In accordance with public notice requirements established at 42 CFR 441.301 the Indiana Family and Social Services Administration (FSSA) Division of Disabilities and Rehabilitative Services (DDRS) intends to submit a renewal of the Community Integration and Habilitation (CIH) waiver and a renewal of the Family Supports waiver (FSW) to the Centers for Medicare and Medicaid Services (CMS) for consideration. These waiver renewals will allow DDRS to continue providing home and community-based services (HCBS) to individuals who, but for provisions of such services, would require institutional care. The anticipated effective date is April 17, 2020.

The FSW and CIH waiver provide Medicaid HCBS services to participants in a range of community settings as an alternative to care in an intermediate care facility individuals with developmental disabilities (ICF/IDD) or related conditions. These waivers serve persons who have 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. Participants may choose to live in their own home, family home, or community setting appropriate to their needs. Participants develop a Person Centered/Individualized Support Plan (PC/ISP) using a person centered planning process guided by an Individualized Support Team (IST). The IST is comprised of the participant, the participant's case manager, and anyone else of the participant's choosing but typically family and/or friends. The DDRS, Bureau of Developmental Disabilities Services (BDDS) has proposed the following changes to be effective with the April 17, 2020, renewals:

• Add Environmental Modification as a service option under the FSW, using the same definition and rate methodology as provided under CIH waiver.

• Add Electronic Monitoring as a service option under FSW, using the same definition and rate methodology as provided under CIH waiver.

• Increase the rate for Community Transition on the CIH waiver from $1,000 to $2,500.

Fiscal Impact (in millions) of Proposed Changes:

The 30 day public comment period will run November 13, 2019, through December 13, 2019. Comments may be emailed to ddrswaivernoticecomment@fssa.in.gov or mailed to the address below:

The FSW and the CIH waiver renewal drafts are available for review and public comment on the DDRS Medicaid public comment webpage (https://www.in.gov/fssa/ddrs/4205.htm). Hard copies of the proposed renewal are available upon request by emailing ddrswaivernoticecomment@fssa.in.gov. Copies of the renewal are also available at local Division of Family Resources offices as well as local Area Agencies on Aging. In-person consultations or phone calls are available upon request.

Jennifer Sullivan, MD, MPH

Secretary

Family and Social Services Administration