Community Integration and Habilitation (CIH) Home and Community-Based Services (HCBS) waiver
The Community Integration and Habilitation (CIH) waiver provides services that enable individuals to remain in their homes or community-based settings and also assists individuals who are transitioning from state-operated facilities or other institutions into community settings. Home and community-based services (HCBS) through the CIH Waiver allow flexibility in providing the supports necessary to help individuals gain and maintain optimum levels of self-determination and community integration.
Individuals must meet HCBS waiver eligibility and Medicaid eligibility guidelines in order to be eligible for a Medicaid HCBS waiver. To be eligible, individuals must:
Be diagnosed as having an intellectual disability prior to the age of 22
Reside in or be transitioning into an HCBS-compliant setting (non-institutionalized)
Have income no greater than 300% of maximum Supplemental Security Income (SSI) amount (parental income for children under 18 years of age is disregarded)
Meet “ICF/IID level of care”
What is ICF/IID Level of Care?
To be eligible for intellectual disability services, an individual must meet the required "ICF/IID level of care." Level of care is the minimum need an individual must have to be considered eligible for HCBS waiver services. Level of care is evaluated both when you apply and then at least once a year after that. For the purposes of ICF/IID level of care, a person must have a disability that:
- Results in impairment of functioning similar to that of a person who is intellectually disabled, including autism spectrum disorder, epilepsy, cerebral palsy, or a similar condition (other than mental illness)
- Originates before the person is twenty-two (22) years of age
- Has continued or is expected to continue indefinitely
- Substantially limits a person's ability to function normally in society in three of the six major life areas: self-care, receptive and expressive language, learning, mobility, self-direction, and capacity for independent living.
- Requires access to 24-hour assistance, as needed.
Available Waiver Services
Eligible individuals may receive authorized waiver services in conjunction with Traditional Medicaid. Authorized waiver services may include:
- Adult Day Services
- Behavioral Support Services/ Crisis Assistance
- Case Management
- Community-Based Habilitation-Group
- Community-Based Habilitation-Individual
- Community Transition Services
- Electronic Monitoring
- Extended Services
- Environmental Modifications
- Facility-Based Habilitation-Group
- Facility-Based Habilitation-Individual
- Facility-Based Support Services
- Family & Caregiver Training
- Intensive Behavior Intervention
- Music Therapy
- Occupational Therapy
- Personal Emergency Response System
- Physical Therapy
- Prevocational Services
- Psychological Therapy
- Recreational Therapy
- Rent & Food for Unrelated Live-In Caregiver
- Residential Habilitation & Support
- Specialized Medical Equipment & Supplies
- Speech/ Language Therapy
- Structured Family Caregiving
- Wellness Coordination
- Workplace Assistance
The specific services that meet the needs of the individual member are identified by the member’s case manager. These services are submitted by the state agency for approval and are listed on the member’s Plan of Care (POC)/Notice of Action (NOA).
To apply, first, go to your local Bureau of Developmental Disabilities Services (BDDS) District Office. There are 8 BDDS District Offices throughout the State. It is helpful to apply as soon as you identify a need for waiver services.
You must also apply for Medicaid. You can learn more about applying for Medicaid by going to the Apply for Medicaid web page.
Families waiting for CIH Waiver services are eligible to receive a small amount of Care Giver Support Services (i.e. Respite) each year. Your local BDDS office can provide information and a listing of providers for this service. Contact your local BDDS office directly to find out how to access Care Giver Support funding while waiting for a waiver slot.
To become a Medicaid provider under the CIH Waiver, a provider must first be certified by the Indiana Family and Social Services Administration, Division of Disability and Rehabilitative Services (FSSA/DDRS). Waiver providers can be certified to provide multiple waiver services. To find out more about the certification process, visit the Bureau of Developmental Disabilities (BDDS) Provider Services page.
After certification, the provider must enroll as an Indiana Health Coverage Programs (IHCP) provider. Visit the IHCP Become a Provider webpage for more information about that process. Note that some providers also offer nonwaiver services within the IHCP. These providers are issued two unique provider identification numbers for billing purposes - one for waiver billing and one for nonwaiver billing. Providers must submit claims using the provider ID that corresponds to the services entered on the claim. The waiver services that can be provided to an CIH Waiver member are limited to those listed on the member’s individualized POC/NOA.
For more information about providing CIH Waiver services, see the Division of Disability and Rehabilitative Services Home and Community-Based Services Waivers and the Home and Community-Based Services Billing Guidelines provider reference modules.