[Virtual Presenter] We will discuss the significance of structured family care and the service standards that provider agencies must adhere to. We will outline the specific needs identified by the participant's person-centered planning process, as well as the supports provided within the home, which are managed and completed by the principal caregiver based on the participant's daily needs. We will also discuss the training and medication oversight provided to principal caregivers and providers.. 

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Section 12: Health and Wellness (H&W) and Traumatic Brain Injury (TBI) Waivers 
DDRS HCBS Waivers 
Library Reference Number: PRPR10014 
285 
Published: Sept. 9, 2024 
Policies and procedures as of July 1, 2024 
Version: 11.1 
• Attendant Care services related to needed ADLs 
• Medication oversight (to the extent permitted under state law) 
• Escorting for necessary appointments, whenever possible, such as transporting individuals to doctor. 
(Note: When provided, such transportation is incidental and not duplicative of any other Indiana 
Medicaid State Plan or waiver service.) 
• Appointments and community activities that are therapeutic in nature or assist with maintaining 
natural supports 
• Other appropriate supports as described in the individual’s service plan 
Service Standards 
These service standards must be followed for Structured Family Caregiving: 
• Structured Family Caregiving provider agencies must demonstrate three years of delivering services 
to older adults and adults with disabilities and their caregivers in Indiana or as a Medicaid 
participating provider in another state or have a national accreditation. 
• Structured Family Caregiving must be reflected in the participant’s service plan and address specific 
needs determined by the participant’s person-centered planning process. 
• Structured Family Caregiving provider agencies develop, implement and provide ongoing 
management and support of a person-centered service plan that addresses the participant’s level of 
service needs. 
• The supports provided within the home are managed and completed by the principal caregiver 
throughout the day based on the participant’s daily needs. 
• Structured Family Caregiving is provided in a private residence and affords all of the rights, dignity 
and qualities of living in a private residence including privacy, comfortable surroundings, and the 
opportunity to modify one’s living area to suit one’s individual preferences. 
• Provider agencies must conduct, at a minimum, two home visits per quarter based on the 
participant’s assessed needs and caregiver coaching needs, but the actual frequency of visits should 
be based on the participant’s assessed needs and caregiver coaching needs. 
• The provider agency must identify the skill development and wellness needs of the primary 
caregiver and provide access to a qualified substitute caregiver as needed for up to 15 days per year. 
• Principal caregivers receive a minimum of eight hours in-person annual training that reflects the 
participant’s and principal caregiver’s assessed needs. Training may be delivered during quarterly 
home visits, or in another manner that is flexible and meaningful for the caregiver. 
• Provider agencies must work with participants and principal caregivers to establish backup plans for 
emergencies and other times when the principal caregiver is unable to provide care. 
• Structured Family Caregiving emphasizes the participant’s independence in a setting that protects 
and encourages the participant’s dignity, choice, and decision-making while preserving self-respect. 
• Provider agencies that provide medication oversight, as addressed under Allowable Activities, must 
receive necessary instruction from a doctor, nurse or pharmacist regarding medications prescribed to 
the participant.

[Audio] We will now discuss the attendant care services, medication oversight, escorting for necessary appointments, and other appropriate supports provided under the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers. We will also outline the service standards for structured family caregiving, which includes delivering services to older adults and adults with disabilities for three years. Provider agencies must conduct two home visits per quarter, provide access to a qualified substitute caregiver, and establish backup plans for emergencies. To ensure the success of structured family caregiving, documentation standards must be followed. The waiver care manager must document the identified need for Structured Family Caregiving in the service plan, services outlined in the service plan performed by the principal caregiver, and caregiver assessment findings. The provider agency is responsible for documenting training provided to the principal caregiver, electronic caregiver notes, medication management records, and regular review of caregiver notes. It is important to note that separate payment will not be made for any of the following waiver services: Adult Family Care, Assisted Living, Attendant Care, and Home and Community Assistance. In summary, structured family caregiving can greatly improve the quality of life for individuals with disabilities and older adults by following the documentation and service standards outlined in Section 12 of the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers.. 

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DDRS HCBS Waivers 
Section 12: Health and Wellness (H&W) and Traumatic Brain Injury (TBI) Waivers 
286 
Library Reference Number: PRPR10014 
 
Published: Sept. 9, 2024 
 
Policies and procedures as of July 1, 2024 
 
Version: 11.1 
Documentation Standards 
These documentation standards must be followed for Structured Family Caregiving. 
The waiver care manager must document the following: 
• Identified need for Structured Family Caregiving in the service plan 
• Services outlined in the service plan performed by the principal caregiver 
• Caregiver assessment findings 
The care manager must give the completed person-centered service plan and caregiver assessment to the 
Structured Family Caregiving provider. 
The provider agency is responsible for the following: 
• Documentation to support service rendered include: 
– Training outlined in the service plan that provider agency will provide to the principal caregiver 
– Electronic caregiver notes that record and track the participant’s status, and updates or 
significant changes in the participant’s health status or behaviors and participation in 
community-based activities and other notable or reportable events 
– Medication management records, if applicable 
• Regular review of caregiver notes by provider agency in order to: 
– Understand and respond to changes in the participant’s health status and identify potential new 
issues in an effort to better communicate changes with the participant’s doctors or healthcare 
providers and avoid unnecessary hospitalizations or emergency room use 
– Document and investigate and refer reportable events to the waiver care manager 
• Documentation of home visits conducted by the provider agency 
• Documentation of education, skills training and coaching conducted with the principal caregiver 
• Documentation demonstrating collaboration and communication with other service providers and 
healthcare professionals (as appropriate), waiver care managers and other caregivers or individuals 
important to the participant regarding changes in the participant’s health status and reportable events 
• Documentation of all qualified caregivers (including paid substitute caregivers) 
Activities Not Allowed 
Separate payment will not be made for any of the following waiver services: 
• Adult Family Care 
• Assisted Living 
• Attendant Care 
• Home and Community Assistance

[Audio] We are here to discuss the information presented in the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers DDRS HCBS Waivers. Our topic will be the service standards for structured family caregiving and the requirements for becoming an approved provider. Provider agencies must conduct two home visits per quarter, provide access to a qualified substitute caregiver, and establish backup plans for emergencies. Principal caregivers receive annual training and medication oversight providers must receive instruction from a doctor, nurse or pharmacist. The Provider Qualifications for Structured Family Caregiving are presented in Table 30 and the General requirements for direct care staff, procedures for protecting individuals, unusual occurrence; reporting, transfer of individual’s record upon change of provider, notice of termination of services, provider organizational chart, collaboration and quality control, data collection and reporting standards, quality assurance and quality improvement system, financial information, liability insurance, transportation of an individual, documentation of qualifications, maintenance of personnel records, adoption of personnel policies, operations manual, and maintenance of records of services provided are also noted. Next, we will move on to the Supported Employment for T-B-I Waiver. Supported Employment services consist of paid employment for persons for whom competitive employment at or above the minimum wage is unlikely, and who, because of their disabilities, need intensive ongoing support to perform in a work setting. Supported Employment is conducted in a variety of settings, particularly worksites where persons without disabilities are employed. Supported Employment includes activities needed to sustain paid work by individuals receiving waiver services, including supervision and training.. 

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Section 12: Health and Wellness (H&W) and Traumatic Brain Injury (TBI) Waivers 
DDRS HCBS Waivers 
Library Reference Number: PRPR10014 
287 
Published: Sept. 9, 2024 
Policies and procedures as of July 1, 2024 
Version: 11.1 
Provider Qualifications 
Provider qualifications for Structured Family Caregiving are presented in Table 30. 
Table 30 – Provider Qualifications for Structured Family Caregiving 
Waiver 
Provider 
Licensure/ 
Certification 
Other Standards 
H&W/TBI  FSSA-approved 
Structured Family 
Caregiving Agency  
Not required 
Provider and home must meet the requirements of the 
Indiana AFC Service Provision and Certification 
Standards. 
FSSA approved  
455 IAC 2 Becoming an approved provider; 
maintaining approval  
455 IAC 2 Provider qualifications: general 
requirements  
455 IAC 2 General requirements for direct care staff  
455 IAC 2 Procedures for protecting individuals  
455 IAC 2 Unusual occurrence; reporting  
455 IAC 2 Transfer of individual’s record upon change 
of provider  
455 IAC 2 Notice of termination of services  
455 IAC 2 Provider organizational chart  
455 IAC 2 Collaboration and quality control 
455 IAC 2 Data collection and reporting standards  
455 IAC 2 Quality assurance and quality improvement 
system  
455 IAC 2 Financial information  
455 IAC 2 Liability insurance  
455 IAC 2 Transportation of an individual  
455 IAC 2 Documentation of qualifications  
455 IAC 2 Maintenance of personnel records  
455 IAC 2 Adoption of personnel policies  
455 IAC 2 Operations manual  
455 IAC 2 Maintenance of records of services 
provided  
455 IAC 2 Individual’s personal file; site of service 
delivery  
Section 12.29: Supported Employment for TBI Waiver 
The following subsections provide information and requirements for Supported Employment services under 
the TBI Waiver. 
Service Definition 
Supported Employment services consist of paid employment for persons for whom competitive 
employment at or above the minimum wage is unlikely, and who, because of their disabilities, need 
intensive ongoing support to perform in a work setting. Supported Employment is conducted in a variety of 
settings, particularly worksites where persons without disabilities are employed. Supported Employment 
includes activities needed to sustain paid work by individuals receiving waiver services, including 
supervision and training.

[Audio] We will discuss the information provided in Section 12 of the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers regarding attendant care services, medication oversight, escorting for necessary appointments, appointments and community activities that are therapeutic in nature, and other appropriate supports. We will also outline the service standards for structured family caregiving, which includes three years of delivering services to older adults and adults with disabilities, personalized service plans, ongoing management and support, and the ability to modify one's living area. Provider agencies must conduct two home visits per quarter, provide access to a qualified substitute caregiver, and establish backup plans for emergencies. Principal caregivers receive annual training and medication oversight providers must receive instruction from a doctor, nurse or pharmacist. Supported Employment services must follow a written service plan addressing specific needs determined by the individual's assessment. When Supported Employment services are provided at a worksite where persons without disabilities are employed, payment will be made only for the adaptation, supervision, and training required by individuals receiving waiver services as a result of their disabilities and will not include payment for supervisory activities rendered as a normal part of the business setting. Supported Employment services furnished under the waiver must be services that are not available under a program funded by either the Rehabilitation Act of 1973 or Public Law PL 94-142. Documentation standards for Supported Employment services include identified need in the service plan, services outlined in the service plan, data record of services provided, at least one entry on each day of service made by each staff member providing direct care or supervision of care to the individual, and documentation must be maintained in the file of each individual receiving this service, showing that the service is not otherwise available under a program funded under the Rehabilitation Act of 1973 or PL 94-142.. 

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DDRS HCBS Waivers 
Section 12: Health and Wellness (H&W) and Traumatic Brain Injury (TBI) Waivers 
288 
Library Reference Number: PRPR10014 
 
Published: Sept. 9, 2024 
 
Policies and procedures as of July 1, 2024 
 
Version: 11.1 
Service Standards 
The following service standards must be met: 
• Supported Employment services must follow a written service plan addressing specific needs 
determined by the individual’s assessment.  
• When Supported Employment services are provided at a worksite where persons without disabilities 
are employed, payment will be made only for the adaptation, supervision, and training required by 
individuals receiving waiver services as a result of their disabilities and will not include payment for 
supervisory activities rendered as a normal part of the business setting.  
• Supported Employment services furnished under the waiver must be services that are not available 
under a program funded by either the Rehabilitation Act of 1973 or Public Law PL 94-142.  
Documentation Standards 
The following documentation standards must be met for Supported Employment services: 
• Identified need in the service plan  
• Services outlined in the service plan  
• Data record of services provided, including:  
– Complete date and time of service (in and out)  
– Specific services /tasks provided  
– Signature of employee providing the service (minimally the last name and first initial) (Note: If 
the person providing the service is required to be a professional, the title of the individual must 
also be included.)  
• At least one entry on each day of service made by each staff member providing direct care or 
supervision of care to the individual (Note: All entries should describe an issue or circumstance 
concerning the individual.)  
• Documentation must be maintained in the file of each individual receiving this service, showing that 
the service is not otherwise available under a program funded under the Rehabilitation Act of 1973 
or PL 94-142. 
Note: If applicable, copies of personal record must be: 
 
• 
Placed in a prominent place in the participant’s file  
 
• 
Sent with the participant when transferred for medical care or upon moving 
from the residence and in accordance with state law 
Limitations 
When Supported Employment services are provided at a worksite where persons without disabilities are 
employed, payment will be made only for the adaptation, supervision and training required by individuals 
receiving waiver services as a result of their disabilities.

[Audio] We are discussing attendant care services, medication oversight, escorting for necessary appointments, community activities that are therapeutic in nature, and other appropriate supports. Additionally, we are outlining the service standards for structured family caregiving. These standards include three years of delivering services to older adults and adults with disabilities, personalized service plans, ongoing management and support, and the ability to modify one's living area. Provider agencies must conduct two home visits per quarter, provide access to a qualified substitute caregiver, and establish backup plans for emergencies. Principal caregivers receive annual training and medication oversight providers must receive instruction from a doctor, nurse or pharmacist.. 

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Section 12: Health and Wellness (H&W) and Traumatic Brain Injury (TBI) Waivers 
DDRS HCBS Waivers 
Library Reference Number: PRPR10014 
289 
Published: Sept. 9, 2024 
Policies and procedures as of July 1, 2024 
Version: 11.1 
Activities Not Allowed 
The following activities are not allowed under the Supported Employment service: 
• Services funded under the Rehabilitation Act of 1973 or PL 94-142  
• Reimbursement for supervisory activities rendered as a normal part of standard business procedures 
in a business setting where persons without disabilities are also employed  
• Reimbursement for incentive payments, subsidies, or unrelated vocational training expenses for the 
following:  
– Incentive payments made to an employer to encourage or subsidize the employer’s participation 
in a Supported Employment program  
– Payments that are passed through to users of Supported Employment programs 
– Payments for vocational training that are not directly related to an individual’s employment 
program  
• Service provided by the parent of a minor child participant or the spouse of a participant (also 
known as LRIs) as outlined in C-2-d and C-2-e of the TBI Waiver  
Provider Qualifications 
Provider qualifications for the Supported Employment service are presented in Table 31. 
Table 31 – Provider Qualifications for Supported Employment 
Waiver 
Provider 
Licensure/ 
Certification 
Other Standards 
TBI  
FSSA-approved 
Supported 
Employment 
Agency  
Certification 
from the 
Commission on 
Accreditation 
of  
Rehabilitation 
Facilities  
(CARF)  
FSSA approved  
455 IAC 2 Provider qualifications: general 
requirements 
455 IAC 2 General requirements for direct care 
staff 
455 IAC 2 Liability insurance 
455 IAC 2 Professional qualifications and 
requirements 
455 IAC 2 Personnel records 
TBI  
FSSA-approved 
Community 
Mental Health 
Center  
Not required  
FSSA approved 
455 IAC 2 Provider qualifications: general 
requirements 
455 IAC 2 General requirements for direct care 
staff 
455 IAC 2 Liability insurance 
455 IAC 2 Professional qualifications and 
requirements 
455 IAC 2 Personnel records 
IC 12-7-2-38(1) Community Mental Health 
Center  
Section 12.30: Transportation for H&W and TBI Waivers 
The following subsections provide information and requirements for Transportation services for the H&W 
and TBI waivers.

[Audio] We are currently discussing the information provided in Section 12 of the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers. We are on slide 6 of 12, and the topic is attendant care services, medication oversight, escorting for necessary appointments, appointments and community activities that are therapeutic in nature, and other appropriate supports. These services are offered as part of the waiver, and participants must have a written service plan that addresses their specific needs. The plan is determined by their Personal Care Assistant (P-C-A--). These services are in addition to medical transportation, which is required under 42 CFR 431.53 and Transportation services under the Indiana Medicaid State Plan, defined at 42 CFR 440.170(a). They do not replace these services. Transportation services are reimbursed as three types of service: Level 1 Nonassisted Transportation, Level 2 Assisted Transportation, and Adult Day Service Transportation. It is important to follow documentation standards for Transportation waiver services. This includes identifying the need in the service plan, outlining the services in the plan, maintaining documentation by the provider or its agent to ensure they meet the requirements for providing services under 455 I-A-C 2, and specifying applicable limits on the amount, frequency, or duration of this service. Personal records must be kept in a prominent place in the participant's file and transferred with them for medical care or when they move from their residence, as required by state law. It is important to note that services provided under Transportation services will not duplicate those provided under the Indiana Medicaid State Plan or any other waiver service.. 

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DDRS HCBS Waivers 
Section 12: Health and Wellness (H&W) and Traumatic Brain Injury (TBI) Waivers 
290 
Library Reference Number: PRPR10014 
 
Published: Sept. 9, 2024 
 
Policies and procedures as of July 1, 2024 
 
Version: 11.1 
Service Definition 
Transportation services are offered to enable participants served under the waiver to gain access to waiver 
and other nonmedical community services, activities, and resources, specified by the service plan. 
Service Standards 
These service standards must be followed for nonmedical Transportation waiver services: 
• Transportation services must follow a written service plan addressing specific needs determined by 
the participant’s PCA. 
• This service is offered in addition to medical transportation required under 42 CFR 431.53 and 
Transportation services under the Indiana Medicaid State Plan, defined at 42 CFR 440.170(a) (if 
applicable), and shall not replace them. 
• Whenever possible, family, neighbors, friends, or community agencies that can provide this service 
without charge will be used. 
Transportation services are reimbursed as three types of service: 
• Level 1 - Nonassisted Transportation – The participant does not require mechanical assistance to 
transfer in and out of the vehicle. 
• Level 2 - Assisted Transportation – The participant requires mechanical assistance to transfer into 
and out of the vehicle. 
• Adult Day Service Transportation – The participant requires round-trip transportation to access 
Adult Day Services. 
Documentation Standards 
These documentation standards must be followed for Transportation waiver services: 
• Identified need in the service plan 
• Services outlined in the service plan 
• Documentation, maintained by the provider or its agent, that the provider meets and maintains the 
requirements for providing services under 455 IAC 2 
• Specify applicable (if any) limits on the amount, frequency, or duration of this service. 
Note: If applicable, copies of personal record must be: 
 
• 
Placed in a prominent place in the participant’s file  
 
• 
Sent with the participant when transferred for medical care or upon moving 
from the residence and in accordance with state law 
Limitations 
Services provided under Transportation services will not duplicate services provided under the Indiana 
Medicaid State Plan or any other waiver service.

[Audio] During our meeting, we will cover various topics such as attendant care services, medication oversight, escorting to essential appointments, engaging in community activities, and identifying suitable support options. Additionally, we will outline the service standards for structured family caregiving, which includes a minimum of three years of providing services to older adults and adults with disabilities, personalized service plans, ongoing management and support, and the ability to make modifications to one's living area. As per regulations, provider agencies are required to conduct two home visits per quarter, provide a qualified substitute caregiver when needed, and have backup plans in place for emergencies. It is also mandatory for principal caregivers to receive annual training, and for medication oversight providers to receive instruction from a doctor, nurse, or pharmacist.. 

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Section 12: Health and Wellness (H&W) and Traumatic Brain Injury (TBI) Waivers 
DDRS HCBS Waivers 
Library Reference Number: PRPR10014 
291 
Published: Sept. 9, 2024 
Policies and procedures as of July 1, 2024 
Version: 11.1 
Activities Not Allowed 
The following activities are not allowed under the Transportation waiver service: 
• Services available through the Indiana Medicaid State Plan (Note: A Medicaid State Plan prior 
authorization [PA] denial is required before reimbursement is available through the Medicaid 
waiver for this service.)  
• Services provided to participants receiving any of the following waiver services:  
– Adult Family Care 
– Assisted Living 
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) as outlined in C-2-d and C-2-e of the H&W and TBI waivers.  
Provider Qualifications 
Provider qualifications for Transportation waiver services are presented in Table 32. 
Table 32 – Provider Qualifications for Transportation 
Waiver 
Provider 
Licensure/ 
Certification 
Other Standards 
H&W/TBI  Licensed Home 
Health Agency  
IC 16-27-1  
FSSA Approved 
Compliance with applicable vehicle/driver licensure 
for vehicle being utilized 
H&W/TBI  FSSA-approved 
Transportation  
Agency  
Not required  
FSSA Approved  
455 IAC 2 Becoming an approved provider; 
maintaining approval 
455 IAC 2 Provider qualifications: general 
requirements 
455 IAC 2 Procedures for protecting individuals  
455 IAC 2 Unusual occurrence; reporting 
455 IAC 2 Transfer of individual’s record upon 
change of provider 
455 IAC 2 Notice of termination of services 
455 IAC 2 Provider organizational chart 
455 IAC 2 Collaboration and quality control 
455 IAC 2 Data collection and reporting standards 
455 IAC 2 Quality assurance and quality 
improvement system 
455 IAC 2 Financial information 
455 IAC 2 Liability insurance 
455 IAC 2 Transportation of an individual 
455 IAC 2 Documentation of qualifications 
455 IAC 2 Maintenance of personnel records 
455 IAC 2 Adoption of personnel policies 
455 IAC 2 Operations manual 
455 IAC 2 Maintenance of records of services 
provided 
Compliance with applicable vehicle/driver 
licensure for vehicle being utilized

[Audio] We will discuss the information provided in Section 12 of the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers. This section covers attendant care services, medication oversight, escorting for necessary appointments, community activities with therapeutic benefits, and other appropriate supports. We will also outline the service standards for structured family caregiving, which includes three years of providing services to older adults and adults with disabilities, personalized service plans, ongoing management and support, and the ability to modify one's living area. Provider agencies are required to conduct two home visits per quarter, provide access to a qualified substitute caregiver, and establish backup plans for emergencies. Principal caregivers receive annual training and medication oversight providers must receive instruction from a doctor, nurse, or pharmacist. Next, we will focus on the Vehicle Modifications for H&W and T-B-I Waivers, which include the following subsections: Service Definition, Allowable Activities, and Maintenance. The Service Definition for Vehicle Modifications is the addition of adaptive equipment or structural changes to a motor vehicle that will enable a participant to have safe transportation. In order for a modification to be approved, justification and documentation must be provided to demonstrate its necessity for meeting the participant's identified needs. The following are allowable activities under the Vehicle Modifications service: 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, and power transfer seat base. Additionally, there is a maintenance limit of $1000 annually for repair and service of items funded through the H-C-B-S waiver. Requests for service must clearly differentiate between parts and labor costs. If maintenance costs exceed $1000, the care manager will work with other available funding sources and community agencies to fulfill the need. If service costs exceed the annual limit, the parts and labor funded through the waiver must be itemized separately from those provided through a non-waiver funding source. It's important to note that any items requested that are not listed in this section must be requested and approved through a different process.. 

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DDRS HCBS Waivers 
Section 12: Health and Wellness (H&W) and Traumatic Brain Injury (TBI) Waivers 
292 
Library Reference Number: PRPR10014 
 
Published: Sept. 9, 2024 
 
Policies and procedures as of July 1, 2024 
 
Version: 11.1 
Section 12.31: Vehicle Modifications for H&W and TBI 
Waivers 
The following subsections provide information and requirements for Vehicle Modifications under the 
H&W and TBI waivers. 
Service Definition 
Vehicle Modifications are the addition of adaptive equipment or structural changes to a motor vehicle that 
will empower a participant to have safe transportation in a motor vehicle.  
Allowable Activities 
Justification and documentation are required to demonstrate that the modification is necessary to meet the 
participant’s identified needs. 
The following are allowable under the Vehicle Modifications service: 
• 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 
Maintenance is limited to $1,000 annually for repair and service of items that have been funded through a 
HCBS waiver: 
• Requests for service must differentiate between parts and labor costs. 
• If the need for maintenance exceeds $1,000 the care manager will work with other available funding 
streams and community agencies to fulfill the need. If 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. 
Note: Items requested that are not listed in this section, must be reviewed and decision 
rendered by the state division director or state agency designee. 
Service Standards 
These service standards must be followed: 
• The vehicle to be modified must meet all the following: 
– The participant or primary caregiver is the titled 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 participant’s sole or primary means of transportation. 
– The vehicle is not registered to or titled by an FSSA-approved provider. 
– Only one vehicle per a participant’s household may be modified.

[Audio] During our discussion, we went over the information found in Section 12 of the Health and Wellness and Traumatic Brain Injury Waivers DDRS HCBS Waivers. This included topics such as attendant care services, medication oversight, escorted appointments, therapeutic community activities, and other appropriate supports. In addition, we reviewed the service standards for structured family caregiving, which involves three years of experience working with older adults and adults with disabilities, personalized service plans, ongoing management and support, and the ability to modify one's living area. It was noted that provider agencies are required to conduct two home visits per quarter and provide access to a qualified substitute caregiver. In case of emergencies, backup plans must also be established. Principal caregivers will receive annual training, while medication oversight providers must receive instruction from a doctor, nurse, or pharmacist. We also discussed the rebate program for participants who purchase a new vehicle that requires modifications for accessibility. Many automobile manufacturers offer a rebate of up to $1000 for these modifications. To receive the rebate, participants must submit documented proof of their expenditures for the modifications. We emphasized the standards for documenting vehicle modifications and how the care manager is responsible for determining the medical need for these modifications. This involves describing the specific modification requested, collecting two bids if the cost is over $1000, and submitting warranty information from the provider to the FSSA. A picture of the modification is also necessary. It was also mentioned that the provider is responsible for keeping receipts for all expenses related to the modifications, itemizing bids, and following F-S-S-A and FSSA-specific guidelines and policies. We discussed the limitations of this service, which include a lifetime cap of $15000 for one vehicle per every 10-year period for a participant's household and an annual allowable amount of $1000 for repairs, replacements, or adjustments to existing modifications funded by an H-C-B-S waiver. Lastly, we clarified that certain activities are not covered under this service, such as repairing or replacing modified equipment that has been damaged or destroyed in an accident.. 

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Section 12: Health and Wellness (H&W) and Traumatic Brain Injury (TBI) Waivers 
DDRS HCBS Waivers 
Library Reference Number: PRPR10014 
293 
Published: Sept. 9, 2024 
Policies and procedures as of July 1, 2024 
Version: 11.1 
• Many automobile manufacturers offer a rebate of up to $1,000 for participants purchasing a new 
vehicle requiring modifications for accessibility. To obtain the rebate, the participant 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 the FSSA director or designee determines the 
documentation does not support the service requested. 
• All Vehicle Modifications must be approved by the waiver program prior to services being rendered. 
Documentation Standards 
The care manager is responsible for the following documentation standards: 
• Document the medical need for Vehicle Modifications determined to meet the needs of the 
participant through the PCA. 
• Describe the specific modification being requested to the vehicle. 
• Collect two bids if over $1,000; if only one bid is obtained, the care manager must document the 
date of contact, the provider name and why the bid was not obtained from another provider. 
• Submit warranty information from the provider to the FSSA. 
• Ensure that a picture of vehicle modification is included with the bid.  
The provider is responsible for the following documentation standards: 
• Maintain receipts for all incurred expenses related to the modification. 
• Itemize all bids. 
• Be in compliance with FSSA and FSSA-specific guidelines and/or policies. 
Limitations 
A lifetime cap of $15,000 is available for one vehicle per every 10-year period for a participant’s 
household. In addition to the applicable lifetime cap, $1,000 will be allowable annually for repair, 
replacement, or an adjustment to an existing modification that was funded by an HCBS waiver. 
Activities Not Allowed 
Examples or descriptions of modifications or items not covered under this service 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 
• Leased vehicles

[Audio] "We are pleased to provide details about our attendant care services, medication oversight, transportation for necessary appointments, therapeutic appointments and community activities, as well as other appropriate supports for individuals with Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) waivers. Our service standards for structured family caregiving include three years of experience in serving older adults and individuals with disabilities, personalized service plans, ongoing management and support, and the ability to modify living spaces. Table 33 outlines the qualifications for providers of Vehicle Modifications. We encourage providers to visit the following websites for more information: F-S-S-A home page Medicaid H-C-B-S webpage Incident and Follow-Up Reporting (I-F-U-R-) Tool I-H-C-P Providers website For further inquiries, providers can contact F-S-S-A at 888-673-0002. Please refer to Figure 1 for information on local Area Agency on Aging (A-A-A--) offices. We hope this information is helpful in ensuring that individuals receive the necessary services to live their best lives.. 

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DDRS HCBS Waivers 
Section 12: Health and Wellness (H&W) and Traumatic Brain Injury (TBI) Waivers 
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Library Reference Number: PRPR10014 
 
Published: Sept. 9, 2024 
 
Policies and procedures as of July 1, 2024 
 
Version: 11.1 
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) as outlined in C-2-d and C-2-e of the H&W and TBI waiver.  
Provider Qualifications 
Provider qualifications for Vehicle Modifications are presented in Table 33. 
Table 33 – Provider Qualifications for Vehicle Modifications 
Waiver 
Provider 
Licensure/ 
Certification 
Other Standards 
H&W/TBI  FSSA-
approved 
Vehicle  
Modification  
Agency  
Not required  
FSSA approved  
455 IAC 2 Becoming an approved provider; 
maintaining approval  
455 IAC 2 Provider qualifications: general 
requirements 
455 IAC 2 Liability insurance  
455 IAC 2 Professional qualifications and 
requirements; documentation of qualifications  
455 IAC 2 Maintenance of records of services 
provided 455 IAC 2 Warranty required  
Section 12.32: Provider Help 
This section provides websites, contact information and publications for providers to use. 
Helpful Websites 
Consult the following websites for more information: 
• FSSA home page – Find information by type of person in need: children, seniors, families, those 
with intellectual disabilities (ID) and so forth. All programs and services available are listed on this 
site. 
• Medicaid HCBS webpage – Find information about how to become a provider of FSSA services. 
• Incident And Follow-Up Reporting (IFUR) Tool – Submit initial incident reports and care manager 
follow-up reports for waiver and Money Follows the Person (MFP) services via the IFUR Tool. 
• IHCP Providers website – Find Indiana Health Coverage Programs (IHCP) provider bulletins and 
banner pages and the IHCP provider reference modules. Telephone contact information for 
providers is also available on this website.  
Helpful Contact Numbers 
Contact the FSSA at 888-673-0002. See Figure 1 for information on local Area Agency on Aging (AAA) 
offices.

[Audio] Attendant Care Services To ensure that individuals with disabilities receive the care they need, attendant care services are available. These services include assistance with activities of daily living (ADLs), such as bathing, grooming, dressing, and toileting. They also include assistance with instrumental activities of daily living (IADLs), such as managing medication, preparing meals, and managing finances. Medication Oversight Individuals with disabilities often require medication to manage their health conditions. To ensure that individuals receive the right medication at the right time, medication oversight is available. This includes monitoring medication adherence, ensuring that medications are stored safely, and administering medications as prescribed. Escorting for Necessary Appointments Individuals with disabilities may require assistance with attending appointments, such as doctor’s appointments or therapy sessions. Escorting for necessary appointments is available to ensure that individuals can attend their appointments safely and effectively. Community Activities that are Therapeutic in Nature Participating in community activities that are therapeutic in nature, such as exercise or music therapy, can have many benefits for individuals with disabilities. To ensure that individuals have access to these activities, community activities that are therapeutic in nature are available. Service Standards for Structured Family Caregiving Structured family caregiving is a program that provides individuals with disabilities with personalized care plans and ongoing support from a principal caregiver. To ensure that individuals receive the best possible care, service standards for structured family caregiving are in place. These standards include three years of delivering services to older adults and adults with disabilities, personalized service plans, ongoing management and support, and the ability to modify one’s living area. Provider Agencies Provider agencies are responsible for delivering attendant care services, medication oversight, escorting for necessary appointments, and community activities that are therapeutic in nature. To ensure that individuals receive the best possible care, provider agencies must conduct two home visits per quarter, provide access to a qualified substitute caregiver, and establish backup plans for emergencies. Principal caregivers receive annual training, and medication oversight providers must receive instruction from a doctor, nurse, or pharmacist.. 

Scene 11

Section 12: Health and Wellness (H&W) and Traumatic Brain Injury (TBI) Waivers 
DDRS HCBS Waivers 
Library Reference Number: PRPR10014 
295 
Published: Sept. 9, 2024 
Policies and procedures as of July 1, 2024 
Version: 11.1 
Figure 1 – Location and Contact Information for Local AAA Offices 
AREA 1 
Northwest Indiana Community Action 
Corporation 
5240 Fountain Dr. 
Crown Point, IN 46307 
219-794-1829 or 800-826-7871 
TTY: 888-814-7597 
Fax: 219-794-1860 
nwi-ca.com 
AREA 2 
REAL Services, Inc. 
1151 S. Michigan St. 
South Bend, IN 46601-3427 
574-284-2644 or 800-552-7928 
Fax: 574-284-2642 
realservices.org 
AREA 3 
Aging & In-Home Services of Northeast 
Indiana, Inc. 
8101 W. Jefferson Blvd. 
Fort Wayne, IN 46804 
260-745-1200 or 800-552-3662 
Fax: 260-422-4916 
agingihs.org 
AREA 4 
Area IV Agency on Aging & Community 
Action Programs, Inc. 
660 N. 36th St. 
Lafayette, IN 47903-4727 
765-447-7683 or 800-382-7556 
TDD: 765-447-3307 
Fax: 765-447-6862 
areaivagency.org 
AREA 5 
Area Five Agency on Aging & Community 
Services, Inc. 
1801 Smith St., Suite 300 
Logansport, IN 46947-1577 
574-722-4451 or 800-654-9421 
Fax: 574-722-3447 
areafive.com 
AREA 6 
LifeStream Services, Inc. 
1701 Pilgrim Blvd. 
Yorktown, IN 47396-0308 
765-759-1121 or 800-589-1121 
TDD: 866-801-6606 
Fax: 765-759-0060 
lifestreaminc.org 
 
16 Area Agencies  
 
  
AREA 7 
Thrive West Central 
2800 Poplar St., Suite 9A 
Terre Haute, IN 47803 
812-238-1561 or 800-489-1561 
TDD: 800-489-1561 
Fax: 812-238-1564 
thrivewestcentral.com/ 
AREA 8  
CICOA Aging & In-Home Solutions 
8440 Woodfield Crossing Blvd., Suite 175 
Indianapolis, IN 46240-4359 
317-254-5465 or 800-432-2422 
TDD: 317-254-5497 
Fax: 317-254-5494 
cicoa.org 
AREA 9 
LifeStream Services, Inc. 
2404 National Road W. 
Richmond, IN 47374 
765-966-1795 or 800-589-1121 
Fax: 765-759-1121 
lifestreaminc.org 
 
AREA 10 
Area 10 Agency on Aging 
631 W. Edgewood Dr. 
Ellettsville, IN 47429 
812-876-3383 or 800-844-1010 
Fax: 812-876-9922 
area10agency.org 
AREA 11 
Thrive Alliance 
1531 13th Street, Suite G900 
Columbus, IN 47201 
812-372-6918 or 866-644-6407 
Fax: 812-372-7846 
thrive-alliance.org 
AREA 12 
LifeTime Resources, Inc. 
13091 Benedict Dr. 
Dillsboro, IN 47018 
812-432-6200 or 800-742-5001 
Fax: 812-432-3822 
lifetime-resources.org 
AREA 13 
Generations 
Vincennes University Statewide 
Services 
1019 N. 4th St. 
Vincennes, IN 47591 
812-888-5880 or 800-742-9002 
Fax: 812-888-4566 
vinu.edu/web/generations 
AREA 14 
LifeSpan Resources, Inc. 
33 State St., Third Floor 
New Albany, IN 47151-0995 
812-948-8330 or 888-948-8330 
TTY: 812-542-6895 
Fax: 812-948-0147 
lsr14.org 
AREA 15 
Hoosier Uplands / Public Service Area 
15 Agency on Aging and Disability 
Services 
521 W. Main St. 
Mitchell, IN 47446 
812-849-4457 or 800-333-2451 
TDD: 800-473-3333 
Fax: 812-849-4467 
hoosieruplands.org 
AREA 16 
SWIRCA & More 
16 W. Virginia St. 
Evansville, IN 47737-3938 
812-464-7800 or 800-253-2188 
Fax: 812-464-7843 or 812-464-7811 
swirca.org 
  
To contact your local Area Agency on Aging toll-free, call 800-713-9023.

[Audio] In conclusion, we have discussed essential information from Section 12 of the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers DDRS HCBS Waivers. This section addresses important topics such as attendant care services, medication oversight, escorting for necessary appointments, community activities, and other necessary supports. We have also highlighted the service standards for structured family caregiving, including the three-year requirement for delivering services to older adults and adults with disabilities, personalized service plans, ongoing management and support, and the ability to modify one's living area. As a provider agency, it is critical to stay informed about communications from the I-H-C-P-. The I-H-C-P publishes bulletins and provider reference modules that can be accessed through the Bulletins, Banner Pages and Reference Modules page at in.gov/medicaid/providers. We strongly recommend subscribing to the Email Notification Service, which sends emails to subscribers when new communications are posted on the I-H-C-P website. This will ensure that you are up-to-date with the latest policies and procedures. Thank you for your attention today as we discussed these important topics. The information provided in this presentation is current as of July 1, 2024, and version 11.1. We hope it has been informative and useful for your understanding of the DDRS HCBS Waivers.. 

Scene 12

DDRS HCBS Waivers 
Section 12: Health and Wellness (H&W) and Traumatic Brain Injury (TBI) Waivers 
296 
Library Reference Number: PRPR10014 
 
Published: Sept. 9, 2024 
 
Policies and procedures as of July 1, 2024 
 
Version: 11.1 
Communications 
The IHCP publishes IHCP bulletins and provider reference modules for providers, which are accessible 
from the Bulletins, Banner Pages and Reference Modules page at in.gov/medicaid/providers. 
Providers may also subscribe to the Email Notification Service, accessible from the homepage at 
in.gov/medicaid/providers. This service sends emails to subscribers when new communications are posted 
on the IHCP website.

 part 22

We will now discuss the attendant care services, medication oversight, escorting for necessary appointments, and other appropriate supports provided under the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers. We will also outline the service standards for structured family caregiving, which includes delivering services to older adults and adults with disabilities for three years. Provider agencies must conduct two home visits per quarter, provide access to a qualified substitute caregiver, and establish backup plans for emergencies.

To ensure the success of structured family caregiving, documentation standards must be followed. The waiver care manager must document the identified need for Structured Family Caregiving in the service plan, services outlined in the service plan performed by the principal caregiver, and caregiver assessment findings. The provider agency is responsible for documenting training provided to the principal caregiver, electronic caregiver notes, medication management records, and regular review of caregiver notes.

It is important to note that separate payment will not be made for any of the following waiver services: Adult Family Care, Assisted Living, Attendant Care, and Home and Community Assistance. In summary, structured family caregiving can greatly improve the quality of life for individuals with disabilities and older adults by following the documentation and service standards outlined in Section 12 of the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers.

avatar

We are here to discuss the information presented in the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers DDRS HCBS Waivers. Our topic will be the service standards for structured family caregiving and the requirements for becoming an approved provider. Provider agencies must conduct two home visits per quarter, provide access to a qualified substitute caregiver, and establish backup plans for emergencies. Principal caregivers receive annual training and medication oversight providers must receive instruction from a doctor, nurse or pharmacist. The Provider Qualifications for Structured Family Caregiving are presented in Table 30 and the General requirements for direct care staff, procedures for protecting individuals, unusual occurrence; reporting, transfer of individual’s record upon change of provider, notice of termination of services, provider organizational chart, collaboration and quality control, data collection and reporting standards, quality assurance and quality improvement system, financial information, liability insurance, transportation of an individual, documentation of qualifications, maintenance of personnel records, adoption of personnel policies, operations manual, and maintenance of records of services provided are also noted. Next, we will move on to the Supported Employment for T-B-I Waiver. Supported Employment services consist of paid employment for persons for whom competitive employment at or above the minimum wage is unlikely, and who, because of their disabilities, need intensive ongoing support to perform in a work setting. Supported Employment is conducted in a variety of settings, particularly worksites where persons without disabilities are employed. Supported Employment includes activities needed to sustain paid work by individuals receiving waiver services, including supervision and training.

We will discuss the information provided in Section 12 of the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers regarding attendant care services, medication oversight, escorting for necessary appointments, appointments and community activities that are therapeutic in nature, and other appropriate supports. We will also outline the service standards for structured family caregiving, which includes three years of delivering services to older adults and adults with disabilities, personalized service plans, ongoing management and support, and the ability to modify one's living area. Provider agencies must conduct two home visits per quarter, provide access to a qualified substitute caregiver, and establish backup plans for emergencies. Principal caregivers receive annual training and medication oversight providers must receive instruction from a doctor, nurse or pharmacist. Supported Employment services must follow a written service plan addressing specific needs determined by the individual's assessment. When Supported Employment services are provided at a worksite where persons without disabilities are employed, payment will be made only for the adaptation, supervision, and training required by individuals receiving waiver services as a result of their disabilities and will not include payment for supervisory activities rendered as a normal part of the business setting. Supported Employment services furnished under the waiver must be services that are not available under a program funded by either the Rehabilitation Act of 1973 or Public Law PL 94-142. Documentation standards for Supported Employment services include identified need in the service plan, services outlined in the service plan, data record of services provided, at least one entry on each day of service made by each staff member providing direct care or supervision of care to the individual, and documentation must be maintained in the file of each individual receiving this service, showing that the service is not otherwise available under a program funded under the Rehabilitation Act of 1973 or PL 94-142.

We are discussing attendant care services, medication oversight, escorting for necessary appointments, community activities that are therapeutic in nature, and other appropriate supports. Additionally, we are outlining the service standards for structured family caregiving. These standards include three years of delivering services to older adults and adults with disabilities, personalized service plans, ongoing management and support, and the ability to modify one's living area. Provider agencies must conduct two home visits per quarter, provide access to a qualified substitute caregiver, and establish backup plans for emergencies. Principal caregivers receive annual training and medication oversight providers must receive instruction from a doctor, nurse or pharmacist.

We are currently discussing the information provided in Section 12 of the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers. We are on slide 6 of 12, and the topic is attendant care services, medication oversight, escorting for necessary appointments, appointments and community activities that are therapeutic in nature, and other appropriate supports. These services are offered as part of the waiver, and participants must have a written service plan that addresses their specific needs. The plan is determined by their Personal Care Assistant (P-C-A--). These services are in addition to medical transportation, which is required under 42 CFR 431.53 and Transportation services under the Indiana Medicaid State Plan, defined at 42 CFR 440.170(a). They do not replace these services. Transportation services are reimbursed as three types of service: Level 1  Nonassisted Transportation, Level 2  Assisted Transportation, and Adult Day Service Transportation.                                     
It is important to follow documentation standards for Transportation waiver services. This includes identifying the need in the service plan, outlining the services in the plan, maintaining documentation by the provider or its agent to ensure they meet the requirements for providing services under 455 I-A-C 2, and specifying applicable limits on the amount, frequency, or duration of this service. Personal records must be kept in a prominent place in the participant's file and transferred with them for medical care or when they move from their residence, as required by state law.                                     
It is important to note that services provided under Transportation services will not duplicate those provided under the Indiana Medicaid State Plan or any other waiver service.

During our meeting, we will cover various topics such as attendant care services, medication oversight, escorting to essential appointments, engaging in community activities, and identifying suitable support options. Additionally, we will outline the service standards for structured family caregiving, which includes a minimum of three years of providing services to older adults and adults with disabilities, personalized service plans, ongoing management and support, and the ability to make modifications to one's living area. As per regulations, provider agencies are required to conduct two home visits per quarter, provide a qualified substitute caregiver when needed, and have backup plans in place for emergencies. It is also mandatory for principal caregivers to receive annual training, and for medication oversight providers to receive instruction from a doctor, nurse, or pharmacist.

We will discuss the information provided in Section 12 of the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers. This section covers attendant care services, medication oversight, escorting for necessary appointments, community activities with therapeutic benefits, and other appropriate supports. We will also outline the service standards for structured family caregiving, which includes three years of providing services to older adults and adults with disabilities, personalized service plans, ongoing management and support, and the ability to modify one's living area. Provider agencies are required to conduct two home visits per quarter, provide access to a qualified substitute caregiver, and establish backup plans for emergencies. Principal caregivers receive annual training and medication oversight providers must receive instruction from a doctor, nurse, or pharmacist. 
Next, we will focus on the Vehicle Modifications for H&W and T-B-I Waivers, which include the following subsections: Service Definition, Allowable Activities, and Maintenance. The Service Definition for Vehicle Modifications is the addition of adaptive equipment or structural changes to a motor vehicle that will enable a participant to have safe transportation. In order for a modification to be approved, justification and documentation must be provided to demonstrate its necessity for meeting the participant's identified needs. The following are allowable activities under the Vehicle Modifications service: 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, and power transfer seat base. 
Additionally, there is a maintenance limit of $1000 annually for repair and service of items funded through the H-C-B-S waiver. Requests for service must clearly differentiate between parts and labor costs. If maintenance costs exceed $1000, the care manager will work with other available funding sources and community agencies to fulfill the need. If service costs exceed the annual limit, the parts and labor funded through the waiver must be itemized separately from those provided through a non-waiver funding source. It's important to note that any items requested that are not listed in this section must be requested and approved through a different process.

During our discussion, we went over the information found in Section 12 of the Health and Wellness and Traumatic Brain Injury Waivers DDRS HCBS Waivers. This included topics such as attendant care services, medication oversight, escorted appointments, therapeutic community activities, and other appropriate supports. In addition, we reviewed the service standards for structured family caregiving, which involves three years of experience working with older adults and adults with disabilities, personalized service plans, ongoing management and support, and the ability to modify one's living area.

It was noted that provider agencies are required to conduct two home visits per quarter and provide access to a qualified substitute caregiver. In case of emergencies, backup plans must also be established. Principal caregivers will receive annual training, while medication oversight providers must receive instruction from a doctor, nurse, or pharmacist. 

We also discussed the rebate program for participants who purchase a new vehicle that requires modifications for accessibility. Many automobile manufacturers offer a rebate of up to $1000 for these modifications. To receive the rebate, participants must submit documented proof of their expenditures for the modifications. We emphasized the standards for documenting vehicle modifications and how the care manager is responsible for determining the medical need for these modifications. This involves describing the specific modification requested, collecting two bids if the cost is over $1000, and submitting warranty information from the provider to the FSSA. A picture of the modification is also necessary. 

It was also mentioned that the provider is responsible for keeping receipts for all expenses related to the modifications, itemizing bids, and following F-S-S-A and FSSA-specific guidelines and policies. We discussed the limitations of this service, which include a lifetime cap of $15000 for one vehicle per every 10-year period for a participant's household and an annual allowable amount of $1000 for repairs, replacements, or adjustments to existing modifications funded by an H-C-B-S waiver. Lastly, we clarified that certain activities are not covered under this service, such as repairing or replacing modified equipment that has been damaged or destroyed in an accident.

"We are pleased to provide details about our attendant care services, medication oversight, transportation for necessary appointments, therapeutic appointments and community activities, as well as other appropriate supports for individuals with Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) waivers. Our service standards for structured family caregiving include three years of experience in serving older adults and individuals with disabilities, personalized service plans, ongoing management and support, and the ability to modify living spaces.

Table 33 outlines the qualifications for providers of Vehicle Modifications. We encourage providers to visit the following websites for more information: 
 F-S-S-A home page 
 Medicaid H-C-B-S webpage 
 Incident and Follow-Up Reporting (I-F-U-R-) Tool 
 I-H-C-P Providers website 

For further inquiries, providers can contact F-S-S-A at 888-673-0002. 
Please refer to Figure 1 for information on local Area Agency on Aging (A-A-A--) offices. We hope this information is helpful in ensuring that individuals receive the necessary services to live their best lives.

Attendant Care Services                           To ensure that individuals with disabilities receive the care they need, attendant care services are available. These services include assistance with activities of daily living (ADLs), such as bathing, grooming, dressing, and toileting. They also include assistance with instrumental activities of daily living (IADLs), such as managing medication, preparing meals, and managing finances.

Medication Oversight                           Individuals with disabilities often require medication to manage their health conditions. To ensure that individuals receive the right medication at the right time, medication oversight is available. This includes monitoring medication adherence, ensuring that medications are stored safely, and administering medications as prescribed.

Escorting for Necessary Appointments                        Individuals with disabilities may require assistance with attending appointments, such as doctor’s appointments or therapy sessions. Escorting for necessary appointments is available to ensure that individuals can attend their appointments safely and effectively.

Community Activities that are Therapeutic in Nature                        Participating in community activities that are therapeutic in nature, such as exercise or music therapy, can have many benefits for individuals with disabilities. To ensure that individuals have access to these activities, community activities that are therapeutic in nature are available.

Service Standards for Structured Family Caregiving                          Structured family caregiving is a program that provides individuals with disabilities with personalized care plans and ongoing support from a principal caregiver. To ensure that individuals receive the best possible care, service standards for structured family caregiving are in place. These standards include three years of delivering services to older adults and adults with disabilities, personalized service plans, ongoing management and support, and the ability to modify one’s living area.

Provider Agencies                                            Provider agencies are responsible for delivering attendant care services, medication oversight, escorting for necessary appointments, and community activities that are therapeutic in nature. To ensure that individuals receive the best possible care, provider agencies must conduct two home visits per quarter, provide access to a qualified substitute caregiver, and establish backup plans for emergencies. Principal caregivers receive annual training, and medication oversight providers must receive instruction from a doctor, nurse, or pharmacist.

In conclusion, we have discussed essential information from Section 12 of the Health and Wellness (H&W) and Traumatic Brain Injury (T-B-I--) Waivers DDRS HCBS Waivers. This section addresses important topics such as attendant care services, medication oversight, escorting for necessary appointments, community activities, and other necessary supports. We have also highlighted the service standards for structured family caregiving, including the three-year requirement for delivering services to older adults and adults with disabilities, personalized service plans, ongoing management and support, and the ability to modify one's living area.

As a provider agency, it is critical to stay informed about communications from the I-H-C-P-. The I-H-C-P publishes bulletins and provider reference modules that can be accessed through the Bulletins, Banner Pages and Reference Modules page at in.gov/medicaid/providers. We strongly recommend subscribing to the Email Notification Service, which sends emails to subscribers when new communications are posted on the I-H-C-P website. This will ensure that you are up-to-date with the latest policies and procedures.

Thank you for your attention today as we discussed these important topics. The information provided in this presentation is current as of July 1, 2024, and version 11.1. We hope it has been informative and useful for your understanding of the DDRS HCBS Waivers.