] Welcome to section 13 of our presentation on the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs. In this section, we will be discussing the objective-based allocation (O-B-A--) methodology for the C-I-H Waiver program. The O-B-A methodology is used by the Family and Social Security Administration (F-S-S-A-) Division of Disability and Rehabilitative Services (D-D-R-S-) to determine the level of supports an individual needs to live in a community setting while receiving services under the C-I-H Waiver. This methodology was developed in 2007 in collaboration with advocates, providers, and industry professionals. It involved extensive research, cost reporting by providers, modeling, assessment validation, pilots, and best practices. The parameters for the algorithm (Algo) were determined through modeling, which combines the overall Algo determined by the Inventory for Client and Agency Planning (I-C-A-P-) and the ICA. Section 6.1 focuses specifically on the development of the O-B-A for the C-I-H Waiver. This included baseline research, provider cost reporting, modeling, assessment validation, pilots, and best practices. The use of modeling allowed us to determine the parameters for the algorithm development. It's important to note that the O-B-A is determined by combining the overall Algo with the results from the I-C-A-P and I-C-A--. This ensures an accurate and fair assessment of an individual's needs for living in a community setting while receiving services under the C-I-H Waiver. Thank you for your attention to this important section of our presentation. In the next section, we will discuss the results of the O-B-A and how they impact the allocation of supports for individuals under the C-I-H Waiver program..

[Audio] We have now completed our presentation on the Family Supports Waiver and Community Integration and Habilitation Waiver programs. To wrap things up, we would like to discuss the application process. There are two options available: the B-D-S Gateway, an online application that is accessible 24/7, or filling out and returning an Application for Developmental Disability Services to your local B-D-S office. During the application process, B-D-S staff will go over the eligibility requirements with you. This includes providing documentation of an intellectual or developmental disability, proving Medicaid eligibility, and determining your initial level of care. If you are not currently a Medicaid member, you will be directed to your local Division of Family Resources office to apply for Medicaid. For those applying to the C-I-H Waiver program, there are specific criteria for reserved waiver capacity that must be met. If these criteria are met, you will be informed about the available services and given a funded priority slot. Medicaid eligibility will also be discussed during this process. Applicants under the age of 18 will need to submit a plan of care or service plan approval letter to the Family and Social Services Administration. Moving on to the Indiana Administrative Code, particularly Section 6 regarding Objective-Based Allocation for the C-I-H Waiver, we have Table 1 which outlines the Algo level descriptors. These descriptors indicate the level of care needed for each individual. Level 0, the low level, indicates a high level of independence with minimal support required. On the other hand, level 2, the regular level, indicates a moderate level of independence with frequent support needed. In conclusion, we hope this presentation has given you a better understanding of the Family Supports Waiver and Community Integration and Habilitation Waiver programs. Thank you for your attention and please feel free to contact your local B-D-S office for further information on the application process. Thank you..