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Family and Social Services Administration

Balancing Incentive Program Balancing Incentive Program

The Centers for Medicare and Medicaid Services (CMS) is dedicated to helping States provide quality care to individuals in the most appropriate, least restrictive settings. Against this backdrop, CMS is pleased to offer its State partners new opportunities under the Balancing Incentive Payments Program (referred to as the Balancing Incentive Program, or BIP).

Authorized by Section 10202 of the Patient Protection and Affordable Care Act of 2010 (Pub. L. 111-148), the Balancing Incentive Program provides enhanced Federal Medical Assistance Percentages (FMAP) to States that spend less than 50 percent of long-term care dollars on care provided in home and community-based settings.

The collaborated efforts of the Division of Aging (DA), Division of Disability and Rehabilitative Services (DDRS), and the Division of Mental Health and Addiction (DMHA) have resulted in the State’s award of resources made available by the Affordable Care Act to help seniors and people with disabilities live in their communities. 

Between October 1, 2012, and September 30, 2015, the State will receive approximately $78 million to improve how Long-Term Services and Supports (LTSS) in home and community-based settings are accessed and delivered throughout the state.  These funds will be used to:

  • Continue to implement the current co-location pilot throughout the state at Aging and Disability Resource Centers (ADRCs) to enhance the No Wrong Door/Single Entry Point (NWD/SEP) model.  This pilot would ensure that DDRS and/ or Division of Family Resources staff are onsite in ADRCs to work specifically with the Developmentally Disabled population

  • Complete implementation of an integrated data system, which will support the State’s efforts to streamline the LTSS eligibility and assessment process and provide SEPs and community partners a broadly accessible database housing the Core Data Set as established through Core Standardized Assessment Tools, and

  • Ensure that there are Conflict-Free Case Management Services, and remediate all case management arrangements and policies that do not align with the BIP principles. 

The state of Indiana also intends to utilize enhanced funding through the Balancing Incentives Program for the following purposes:

  • Enrolling individuals from DDRS Medicaid waiver waitlist to be served through the Family Supports waiver.

  • Investing in small group Intermediate Care Facilities for persons with Intellectual Disabilities (ICF/ID) providers via grants to convert their group homes into Medicaid waiver homes.

  • Transitioning approximately 500 current nursing facility residents, who are considered to be appropriate for community-based services, into LTSS through the Community Integration and Habilitation waiver.

  • Development of Program of All-Inclusive Care for the Elderly, with at least two organizations opening centers over the next eighteen months to two years.

  • Continued success in serving individuals in the Money Follows the Person Demonstration.

  • Growth in home health utilization, primarily by populations served in the Aged and Disabled waiver and the Traumatic Brain Injury waiver.

  • 1915(i) state plan option for adults with serious mental illness requiring habilitation services to remain in the community.

The State’s cover letter and application for this program are listed below.

Further, Indiana has submitted its Work Plan for the project, which was due to CMS by January 29, 2013. This Work Plan includes tasks, timelines, quarterly deliverables, and other information to help CMS support Indiana in its implementation of structural changes.  Representatives from the Division of Aging, Division of Disability and Rehabilitative Services, and the Division of Mental Health and Addiction are working together to finalize timelines for future tasks beyond the January 29th deadline. 

A copy of the Work Plan and its accompanying Addendum are listed here.