In accordance with public notice requirements established at 42 CFR 441.304(f), The Indiana Family and Social Services Administration (FSSA), Office of Medicaid Policy and Planning (OMPP) intends to submit proposed amendments to the Traumatic Brain Injury (TBI) waiver to the Centers for Medicare and Medicaid Services (CMS) for consideration.

A previous public comment period for this waiver was held from November 8, 2023, through December 14, 2023. Comments submitted during the initial public comment period were reviewed by the state. Additional changes are now being proposed to the waiver. Therefore, a second public comment period is being held to allow stakeholders an opportunity to provide input on the following modifications to this waiver.

Newly Proposed Amendments to the TBI Waiver

• Clarifies the policies surrounding the allowance of services provided by legally responsible individuals.

• Revises provisions for an annual rate adjustment.

• Makes other technical changes to waiver language to conform and align with existing waiver policies.

• Adds language for service definition clarifications.

Previously Proposed Amendments Included in the Initial Public Comment Period

• Makes minor changes to language in the waiver to align all 1915(c) waivers with matching language.

• Switches the government agency which oversees this waiver.

• Adds Structured Family Caregiving service.

• Adds Home Modifications Assessment service.

Fiscal Impact (in millions):

The effective date of the proposed amendments is July 1, 2024, pending approval from CMS.

The 30 day public comment period for the TBI amendments will run from January 17, 2024, through February 16, 2024. Comments can be emailed to DDRSwaivernoticecomment@fssa.in.gov or mailed to:

The TBI amendments are available for review and public comment on the DDRS Draft Policies for Public Comment webpage (https://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 Division of Family Resources offices.

Daniel Rusyniak, MD

Secretary

Family and Social Services Administration