part 1

[Virtual Presenter] Hello everyone, today is the day that we are here to discuss a crucial topic concerning the Division of Disability and Rehabilitative Services. Recently, the Division has announced the offering of home and community-based services waivers. As a professional in the field, I fully understand the importance of home and community-based services for individuals with disabilities. These services offer them the opportunity to lead independent lives and access the support and resources they need to thrive. The Division of Disability and Rehabilitative Services has recognized the need for these services and is now offering waivers. This means that individuals with disabilities can now access these services without having to go through the traditional waiver process. However, it is important to note that these waivers are subject to certain conditions and limitations. To help individuals navigate this process, the Division of Disability and Rehabilitative Services has published a detailed reference guide. This guide can be found on PubMed, and it is recommended that individuals review it carefully before applying for waivers. As of this presentation, the most up-to-date version is version 1.1.1. It is important to ensure that you are using the most current version. Finally, I would like to emphasize that this is a copyrighted product of Gainwell Technologies, and all rights are reserved. Thank you for your attention, and I hope that this information has been helpful to you..

[Audio] We are pleased to announce that the Division of Disability and Rehabilitative Services is offering home and community-based services waivers. This waiver provides more flexibility for states to design and implement programs that best meet the needs of individuals with disabilities. We are committed to working with states to ensure that these waivers are implemented in a way that is both effective and efficient. We believe that this waiver will be a valuable tool for states looking to improve the quality of services for individuals with disabilities. The Revision History for this document provides a detailed overview of the changes that have been made to the policies and procedures over time. From the initial release in 2012 to the most recent update in 2024, we have worked tirelessly to ensure that this document remains up-to-date and relevant. We are proud of the work that has been done and look forward to continuing to work with states to improve the lives of individuals with disabilities. Thank you for your interest in this important topic. If you have any questions, please do not hesitate to reach out to us. We are here to help..

[Audio] We are here to discuss the home and community-based services (H-C-B-S-) waivers offered by the Division of Disability and Rehabilitative Services (D-D-R-S-). D-D-R-S offers waivers for Family Supports Waiver (F-S-W--) and Community Integration and Habilitation Waiver (C-I-H--) services. These waivers are designed to provide individuals with disabilities with more flexibility and control over their services. With these waivers, individuals can choose the services they need and where they want to receive them. D-D-R-S has revised the policies and procedures for the H-C-B-S waivers several times, with the most recent version being published on July 1, 2024. This version includes information about legally responsible individuals (LRIs) and whether they are allowed or not allowed to provide certain services. The H-C-B-S waivers have also been updated to include information about Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) services. D-D-R-S has updated the provider application process for F-S-W and C-I-H waivers. The application process now includes a review of the applicant's qualifications and a determination of their ability to provide the services required by the waiver. D-D-R-S has also updated the billing and reimbursement process for waiver services. Providers must now meet certain requirements in order to bill for their services..

[Audio] Good morning everyone. We are here to discuss the Home and Community-based Services waivers offered by the Division of Disability and Rehabilitative Services. These waivers were introduced to provide individuals with disabilities access to a variety of services that were previously inaccessible. We have made several updates to the Home and Community-based Services waivers. We have updated the Limitations section of the Music Therapy service for F-S-W and C-I-H Waiver. We have also updated Section 10.13: Home Modifications for F-S-W and C-I-H Waiver. Additionally, we have made changes to the Service Definition section of the Residential Habilitation and Support (hourly) service for the C-I-H Waiver, as well as the Service Definition section of the Residential Habilitation and Support (daily) service for the C-I-H Waiver. We have also updated the rates in the Service Standards and Limitations sections of the Specialized Medical Equipment and Supplies service for the F-S-W and C-I-H Waiver. We have also updated the Reimbursable Activities and Activities Not Allowed sections of the Structured Family Caregiving service for the F-S-W and C-I-H Waiver. Additionally, we have made updates to the Transportation service for the F-S-W and C-I-H Waiver. We are committed to providing individuals with disabilities access to the services they need to live a fulfilling life. We believe that the Home and Community-based Services waivers are an important step towards achieving this goal. Thank you for your attention to this matter..

[Audio] We will provide information on the application process for F-S-W and C-I-H Waiver, the reversion process for F-S-W and C-I-H Waiver, details on billing and reimbursement for waiver services, and information on financial oversight and waiver audits..

[Audio] The home and community-based services waiver program includes important sections that are essential to understand. These include the monitoring and continuation of services, such as level of care reevaluation, Medicaid eligibility redetermination, annual person-centered individualized support plan (P-C-I-S-P) development, person-centered individualized support plan/service authorization updates and revisions, state authorization of the service authorization, service plan implementation and monitoring, interruption/termination of waiver services, waiver slot retention after termination and reentry, parents, guardians and relatives providing home and community-based services, appeal process, and more. It is important to note that specific actions must be taken in order to appeal a decision related to these waivers. This includes requesting an appeal, group appeals, time limits for requesting appeals, the hearing notice, request for continuance from the appellant, review of action, disposal of appeal without a fair hearing, the fair hearing, preparation for hearing by appellant, preparation for hearing by the B-D-S Service Coordinator or District Representative, B-D-S Waiver Unit, D-D-R-S Central Office, or Other State Designee, conduct of the hearing, continuance of hearing, the hearing record, the fair hearing decision, actions of the administrative law judge’s decision, agency review, judicial review, lawsuit, and more. In addition to these key sections, there are also important quality assurance measures in place for the home and community-based services waiver program. This includes incident reports, complaints, mortality reviews, national core indicator (N-C-I--) project, case record reviews, quality on-site provider review for home and community-based services, statewide waiver ombudsman for waiver participants with intellectual/developmental disabilities, and more. It is also important to understand the service definitions and requirements for the home and community-based services waivers. This includes information on service definition overview, home and community-based services, codes and rates, adult day services for home and community-based services, behavioral support services for home and community-based services, career exploration and planning for home and community-based services, case management for home and community-based services, community transition for home and community-based services, day habilitation for home and community-based services, extended services for home and community-based services, facility-based support for home and community-based services, family and caregiver training for home and community-based services, home modification assessment for home and community-based services, and more..

[Audio] We are thrilled to announce that we are now offering home and community-based services waivers. Our clients will finally have the opportunity to receive the care they need in the comfort of their own homes or communities. We are proud to provide a wide range of services that meet the unique needs of our clients. These services include home modifications, intensive behavioral intervention, music therapy, occupational therapy, participant assistance and care, personal emergency response system, physical therapy, prevocational services, psychological therapy, recreational therapy, remote supports, rent and food for unrelated live-in caregiver for the C-I-H waiver, residential habilitation and support – daily (RHS daily), respite, specialized medical equipment and supplies, speech/language therapy, structured family caregiving, transportation, vehicle modifications, wellness coordination, workplace assistance, home modification policy for F-S-W and C-I-H waiver, specialized medical equipment and supplies for the F-S-W and C-I-H waiver, vehicle modifications for F-S-W and C-I-H waiver, eligibility for H&W and T-B-I waiver services, H&W and T-B-I waiver provider certification, enrollment, and responsibility, quality assurance/quality improvement, program integrity and financial oversight, care coordination for T-B-I and H&W waivers, H&W and T-B-I waiver services, codes and rates, adult day services for H&W and T-B-I waivers, adult family care for H&W and T-B-I waivers, assisted living for H&W and T-B-I waivers, attendant care for H&W and T-B-I waivers, behavior management/behavior program and counseling for T-B-I waiver, care management for H&W and T-B-I waivers, caregiver coaching for H&W waiver, community transition for H&W and T-B-I waivers, home and community assistance for H&W and T-B-I waivers, home-delivered meals for H&W and T-B-I waivers, home modification assessment for H&W and T-B-I waivers, home modifications for H&W and T-B-I waivers, integrated health care coordination for H&W and T-B-I waiver, nutritional supplements for H&W and T-B-I waivers, participant-directed home care service for H&W waiver, personal emergency response system for H&W and T-B-I waivers, pest control for H&W and T-B-I waivers, residential-based habilitation for T-B-I waiver, skilled respite services for H&W and T-B-I waivers, specialized medical equipment and supplies for H&W and T-B-I waivers, library reference number: PRPR10014, published: Sept. 9, 2024, policies and procedures as of July 1, 2024, version: 11.1..

[Audio] We are delighted to inform you that the Division of Disability and Rehabilitative Services is now offering home and community-based services waivers. The purpose of these waivers is to offer additional support and resources to individuals with disabilities and their families. We are pleased to share the following waivers: Structured Day Program for T-B-I Structured Family Caregiving for H&W and T-B-I Supported Employment for T-B-I Transportation for H&W and T-B-I Vehicle Modifications for H&W and T-B-I As of July 1, 2024, we have updated the policies and procedures for these waivers, and we are committed to providing ongoing support and resources to individuals and their families. We are thrilled to offer these waivers and are confident that they will have a positive impact on the lives of individuals with disabilities and their families. We hope you will consider these waivers and please reach out if you have any questions or need additional information..

[Audio] The Division of Disability and Rehabilitative Services (D-D-R-S-) is pleased to announce that they will be offering home and community-based services waivers. This presentation will provide an in-depth analysis of the roles and responsibilities of the various stakeholders involved in providing these services, including the Centers for Medicare & Medicaid Services (C-M-S--), the Bureau of Disabilities Services (B-D-S--), and individuals and guardians..

[Audio] We are here to provide an update on the home and community-based services waivers that we are offering. We are responsible for providing individualized, integrated community-based services for individuals with disabilities and their families. The Bureau of Disabilities Services (B-D-S--) is a part of us that administers four H-C-B-S waiver programs for individuals who meet the level-of-care (L-O-C--) requirements for admission to an intermediate care facility for individuals with intellectual disabilities (ICF/IID) or to a nursing facility (N-F---): Community Integration and Habilitation (C-I-H--) Waiver – Must meet L-O-C for an ICF/IID, Family Supports Waiver (F-S-W--) – Must meet L-O-C for an ICF/IID, Health and Wellness (H&W) Waiver – Must meet L-O-C for an NF, and Traumatic Brain Injury (T-B-I--) Waiver – Must meet L-O-C for either an ICF/IID or an NF. B-D-S administers the H&W and T-B-I waivers and minor differences exist between waiver programs. With the transition of the H&W and T-B-I waivers from the Division of Aging to us, and differences in the applicable administrative code requirements, statewide provision of services and supports is ensured through the establishment of eight B-D-S district offices serving specific regions in Indiana. B-D-S service coordinators determine initial eligibility for intellectual/developmental disability services, determining L-O-C for ICF/IID services. B-D-S service coordinators also determine a new “initial” L-O-C for individuals who have been terminated from the H-C-B-S waiver program, but desire to return to waiver services within the same waiver year. We have statutory authority over the state’s home and community-based services for individuals of all ages with intellectual/developmental disabilities, and for individuals age 59 and under with physical disabilities. We are also the placement authority for persons with intellectual/developmental disabilities and help develop policies and procedures for Indiana Medicaid waivers that serve persons with intellectual/developmental disabilities. To ensure the health and welfare of individuals receiving Medicaid H-C-B-S waiver services, we have developed and implemented quality improvement and quality assurance systems. Oversight activities include the development of policy, case record reviews, investigation of complaints, and reviewing mortality. Thank you for listening..

[Audio] We are presenting an overview of the Division of Disability and Rehabilitative Services (D-D-R-S-) H-C-B-S Waivers. This presentation will provide an in-depth look at the roles and responsibilities of the D-D-R-S in managing the state’s automated system for reporting incidents of abuse, neglect, and exploitation, assuring compliance with Indiana waiver regulations, researching best practices, analyzing quality data, managing provider reverification, and monitoring provider accreditation. We will also discuss the responsibilities of the F-S-S-A Office of Medicaid Policy and Planning (O-M-P-P-) in monitoring the D-D-R-S operation of the H-C-B-S programs for compliance with C-M-S requirements, developing Medicaid policy for the state of Indiana, and collaborating with the D-D-R-S to revise and develop the application of the H-C-B-S program to reflect current F-S-S-A goals and policy programs..

[Audio] We thank you for joining us on our presentation on the Division of Disability and Rehabilitative Services offering home and community-based services waivers. We hope you have a better understanding of the roles and responsibilities involved in the DDRS HCBS waivers program. If you have any more questions, please don't hesitate to reach out to the D-D-R-S-. Thank you for your time and attention..