In accordance with public notice requirements established at 42 CFR 447.205, The Indiana Family and Social Services Administration (FSSA) Office of Medicaid Policy and Planning (OMPP) intends to submit proposed amendments to the Community Integration and Habilitation (CIH) waiver and the Family Supports Waiver (FSW) to the Centers for Medicare and Medicaid Services (CMS) for consideration.

Both waivers provide Medicaid home and community-based services (HCBS) to members in a range of community settings as an alternative to care in an intermediate care facility for individuals with intellectual disabilities (ICF/IID) or related conditions. The waivers serve persons with a developmental disability, intellectual disability, or autism and who have substantial functional limitations, as defined under the paragraph for "Persons with related conditions" in 42 CFR 435.1010. Members may choose to live in their own home, family home, or community setting appropriate to their needs. The goal of CIH and FSW is to provide access to meaningful and necessary home and community-based services and supports, seek to implement services and supports in a manner that respects the member's personal beliefs and customs, ensure that services are cost-effective, facilitate the member's involvement in the community where he/she lives and works, facilitate the member's development of social relationships in his/her home and work communities, and facilitate the member's independent living.

The proposed amendment to the CIH waiver seeks to add the provision of transitional case management in order to facilitate the movement of individuals from segregated institutions (i.e. nursing facilities) to community-based residential options. The proposed amendment to FSW seeks to equalize the rate reimbursement for case management between the FSW and CIH waivers by increasing the FSW monthly rate reimbursement for case management by 5%, from $125.00 to $131.25.

Both proposed amendments will include an annual reimbursement rate for case management services to better facilitate person-centered planning to fully meet CMS requirements. The amendments will be effective August 1, 2018, contingent upon CMS approval.

Fiscal Impact:

The 30 day public comment period for the CIH and FSW amendments will run March 21, 2018, through April 20, 2018. Comments can be emailed to DDRSwaivernoticecomment@fssa.in.gov or mailed to the address below:

The CIH and FSW amendments and updated waiver rate chart are available for review and public comment on the DDRS Draft Policies for Public Comment webpage (http://www.in.gov/fssa/ddrs/4205.htm). Hard copies of the proposed amendments are available upon request at the address contained herein. Additionally, copies of the proposed amendments are available at local Bureau of Developmental Disabilities Services offices and Division of Family Resources offices.

Jennifer Walthall, MD MPH

Secretary

Family and Social Services Administration