[Virtual Presenter] We are thrilled to share with you details about transportation services and vehicle modifications. Our presentation will provide an in-depth look at the For the Family Supported Waiver (F-S-W--), including its services, annual cap, and annual limits. We will outline the activities that are permitted and not permitted under transportation services, as well as the qualifications required for transportation providers. Furthermore, we will discuss the requirements for vehicle modifications services under the F-S-W and C-I-H Waiver. Thank you for joining us today, and we hope this information is helpful to you.. 

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DDRS HCBS Waivers 
Section 10: Service Definitions and Requirements for FSW and CIH Waivers 
Library Reference Number: PRPR10014 
173 
Published: Sept. 9, 2024 
Policies and procedures as of July 1, 2024 
Version: 11.1 
• For the FSW, the costs of nonmedical Transportation services and are paid for within the waiver’s 
$26,482 annual cap. 
– The annual limits for each level of nonmedical waiver Transportation under the FSW are: 
➢ $7,530 for Level 1 Transportation 
➢ $8,255 for Level 2 Transportation 
➢ $8,980 for Level 3 Transportation 
Activities Not Allowed 
Reimbursement is not available under Transportation services for the following activities: 
• May not be used to meet medical transportation needs already available under the Indiana Medicaid 
State Plan. 
• May not be used in conjunction with the Structured Family Caregiving services available under the 
CIH Waiver. 
• This service will not be reimbursed when provided by the parent of a minor child participant or the 
spouse of a participant (also known as LRIs). 
Provider Qualifications 
Providers must meet the following criteria: 
• Enrolled as an active Medicaid provider 
• Be FSSA DDRS-approved 
• Comply with Indiana Administrative Code, 460 IAC 6, including but not limited to: 
– 460 IAC 6-10-5 Documentation of Criminal Histories 
– 460 IAC 6-12-1 and 460 IAC 6-12-2 Insurance 
– 460 IAC 6-11-1 to 460 IAC 6-11-3 Financial Status of Providers 
– 460 IAC 6-5-30 Transportation Services Provider Qualifications, 460 IAC 6-5-31 Transportation 
Supports Provider Qualifications, and 460 IAC 6-34-1 to 460 IAC 6-34-3 Transportation 
Services 
– 460 IAC 6-14-5 Requirements for Direct Care Staff 
– 460 IAC 6-14-4 Staff Training  
• Comply with any applicable BDS service standards, guidelines, policies and/or manuals, including 
FSSA DDRS policies and this module, accessible from the IHCP Provider Reference Modules page 
at in.gov/medicaid/providers 
Section 10.32: Vehicle Modifications for FSW and CIH 
Waiver 
The following subsections provide information and requirements for Vehicle Modifications services for the 
FSW and CIH Waiver. 
Service Definition  
Vehicle Modifications are the addition of adaptive equipment or structural changes to a motor vehicle that 
will provide the individual with a safe and accessible mode of transportation that increases their ability to 
access their home and community.

[Audio] We are discussing transportation services provided under the Family Supported Waiver (F-S-W--) and Community Integrated Health (C-I-H--) Waiver. These services have limitations and criteria that providers must meet to be approved. We also touch on vehicle modifications services available under these waivers, which are subject to specific guidelines and requirements. It's important to note that the information provided on this slide is specific to the F-S-W and C-I-H Waivers and may not be applicable to other waiver programs or services.. 

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DDRS HCBS Waivers 
Section 10: Service Definitions and Requirements for FSW and CIH Waivers 
174 
Library Reference Number: PRPR10014 
 
Published: Sept. 9, 2024 
 
Policies and procedures as of July 1, 2024 
 
Version: 11.1 
DDRS waiver services staff must approve all environmental modifications prior to service being rendered.  
Additional Information: 
• 
Vehicle Modifications services described in this section are available under the FSW 
and CIH Waiver. 
• 
For information specific to vehicle modifications services available under the H&W 
and TBI Waivers, see Section 12.31: Vehicle Modifications for H&W and TBI 
Waivers. 
Reimbursable Activities 
Justification and documentation is required to demonstrate that the modification is necessary in order to 
meet the individual’s identified needs. The following are allowable under Vehicle Modifications:  
• Wheelchair lifts 
• Wheelchair tie-downs (if not included with lift) 
• Wheelchair/scooter hoist 
• Wheelchair/scooter carrier for roof or back of vehicle 
• Raised roof and raised door openings 
• Power transfer seat base 
• Lowered floor and lowered door openings 
• Wheelchair ramp for vehicle 
Maintenance is limited to $1,000 annually for repair and service of items that have been funded through an 
HCBS waiver. Requests for service must differentiate between parts and labor costs. Pricing must be 
consistent with the fair market price for such modifications. If the need for maintenance exceeds $1,000, 
the case manager will work with other available funding streams and community agencies to fulfill the 
need. When service costs exceed the annual limit, those parts and labor costs funded through the waiver 
must be itemized clearly to differentiate the waiver service provision from those parts and labor provided 
through a nonwaiver funding source.  
Items requested which are not listed above, must be reviewed and a decision rendered by the state division 
director or state agency designee.  
Reimbursement is available for modifications that satisfy each of the following:  
• Service and documentation standards outlined within DDRS policy  
• Allowable under current Medicaid waiver guideline  
• Not available under the Rehabilitation Act of 1973, as amended  
• Included in the individual’s approved PCISP/service authorization 
• Authorized on the RFA and linked to the PCISP/service authorization 
• Included on a state-approved and signed service authorization 
• Completed by an approved Medicaid waiver service provider (that is approved to perform this 
service)

[Audio] We are here to discuss the transportation services provided for individuals with disabilities in Indiana. The F-S-W is a program that allows for the payment of transportation services within a certain annual cap of $26482. However, there are certain restrictions on what transportation services can be used for. For example, transportation services cannot be used to meet medical transportation needs that are already available under the Indiana Medicaid State Plan or in conjunction with structured family caregiving services available under the Community Integrated Health (C-I-H--) Waiver. Additionally, transportation services cannot be used to transport individuals to places where they are not required to go, such as to a place of worship or to a recreational activity.. 

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DDRS HCBS Waivers 
Section 10: Service Definitions and Requirements for FSW and CIH Waivers 
Library Reference Number: PRPR10014 
175 
Published: Sept. 9, 2024 
Policies and procedures as of July 1, 2024 
Version: 11.1 
Service Standards 
The vehicle to be modified must meet all of the following:  
• The individual or primary caregiver is the titled vehicle owner.  
• The vehicle is registered and/or licensed under state law. 
• The vehicle has appropriate insurance as required by state law.  
• The vehicle is the individual’s sole or primary means of transportation.  
• The vehicle is less than 10 years old and has less than 100,000 miles on the odometer.  
• The vehicle is not registered to or titled by a Family and Social Services Administration (FSSA) 
approved provider.  
• Only one vehicle per an individual may be modified in a 10-year period. 
Many automobile manufacturers offer a rebate for individuals purchasing a new vehicle requiring 
modifications for accessibility. To obtain the rebate the individual is required to submit to the manufacturer 
documented expenditures of modifications. If the rebate is available, it must be applied to the cost of the 
modifications.  
Requests for modifications may be denied if DDRS determines the documentation does not support the 
service requested.  
All Vehicle Modifications must be approved prior to services being rendered. 
All Vehicle Modification shall be authorized only when it is determined to be medically necessary and/or 
shall have direct medical or remedial benefit for the waiver individual. Requests to upgrade products or to 
use materials exceeding the individual’s basic needs will not be approved.  
This determination includes the following considerations:  
• The modification is the most cost effective or conservative means to meet the individual’s specific 
needs.  
• The modification is individualized, specific and consistent with, but not in excess of, the 
individual’s needs.  
• Two modification bids must be obtained for all modifications over $1,000.  
• If two bids cannot be obtained, it must be documented to show what efforts were made to secure the 
two bids and explain why fewer than two bids were obtained (for example, provider name, dates of 
contact, response received).  
Documentation Standards 
The PCISP must reflect the identified direct benefit or need for VMOD determined to support the 
individual in accessing their community.  
Documentation/explanation within the Request for Approval to Authorize Services (RFA) must include:  
• The specific modification being requested to the vehicle, including a picture of the modification  
• Two bids if the cost exceeds $1,000: The individual chooses which approved/certified providers will 
submit bids or estimates for this service. The provider with the lowest bid will be chosen, unless 
there is strong written justification detailing why a provider with a higher bid should be selected.  
• Warranty information of the modification  
• Copy of the vehicle registration

[Audio] Transportation services are crucial components of the F-S-W and C-I-H Waivers. These services offer individuals with the means to access community-based services. For the F-S-W--, transportation services are covered under an annual cap of $26482, and there are annual limits for each level of non-medical waiver transportation. However, certain activities are not allowed under transportation services. For example, transportation services cannot be used to meet medical transportation needs already available under the Indiana Medicaid State Plan or in conjunction with structured family caregiving services available under the C-I-H Waiver. Additionally, transportation services provided by the parent of a minor child participant or the spouse of a participant are not allowed. To ensure the safety and effectiveness of these services, providers must meet specific criteria, such as being an active Medicaid provider, being FSSA DDRS-approved, complying with Indiana Administrative Code, and complying with any applicable B-D-S service standards, guidelines, policies, and manuals. In addition to transportation services, the F-S-W and C-I-H Waivers also include vehicle modifications services to accommodate the needs of individuals with disabilities. These modifications must follow specific guidelines to ensure safety and effectiveness. A cap of $15000 is available for one vehicle per every 10-year period for an individual’s household. In addition to the applicable cap, $1000 will be allowable annually for repair, replacement, or an adjustment to an existing modification that was funded by a Home and Community-Based Services (H-C-B-S-) waiver. There are certain activities that are not allowed under vehicle modifications, such as modifications/adaptations that have not been approved on a Request for Approval to Authorize Services (R-F-A--) form, as well as examples/descriptions of modifications/items not covered, such as repair or replacement of modified equipment damaged or destroyed in an accident, alarm systems, auto loan payments, insurance coverage, driver’s license, title registration or license plates, emergency road service, routine maintenance and repairs related to the vehicle itself, specialized medical equipment or home modification items, and leased vehicles. To ensure the safety and quality of vehicle modifications, providers must meet specific criteria, such as being enrolled as an active Medicaid provider, being FSSA DDRS-approved, complying with Indiana Administrative Code, and complying with any applicable B-D-S service standards, guidelines, policies, and manuals. Providers rendering waiver-funded services must also obtain/maintain Indiana licensure, where licensure is required.. 

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DDRS HCBS Waivers 
Section 10: Service Definitions and Requirements for FSW and CIH Waivers 
176 
Library Reference Number: PRPR10014 
 
Published: Sept. 9, 2024 
 
Policies and procedures as of July 1, 2024 
 
Version: 11.1 
• Copy of the vehicle insurance  
Provider standards for documentation include the following:  
• Provider of services must maintain receipts for all incurred expenses related to the modification. 
• All bids must be itemized.  
• Must be in compliance with the FSSA and division-specific guidelines and/or policies.  
Limitations 
A cap of $15,000 is available for one vehicle per every 10-year period for an individual’s household. In 
addition to the applicable cap, $1,000 will be allowable annually for repair, replacement or an adjustment to 
an existing modification that was funded by a Home- and Community-Based Services (HCBS) waiver.  
Activities Not Allowed 
The following activities are not allowed under Vehicle Modifications:  
• Modifications/adaptations that have not been approved on a Request for Approval to Authorize 
Services (RFA) form.  
• Examples/descriptions of modifications/items not covered include but are not limited to the 
following:  
– Repair or replacement of modified equipment damaged or destroyed in an accident 
– Alarm systems 
– Auto loan payments 
– Insurance coverage 
– Driver’s license, title registration or license plates 
– Emergency road service 
– Routine maintenance and repairs related to the vehicle itself 
– Specialized medical equipment or home modification items are not allowed. 
– Leased vehicles  
Provider Qualifications  
Providers of Vehicle Modifications must meet the following criteria: 
• Enrolled as an active Medicaid provider  
• Must be FSSA DDRS-approved 
• Must comply with Indiana Administrative Code 460 IAC 6, including but not limited to:  
– 460 IAC 6-10-5 Documentation of Criminal Histories  
– 460 IAC 6-12-1 and 460 IAC 6-12-2 Insurance  
– 460 IAC 6-11-1 to 460 IAC 6-11-3 Financial Status of Providers  
– 460 IAC 6-5-27 Specialized Medical Equipment and Supplies Supports Provider Qualifications  
• Must comply with any applicable BDS service standards, guidelines, policies and/or manuals, 
including FSSA DDRS policies and this module, accessible from the IHCP Provider Reference 
Modules page at in.gov/medicaid/providers  
• Where licensure is required, providers rendering waiver funded services must obtain/maintain 
Indiana licensure.

[Audio] We will be discussing transportation and wellness coordination services offered under the For the Family Supported Waiver (F-S-W--) and Community Integrated Health (C-I-H--) Waiver. Transportation services are available up to an annual cap of $26482 under the F-S-W--, and there are annual limits for each level of non-medical waiver transportation. However, certain activities are not allowed under transportation services, such as using it to meet medical transportation needs already available under the Indiana Medicaid State Plan, using it in conjunction with structured family caregiving services available under the C-I-H Waiver, and providing it by the parent of a minor child participant or the spouse of a participant (LRIs). Providers must meet certain criteria, including being an active Medicaid provider, being FSSA DDRS-approved, complying with Indiana Administrative Code, and complying with any applicable B-D-S service standards, guidelines, policies, and/or manuals.
Wellness Coordination services are available under the C-I-H Waiver to assist individuals in managing their health care needs. These services are specifically designed for individuals requiring the assistance of an RN or L-P-N to properly coordinate their medical needs. There are three levels of support, with Tier I requiring a face-to-face visit once a month with an RN or L-P-N and consultations/reviews based on the individual’s current healthcare needs. Tier II requires a face-to-face visit twice a month with an RN or L-P-N and consultations/reviews based on the individual’s current healthcare needs. Tier I-I-I requires a face-to-face visit once a week with an RN or L-P-N and consultations/reviews based on the individual’s current healthcare needs. The necessity for Wellness Coordination services is typically reserved for individuals assessed with health scores of 5 or higher through the state’s objective-based allocation process. Individuals assessed with health scores of 0-4 would not require assistance of an RN or L-P-N to coordinate medical needs.
Wellness Coordination services are available only under the C-I-H Waiver and are not available under the FSW, H&W, or T-B-I waivers. Reimbursement is available for Wellness Coordination services only when the following circumstances are present: the individual requires assistance in coordinating medical needs beyond what can be provided through routine doctor/healthcare visits, Wellness Coordination services are specifically included in the individual’s PCISP, and the member has a Wellness Coordination plan.. 

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DDRS HCBS Waivers 
Section 10: Service Definitions and Requirements for FSW and CIH Waivers 
Library Reference Number: PRPR10014 
177 
Published: Sept. 9, 2024 
Policies and procedures as of July 1, 2024 
Version: 11.1 
Section 10.33: Wellness Coordination for the CIH 
Waiver 
The following subsections provide information and requirements for Wellness Coordination services for 
the CIH Waiver. 
Service Definition 
Wellness Coordination services means the development, maintenance and routine monitoring of the 
individual’s wellness coordination plan and the medical services required to manage their health care needs. 
A comprehensive medical risk plan may substitute for the wellness coordination plan or individual risk plans. 
Wellness Coordination services extend beyond those services provided through routine doctor/healthcare 
visits required under the Indiana Medicaid State Plan and are specifically designed for individuals requiring 
the assistance of an RN or LPN to properly coordinate their medical needs. The following levels of support 
have these requirements: 
• Tier I: Healthcare needs require a face-to-face visit once a month with an RN or LPN and 
consultations/reviews based on the individual’s current healthcare needs.  
• Tier II: Healthcare needs require a face-to-face visit twice a month with an RN or LPN and 
consultations/reviews based on the individual’s current healthcare needs. 
• Tier III: Healthcare needs require a face-to-face visit once a week with an RN or LPN and 
consultations/reviews based on the individual’s current healthcare needs.  
Conditions and Requirements 
Necessity for Wellness Coordination services will typically be reserved for individuals assessed with health 
scores of 5 or higher through the state’s objective-based allocation process. Individuals assessed with health 
scores of 0-4 would not require assistance of an RN or LPN to coordinate medical needs. As medical events 
occur and/or an individual’s medical needs change, the IST is expected to obtain reassessment for potential 
revision to the health score and to ensure utilization of the appropriate tier of services.  
Additional Information: 
• 
Wellness Coordination services are available only under the CIH Waiver. These 
services are not available under the FSW, H&W or TBI waivers. 
Service Standards 
Reimbursement is available for Wellness Coordination services only when the following circumstances are 
present:  
• The individual requires assistance in coordinating medical needs beyond what can be provided 
through routine doctor/health care visits. 
• Wellness Coordination services are specifically included in the individual’s PCISP. 
• The member has a Wellness Coordination plan.

[Audio] We offer transportation services to participants under the Family Supported Waiver (F-S-W--) with a yearly restriction of $26482 and limitations on how much can be spent on non-medical transportation for each level. Non-medical transportation services are not allowed to be used for certain activities, such as meeting medical transportation needs already available under the Indiana Medicaid State Plan, using them in conjunction with structured family caregiving services offered under the Community Integrated Health (C-I-H--) Waiver, or providing them by the parent of a minor child participant or the spouse of a participant. To offer these services, providers must meet certain requirements, including being an active Medicaid provider, being FSSA DDRS-approved, complying with Indiana Administrative Code, and complying with any applicable B-D-S service standards, guidelines, policies and/or manuals.. 

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DDRS HCBS Waivers 
Section 10: Service Definitions and Requirements for FSW and CIH Waivers 
178 
Library Reference Number: PRPR10014 
 
Published: Sept. 9, 2024 
 
Policies and procedures as of July 1, 2024 
 
Version: 11.1 
Reimbursable Activities 
Coordination of wellness services by the wellness coordinator, who must be an RN or LPN, must include, 
but is not limited to the following: 
• Completion of risk assessment information gathered by the IST and documented by the case 
manager in the PCISP 
• Development, oversight and maintenance of a wellness coordination plan, while noting that a 
comprehensive medical risk plan may substitute for the wellness coordination plan or individual risk 
plans 
• Development, oversight and maintenance of the medical risk plan, which includes: 
– Determination of the appropriate mode of training to be used for the direct support professional 
to ensure implementation of risk plans, noting that training may be by staff trained by the RN or 
LPN with the exception of nursing delegated tasks or other items the nurse feels that only a 
licensed nurse should train  
– Ensuring the completion of training of direct support professionals to ensure implementation of 
risk plans 
– Consultation with the individual’s healthcare providers 
– Face-to-face consultations with the as described in the support plan based on tier level 
– Consultation with the individual’s IST 
– Active involvement at annual team meetings (and any additional team meetings if an individual 
is having a medical concern or a health and safety issue that the IST needs to address), reporting 
on the wellness coordination plan as it relates to the individual’s full array of services as listed in 
the PCISP 
Limitations 
This waiver service is only provided to individuals ages 21 and over. All medically necessary Wellness 
Coordination services for children under age 21 are covered in the Indiana Medicaid State Plan benefit 
pursuant to the EPSDT benefit. 
Individuals assessed with health scores of 0-4 would not require assistance of an RN or LPN to coordinate 
medical needs. 
Activities Not Allowed 
Reimbursement for Wellness Coordination is not available under the following circumstances:  
• The individual does not require Wellness Coordination services. 
• Services are furnished to a minor by a parents, stepparents or legal guardian. 
• Services are furnished to an individual by the individual’s spouse. 
Documentation Standards 
Wellness Coordination services documentation standards are as follows: 
• Wellness Coordination services must be documented in agency files: 
– Weekly consultations/reviews 
– Face-to-face visits with the individual 
– Other activities, as appropriate

[Audio] We will discuss transportation and workplace assistance services provided under the Family Supported Waiver (F-S-W--) and Community Integrated Health (C-I-H--) Waivers. Transportation services are paid for within an annual cap of $26482, and there are annual limits for each level of nonmedical waiver transportation. However, certain activities are not allowed under transportation services, such as using it to meet medical transportation needs already available under the Indiana Medicaid State Plan, using it in conjunction with structured family caregiving services available under the C-I-H Waiver, and providing it by the parent of a minor child participant or the spouse of a participant. To be eligible for transportation services, providers must meet certain criteria, such as being an active Medicaid provider, being FSSA DDRS-approved, complying with Indiana Administrative Code, and complying with any applicable B-D-S service standards, guidelines, policies and/or manuals. Additionally, providers must document what level of consultation/visits has been deemed necessary or appropriate for the individual, as outlined in the PCISP. It's also important to note that wellness coordination services must address needs identified in the person-centered planning process and be outlined in the PCISP. The provider of wellness coordination will provide a written report to pertinent parties at least quarterly, and as applicable, monthly/quarterly reports must be uploaded to the document library of the state's case management system by the chosen service provider on or before the 15th day of the following month. Within the wellness coordination plan, the provider must document what level of consultation/visits has been deemed necessary or appropriate for the individual. In terms of workplace assistance services, these provide a range of personal care services and/or supports during paid competitive community employment hours and in a competitive community employment setting to enable waiver individuals to accomplish tasks that they would normally do for themselves if they did not have a disability. Assistance may take the form of hands-on assistance (actually performing a personal care task for the individual) or prompting the individual to perform a personal care task. Workplace Assistance services may be provided on an episodic or on a continuous basis.. 

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DDRS HCBS Waivers 
Section 10: Service Definitions and Requirements for FSW and CIH Waivers 
Library Reference Number: PRPR10014 
179 
Published: Sept. 9, 2024 
Policies and procedures as of July 1, 2024 
Version: 11.1 
• Services must address needs identified in the person-centered planning process and be outlined in 
the PCISP. 
• The provider of wellness coordination will provide a written report to pertinent parties at least 
quarterly. (“Pertinent parties” include the individual, guardian, BDS service coordinator and waiver 
case manager.) 
• As applicable, monthly/quarterly reports must be uploaded to the document library of the state’s 
case management system by the chosen service provider on or before the 15th day of the following 
month. 
• Within the wellness coordination plan, the provider must document what level of consultation/visits 
has been deemed necessary or appropriate for the individual. 
Provider Qualifications 
Providers must meet the following criteria: 
• Enrolled as an active Medicaid provider 
• Be FSSA DDRS-approved 
• Comply with Indiana Administrative Code, 460 IAC 6, including but not limited to:  
– 460 IAC 6-10-5 Documentation of Criminal Histories  
– 460 IAC 6-12-1 and 460 IAC 6-12-2 Insurance  
– 460 IAC 6-11-1 to 460 IAC 6-11-3 Financial Status of Providers  
– 460 IAC 6-14-5 Requirements for Direct Care Staff  
– 460 IAC 6-14-4 Training  
– 460 IAC 6-5-14 Health Care Coordination Provider Qualifications  
Note:  Wellness Coordination is referred to as Health Care Coordination within 460 IAC 6.  
• Comply with any applicable BDS service standards, guidelines, policies and/or manuals, including 
FSSA DDRS policies and this module, accessible from the IHCP Provider Reference Modules 
page at in.gov/medicaid/providers 
• Nurses rendering waiver funded services must obtain/maintain Indiana licensure  
Section 10.34: Workplace Assistance for FSW and CIH 
Waiver 
The following subsections provide information and requirements for Workplace Assistance services for the 
FSW and CIH Waiver. 
Service Definition 
Workplace Assistance services provide a range of personal care services and/or supports during paid 
competitive community employment hours and in a competitive community employment setting to enable 
waiver individuals to accomplish tasks that they would normally do for themselves if they did not have a 
disability. Assistance may take the form of hands-on assistance (actually performing a personal care task 
for the individual) or prompting the individual to perform a personal care task. Workplace Assistance 
services may be provided on an episodic or on a continuous basis.

[Audio] Under the For the Family Supported Waiver (F-S-W--), transportation services and workplace assistance services are available. These services have certain restrictions such as not using them to meet medical transportation needs available under the Indiana Medicaid State Plan, not using them in conjunction with structured family caregiving services available under the Community Integrated Health (C-I-H--) Waiver, and not providing transportation services by the parent of a minor child participant or the spouse of a participant. To be eligible for these services, providers must meet certain criteria such as being an active Medicaid provider, FSSA DDRS-approved, complying with Indiana Administrative Code, and complying with any applicable B-D-S service standards, guidelines, policies, and/or manuals. Additionally, there are service standards and documentation standards that apply to Workplace Assistance services. These services should complement but not duplicate Day Habilitation services being provided in other settings and may only be delivered in the employment setting. No physician’s prescription or authorization is required for Workplace Assistance services, and the documentation for these services must include the following data elements for each service rendered: the name of the individual served, the I-H-C-P Member ID of the individual, the name of the provider, the service rendered, the time frame of the service, the date of the service including the year, the primary location of service delivery, and a brief activity summary of the service rendered.. 

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DDRS HCBS Waivers 
Section 10: Service Definitions and Requirements for FSW and CIH Waivers 
180 
Library Reference Number: PRPR10014 
 
Published: Sept. 9, 2024 
 
Policies and procedures as of July 1, 2024 
 
Version: 11.1 
Workplace Assistance services are designed to ensure the health, safety and welfare of the individual, 
thereby assisting in the retention of paid employment for the individual who is paid at or above the federal 
minimum wage. 
Additional Information: 
• 
Workplace Assistance services are available under the FSW and CIH Waiver. 
• 
Workplace Assistance may be used in conjunction with Extended Services. 
• 
Workplace Assistance may be used with each hour the individual is engaged in paid 
competitive community employment, including employment hours overlapping with 
Extended Services. 
Reimbursable Activities 
Reimbursable activities under Workplace Assistance include the following: 
• Direct support, monitoring, training, education, demonstration or support to assist with personal care 
while on the job or at the job site (may include assistance with meals, hygiene, toileting, 
transferring, maintaining continence, administration of medication and so forth) 
• May have been used in conjunction with Extended Services 
• May be used with each hour the individual is engaged in paid competitive community employment 
Service Standards 
The following service standards apply to Workplace Assistance: 
• Workplace Assistance services must be reflected in the PCISP. 
• Workplace Assistance services should complement but not duplicate Day Habilitation services 
being provided in other settings. 
• Workplace Assistance services may only be delivered in the employment setting.  
• There is no requirement for a physician’s prescription or authorization. The need for Workplace 
Assistance services is determined entirely by the IST.  
Documentation Standards 
Workplace Assistance services documentation must include the following: 
• Services must be outlined in the PCISP. 
• In addition to compliance with documentation requirements outlined in 460 IAC 6, the following 
data elements are required for each service rendered: 
– Name of individual served 
– IHCP Member ID of the individual 
– Name of provider 
– Service rendered 
– Time frame of service (include a.m. or p.m.) 
– Date of service including the year 
– Notation of the primary location of service delivery 
– A brief activity summary of service rendered

[Audio] We are here to discuss transportation services available for individuals with disabilities under the For the Family Supported Waiver (F-S-W--) and the Community Integrated Health (C-I-H--) Waiver. These waivers allow for transportation services to be paid for within an annual cap of $26482, and there are annual limits for each level of nonmedical waiver transportation. However, certain activities are not allowed under transportation services, such as using it for medical transportation needs that are already available under the Indiana Medicaid State Plan, using it in conjunction with structured family caregiving services available under the C-I-H Waiver, and providing it by the parent of a minor child participant or the spouse of a participant (LRIs). To be eligible for transportation services, providers must meet certain criteria, including being an active Medicaid provider, being FSSA DDRS-approved, complying with Indiana Administrative Code, and complying with any applicable B-D-S service standards, guidelines, policies and/or manuals. Additionally, providers must provide a description by direct care staff of any issue or circumstance concerning the individual, including significant medical or behavioral incidents or any other situation that may be uncommon for the individual. This description must include the last name and first initial of the direct care staff person making the entry, and must be made available to auditors, quality monitors, case managers, and any other government entity upon request. It is important to note that there are limitations on Workplace Assistance services, which are used to provide transportation services for individuals with disabilities in the workplace. The allowed ratio is one client to one staff, and reimbursement is available only during the individual's hours of paid, competitive community employment. Additionally, certain activities are not allowed under Workplace Assistance, such as providing services to a minor child by the parents, stepparents, or legal guardian, and providing services to an individual by that individual's spouse.. 

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DDRS HCBS Waivers 
Section 10: Service Definitions and Requirements for FSW and CIH Waivers 
Library Reference Number: PRPR10014 
181 
Published: Sept. 9, 2024 
Policies and procedures as of July 1, 2024 
Version: 11.1 
– In addition to the brief activity summary of service rendered, a description by direct care staff of 
any issue or circumstance concerning the individual including, but not limited to, significant 
medical or behavioral incidents or any other situation that may be uncommon for the individual 
– Signature that includes at least the last name and first initial of the direct care staff person 
making the entry (Electronic signatures are permissible when in compliance with the Uniform 
Electronic Transactions Act [IC 26-2-8].) 
Upon request, all data elements must be made available to auditors, quality monitors, case managers and 
any other government entity. The documentation may reside in multiple locations but must be clearly and 
easily linked to the individual or the standard will not be met. 
As applicable, monthly/quarterly reports must be uploaded to the document library of the state’s case 
management system by the chosen service provider on or before the 15th day of the following month. 
Limitations 
The following are limitations on Workplace Assistance services: 
• Allowed Ratio – Individual, one client to one staff. 
• Reimbursement for Workplace Assistance services is available only during the individual’s hours of 
paid, competitive community employment. 
Activities Not Allowed 
Reimbursement is not available through Workplace Assistance under the following circumstances: 
• When services are furnished to a minor child by the parents, stepparents or legal guardian 
• When services are furnished to an individual by that individual’s spouse  
• Any service that is otherwise available under the Rehabilitation Act of 1973 or Public Law 94-142 
• During volunteer activities 
• In a facility setting 
• In conjunction with sheltered employment 
• During activities other than paid competitive community employment 
• Workplace Assistance should complement but not duplicate services being provided under Extended 
Services.  
• Workplace Assistance is not to be used for observation or supervision of the individual for the 
purpose of teaching job tasks or to ascertain the success of the job placement. 
• Workplace Assistance is not to be used for offsite monitoring when the monitoring directly relates 
to maintaining a job. 
• Workplace Assistance is not to be used for the provision of skilled job trainers who accompany the 
individual for short-term job skill training at the work site to help maintain employment. 
• Workplace Assistance is not to be used for regular contact and/or follow-up with the employers, 
individuals, parents, family members, guardians, advocates or authorized representatives of the 
individuals, or other appropriate professional or informed advisors, to reinforce and stabilize the job 
placement. 
• Workplace Assistance is not to be used for the facilitation of natural supports at the work site. 
• Workplace Assistance is not to be used for individual program development, writing tasks analyses, 
monthly reviews, termination reviews or behavioral intervention programs.

[Audio] We are pleased to share information about the For the Family Supported Waiver (F-S-W--) and transportation services. Under the F-S-W--, transportation services are covered up to an annual cap of $26482, and there are annual limits for each level of non-medical waiver transportation. It is important to be aware that certain activities are not permitted under transportation services, including using it to fulfill medical transportation requirements already available under the Indiana Medicaid State Plan, utilizing it in conjunction with structured family caregiving services available under the Community Integrated Health (C-I-H--) Waiver, and providing it by the parent of a minor child participant or the spouse of a participant (LRIs). Providers must adhere to specific criteria, including being an active Medicaid provider, being FSSA DDRS-approved, complying with Indiana Administrative Code, and complying with any applicable B-D-S service standards, guidelines, policies, and manuals. The presentation also covers vehicle modification services for the F-S-W and C-I-H Waiver. It is important to note that Workplace Assistance is not to be used for advocating for the individual, staff time in traveling to and from a work site, and will not be reimbursed when provided by the parent of a minor child participant or the spouse of a participant (also known as LRIs). Providers must meet the following criteria: be enrolled as an active Medicaid provider, be FSSA DDRS-approved, comply with Indiana Administrative Code, insurance, financial status of providers, requirements for direct care staff, staff training and training, transportation services provider qualifications, transportation supports provider qualifications, and comply with any applicable B-D-S service standards, guidelines, policies, and manuals, including FSSA DDRS policies and this module, accessible from the I-H-C-P Provider Reference Modules page at in.gov/medicaid/providers. In summary, transportation services under the F-S-W are subject to certain limitations and provider qualifications. It is crucial for providers to meet these criteria to ensure that transportation services are provided safely and effectively. Thank you for your attention.. 

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Published: Sept. 9, 2024 
 
Policies and procedures as of July 1, 2024 
 
Version: 11.1 
• Workplace Assistance is not to be used for advocating for the individual. 
• Workplace Assistance is not to be used for staff time in traveling to and from a work site. 
• This service will not be reimbursed when provided by the parent of a minor child participant or the 
spouse of a participant (also known as LRIs). 
Provider Qualifications 
Providers must meet the following criteria: 
• Enrolled as an active Medicaid provider 
• Be FSSA DDRS-approved 
• Comply with Indiana Administrative Code, 460 IAC 6, including but not limited to: 
– 460 IAC 6-10-5 Documentation of Criminal Histories 
– 460 IAC 6-12-1 and 460 IAC 6-12-2 Insurance 
– 460 IAC 6-11-1 to 460 IAC 6-11-3 Financial Status of Providers 
– 460 IAC 6-14-5 Requirements for Direct Care Staff 
– 460 IAC 6-14-4 Staff Training and 460 IAC 6-14-4 Training 
– 460 IAC 6-5-30 Transportation Services Provider Qualifications 
– 460 IAC 6-5-31 Transportation Supports Provider Qualifications 
• Comply with any applicable BDS service standards, guidelines, policies and/or manuals, including 
FSSA DDRS policies and this module, accessible from the IHCP Provider Reference Modules page 
at in.gov/medicaid/providers

[Audio] Welcome valued attendees. We are currently on slide number 11 out of 14 in our presentation about the Family Supported Waiver (F-S-W--) transportation services. Today, we will be discussing the R-F-A policies that pertain to home modifications, specialized medical equipment and supplies, and vehicle modifications services in order to provide a better understanding of these services. Section 11.1 of the R-F-A policies addresses the use of the required Request for Approval to Authorize Services form for authorization of these services for both the F-S-W and C-I-H waivers. This policy, which was implemented on July 16, 2020, replaces all previous policies related to authorizing Home Modifications. It is important to note that policy updates are currently in process. The Home Modifications services covered under the F-S-W and C-I-H waivers include minor physical adaptations to the home as specified in the individual's service authorization. These modifications are intended to support the individual's independence and safety in their home environment, such as ramps, grab bars, and other accommodations to aid in daily activities. Our policies for home modifications adhere to the guidelines outlined in the Code of Federal Regulations, and align with the goals of both the C-I-H and F-S-W waivers to promote community integration and support individuals with disabilities in living independently. We would like to remind attendees that these policies have been in effect since December 1, 2007, and any previous policies related to these services are no longer valid. We are continuously working to update and improve our policies to better serve our participants and provide the best possible care. Thank you for your attention and please feel free to ask any questions during the Q&A session at the end of the presentation. We appreciate your participation and look forward to discussing the remaining topics with you.. 

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Library Reference Number: PRPR10014 
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Published: Sept. 9, 2024 
Policies and procedures as of July 1, 2024 
Version: 11.1 
Section 11: RFA Policies 
The following policies address use of the required Request for Approval to Authorize Services (RFA) form 
for authorization of the Home Modifications, Specialized Medical Equipment and Supplies, and Vehicle 
Modification services. 
Section 11.1: Home Modification Policy for FSW and 
CIH Waiver 
Waiver Policy Notification 
Authority: Code of Federal Regulations 42 CFR 441.302 
Policy Topic: Home Modification Policy Clarification 
Impacts the following Home- and Community-Based Services (HCBS) waivers:  
• Community Integration and Habilitation (CIH) Waiver  
• Family Supports Waiver (FSW) Effective July 16, 2020, Home Modifications are now a covered 
service under both the Community Integration and Habilitation (CIH) and the Family Supports 
Waiver (FSW)  
Effective Date: Dec. 1, 2007, and replaces all previous policies related to the authorization of Home 
Modifications. Policy updates are in process. 
Description 
Home Modifications services are minor physical adaptations to the home, as required by the individual’s 
service authorization, which are necessary to ensure the health, welfare and safety of the individual. These 
modifications enable the individual to function with greater independence in the home and without which 
the individual would require institutionalization.  
A lifetime cap of $20,000 is available for Home Modifications per waiver. The cap represents a cost for 
basic modification of an individual’s home for accessibility and safety and accommodates the individual’s 
needs for housing modifications. The cost of a Home Modifications service includes all materials, 
equipment, labor and permits to complete the project. No parts of a Home Modifications service may be 
billed separately as part of any other service category (for example, Specialized Medical Equipment and 
Supplies). In addition to the $20,000 lifetime cap, $1,000 is allowable annually for the repair, replacement, 
or an adjustment to an existing home modification that was funded by an HCBS waiver. 
For the FSW, Home Modifications services are outside the $26,482 cap.

[Audio] This section will cover the policies related to the Request for Application (R-F-A--) for the D-D-R-S Home and Community-Based Services (H-C-B-S-) Waivers. It should be noted that the funding provided by these waivers only includes basic modifications that are deemed medically necessary for the individual. This means that any requests for items or upgrades beyond basic medical need will not be approved. For instance, if a bathroom modification is necessary, but the individual or family wants higher-end materials, such as tiled flooring, a decision must be made whether to use waiver funds for the basic modification or to cover the additional cost for the desired upgrade. This applies to all modifications under the waivers, including vehicle modifications. As the state is responsible for ensuring that each modification is the most cost-effective and conservative means to meet the individual's accessibility needs in their home, it is not acceptable to submit bids that combine waiver funding with private funds to cover the costs of desired upgrades. This applies to all modifications, including home ownership. Providers must adhere to specific criteria in order to offer these waiver services, including being an active Medicaid provider and being approved by FSSA DDRS. They must also comply with the Indiana Administrative Code and any applicable B-D-S service standards, guidelines, policies, and manuals. It is our responsibility to ensure that the funds provided for transportation services under the Family Supported Waiver (F-S-W--) are used appropriately within the annual cap of $26482. There are also annual limits for each level of non-medical waiver transportation. It should be noted that transportation services cannot be used for medical transportation needs that are already covered under the Indiana Medicaid State Plan, or in conjunction with structured family caregiving services available under the Community Integrated Health (C-I-H--) Waiver. Additionally, transportation services cannot be provided by the parent of a minor child participant or the spouse of a participant (LRIs). We appreciate your attention to these policies surrounding the DDRS HCBS Waivers, specifically in regards to transportation and vehicle modifications. Let's continue to work together to ensure the best use of these funds and accessibility for individuals under these waivers.. 

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Library Reference Number: PRPR10014 
 
Published: Sept. 9, 2024 
 
Policies and procedures as of July 1, 2024 
 
Version: 11.1 
Note: As a reminder, HCBS waiver funding covers only basic modifications determined to 
be medically necessary for the waiver individual and is not available for items that 
exceed basic medical need. Requests to upgrade products or to use materials 
exceeding the individual’s basic need will not be approved. For example, if a 
bathroom modification is necessary but the individual or family requests tiled 
flooring when basic vinyl flooring could be installed, the individual or family must 
decide whether to access waiver funds for completion of the basic modification or to 
assume financial responsibility for the entire modification inclusive of desired 
upgrades.  
 
Due to the state’s responsibility to ensure each modification is the most cost effective 
or conservative means to meet the individual’s needs for accessibility within the 
home, it is not acceptable to submit bids attempting to combine waiver funding for 
basic modifications with private funding to cover the higher costs of the desired 
upgrades. 
Home Ownership 
Home Modifications shall be approved for the individual’s own home or family-owned home. Rented 
homes or apartments are allowed to be modified only when a signed agreement from the landlord is 
obtained. The signed agreement must be submitted along with all other required waiver documentation.  
Choice of Provider 
The individual chooses which approved/certified providers will submit bids or estimates for this service. 
The provider with the lowest bid will be chosen, unless there is a strong written justification from the case 
manager detailing why a provider with a higher bid should be selected. 
Requirements 
All Home Modifications must be approved by the waiver program prior to services being rendered.  
Home Modification requests must be provided in accordance with applicable state and/or local building 
codes and should be guided by the Americans with Disability Act (ADA) or ADA Accessibility Guidelines 
(ADAAG) requirements when in the best interest of the individual and the individual’s specific situation. 
Home Modifications shall be authorized only when it is determined to be medically necessary and shall 
have direct medical or remedial benefit for the waiver individual. This determination includes the following 
considerations: 
• The modification is the most cost effective or conservative means to meet the individual’s needs for 
accessibility within the home. 
• The Home Modification is individualized, specific and consistent with, but not in excess of, the 
individual’s needs. 
• Three Home Modification bids must be obtained for all modifications over $1,000. 
• If three bids cannot be obtained, it must be documented to show what efforts were made to secure 
the three bids and explain why fewer than three bids were obtained (including provider name, dates 
of contact, response received). 
• For modifications under $1,000, one bid is required, and pricing must be consistent with the fair 
market price for such modifications. 
• Bids must be itemized to include information shown in the example in Table 5.

[Audio] Welcome to slide number 13. In this presentation, we will be discussing the transportation services provided under the Family Supported Waiver (F-S-W--). These services have an annual cap of $26482 and additional limits based on the level of nonmedical waiver transportation needed. It is crucial to note that these services cannot be used for medical transportation that is already available under the Indiana Medicaid State Plan or in conjunction with structured family caregiving services available under the Community Integrated Health (C-I-H--) Waiver. Furthermore, transportation services cannot be provided by the parent of a minor child participant or the spouse of a participant, also known as L-R-I-s-. In order to provide these services, providers must meet certain criteria, including being an active Medicaid provider, being FSSA DDRS-approved, and complying with Indiana Administrative Code, as well as any applicable B-D-S service standards, guidelines, policies, and/or manuals. Moving on to Section 11, R-F-A Policies for DDRS HCBS Waivers, we will specifically be looking at Table 5 – Bid Itemization Example – Home Modifications. This table outlines the scope of work, labor and material costs, and related expenses for various home modifications. These modifications can include a 15-inch ramp, widening of front and bathroom doors to 36 inches, installation of an A-D-A toilet, and building permits as needed. The total cost for all modifications will be listed as $$$$. However, please note that requests for modifications at two or more locations can only be approved at the discretion of the state division director or state agency designee. Additionally, modifications may be denied if the documentation does not support residential stability and/or the specific service requested. It is crucial to adhere to the established federal, state, local, and Family and Social Services Administration (F-S-S-A-) standards, as well as A-D-A requirements when making home modifications. This ensures that the modifications are of direct medical or remedial benefit to the individual. Thank you for your attention, and please continue to the next slide for more information on home modifications.. 

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Published: Sept. 9, 2024 
Policies and procedures as of July 1, 2024 
Version: 11.1 
Table 5 – Bid Itemization Example – Home Modifications 
Scope of work labor 
Material 
Related 
Ramp 15 inches long 
$$ 
$$ 
Widen front door to 36 inches 
$$ 
$$ 
Widen bathroom door to 36 inches 
$$ 
$$ 
Install ADA toilet 
$$ 
$$ 
Building permits (specify) 
$$ 
$$ 
Total Cost:  
$$$$ 
$$$$ 
• Requests for modifications at two or more locations may only be approved at the discretion of the 
state division director or state agency designee. 
• Requests for modifications may be denied if the state division director or state agency designee 
determines the documentation does not support residential stability and/or the service requested. 
Service Standards 
• Home modifications must be of direct medical or remedial benefit to the individual. 
• To ensure that Home Modifications meet the needs of the individual and abide by established 
federal, state, local, and Family and Social Services Administration (FSSA) standards, as well as 
ADA requirements. When applicable, approved Home Modifications will include: 
– Assessment of the individual’s specific needs, conducted by an approved, qualified individual 
who is independent of the entity providing the Home Modifications 
– Independent inspections during, as well as at the completion of, the modification process, prior 
to authorization for reimbursement 
• Modifications must meet applicable standards of manufacture, design and installation. 
• Modifications must be compliant with applicable building codes. 
Documentation Standards 
• The identified direct benefit or need must be documented within the following: 
– Service authorization 
– Physician prescription and/or clinical evaluation as deemed appropriate 
– Person-centered individualized support plan (PCISP) 
• Documentation/explanation of the service within the Request for Approval to Authorize Services 
(RFA) including the following: 
– Property owner of the residence where the requested modification is proposed 
– Property owner’s relationship to the individual 
– What, if any, relationship the property owner has to the waiver program 
– Length of time the individual has lived at this residence 
– If a rental property – length of lease 
– Written agreement of landlord for modification 
– Verification of individual’s intent to remain in the setting 
– Land survey if required when exterior modifications approach property line 
– Signed and approved RFA 
– Signed and approved service authorization

[Audio] We are here to discuss the reimbursement and coverage requirements for vehicle modifications under the DDRS HCBS Waivers Section 11: R-F-A Policies. In order to comply with F-S-S-A and our division, service providers must understand the guidelines and policies outlined. All expenses related to the modification must be documented and submitted for reimbursement. This includes modifications that comply with F-S-S-A and division-specific guidelines, are allowable under Medicaid waiver guidelines, are not covered by the Rehabilitation Act of 1973, and are included in the individual's approved P-C-I-S-P or service authorization. These modifications must also be authorized on the R-F-A and linked to the P-C-I-S-P or service authorization, included on a state-approved and signed service authorization, completed by an approved Medicaid waiver service provider, and completed in accordance with building permits. It is important to note that justification and documentation are required to demonstrate the necessity of the modification for the individual's specific needs. For example, certain modifications, such as adaptive door openers and locks, may be covered if deemed necessary for the individual's situation. We understand that these guidelines and requirements may seem overwhelming, but they are in place to ensure individuals receive the necessary modifications to improve their quality of life. We appreciate your attention and compliance with these policies.. 

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Policies and procedures as of July 1, 2024 
 
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– Receipts for all incurred expenses by service provider related to the modification 
– Anything needed to be in compliance with FSSA and division-specific guidelines and/or policies 
Reimbursement 
Reimbursement is available for modifications that satisfy each of the following: 
• Service and documentation standards outlined within this policy 
• Allowable under current Medicaid waiver guidelines 
• Not available under the Rehabilitation Act of 1973, as amended 
• Included in the individual’s approved PCISP/service authorization 
• Authorized on the RFA and linked to the PCISP/service authorization 
• Included on a state-approved and signed service authorization 
• Completed by an approved Medicaid waiver service provider (who is approved to perform this 
service) 
• Completed in accordance with the applicable building permits 
Modifications/Items – Covered 
Justification and documentation are required to demonstrate that the modification is necessary to meet the 
individual’s identified needs: 
• Adaptive door openers and locks – Limited to one per individual primary residence for an individual 
living alone or who is alone without a caregiver for substantial periods of time but has a need to 
open, close or lock the doors and cannot do so without special adaptation.  
• Bathroom modification – Limited to one existing bathroom per individual primary residence when 
no other accessible bathroom is available. The bathroom modification may include: 
– Removal of existing bathtub, toilet and/or sink 
– Installation of roll-in shower, grab bars, ADA toilet and wall-mounted sink 
– Installation of replacement flooring, if necessary due to bath modification 
• Environmental control units – Adaptive switches and buttons to operate medical equipment, 
communication devices, heat and air conditioning, and lights for an individual living alone or who is 
alone without a caregiver for a substantial portion of the day. 
• Environmental safety devices limited to:  
– Door alarms 
– Anti-scald devices 
– Hand-held shower head 
– Grab bars for the bathroom 
• Fence – Limited to 200 linear feet (individual must have a documented history of elopement). 
• Ramp – Limited to one per individual primary residence, and only when no other accessible ramp 
exists: 
– In accordance with the ADA or ADAAG, unless this is not in the best interest of the client 
– Portable – Considered for rental property only 
– Permanent 
– Vertical lift – May be considered in lieu of a ramp if there is photographic and written 
documentation that shows it is not possible for a ramp to be used

 part 14

We are discussing transportation services provided under the Family Supported Waiver (F-S-W--) and Community Integrated Health (C-I-H--) Waiver. These services have limitations and criteria that providers must meet to be approved. We also touch on vehicle modifications services available under these waivers, which are subject to specific guidelines and requirements. It's important to note that the information provided on this slide is specific to the F-S-W and C-I-H Waivers and may not be applicable to other waiver programs or services.

avatar

We are here to discuss the transportation services provided for individuals with disabilities in Indiana. The F-S-W is a program that allows for the payment of transportation services within a certain annual cap of $26482. However, there are certain restrictions on what transportation services can be used for. For example, transportation services cannot be used to meet medical transportation needs that are already available under the Indiana Medicaid State Plan or in conjunction with structured family caregiving services available under the Community Integrated Health (C-I-H--) Waiver. Additionally, transportation services cannot be used to transport individuals to places where they are not required to go, such as to a place of worship or to a recreational activity.

Transportation services are crucial components of the F-S-W and C-I-H Waivers. These services offer individuals with the means to access community-based services. For the F-S-W--, transportation services are covered under an annual cap of $26482, and there are annual limits for each level of non-medical waiver transportation. However, certain activities are not allowed under transportation services. For example, transportation services cannot be used to meet medical transportation needs already available under the Indiana Medicaid State Plan or in conjunction with structured family caregiving services available under the C-I-H Waiver. Additionally, transportation services provided by the parent of a minor child participant or the spouse of a participant are not allowed.

To ensure the safety and effectiveness of these services, providers must meet specific criteria, such as being an active Medicaid provider, being FSSA DDRS-approved, complying with Indiana Administrative Code, and complying with any applicable B-D-S service standards, guidelines, policies, and manuals.

In addition to transportation services, the F-S-W and C-I-H Waivers also include vehicle modifications services to accommodate the needs of individuals with disabilities. These modifications must follow specific guidelines to ensure safety and effectiveness. A cap of $15000 is available for one vehicle per every 10-year period for an individual’s household. In addition to the applicable cap, $1000 will be allowable annually for repair, replacement, or an adjustment to an existing modification that was funded by a Home and Community-Based Services (H-C-B-S-) waiver.

There are certain activities that are not allowed under vehicle modifications, such as modifications/adaptations that have not been approved on a Request for Approval to Authorize Services (R-F-A--) form, as well as examples/descriptions of modifications/items not covered, such as repair or replacement of modified equipment damaged or destroyed in an accident, alarm systems, auto loan payments, insurance coverage, driver’s license, title registration or license plates, emergency road service, routine maintenance and repairs related to the vehicle itself, specialized medical equipment or home modification items, and leased vehicles.

To ensure the safety and quality of vehicle modifications, providers must meet specific criteria, such as being enrolled as an active Medicaid provider, being FSSA DDRS-approved, complying with Indiana Administrative Code, and complying with any applicable B-D-S service standards, guidelines, policies, and manuals. Providers rendering waiver-funded services must also obtain/maintain Indiana licensure, where licensure is required.

We will be discussing transportation and wellness coordination services offered under the For the Family Supported Waiver (F-S-W--) and Community Integrated Health (C-I-H--) Waiver. 
Transportation services are available up to an annual cap of $26482 under the F-S-W--, and there are annual limits for each level of non-medical waiver transportation. However, certain activities are not allowed under transportation services, such as using it to meet medical transportation needs already available under the Indiana Medicaid State Plan, using it in conjunction with structured family caregiving services available under the C-I-H Waiver, and providing it by the parent of a minor child participant or the spouse of a participant (LRIs). Providers must meet certain criteria, including being an active Medicaid provider, being FSSA DDRS-approved, complying with Indiana Administrative Code, and complying with any applicable B-D-S service standards, guidelines, policies, and/or manuals.
Wellness Coordination services are available under the C-I-H Waiver to assist individuals in managing their health care needs. These services are specifically designed for individuals requiring the assistance of an RN or L-P-N to properly coordinate their medical needs. There are three levels of support, with Tier I requiring a face-to-face visit once a month with an RN or L-P-N and consultations/reviews based on the individual’s current healthcare needs. Tier II requires a face-to-face visit twice a month with an RN or L-P-N and consultations/reviews based on the individual’s current healthcare needs. Tier I-I-I requires a face-to-face visit once a week with an RN or L-P-N and consultations/reviews based on the individual’s current healthcare needs. The necessity for Wellness Coordination services is typically reserved for individuals assessed with health scores of 5 or higher through the state’s objective-based allocation process. Individuals assessed with health scores of 0-4 would not require assistance of an RN or L-P-N to coordinate medical needs.
Wellness Coordination services are available only under the C-I-H Waiver and are not available under the FSW, H&W, or T-B-I waivers. Reimbursement is available for Wellness Coordination services only when the following circumstances are present: the individual requires assistance in coordinating medical needs beyond what can be provided through routine doctor/healthcare visits, Wellness Coordination services are specifically included in the individual’s PCISP, and the member has a Wellness Coordination plan.

We offer transportation services to participants under the Family Supported Waiver (F-S-W--) with a yearly restriction of $26482 and limitations on how much can be spent on non-medical transportation for each level. Non-medical transportation services are not allowed to be used for certain activities, such as meeting medical transportation needs already available under the Indiana Medicaid State Plan, using them in conjunction with structured family caregiving services offered under the Community Integrated Health (C-I-H--) Waiver, or providing them by the parent of a minor child participant or the spouse of a participant. To offer these services, providers must meet certain requirements, including being an active Medicaid provider, being FSSA DDRS-approved, complying with Indiana Administrative Code, and complying with any applicable B-D-S service standards, guidelines, policies and/or manuals.

We will discuss transportation and workplace assistance services provided under the Family Supported Waiver (F-S-W--) and Community Integrated Health (C-I-H--) Waivers. Transportation services are paid for within an annual cap of $26482, and there are annual limits for each level of nonmedical waiver transportation. However, certain activities are not allowed under transportation services, such as using it to meet medical transportation needs already available under the Indiana Medicaid State Plan, using it in conjunction with structured family caregiving services available under the C-I-H Waiver, and providing it by the parent of a minor child participant or the spouse of a participant. To be eligible for transportation services, providers must meet certain criteria, such as being an active Medicaid provider, being FSSA DDRS-approved, complying with Indiana Administrative Code, and complying with any applicable B-D-S service standards, guidelines, policies and/or manuals. Additionally, providers must document what level of consultation/visits has been deemed necessary or appropriate for the individual, as outlined in the PCISP.
                                    
                                    It's also important to note that wellness coordination services must address needs identified in the person-centered planning process and be outlined in the PCISP. The provider of wellness coordination will provide a written report to pertinent parties at least quarterly, and as applicable, monthly/quarterly reports must be uploaded to the document library of the state's case management system by the chosen service provider on or before the 15th day of the following month. Within the wellness coordination plan, the provider must document what level of consultation/visits has been deemed necessary or appropriate for the individual.
                                    
                                    In terms of workplace assistance services, these provide a range of personal care services and/or supports during paid competitive community employment hours and in a competitive community employment setting to enable waiver individuals to accomplish tasks that they would normally do for themselves if they did not have a disability. Assistance may take the form of hands-on assistance (actually performing a personal care task for the individual) or prompting the individual to perform a personal care task. Workplace Assistance services may be provided on an episodic or on a continuous basis.

Under the For the Family Supported Waiver (F-S-W--), transportation services and workplace assistance services are available. These services have certain restrictions such as not using them to meet medical transportation needs available under the Indiana Medicaid State Plan, not using them in conjunction with structured family caregiving services available under the Community Integrated Health (C-I-H--) Waiver, and not providing transportation services by the parent of a minor child participant or the spouse of a participant. To be eligible for these services, providers must meet certain criteria such as being an active Medicaid provider, FSSA DDRS-approved, complying with Indiana Administrative Code, and complying with any applicable B-D-S service standards, guidelines, policies, and/or manuals. Additionally, there are service standards and documentation standards that apply to Workplace Assistance services. These services should complement but not duplicate Day Habilitation services being provided in other settings and may only be delivered in the employment setting. No physician’s prescription or authorization is required for Workplace Assistance services, and the documentation for these services must include the following data elements for each service rendered: the name of the individual served, the I-H-C-P Member ID of the individual, the name of the provider, the service rendered, the time frame of the service, the date of the service including the year, the primary location of service delivery, and a brief activity summary of the service rendered.

We are here to discuss transportation services available for individuals with disabilities under the For the Family Supported Waiver (F-S-W--) and the Community Integrated Health (C-I-H--) Waiver. These waivers allow for transportation services to be paid for within an annual cap of $26482, and there are annual limits for each level of nonmedical waiver transportation. However, certain activities are not allowed under transportation services, such as using it for medical transportation needs that are already available under the Indiana Medicaid State Plan, using it in conjunction with structured family caregiving services available under the C-I-H Waiver, and providing it by the parent of a minor child participant or the spouse of a participant (LRIs).

To be eligible for transportation services, providers must meet certain criteria, including being an active Medicaid provider, being FSSA DDRS-approved, complying with Indiana Administrative Code, and complying with any applicable B-D-S service standards, guidelines, policies and/or manuals. Additionally, providers must provide a description by direct care staff of any issue or circumstance concerning the individual, including significant medical or behavioral incidents or any other situation that may be uncommon for the individual. This description must include the last name and first initial of the direct care staff person making the entry, and must be made available to auditors, quality monitors, case managers, and any other government entity upon request.

It is important to note that there are limitations on Workplace Assistance services, which are used to provide transportation services for individuals with disabilities in the workplace. The allowed ratio is one client to one staff, and reimbursement is available only during the individual's hours of paid, competitive community employment. Additionally, certain activities are not allowed under Workplace Assistance, such as providing services to a minor child by the parents, stepparents, or legal guardian, and providing services to an individual by that individual's spouse.

We are pleased to share information about the For the Family Supported Waiver (F-S-W--) and transportation services. Under the F-S-W--, transportation services are covered up to an annual cap of $26482, and there are annual limits for each level of non-medical waiver transportation. It is important to be aware that certain activities are not permitted under transportation services, including using it to fulfill medical transportation requirements already available under the Indiana Medicaid State Plan, utilizing it in conjunction with structured family caregiving services available under the Community Integrated Health (C-I-H--) Waiver, and providing it by the parent of a minor child participant or the spouse of a participant (LRIs). Providers must adhere to specific criteria, including being an active Medicaid provider, being FSSA DDRS-approved, complying with Indiana Administrative Code, and complying with any applicable B-D-S service standards, guidelines, policies, and manuals. The presentation also covers vehicle modification services for the F-S-W and C-I-H Waiver. It is important to note that Workplace Assistance is not to be used for advocating for the individual, staff time in traveling to and from a work site, and will not be reimbursed when provided by the parent of a minor child participant or the spouse of a participant (also known as LRIs). Providers must meet the following criteria: be enrolled as an active Medicaid provider, be FSSA DDRS-approved, comply with Indiana Administrative Code, insurance, financial status of providers, requirements for direct care staff, staff training and training, transportation services provider qualifications, transportation supports provider qualifications, and comply with any applicable B-D-S service standards, guidelines, policies, and manuals, including FSSA DDRS policies and this module, accessible from the I-H-C-P Provider Reference Modules page at in.gov/medicaid/providers. In summary, transportation services under the F-S-W are subject to certain limitations and provider qualifications. It is crucial for providers to meet these criteria to ensure that transportation services are provided safely and effectively. Thank you for your attention.

Welcome valued attendees. We are currently on slide number 11 out of 14 in our presentation about the Family Supported Waiver (F-S-W--) transportation services. Today, we will be discussing the R-F-A policies that pertain to home modifications, specialized medical equipment and supplies, and vehicle modifications services in order to provide a better understanding of these services. Section 11.1 of the R-F-A policies addresses the use of the required Request for Approval to Authorize Services form for authorization of these services for both the F-S-W and C-I-H waivers. This policy, which was implemented on July 16, 2020, replaces all previous policies related to authorizing Home Modifications. It is important to note that policy updates are currently in process. The Home Modifications services covered under the F-S-W and C-I-H waivers include minor physical adaptations to the home as specified in the individual's service authorization. These modifications are intended to support the individual's independence and safety in their home environment, such as ramps, grab bars, and other accommodations to aid in daily activities. Our policies for home modifications adhere to the guidelines outlined in the Code of Federal Regulations, and align with the goals of both the C-I-H and F-S-W waivers to promote community integration and support individuals with disabilities in living independently. We would like to remind attendees that these policies have been in effect since December 1, 2007, and any previous policies related to these services are no longer valid. We are continuously working to update and improve our policies to better serve our participants and provide the best possible care. Thank you for your attention and please feel free to ask any questions during the Q&A session at the end of the presentation. We appreciate your participation and look forward to discussing the remaining topics with you.

This section will cover the policies related to the Request for Application (R-F-A--) for the D-D-R-S Home and Community-Based Services (H-C-B-S-) Waivers. It should be noted that the funding provided by these waivers only includes basic modifications that are deemed medically necessary for the individual. This means that any requests for items or upgrades beyond basic medical need will not be approved. For instance, if a bathroom modification is necessary, but the individual or family wants higher-end materials, such as tiled flooring, a decision must be made whether to use waiver funds for the basic modification or to cover the additional cost for the desired upgrade. This applies to all modifications under the waivers, including vehicle modifications.

As the state is responsible for ensuring that each modification is the most cost-effective and conservative means to meet the individual's accessibility needs in their home, it is not acceptable to submit bids that combine waiver funding with private funds to cover the costs of desired upgrades. This applies to all modifications, including home ownership. Providers must adhere to specific criteria in order to offer these waiver services, including being an active Medicaid provider and being approved by FSSA DDRS. They must also comply with the Indiana Administrative Code and any applicable B-D-S service standards, guidelines, policies, and manuals.

It is our responsibility to ensure that the funds provided for transportation services under the Family Supported Waiver (F-S-W--) are used appropriately within the annual cap of $26482. There are also annual limits for each level of non-medical waiver transportation. It should be noted that transportation services cannot be used for medical transportation needs that are already covered under the Indiana Medicaid State Plan, or in conjunction with structured family caregiving services available under the Community Integrated Health (C-I-H--) Waiver. Additionally, transportation services cannot be provided by the parent of a minor child participant or the spouse of a participant (LRIs).

We appreciate your attention to these policies surrounding the DDRS HCBS Waivers, specifically in regards to transportation and vehicle modifications. Let's continue to work together to ensure the best use of these funds and accessibility for individuals under these waivers.

Welcome to slide number 13. In this presentation, we will be discussing the transportation services provided under the Family Supported Waiver (F-S-W--). These services have an annual cap of $26482 and additional limits based on the level of nonmedical waiver transportation needed. It is crucial to note that these services cannot be used for medical transportation that is already available under the Indiana Medicaid State Plan or in conjunction with structured family caregiving services available under the Community Integrated Health (C-I-H--) Waiver.

Furthermore, transportation services cannot be provided by the parent of a minor child participant or the spouse of a participant, also known as L-R-I-s-. In order to provide these services, providers must meet certain criteria, including being an active Medicaid provider, being FSSA DDRS-approved, and complying with Indiana Administrative Code, as well as any applicable B-D-S service standards, guidelines, policies, and/or manuals.

Moving on to Section 11, R-F-A Policies for DDRS HCBS Waivers, we will specifically be looking at Table 5 – Bid Itemization Example – Home Modifications. This table outlines the scope of work, labor and material costs, and related expenses for various home modifications. These modifications can include a 15-inch ramp, widening of front and bathroom doors to 36 inches, installation of an A-D-A toilet, and building permits as needed. The total cost for all modifications will be listed as $$$$. However, please note that requests for modifications at two or more locations can only be approved at the discretion of the state division director or state agency designee. Additionally, modifications may be denied if the documentation does not support residential stability and/or the specific service requested.

It is crucial to adhere to the established federal, state, local, and Family and Social Services Administration (F-S-S-A-) standards, as well as A-D-A requirements when making home modifications. This ensures that the modifications are of direct medical or remedial benefit to the individual. Thank you for your attention, and please continue to the next slide for more information on home modifications.

We are here to discuss the reimbursement and coverage requirements for vehicle modifications under the DDRS HCBS Waivers Section 11: R-F-A Policies. In order to comply with F-S-S-A and our division, service providers must understand the guidelines and policies outlined. All expenses related to the modification must be documented and submitted for reimbursement. This includes modifications that comply with F-S-S-A and division-specific guidelines, are allowable under Medicaid waiver guidelines, are not covered by the Rehabilitation Act of 1973, and are included in the individual's approved P-C-I-S-P or service authorization. These modifications must also be authorized on the R-F-A and linked to the P-C-I-S-P or service authorization, included on a state-approved and signed service authorization, completed by an approved Medicaid waiver service provider, and completed in accordance with building permits. It is important to note that justification and documentation are required to demonstrate the necessity of the modification for the individual's specific needs. For example, certain modifications, such as adaptive door openers and locks, may be covered if deemed necessary for the individual's situation. We understand that these guidelines and requirements may seem overwhelming, but they are in place to ensure individuals receive the necessary modifications to improve their quality of life. We appreciate your attention and compliance with these policies.