[Virtual Presenter] We would like to provide information on the application process for the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs. There are two methods available for applying for these programs: an online application and completing and returning an Application for Developmental Disability Services (State Form 55068) to the local B-D-S office. If you choose to apply through the online application, you can access it at Bdsgateway.fssa.in.gov. This option is available to individuals and families seeking services and is available 24 hours a day, seven days a week. Alternatively, if you prefer to apply through the traditional method, you can complete, sign, and date an Application for Developmental Disability Services (State Form 55068), which is available on the D-D-R-S Forms page at in.gov/fssa/ddrs. This form can be completed as a fillable P-D-F or handwritten and must be printed, signed, and returned to the local B-D-S office via fax, mail, or in-person delivery. Once your application has been received, B-D-S staff will discuss eligibility requirements with you, including documentation of an intellectual or developmental disability, Medicaid eligibility, and initial level of care (L-O-C--). If you are not a Medicaid member, you will be referred to the local Division of Family Resources (D-F-R--) office to apply for Medicaid. For applicants who have requested, met, and been approved for specific reserved waiver capacity (priority) criteria for entrance into the C-I-H Waiver program, they will be advised of available services and the availability of a funded priority slot. It is important to note that if you are under 18, you will need to submit a plan of care/service plan approval letter to the Family and Social Services Administration (F-S-S-A-) Division of Family Resources (D-F-R--) when submitting an application for Medicaid benefits or when requesting a change of Medicaid Aid Category to qualify for waiver eligibility. In conclusion, the application process for the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs is straightforward and accessible to all individuals seeking services. Whether you choose to apply through the online application or the traditional method, B-D-S staff will be available to guide you through the eligibility requirements and provide you with the necessary information to access the services you need to live a fulfilling and integrated life within your community. Thank you for your attention, and we hope this information is helpful.. 

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Library Reference Number: PRPR10014 
33 
Published: Sept. 9, 2024 
Policies and procedures as of July 1, 2024 
Version: 11.1 
Section 5: Application for and Start of FSW and CIH 
Waiver Services 
The section explains the application process for the Family Supports Waiver (FSW) and Community 
Integration and Habilitation (CIH) Waiver programs. Also presented are the activities that take place after an 
individual is approved for one of the waiver programs. 
 See Section12: Health and Wellness (H&W) and Traumatic Brain Injury (TBI) Waivers for information 
about the H&W and TBI waiver programs. 
Section 5.1: Request for Application 
An individual or the individual’s guardian may apply for the FSW or the CIH Waiver program through the 
local Division of Disability and Rehabilitative Services (DDRS) Bureau of Disabilities Services (BDS) 
office. An individual or the individual’s guardian has the right to apply without questions or delay. 
To apply for BDS services, including the FSW or CIH Waiver, the individual or guardian now has two 
options available.  
• The first option is to use the BDS Gateway, an online application available 24 hours a day, seven 
days a week where individuals and families seeking may submit an application for services. The BDS 
Gateway may be accessed at: Bdsgateway.fssa.in.gov. 
• The second option is to complete, sign and date an Application for Developmental Disability Services 
(State Form 55068 [8-12]), which is available on the DDRS Forms page at in.gov/fssa/ddrs. The 
form may be completed as a fillable PDF or handwritten. The form must be printed, signed and 
returned to the local BDS office via fax, mail or in-person delivery. Other individuals or agency 
representatives may help the individual or guardian complete the application and forward it to the 
BDS office serving the county in which the individual currently resides. 
Upon receiving the waiver application, the BDS staff must contact the individual and the individual’s 
guardian and discuss the process for determining eligibility for the waiver (documentation of an 
intellectual/developmental disability, Medicaid eligibility and initial level of care [LOC]). If the applicant is 
not a Medicaid member, they are referred to the local Division of Family Resources (DFR) office to apply 
for Medicaid. 
Applicants who have requested, met and been approved for specific reserved waiver capacity (priority) 
criteria for entrance into the CIH Waiver program are advised of those services and the availability of a 
funded priority slot. See Section 5.6: Entrance into the Community Integration and Habilitation Waiver 
Program for details. 
Section 5.2: Medicaid Eligibility 
Note: Member guidance is included in this section for provider reference. 
Applicants under the age of 18 should submit the plan of care (POC)/service plan approval letter (see 
Section 5.8: State Authorization of the Initial POC/Service Plan) to the Family and Social Services 
Administration (FSSA) Division of Family Resources (DFR) when submitting an application for Medicaid 
benefits or when requesting a change of Medicaid Aid Category to qualify for waiver eligibility.

[Audio] We are here to discuss the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs, which have two application options. The first option is the B-D-S Gateway, an online application available 24/7. The second option is to complete and return an Application for Developmental Disability Services (State Form 55068) to the local B-D-S office. B-D-S staff will discuss eligibility requirements, including documentation of an intellectual/developmental disability, Medicaid eligibility, and initial level of care (L-O-C--). If the applicant is not a Medicaid member, they will be referred to the local Division of Family Resources (D-F-R--) office to apply for Medicaid. C-I-H Waiver program applicants who meet specific reserved waiver capacity (priority) criteria will be advised of available services and a funded priority slot. Medicaid eligibility is also discussed, with applicants under 18 required to submit a plan of care/service plan approval letter to the Family and Social Services Administration (F-S-S-A-) Division of Family Resources (D-F-R--). Now, let's dive into the Initial Level of Care Evaluation for F-S-W and C-I-H Waiver. For the F-S-W and C-I-H Waiver, an individual targeted for the F-S-W or who meets reserved waiver capacity (priority) criteria and is approved for entrance into the F-S-W or C-I-H Waiver program, must meet the level of care (L-O-C--) required for placement in an intermediate care facility for individuals with intellectual disabilities (ICF/IID). All L-O-C determinations require secondary review to ensure accuracy. Initial L-O-C determinations are made by a B-D-S service coordinator, including a new “initial” L-O-C for individuals who have been terminated from the Home and Community-Based Services (H-C-B-S-) waiver program but desire to return to waiver services within the same waiver year. Reevaluations are performed by the selected provider of Case Management services. For those applicants whose initial L-O-C evaluation was unfavorable, the information is submitted to the B-D-S Central Office for a tertiary review. The F-S-S-A Office of Medicaid Policy and Planning (O-M-P-P-) retains final authority for determination of eligibility. Only individuals (state employees) who are Qualified Intellectual Disability Professionals (QIDPs), as specified by the standard in Code of Federal Regulations 42 CFR 483.430(a), may perform initial L-O-C determinations. If collateral records are not available or are not valid reflections of the individual, additional assessments may be obtained from contracted psychologists, physicians, nurses and licensed social workers. Following review of the collateral records, the L-O-C assessment tool applicable to individuals with intellectual/developmental disabilities and other related conditions is completed to ascertain if the individual meets ICF/IID L-O-C-. The L-O-C assessment tool is used for reviewing and referencing documentation related to the intellectual/developmental disabilities of the applicant or individual, as well as any psychiatric diagnosis and results of the individual’s intellectual assessment. It is also used to record the age of onset and identify areas of major life activity in which the individual may exhibit a substantial functional limitation, including the areas of mobility, understanding and use of language, self-care, capacity for independent living, learning, self-direction, economic self-sufficiency, and the state definition of developmental disability found in Indiana Code IC 12-7-2-61. The B-D-S service coordinator (initial L-O-C--) or selected provider of case management (reevaluations) reviews the L-O-C assessment tool and collateral material applicable to individuals with intellectual/developmental disabilities and other related conditions to ascertain whether the individual meets ICF/IID LOC requirements. An applicant or individual must meet requirements for three of six substantial functional limitations and each of four basic conditions (lists follow) to meet L-O-C criteria. The basic conditions are:. 

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Section 5: Application for and Start of FSW and CIH Waiver Services 
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Library Reference Number: PRPR10014 
 
Published: Sept. 9, 2024 
 
Policies and procedures as of July 1, 2024 
 
Version: 11.1 
Note: Medicaid eligibility is required before starting waiver services. See the Apply for 
Coverage page at in.gov/medicaid/members for instructions on how to apply for 
Medicaid. 
Section 5.3: Initial Level of Care Evaluation for FSW and 
CIH Waiver 
For the FSW and CIH Waiver, an individual targeted for the FSW or who meets reserved waiver capacity 
(priority) criteria and is approved for entrance into the FSW or CIH Waiver program, must meet the level of 
care (LOC) required for placement in an intermediate care facility for individuals with intellectual 
disabilities (ICF/IID). All LOC determinations require secondary review to ensure accuracy. 
• Initial LOC determinations are made by a BDS service coordinator, including a new “initial” LOC 
for individuals who have been terminated from the Home- and Community-Based Services (HCBS) 
waiver program but desire to return to waiver services within the same waiver year.  
• Reevaluations are performed by the selected provider of Case Management services. 
• For those applicants whose initial LOC evaluation was unfavorable, the information is submitted to 
the BDS Central Office for a tertiary review. The FSSA Office of Medicaid Policy and Planning 
(OMPP) retains final authority for determination of eligibility.  
• Only individuals (state employees) who are Qualified Intellectual Disability Professionals (QIDPs), 
as specified by the standard in Code of Federal Regulations 42 CFR 483.430(a), may perform initial 
LOC determinations. 
• If collateral records are not available or are not valid reflections of the individual, additional 
assessments may be obtained from contracted psychologists, physicians, nurses and licensed social 
workers. Following review of the collateral records, the LOC assessment tool applicable to 
individuals with intellectual/developmental disabilities and other related conditions is completed to 
ascertain if the individual meets ICF/IID LOC. 
• The LOC assessment tool is used for: 
– Reviewing and referencing documentation related to the intellectual/developmental disabilities of 
the applicant or individual, as well as any psychiatric diagnosis and results of the individual’s 
intellectual assessment 
– Recording age of onset 
– Identifying areas of major life activity in which the individual may exhibit a substantial functional 
limitation, including the areas of mobility, understanding and use of language, self-care, capacity 
for independent living, learning, self-direction, economic self-sufficiency, and the state definition 
of developmental disability found in Indiana Code IC 12-7-2-61 
• The BDS service coordinator (initial LOC) or selected provider of case management (reevaluations) 
reviews the LOC assessment tool and collateral material applicable to individuals with 
intellectual/developmental disabilities and other related conditions to ascertain whether the individual 
meets ICF/IID LOC requirements. An applicant or individual must meet requirements for three of six 
substantial functional limitations and each of four basic conditions (lists follow) to meet LOC 
criteria.  
– The basic conditions are: 
➢ Intellectual disability, cerebral palsy, epilepsy, autism or other condition (other than a sole 
diagnosis of mental illness) similar to intellectual disability 
➢ The intellectual disability or other related condition is expected to continue indefinitely. 
➢ The intellectual disability or other related condition had an age of onset prior to age 22. 
➢ The intellectual disability or other related condition results in substantial functional limitations 
in at least three major life activities.

[Audio] We are here to discuss the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs and the application process. There are two options for applying: the B-D-S Gateway, an online application available 24/7, or completing and returning an Application for Developmental Disability Services (State Form 55068) to the local B-D-S office. B-D-S staff will discuss eligibility requirements, including documentation of an intellectual/developmental disability, Medicaid eligibility, and initial level of care (L-O-C--). If the applicant is not a Medicaid member, they will be referred to the local Division of Family Resources (D-F-R--) office to apply for Medicaid. C-I-H Waiver program applicants who meet specific reserved waiver capacity (priority) criteria will be advised of available services and a funded priority slot. Medicaid eligibility is also discussed, with applicants under 18 required to submit a plan of care/service plan approval letter to the Family and Social Services Administration (F-S-S-A-) Division of Family Resources (D-F-R--). After the evaluation is complete, a L-O-C decision letter is sent to the individual or legal guardian. Each L-O-C decision letter provides a Right to Appeal Notice explaining the individual’s right to appeal the decision as well as how to file an appeal. For more on appeals, see Section 8: Appeals Process in this module. Note that for information about the waiting list for the H&W Waiver, see the Section 12.1: Eligibility for the H&W and T-B-I Waiver Services. The B-D-S policy states individuals may be placed on a single statewide waiting list after applying for waiver services and meeting specified criteria. Individuals are responsible for maintaining current collateral and contact information with their local B-D-S office. To apply for H-C-B-S waiver services, an individual or their legal representative must complete an application and submit it to their local B-D-S office. The application requires collateral information, including the L-O-C assessment tool, supporting documents such as diagnostic evaluations, functional evaluations, psychological reports, individualized education program from schools, school records, physician’s diagnosis and remarks, existing evaluation done by Supplemental Security Income (S-S-I--) or Vocational Rehabilitation, intelligence quotient (I-Q---) testing done at any time, Medicaid application for individuals over 18 years of age, and S-S-I application, if applicable. The L-O-C must be assessed for all individuals.. 

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Published: Sept. 9, 2024 
Policies and procedures as of July 1, 2024 
Version: 11.1 
– The substantial functional limitation categories, as defined in 42 CFR 435.1010, are: 
➢ Self-care 
➢ Learning 
➢ Self-direction 
➢ Capacity for independent living 
➢ Understanding and use of language 
➢ Mobility 
– After the evaluation is complete, a LOC decision letter is sent to the individual or legal guardian. 
Each LOC decision letter provides a Right to Appeal Notice explaining the individual’s right to 
appeal the decision as well as how to file an appeal. For more on appeals, see Section 8: Appeals 
Process in this module. 
Section 5.4: Waiting List for the Family Supports Waiver 
(FSW) 
Note: For information about the waiting list for the H&W Waiver, see the Section 12.1: 
Eligibility for the H&W and TBI Waiver Services. 
The BDS policy states individuals may be placed on a single statewide waiting list after applying for waiver 
services and meeting specified criteria. Individuals are responsible for maintaining current collateral and 
contact information with their local BDS office. 
Initial Placement on a Single, Statewide Home- and Community-
Based Services Waiver Waiting List 
For initial placement on a single, statewide HCBS waiver waiting list, the following requirements must be 
met: 
• An individual or their legal representative must complete an application and submit the application to 
their local BDS office to apply for HCBS waiver services. 
• The individual or their legal representative is expected to participate in the completion of the 
following: 
– Application 
– Collateral information, including the following: 
➢ LOC assessment tool 
➢ Supporting documents: 
▪ Diagnostic evaluations 
▪ Functional evaluations 
▪ Psychological reports 
▪ Individualized Education Program from schools 
▪ School records 
▪ Physician’s diagnosis and remarks 
▪ Existing evaluation done by Supplemental Security Income (SSI) or Vocational 
Rehabilitation 
➢ Intelligence Quotient (IQ) testing done at any time 
▪ Medicaid application for individuals more than 18 years of age 
▪ SSI application, if applicable 
• LOC must be assessed for all individuals

[Audio] We will be discussing DDRS HCBS Waivers. D-D-R-S stands for the Disability Determination and Rehabilitation Services. H-C-B-S stands for Health Care Benefits for Children with Special Health Care Needs. DDRS HCBS Waivers refer to the waivers that were granted to the Disability Determination and Rehabilitation Services for the Health Care Benefits for Children with Special Health Care Needs.. 

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Published: Sept. 9, 2024 
 
Policies and procedures as of July 1, 2024 
 
Version: 11.1 
• An individual must meet these requirements: 
– The state definition of a developmental disability found in IC 12-7-2-61(a)  
– ICF/IID LOC with substantial functional limitations as defined in 42 CFR 435.1010 
• If an individual completes the application and meets the LOC criteria listed in Section 5.3: Initial 
Level of Care Evaluation for FSW and CIH Waiver, they are placed on a waiting list using the 
individual’s application date 
Waiting List Targeting for a Family Supports Waiver Slot 
For an individual to be targeted for an FSW, the following requirements must be met: 
• Individuals are targeted for an FSW waiver slot from a single statewide waiting list using the 
individual’s application date 
• Individuals are targeted in the order they applied for services, from the oldest date of application to 
newest 
• Individuals ages 18 through 24 who have aged out of, graduated from or permanently separated from 
their school setting may be able to enter waiver services under the FSW upon that separation if 
funded slots are available 
Note: Entrance into services under the CIH Waiver now occurs only by meeting and being 
approved for certain priority criteria known as reserved waiver capacity. 
Responsibilities of Individuals on a Waiting List 
Individuals on a waiting list have the following responsibilities: 
• An individual, or an individual’s legal representative, is expected to maintain current contact 
information with their local BDS office. This information includes any change in address or 
telephone number 
• If, after a reasonable number of attempts, the BDS is unable to make contact with an individual or the 
individual’s legal guardian, and the identified secondary contact person, by mail or telephone, the 
individual may be removed from a waiting list 
Section 5.5: Targeting Process for the Family Supports 
Waiver (FSW) 
When a slot becomes available under the FSW, an individual on the single statewide waiting list for FSW 
services will receive a letter from the BDS Central Office, asking the individual to do the following: 
• Accept or decline the waiver slot within 30 calendar days 
• Apply for Medicaid if they haven’t already done so 
• Provide or obtain confirmation of their diagnosis from a physician on the Confirmation of Diagnosis 
(State Form 54727), available from the DDRS Forms page at in.gov/fssa/ddrs 
• A response accepting or declining the waiver slot must be received by the state within 30 days.  
• Individuals may be eligible to enter into FSW waiver services by meeting one of the specific priority 
criteria of the following reserved waiver capacity categories: 
– Individuals ages 18 through 24 who have aged out of, graduated from, or permanently separated 
from their school setting may be eligible to enter waiver services under the FSW on that 
separation, if funded slots are available

[Audio] We are excited to present to you on Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs. During this session, we will be discussing the application process and eligibility requirements for these programs. There are two options for applying: the B-D-S Gateway, an online application available 24/7, and returning an Application for Developmental Disability Services (State Form 55068) to your local B-D-S office. Our staff will review eligibility requirements, including proof of an intellectual/developmental disability, Medicaid eligibility, and initial level of care (L-O-C--). If you are not a Medicaid member, you will be referred to the local Division of Family Resources (D-F-R--) office to apply for Medicaid. C-I-H Waiver program applicants who meet specific criteria will be informed of available services and a funded priority slot. Medicaid eligibility is also discussed, with applicants under 18 required to submit a plan of care/service plan approval letter to the Family and Social Services Administration (F-S-S-A-) Division of Family Resources (D-F-R--). If you have any questions about the application process or eligibility requirements, please do not hesitate to reach out to your local B-D-S office for assistance. Thank you for your attention.. 

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Section 5: Application for and Start of FSW and CIH Waiver Services 
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Published: Sept. 9, 2024 
Policies and procedures as of July 1, 2024 
Version: 11.1 
– Eligible individuals transitioning from 100% state-funded services 
– Eligible individuals receiving services under Indiana’s Health & Wellness (H&W) Waiver 
(formerly known as the Aged & Disabled [A&D] Waiver) who no longer meet nursing facility 
level of care  
– Eligible children who are either: 
➢ A child of an active member/veteran of the armed forces of the United States, defined in 
IC-5-9-4-2 
➢ A child of an active member/veteran of the National Guard 
If an individual declines the offer for an FSW slot, their name is removed from the single statewide waiting 
list for FSW services. 
If an individual accepts the offer for an FSW slot: 
• An “intake” meeting with a service coordinator from the local BDS District Office is scheduled for 
the BDS to complete the following: 
– Collateral information, provided by the individual, is reviewed. 
– LOC is again established. 
• The individual and/or any legal guardian must obtain confirmation of the individual’s diagnosis on a 
Confirmation of Diagnosis (State Form 54727), signed by the individual’s physician within 21 
calendar days from the date of the letter. 
• The individual and/or any legal guardian has 60 calendar days to apply for and obtain Medicaid if the 
individual does not yet have Medicaid coverage. 
• If the individual already has Medicaid coverage, but the aid category to which the individual’s 
Medicaid eligibility has been assigned is not compatible with waiver program requirements, they 
have 30 calendar days from the date on the contact letter from the BDS to request that the DFR 
process the needed change in Medicaid aid category. 
• The individual or guardian must cooperate fully with requests related to the application for Medicaid 
eligibility and any change needed in the Medicaid aid category. 
After all assessments have been made, applicants under the age of 18 and their legal guardians are given a 
provider choice list by the BDS containing providers of selective contracting case management services that 
are approved by the DDRS.  
Because parental income is not factored into a minor receiving waiver services, proof of an approved 
POC/service plan may be required before some minors can obtain Medicaid eligibility. For that reason, the 
BDS service coordinator creates an initial POC/service plan, although selection of a case management 
organization is still required. The case management organization is cited on the initial POC/service plan if 
the selection has been finalized but may also be added at a later date if necessary. 
For adults, generating the case management choice list and choosing a selective contracting case 
management organization does not occur until after all eligibility criteria are met, including establishing 
Medicaid eligibility in a waiver-compatible aid category. Thereafter, the applicant or guardian (if applicable) 
completes the service planning process and chooses service providers for any other selected services, and the 
case manager submits a POC/service plan for waiver service. 
The timely completion of requirements for the PCISP and service plan should be done through the BDS 
Portal 2.0 at bddsportal.fssa.in.gov: 
• Initial PCISPs are due 45 calendar days following the confirmation date of the initial service plan at a 
minimum. 
• Annual PCISPs are due on or before the start date of the plan year.

[Audio] This section of the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs is open to all individuals. We will provide information on how to apply and the eligibility requirements for these programs. Those who prefer to apply online can access the B-D-S Gateway, an online application available 24/7 from any location with internet access. Alternatively, an Application for Developmental Disability Services (State Form 55068) can be completed and returned to the local B-D-S office. To be eligible for the F-S-W program, individuals must have documentation of an intellectual/developmental disability, Medicaid eligibility, and an appropriate level of care. If the individual is not currently a Medicaid member, they will be directed to the local Division of Family Resources (D-F-R--) office to apply for Medicaid. For the C-I-H Waiver program, applicants must meet specific criteria to be considered for a priority waiver slot. This includes individuals transitioning from a nursing facility, Extensive Support Needs Home, State Psychiatric Hospital, or Supervised Group Living. To apply for a priority waiver slot, individuals, legal representatives, or other authorized persons must request and apply for the slot when the individual meets the necessary criteria. It is important to submit an application to the local B-D-S office to apply for H-C-B-S waiver services. Collateral information, such as the level of care assessment tool and relevant documents like diagnostic evaluations and functional evaluations, must also be provided. We strongly suggest that individuals and their legal guardians review any updated Person-Centered Individualized Support Plans (PCISPs) within seven days of the Individualized Support Team (I-S-T--) meeting, face-to-face visit, or conversation in which the need for revision is identified. PCISPs must be updated whenever there is a change in the individual's needs or circumstances, when services are added or removed, per the request of the individual or their legal representative, and during non-annual team meetings to record the team's discussion on outcomes and any related plan changes. Annual service plans are due 45 days from the date of the Individualized Support Team (I-S-T--) meeting.. 

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Policies and procedures as of July 1, 2024 
 
Version: 11.1 
• Revisions to PCISPs are due within seven calendar days of the Individualized Support Team (IST) 
meeting, face-to-face visit or conversation in which the desire or need for revision is identified. 
Updated PCISPs are required in any of the following situations:  
– When the needs or circumstances of the individual changes 
– When services are added or removed 
– When requested by the individual and/or legal representative 
– For nonannual team meetings to record team discussion on outcomes and any related plan 
changes 
• Annual service plans are due 45 calendar days prior to the end of the current plan year. 
If the individual is unable to start waiver services within the given time frames, the individual may be 
removed from the targeting process. 
Note: Entrance into services under the CIH Waiver program now occurs only by meeting 
and being approved for certain priority criteria known as reserved waiver capacity. 
Section 5.6: Entrance into the Community Integration 
and Habilitation Waiver Program 
Entrance into the HCBS CIH Waiver program requires the following:  
• Individuals must meet and be approved for the specific priority criteria of at least one of the 
following reserved waiver capacity categories: 
– Eligible individuals transitioning to the community from a nursing facility (NF), Extensive 
Support Needs Home (ESN) or a State Psychiatric Hospital (SPH) 
– Eligible individuals determined to no longer need/receive active treatment in Supervised Group 
Living (SGL)  
– Eligible individuals transitioning from 100% state-funded services  
– Eligible individuals aging out of Indiana department of education facility/residential placement; 
the Indiana department of child services foster care; facility, residential or group home placement; 
or Indiana Medicaid Supervised Group Living 
– Eligible individuals choosing to leave an ICF/IID 
– Eligible individuals meeting one of the following emergency placement criteria:  
➢ Death of a primary caregiver when there is no other caregiver available 
➢ Caregiver over 80 years of age when there is no other caregiver available 
➢ Evidence of abuse or neglect in the current institutional or home placement 
➢ Extraordinary health and safety risk as reviewed and approved by the division director 
• Individuals, their legal representatives or other persons acting on the individual’s behalf must request 
and apply for a priority waiver slot when it appears that the individual meets the specific criteria of 
one or more reserved waiver capacity categories. 
• It is necessary to complete an application and submit the application to the local BDS office to apply 
for HCBS waiver services. 
• The individual and any legal guardian are expected to participate in completing the following: 
– Application 
– Collateral information, including the following: 
➢ LOC assessment tool  
➢ Supporting documents: 
▪ Diagnostic evaluations 
▪ Functional evaluations

[Audio] We will be discussing the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs. To apply for these programs, you have two options: the online application available 24/7 through the B-D-S Gateway or completing and returning an Application for Developmental Disability Services (State Form 55068) to the local B-D-S office. If you are applying for the F-S-W or C-I-H Waiver program, you will need to provide various documentation, including psychological reports, Individualized Education Programs from schools, school records, physician’s diagnosis and remarks, and existing evaluation done by Supplemental Security Income or Vocational Rehabilitation. Additionally, you will need to complete an IQ testing done at any time. If you are applying for a C-I-H Waiver priority slot, you will need to maintain current contact information with your local B-D-S office, including changes in address or telephone number. If you are unable to make contact with the B-D-S office by mail or telephone, you will forfeit the current opportunity for a C-I-H Waiver priority slot, but may reapply at any time. If you accept a funded C-I-H Waiver priority slot, you will need to attend an intake meeting with a service coordinator from the B-D-S--. During the intake meeting, collateral information provided by you will be reviewed and L-O-C will be re-established. You will need to complete a L-O-C assessment tool and have a Confirmation of Diagnosis (State Form 54727) signed by your physician within 21 calendar days from the date on the B-D-S letter offering a C-I-H Waiver priority slot. You will also have 60 calendar days from the date on the B-D-S letter to apply for and obtain Medicaid when you do not yet have Medicaid coverage. It is important to understand these requirements and ensure that all necessary documentation is provided in a timely manner. If you have any further questions, please do not hesitate to contact your local B-D-S office.. 

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Version: 11.1 
▪ Psychological reports 
▪ Individualized Education Programs from schools 
▪ School records 
▪ Physician’s diagnosis and remarks 
▪ Existing evaluation done by Supplemental Security Income or Vocational Rehabilitation 
▪ IQ testing done at any time 
➢ Medicaid application for individuals over 18 years of age 
➢ Supplemental Security Income application, if applicable 
• LOC must be assessed for all individuals. 
• An individual must meet the following: 
– The state definition of a developmental disability in IC 12-7-2-61(a) 
– ICF/IID LOC with substantial functional limitations, as defined in 42 CFR 435.1010 
➢ Additionally, if an individual meets the LOC criteria listed in Section 5.3: Initial Level of Care 
Evaluation for FSW and CIH Waiver, and a funded priority slot is available in the reserved 
waiver capacity category met by the individual, the BDS office first determines whether other 
potential placement options have been exhausted before offering the slot to the individual. 
➢ Individuals are responsible for maintaining current collateral and contact information with their 
local BDS office. 
Application for a CIH Waiver Priority Slot 
When application for a CIH Waiver priority slot is made, priority access by reserved waiver capacity 
category is made available only as long as available capacity exists for the current waiver year. 
Responsibilities of Individuals Applying for a CIH Waiver Priority 
Slot 
The responsibilities of an individual applying for a CIH Waiver priority slot are as follows: 
• An individual or an individual’s legal representative is expected to maintain current contact 
information with the individual’s local BDS office, including changes in address or telephone number 
• If the BDS attempts to contact an individual or the individual’s legal guardian or the identified 
secondary contact person, and is unable to make contact by mail or telephone, the individual will 
forfeit the current opportunity for a CIH Waiver priority slot, but may reapply at any time 
If an individual or their legal representative declines placement offered through a funded CIH Waiver 
priority slot, the individual’s application for the CIH Waiver is denied. 
If an individual or an individual’s legal representative accepts placement through the offer of a funded CIH 
Waiver priority slot, an intake meeting with a service coordinator from the BDS must occur. During the 
intake meeting, collateral information provided by the individual is reviewed and LOC is again established: 
• A LOC assessment tool is completed. 
• The allocation is recorded in the state’s electronic case management system. 
The individual or guardian must obtain confirmation of the individual’s diagnosis on a Confirmation of 
Diagnosis (State Form 54727) signed by the individual’s physician within 21 calendar days from the date on 
the BDS letter offering a CIH Waiver priority slot. 
The individual or guardian has 60 calendar days from the date on the BDS letter to apply for and obtain 
Medicaid when the individual does not yet have Medicaid coverage.

[Audio] 1. Apply for the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs by filling out the form on the B-D-S website or by returning the Application for Developmental Disability Services (State Form 55068) to the local B-D-S office. 2. To be eligible for the program, the individual must have an intellectual/developmental disability, Medicaid eligibility, and initial level of care (L-O-C--). If the individual already has Medicaid coverage but the aid category to which they are assigned is not compatible with waiver program requirements, they have 30 days from the date on the contact letter from the B-D-S to request that the D-F-R process the needed change in Medicaid aid category if they are eligible. 3. After all assessments have been made, the B-D-S gives applicants younger than the age of 18 and their legal guardians a choice list of case management providers that are approved by the D-D-R-S and enrolled through the I-H-C-P to provide selected contracting Case Management services. In those situations, the B-D-S creates the POC/service plan, enabling the minor to obtain Medicaid. 4. For adults, generating the B-D-S case management organization choice list and selecting a case management organization does not occur until after all eligibility criteria are met, including establishing Medicaid eligibility in a waiver-compatible aid category. 5. The timely completion of requirements for the P-C-I-S-P and service plan should be done through the B-D-S Portal 2.0 at bddsportal.fssa.in.gov. 6. The individual must work with the local B-D-S office if additional time is needed to complete any required steps in the process. 7. The state monitors and recently enhanced its person-centered planning process to ensure compliance with CMS 2249-F and CMS 2296-F. The new person-centered individualized support plan (P-C-I-S-P) approach enhances the way in which supports and services are explained to individuals and families so that their needs, aspirations and opportunities for the achievement of self-determination, interdependence, productivity, integration and inclusion in all facets of community life can be identified and explored. Additionally, the P-C-I-S-P drives the development of the POC/service plan. The P-C-I-S-P is the new plan that identifies the array of services and supports needed for the individual.. 

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If the individual already has Medicaid coverage, but the aid category to which the individual’s Medicaid 
eligibility has been assigned is not compatible with waiver program requirements, they have 30 calendar 
days from the date on the contact letter from the BDS to request that the DFR process the needed change in 
Medicaid aid category if the applicant is eligible. 
The individual or guardian must cooperate fully with requests related to the application for Medicaid 
eligibility and any needed change in Medicaid aid category. 
After all assessments have been made, the BDS gives applicants younger than the age of 18 and their legal 
guardians a choice list of case management providers that are approved by the DDRS and enrolled through 
the IHCP to provide selected contracting Case Management services. Due to the disregard of parental 
income for minors receiving waiver services, proof of a POC/service plan may be required before some 
minors can obtain Medicaid eligibility. In those situations, the BDS creates the POC/service plan, enabling 
the minor to obtain Medicaid. Otherwise, selection of a DDRS-approved provider of contracted Case 
Management services is required before the POC/service plan can be created. For adults, generating the BDS 
case management organization choice list and selecting a case management organization does not occur until 
after all eligibility criteria are met, including establishing Medicaid eligibility in a waiver-compatible aid 
category. Thereafter, the applicant or guardian (if applicable) completes the service planning process and 
chooses service providers for any other selected services, and the case management provider submits a 
POC/service plan for waiver service. 
The timely completion of requirements for the PCISP and service plan should be done through the BDS 
Portal 2.0 at bddsportal.fssa.in.gov: 
• Initial PCISPs are due 45 calendar days following the confirmation date of the initial service plan at a 
minimum. 
• Annual PCISPs are due on or before the start date of the plan year. 
• Revisions to PCISPs are due within seven calendar days of the IST meeting, face-to-face visit, or 
conversation in which the desire or need for revision is identified. Updated PCISPs are required in 
any of the following situations:  
– When the needs or circumstances of the individual changes 
– When services are added or removed 
– When requested by the individual and/or legal representative 
– For nonannual team meetings to record team discussion on outcomes and any related plan 
changes 
• Annual service plans are due 45 calendar days prior to the end of the current plan year. 
If the individual is unable to start CIH Waiver services within the given time frames, the individual may be 
removed from the process, resulting in the available CIH Waiver priority slot being offered to another 
individual in need of services.  
The individual must work with the local BDS office if additional time is needed to complete any required 
steps in the process. 
Section 5.7: Initial Plan of Care (POC)/Service Plan 
Development for FSW and CIH Waiver 
The state monitors and recently enhanced its person-centered planning process to ensure compliance with 
CMS 2249-F and CMS 2296-F. The new person-centered individualized support plan (PCISP) approach 
enhances the way in which supports and services are explained to individuals and families so that their needs, 
aspirations and opportunities for the achievement of self-determination, interdependence, productivity, 
integration and inclusion in all facets of community life can be identified and explored. Additionally, the 
PCISP drives the development of the POC/service plan. The PCISP is the new plan that identifies the array of

[Audio] If you are applying for the Family Supports Waiver (F-S-W--) program, you have two application options available: 1. The B-D-S Gateway, an online application available 24/7. If you choose this option, you will be directed to the B-D-S website where you will be able to complete the application online. 2. Completing and returning an Application for Developmental Disability Services (State Form 55068) to the local B-D-S office. If you choose this option, you will need to download the State Form 55068 and return it to the local B-D-S office. A BDS staff member will then discuss eligibility requirements with you, including documentation of an intellectual/developmental disability, Medicaid eligibility, and initial level of care (L-O-C--). If you are not a Medicaid member, you will need to apply for Medicaid through the local Division of Family Resources (D-F-R--) office. If you are applying for the Community Integration and Habilitation (C-I-H--) program, you will need to meet specific reserved waiver capacity (priority) criteria. If you meet these criteria, you will be advised of available services and a funded priority slot. In either case, you will need to develop a Plan of Care/Service Plan (POC/service plan) that identifies the supports and services that will be used to implement desired outcomes and ensure your health and welfare while the POC/service plan identifies those supports and services that are funded by the waiver. The POC/service plan is developed by the individual-chosen case manager a minimum of six weeks prior to the initial start date of services and then six weeks prior to the end date of each annual service plan. The POC/service plan is routinely developed to cover a time frame of 12 consecutive months. The POC/service plan is used to coordinate waiver services and other services. The case manager is responsible for ensuring that all identified services and supports have been implemented as identified in the P-C-I-S-P and the POC/service plan. The case manager is also responsible for monitoring and coordinating services on an ongoing basis and is required to record a case note for each encounter with, or on behalf of, the individual.. 

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services and supports, paid and unpaid from all sources that will be used to implement desired outcomes and 
ensure the individual’s health and welfare while the POC/service plan identifies those supports and services 
which are funded by the waiver. The individual, case manager, selected providers and other persons chosen 
by the individual form the IST. The individual has the right and power to command and direct the entire 
PCISP process with a focus on their preferences, aspirations and needs. The process empowers individuals to 
create life plans and direct the planning and allocation of resources to meet their self-directed life goals. The 
POC/service plan is developed by the individual-chosen case manager a minimum of six weeks prior to the 
initial start date of services and then six weeks prior to the end date of each annual service plan. The 
POC/service plan is routinely developed to cover a time frame of 12 consecutive months.  
While the FSW is capped at $26,482 annually for each individual, budgeted amounts for POC/service plans 
developed under the CIH Waiver use the objective-based allocation process described in Section 6: 
Objective-Based Allocation. 
• Coordination of waiver services and other services is completed by the case manager. Within 30 days 
of implementation of the plan, the case manager is responsible for ensuring that all identified services 
and supports have been implemented as identified in the PCISP and the POC/service plan. The case 
manager is responsible for monitoring and coordinating services on an ongoing basis and is required 
to record a case note for each encounter with, or on behalf of, the individual. A formal 90-day review 
is also completed by the case manager using information received from the individual, family or 
guardian as applicable, and other IST members before, during and after the face-to-face visit or IST 
meeting. The IST is advised of any concerns or needs for updates that may require scheduling of 
additional team meetings by the case manager. 
• Most waiver service providers are required to submit a quarterly report summarizing the level of 
support provided to the individual, based on the identified supports and services in the PCISP and the 
POC/service plan. As part of the 90-day review process, the case manager reviews these reports for 
consistency with the PCISP and POC/service plan and works with providers as needed to address 
findings from this review. 
Section 5.8: State Authorization of the Initial 
POC/Service Plan 
The case manager transmits the POC/service plan electronically to the state’s waiver specialist, who reviews 
the POC/service plan and confirms that the individual is a current Medicaid member in one of the following 
categories: 
• Aged (MA A) 
• Blind (MA B) 
• Low-income families (MA GF) 
• Disabled (MA D) 
• Disabled worker (MADW, MADI) 
• Children receiving adoption assistance or children receiving federal foster care payments under 
Title IV E – Sec 1902(a)(10)(A)(i)(I) of the Act (MA 4, MA 8) 
• Children receiving adoption assistance under a state adoption agreement – Sec 
1902(a)(10)(A)(ii)(VIII) (MA 8) 
• Independent foster care adolescents – Sec 1902(a)(10)(A)(ii)(XVII) (MA 14) 
• Children under age 1 – Sec 1902(a)(10)(A)(i)(IV) (MA Y) 
• Children ages 1 to 5 – Sec 1902(a)(10)(A)(i)(VI) (MA Z)

[Audio] For those interested in applying for the Family Supports Waiver and Community Integration and Habilitation Waiver programs, there are two options available. The first is through the B-D-S Gateway, an online application that is accessible 24/7. The second option is to complete and return an Application for Developmental Disability Services (State Form 55068) to your local B-D-S office. During the application process, our dedicated B-D-S staff will discuss the various eligibility requirements. This includes documentation of an intellectual or developmental disability, Medicaid eligibility, and initial level of care determination. If the applicant is not currently a member of Medicaid, they will be referred to their local Division of Family Resources (D-F-R--) office to apply for Medicaid. For those applying for the C-I-H Waiver program, if they meet certain reserved waiver capacity criteria, they will be advised of the available services and a funded priority slot. Medicaid eligibility will also be discussed during this time. It is important to note that applicants under the age of 18 will be required to submit a plan of care or service plan approval letter to the Family and Social Services Administration (F-S-S-A-) Division of Family Resources (D-F-R--). Moving on to Section 5 of the DDRS HCBS Waivers, we want to highlight some important information for children ages 1 through 18. According to Section 1902(a)(10)(A)(i)(V-I-I--) and (MA 9, MA 2), transitional medical assistance is available. Additionally, for individuals in Sec 1634 states such as Indiana who are aged, blind, or disabled, those who are eligible for Supplemental Security Income (S-S-I--) will be automatically enrolled in the Indiana Health Coverage Programs (I-H-C-P-). This means they will not need to file a separate Indiana Application for Health Coverage. Furthermore, for those who receive S-S-I and are deemed disabled by the Social Security Administration, they will not be required to undergo a separate determination of disability from Indiana's Medical Review Team (M-R-T--). For individuals who receive Social Security Disability Income (S-S-D-I-), they will also not be required to undergo a separate determination of disability from Indiana's M-R-T--. As a reminder, a financial eligibility determination will still be required for all applicants. Thank you for your attention and we hope this information has been helpful. Please continue to the next slide for more important details on the F-S-W and C-I-H Waiver programs.. 

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• Children ages 1 through 18 – Sec 1902(a)(10)(A)(i)(VII) (MA 9, MA 2) 
• Transitional medical assistance – Sec 1925 of the Act (MA F) 
Note that for the aged, blind or disabled in Sec 1634 states such as Indiana: 
• Supplemental Security Income (SSI)-eligible individuals will be automatically enrolled in the Indiana 
Health Coverage Programs (IHCP) and will not need to file a separate Indiana Application for Health 
Coverage. Members with SSI will be assigned to the new Modified Adjusted Gross Income (MAGI) 
eligibility aid category. Individuals deemed disabled by the Social Security Administration and who 
are receiving SSI based on that determination will not be required to undergo a separate 
determination of disability from Indiana’s Medical Review Team (MRT). 
• Individuals who receive Social Security Disability Income (SSDI) will not be required to undergo a 
separate determination of disability from Indiana’s MRT. A financial eligibility review will still be 
required, so these individuals will need to complete the Indiana Application for Health Coverage. 
The waiver specialist also confirms the following: 
• The individual has a current ICF/IID LOC approval. 
• The individual has been targeted for an available waiver slot. 
• The individual’s identified needs are addressed with a plan to assure their health, safety and welfare. 
• The individual or guardian has signed, indicating acceptance of the POC/service plan, that they have 
been offered choice of DDRS-approved waiver service providers and that they have chosen waiver 
services over services in an institution. 
The waiver specialist may request additional information from the case manager to assist in reviewing the 
POC/service plan. 
If the waiver specialist approves the initial POC/service plan, the initial approval letter and signed service 
authorization are electronically transmitted to the case manager, BDS (for initial POC/service plans only) 
and service providers. Within three calendar days of receiving the initial POC/service plan approval letter 
and service authorization, the case manager must provide copies of the approval letter, signed service 
authorization and addendum (containing information from the POC/service plan) to the individual or 
guardian. The individual’s chosen waiver service providers are required to register so that they receive the 
service authorization and the addendums electronically. 
Service Authorization 
The service authorization serves as the official authorization for service delivery and reimbursement: 
• If the waiver specialist approves the POC/service plan pending Medicaid eligibility or change of aid 
category (for minors only), disenrollment of a child from Hoosier Healthwise, facility discharge or 
other reasons, the pending approval letter is to be transmitted to the case manager, the BDS and the 
service providers. The case manager must notify the individual or guardian within their calendar days 
of receipt of the pending approval and provide a copy of the initial approval letter naming the 
pending conditions. No service authorization is generated until all pending issues are resolved and a 
final approval letter is released. 
• If the waiver specialist denies the initial POC/service plan, a denial letter must be transmitted to the 
case manager, the BDS (for initial and annual POC/service plans only) and service providers. Within 
three calendar days of receipt of the denial, the case manager must provide a copy of the service 
authorization, the appeal rights as an HCBS waiver services recipient, and an explanation of the 
decision to deny to the individual or guardian. The case manager discusses other service options with 
the individual and guardian, unless the individual or guardian files an appeal.

[Audio] This section will discuss the application process for the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs. There are two options for applying: the B-D-S Gateway, an online application available 24/7, or completing and returning an Application for Developmental Disability Services to the local B-D-S office. Our B-D-S staff will review the eligibility requirements, including documentation of an intellectual/developmental disability, Medicaid eligibility, and initial level of care. Non-Medicaid members will be referred to the local Division of Family Resources office to apply. For C-I-H Waiver program applicants who meet specific reserved waiver capacity criteria, they will be informed of available services and receive a funded priority slot. We will also discuss Medicaid eligibility and, for applicants under the age of 18, the requirement to submit a plan of care or service plan approval letter to the Family and Social Services Administration Division of Family Resources. Moving on to section 5.9, we will cover the initial service plan implementation for F-S-W and C-I-H Waiver. It is important to note that an individual cannot start receiving waiver services under these programs without the approval of their initial Plan of Care (P-O-C--) or service plan by the state's waiver specialist. This plan is determined through the Person-Centered Individualized Support Plan (P-C-I-S-P) development process. If the waiver specialist issues an initial approval letter with certain conditions, those conditions must be resolved before the start of the individual's waiver services. For applicants under the age of 18, if their Medicaid eligibility is approved pending waiver approval, the case manager will notify the local Division of Family Resources caseworker when the waiver has been approved. It is important to remember that once waiver services begin, individuals may be referred to as beneficiaries or members for Medicaid purposes. Thank you for your attention to section 5 of our presentation on the Family Supports Waiver and Community Integration and Habilitation Waiver programs. In our final section, we will cover the ongoing process of maintaining and monitoring waiver services.. 

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Note: After waiver services begin, waiver individuals are sometimes referred to as 
“beneficiaries” or “members” for Medicaid purposes. 
Section 5.9: Initial Service Plan Implementation for FSW 
and CIH Waiver 
An individual cannot begin waiver services under the FSW program or the CIH Waiver program before the 
approval of the initial POC/service plan by the state’s waiver specialist. The initial POC/service plan 
represents the service plan identified for the individual resulting from the PCISP development process. If the 
waiver specialist issues an initial approval letter pending certain conditions being met, those conditions must 
be resolved before the start of the individual’s waiver services. For applicants under the age of 18, if the 
individual’s Medicaid eligibility is approved pending waiver approval, the case manager notifies the local 
DFR caseworker when the waiver has been approved. The DFR caseworker and waiver case manager 
coordinate the Medicaid eligibility date and waiver start date. If Medicaid eligibility depends on eligibility 
for the waiver, the Medicaid start date is usually the first day of the month following approval of the 
POC/service plan. 
If an individual is in a Hoosier Healthwise, Hoosier Care Connect or Medicaid managed care program, the 
case manager must contact the local DFR caseworker to coordinate the managed care program stop date and 
waiver services start date. Individuals receiving the IHCP hospice benefit do not have to disenroll from the 
hospice benefit to receive waiver services that are not related to the terminal condition and are not 
duplicative of hospice care. If applicable, the case manager and managed care benefit advocate must inform 
the individual and individual’s parent or guardian of their options to ensure they make an informed choice. 
When the POC/service plan is approved by the waiver specialist pending facility discharge, the waiver start 
date can be the same day that the individual is discharged from the facility. 
Following discharge from the facility and within three calendar days after the individual begins waiver 
services, the case manager must complete the Confirmation of Waiver Start form in the Insite database and 
electronically transmit it to the state through the DDRS Insite database. 
For all waiver starts, when the case manager completes the Confirmation of Waiver Start form in the Insite 
database and electronically transmits it to the DDRS database, the FSSA is also electronically notified to 
enter the individual’s waiver start information in the Core Medicaid Management Information System 
(CoreMMIS) database. 
When the Confirmation of Waiver Start form is received electronically by the DDRS, the form is reviewed 
and, if accepted, an approval letter is automatically transmitted back to the case manager. The period 
covered by the initial POC/service plan is from the effective date of the confirmation form through the end 
date of the initial POC/service plan that was previously approved by the waiver specialist. 
Within three calendar days of receiving the initial POC/service plan approval letter and signed service 
authorization, the case manager must provide copies of the approval letter, signed service 
authorization and addendum (containing information from the POC/service plan) to the individual or 
guardian. The individual’s chosen waiver service providers are required to register so they receive the 
service authorization and the addendums electronically.  
There is no reimbursement for services delivered before receipt of the service authorization.

Scene 12

[Audio] Welcome to section 13 of our presentation on the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs. In this section, we will be discussing the objective-based allocation (O-B-A--) methodology for the C-I-H Waiver program. The O-B-A methodology is used by the Family and Social Security Administration (F-S-S-A-) Division of Disability and Rehabilitative Services (D-D-R-S-) to determine the level of supports an individual needs to live in a community setting while receiving services under the C-I-H Waiver. This methodology was developed in 2007 in collaboration with advocates, providers, and industry professionals. It involved extensive research, cost reporting by providers, modeling, assessment validation, pilots, and best practices. The parameters for the algorithm (Algo) were determined through modeling, which combines the overall Algo determined by the Inventory for Client and Agency Planning (I-C-A-P-) and the ICA. Section 6.1 focuses specifically on the development of the O-B-A for the C-I-H Waiver. This included baseline research, provider cost reporting, modeling, assessment validation, pilots, and best practices. The use of modeling allowed us to determine the parameters for the algorithm development. It's important to note that the O-B-A is determined by combining the overall Algo with the results from the I-C-A-P and I-C-A--. This ensures an accurate and fair assessment of an individual's needs for living in a community setting while receiving services under the C-I-H Waiver. Thank you for your attention to this important section of our presentation. In the next section, we will discuss the results of the O-B-A and how they impact the allocation of supports for individuals under the C-I-H Waiver program.. 

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Section 6: Objective-Based Allocation for the 
CIH Waiver 
This section presents the objective-based allocation (OBA) methodology that the Family and Social 
Security Administration (FSSA) Division of Disability and Rehabilitative Services (DDRS) uses to 
determine the level of supports an individual needs to live in a community setting while receiving services 
under the Community Integration and Habilitation (CIH) Waiver. 
Section 6.1: OBA Development for CIH Waiver 
In 2007, the DDRS and an external group of stakeholders consisting of advocates, providers and industry 
professionals began the research and development of an OBA method. 
The development included baseline research, provider cost reporting, modeling, assessment validation, 
pilots and best practices. Modeling was used to determine the parameters for Algorithm development 
(Algo). As is further explained in the following section, the OBA is determined by combining the overall 
Algo (determined by the Inventory for Client and Agency Planning [ICAP] and the ICAP addendum), age, 
employment and living arrangement.  
Note: The OBA methodology is not used with the already-capped Family Supports Waiver 
(FSW), Traumatic Brain Injury (TBI) Waiver, or Health and Wellness (H&W) Waiver.  
Section 6.2: ICAP Assessment and Algo Level 
Development for CIH Waiver 
The nationally recognized ICAP was selected to be the primary tool for individual assessment.  
The ICAP assessment determines an individual’s level of functioning for broad independence and general 
maladaptive factors. The ICAP addendum, commonly referred to as the behavior and health factors, 
determines an individual’s level of functioning on behavior and health factors. 
These two assessments determine an individual’s overall Algo level, which can range from 0-6. Algos 0 
and 6 are considered outliers, representing those who are the lowest and the highest on both ends of the 
functioning spectrum. Upon review, the state may manually adjust the designation of an individual from an 
Algo 5 to an Algo 6. Although this individual continues receiving the Algo 5 budget, the Algo 6 
designation indicates a need for additional oversight of the individual. 
The stakeholder group designed a building-block grid to build the allocations. The building-block grid was 
developed with the following tenets playing key roles:  
• Focus on daytime programming 
• Employment 
• Community integration 
• Housemates 
The OBA’s total allocation is then determined by combining the overall Algo (determined by the ICAP and 
ICAP addendum), age, employment and living arrangement.  
It should be noted that for any individual who is living alone, the OBA is based on a shared living model. 
Section 6.5: Long-Term Budget Request and Short-Term Budget Request addresses potential adjustments to 
the allocation amount.

[Audio] We have now completed our presentation on the Family Supports Waiver and Community Integration and Habilitation Waiver programs. To wrap things up, we would like to discuss the application process. There are two options available: the B-D-S Gateway, an online application that is accessible 24/7, or filling out and returning an Application for Developmental Disability Services to your local B-D-S office. During the application process, B-D-S staff will go over the eligibility requirements with you. This includes providing documentation of an intellectual or developmental disability, proving Medicaid eligibility, and determining your initial level of care. If you are not currently a Medicaid member, you will be directed to your local Division of Family Resources office to apply for Medicaid. For those applying to the C-I-H Waiver program, there are specific criteria for reserved waiver capacity that must be met. If these criteria are met, you will be informed about the available services and given a funded priority slot. Medicaid eligibility will also be discussed during this process. Applicants under the age of 18 will need to submit a plan of care or service plan approval letter to the Family and Social Services Administration. Moving on to the Indiana Administrative Code, particularly Section 6 regarding Objective-Based Allocation for the C-I-H Waiver, we have Table 1 which outlines the Algo level descriptors. These descriptors indicate the level of care needed for each individual. Level 0, the low level, indicates a high level of independence with minimal support required. On the other hand, level 2, the regular level, indicates a moderate level of independence with frequent support needed. In conclusion, we hope this presentation has given you a better understanding of the Family Supports Waiver and Community Integration and Habilitation Waiver programs. Thank you for your attention and please feel free to contact your local B-D-S office for further information on the application process. Thank you.. 

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Section 6.3: Algo Level Descriptors for CIH Waiver 
Table 1 presents the Algo level descriptors as found in Indiana Administrative Code 460 IAC 13. 
Table 1 – Algo Level Descriptors 
Level 
Descriptor  
0 
(Low) 
Algo level zero (0): 
(A) high level of independence with few supports needed; 
(B) no significant behavioral issues; and 
(C) requires minimal residential habilitation services. 
1 
(Basic) 
Algo level one (1): 
(A) moderately high level of independence with few supports needed; 
(B) behavioral needs, if any, can be met with medication or informal direction by caregivers 
through the Medicaid State Plan services; and 
(C) likely a need for day programming and light residential habilitation services to assist 
with certain tasks, but the individual can be unsupervised for much of the day and night. 
2 
(Regular) 
Algo level two (2): 
(A) moderate level of independence with frequent supports needed; 
(B) behavioral needs, if any, can be met with medication or light therapy, or both, every 
one (1) to two (2) weeks; 
(C) does not require twenty-four (24) hours a day supervision; and 
(D) generally able to sleep unsupervised, but needs structure and routine throughout the day. 
3 
(Moderate) 
Algo level three (3): 
(A) requires access to full-time supervision for medical or behavioral, or both, needs; 
(B) twenty-four (24) hours a day, seven (7) days a week staff availability; 
(C) behavioral and medical supports are not generally intense; and 
(D) behavioral and medical supports can be provided in a shared staff setting. 
4 
(High) 
Algo level four (4): 
(A) requires access to full-time supervision for medical or behavioral, or both, needs: 
      (i) twenty-four (24) hours a day, seven (7) days a week frequent staff interaction; and 
      (ii) requires line of sight support; and 
(B) has moderately intense needs that can generally be provided in a shared staff setting. 
5 
(Intensive) 
Algo level five (5): 
(A) requires access to full-time supervision with twenty-four (24) hours a day, seven (7) days 
a week absolute line of sight support; 
(B) needs areintense; 
(C) needs require the full attention of a caregiver with a one-to-one staff to individual ratio; 
and 
(D) typically only needed by those with intense behavioral needs, not medical needs alone. 
6 
(High 
Intensive) 
Algo level six (6): 
(A) requires access to full-time supervision: 
      (i) twenty-four (24) hours a day, seven (7) days a week; and 
      (ii) more than a one-to-one staff to individual ratio; 
(B) needs are exceptional; 
(C) needs require more than one (1) caregiver exclusively devoted to the individual for at 
least part of each day; and 
(D) imminent risk of individual harming self or others, or both, without vigilant supervision.

 part 4

We are here to discuss the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs, which have two application options. The first option is the B-D-S Gateway, an online application available 24/7. The second option is to complete and return an Application for Developmental Disability Services (State Form 55068) to the local B-D-S office. B-D-S staff will discuss eligibility requirements, including documentation of an intellectual/developmental disability, Medicaid eligibility, and initial level of care (L-O-C--). If the applicant is not a Medicaid member, they will be referred to the local Division of Family Resources (D-F-R--) office to apply for Medicaid. C-I-H Waiver program applicants who meet specific reserved waiver capacity (priority) criteria will be advised of available services and a funded priority slot. Medicaid eligibility is also discussed, with applicants under 18 required to submit a plan of care/service plan approval letter to the Family and Social Services Administration (F-S-S-A-) Division of Family Resources (D-F-R--).

Now, let's dive into the Initial Level of Care Evaluation for F-S-W and C-I-H Waiver. For the F-S-W and C-I-H Waiver, an individual targeted for the F-S-W or who meets reserved waiver capacity (priority) criteria and is approved for entrance into the F-S-W or C-I-H Waiver program, must meet the level of care (L-O-C--) required for placement in an intermediate care facility for individuals with intellectual disabilities (ICF/IID). All L-O-C determinations require secondary review to ensure accuracy.

Initial L-O-C determinations are made by a B-D-S service coordinator, including a new “initial” L-O-C for individuals who have been terminated from the Home and Community-Based Services (H-C-B-S-) waiver program but desire to return to waiver services within the same waiver year. Reevaluations are performed by the selected provider of Case Management services.

For those applicants whose initial L-O-C evaluation was unfavorable, the information is submitted to the B-D-S Central Office for a tertiary review. The F-S-S-A Office of Medicaid Policy and Planning (O-M-P-P-) retains final authority for determination of eligibility.

Only individuals (state employees) who are Qualified Intellectual Disability Professionals (QIDPs), as specified by the standard in Code of Federal Regulations 42 CFR 483.430(a), may perform initial L-O-C determinations. If collateral records are not available or are not valid reflections of the individual, additional assessments may be obtained from contracted psychologists, physicians, nurses and licensed social workers. Following review of the collateral records, the L-O-C assessment tool applicable to individuals with intellectual/developmental disabilities and other related conditions is completed to ascertain if the individual meets ICF/IID L-O-C-.

The L-O-C assessment tool is used for reviewing and referencing documentation related to the intellectual/developmental disabilities of the applicant or individual, as well as any psychiatric diagnosis and results of the individual’s intellectual assessment. It is also used to record the age of onset and identify areas of major life activity in which the individual may exhibit a substantial functional limitation, including the areas of mobility, understanding and use of language, self-care, capacity for independent living, learning, self-direction, economic self-sufficiency, and the state definition of developmental disability found in Indiana Code IC 12-7-2-61.

The B-D-S service coordinator (initial L-O-C--) or selected provider of case management (reevaluations) reviews the L-O-C assessment tool and collateral material applicable to individuals with intellectual/developmental disabilities and other related conditions to ascertain whether the individual meets ICF/IID LOC requirements. An applicant or individual must meet requirements for three of six substantial functional limitations and each of four basic conditions (lists follow) to meet L-O-C criteria. The basic conditions are:

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We are here to discuss the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs and the application process. There are two options for applying: the B-D-S Gateway, an online application available 24/7, or completing and returning an Application for Developmental Disability Services (State Form 55068) to the local B-D-S office. B-D-S staff will discuss eligibility requirements, including documentation of an intellectual/developmental disability, Medicaid eligibility, and initial level of care (L-O-C--). If the applicant is not a Medicaid member, they will be referred to the local Division of Family Resources (D-F-R--) office to apply for Medicaid. C-I-H Waiver program applicants who meet specific reserved waiver capacity (priority) criteria will be advised of available services and a funded priority slot. Medicaid eligibility is also discussed, with applicants under 18 required to submit a plan of care/service plan approval letter to the Family and Social Services Administration (F-S-S-A-) Division of Family Resources (D-F-R--). After the evaluation is complete, a L-O-C decision letter is sent to the individual or legal guardian. Each L-O-C decision letter provides a Right to Appeal Notice explaining the individual’s right to appeal the decision as well as how to file an appeal. For more on appeals, see Section 8: Appeals Process in this module. Note that for information about the waiting list for the H&W Waiver, see the Section 12.1: Eligibility for the H&W and T-B-I Waiver Services. The B-D-S policy states individuals may be placed on a single statewide waiting list after applying for waiver services and meeting specified criteria. Individuals are responsible for maintaining current collateral and contact information with their local B-D-S office. To apply for H-C-B-S waiver services, an individual or their legal representative must complete an application and submit it to their local B-D-S office. The application requires collateral information, including the L-O-C assessment tool, supporting documents such as diagnostic evaluations, functional evaluations, psychological reports, individualized education program from schools, school records, physician’s diagnosis and remarks, existing evaluation done by Supplemental Security Income (S-S-I--) or Vocational Rehabilitation, intelligence quotient (I-Q---) testing done at any time, Medicaid application for individuals over 18 years of age, and S-S-I application, if applicable. The L-O-C must be assessed for all individuals.

We will be discussing DDRS HCBS Waivers. D-D-R-S stands for the Disability Determination and Rehabilitation Services. H-C-B-S stands for Health Care Benefits for Children with Special Health Care Needs. DDRS HCBS Waivers refer to the waivers that were granted to the Disability Determination and Rehabilitation Services for the Health Care Benefits for Children with Special Health Care Needs.

We are excited to present to you on Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs. During this session, we will be discussing the application process and eligibility requirements for these programs. There are two options for applying: the B-D-S Gateway, an online application available 24/7, and returning an Application for Developmental Disability Services (State Form 55068) to your local B-D-S office. Our staff will review eligibility requirements, including proof of an intellectual/developmental disability, Medicaid eligibility, and initial level of care (L-O-C--). If you are not a Medicaid member, you will be referred to the local Division of Family Resources (D-F-R--) office to apply for Medicaid. C-I-H Waiver program applicants who meet specific criteria will be informed of available services and a funded priority slot. Medicaid eligibility is also discussed, with applicants under 18 required to submit a plan of care/service plan approval letter to the Family and Social Services Administration (F-S-S-A-) Division of Family Resources (D-F-R--). If you have any questions about the application process or eligibility requirements, please do not hesitate to reach out to your local B-D-S office for assistance. Thank you for your attention.

This section of the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs is open to all individuals. We will provide information on how to apply and the eligibility requirements for these programs. Those who prefer to apply online can access the B-D-S Gateway, an online application available 24/7 from any location with internet access. Alternatively, an Application for Developmental Disability Services (State Form 55068) can be completed and returned to the local B-D-S office. To be eligible for the F-S-W program, individuals must have documentation of an intellectual/developmental disability, Medicaid eligibility, and an appropriate level of care. If the individual is not currently a Medicaid member, they will be directed to the local Division of Family Resources (D-F-R--) office to apply for Medicaid. For the C-I-H Waiver program, applicants must meet specific criteria to be considered for a priority waiver slot. This includes individuals transitioning from a nursing facility, Extensive Support Needs Home, State Psychiatric Hospital, or Supervised Group Living. To apply for a priority waiver slot, individuals, legal representatives, or other authorized persons must request and apply for the slot when the individual meets the necessary criteria. It is important to submit an application to the local B-D-S office to apply for H-C-B-S waiver services. Collateral information, such as the level of care assessment tool and relevant documents like diagnostic evaluations and functional evaluations, must also be provided. We strongly suggest that individuals and their legal guardians review any updated Person-Centered Individualized Support Plans (PCISPs) within seven days of the Individualized Support Team (I-S-T--) meeting, face-to-face visit, or conversation in which the need for revision is identified. PCISPs must be updated whenever there is a change in the individual's needs or circumstances, when services are added or removed, per the request of the individual or their legal representative, and during non-annual team meetings to record the team's discussion on outcomes and any related plan changes. Annual service plans are due 45 days from the date of the Individualized Support Team (I-S-T--) meeting.

We will be discussing the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs. To apply for these programs, you have two options: the online application available 24/7 through the B-D-S Gateway or completing and returning an Application for Developmental Disability Services (State Form 55068) to the local B-D-S office.

If you are applying for the F-S-W or C-I-H Waiver program, you will need to provide various documentation, including psychological reports, Individualized Education Programs from schools, school records, physician’s diagnosis and remarks, and existing evaluation done by Supplemental Security Income or Vocational Rehabilitation. Additionally, you will need to complete an IQ testing done at any time.

If you are applying for a C-I-H Waiver priority slot, you will need to maintain current contact information with your local B-D-S office, including changes in address or telephone number. If you are unable to make contact with the B-D-S office by mail or telephone, you will forfeit the current opportunity for a C-I-H Waiver priority slot, but may reapply at any time.

If you accept a funded C-I-H Waiver priority slot, you will need to attend an intake meeting with a service coordinator from the B-D-S--. During the intake meeting, collateral information provided by you will be reviewed and L-O-C will be re-established. You will need to complete a L-O-C assessment tool and have a Confirmation of Diagnosis (State Form 54727) signed by your physician within 21 calendar days from the date on the B-D-S letter offering a C-I-H Waiver priority slot. You will also have 60 calendar days from the date on the B-D-S letter to apply for and obtain Medicaid when you do not yet have Medicaid coverage.

It is important to understand these requirements and ensure that all necessary documentation is provided in a timely manner. If you have any further questions, please do not hesitate to contact your local B-D-S office.

1. Apply for the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs by filling out the form on the B-D-S website or by returning the Application for Developmental Disability Services (State Form 55068) to the local B-D-S office.
                                    2. To be eligible for the program, the individual must have an intellectual/developmental disability, Medicaid eligibility, and initial level of care (L-O-C--). If the individual already has Medicaid coverage but the aid category to which they are assigned is not compatible with waiver program requirements, they have 30 days from the date on the contact letter from the B-D-S to request that the D-F-R process the needed change in Medicaid aid category if they are eligible.
                                    3. After all assessments have been made, the B-D-S gives applicants younger than the age of 18 and their legal guardians a choice list of case management providers that are approved by the D-D-R-S and enrolled through the I-H-C-P to provide selected contracting Case Management services. In those situations, the B-D-S creates the POC/service plan, enabling the minor to obtain Medicaid.
                                    4. For adults, generating the B-D-S case management organization choice list and selecting a case management organization does not occur until after all eligibility criteria are met, including establishing Medicaid eligibility in a waiver-compatible aid category.
                                    5. The timely completion of requirements for the P-C-I-S-P and service plan should be done through the B-D-S Portal 2.0 at bddsportal.fssa.in.gov.
                                    6. The individual must work with the local B-D-S office if additional time is needed to complete any required steps in the process.
                                    7. The state monitors and recently enhanced its person-centered planning process to ensure compliance with CMS 2249-F and CMS 2296-F. The new person-centered individualized support plan (P-C-I-S-P) approach enhances the way in which supports and services are explained to individuals and families so that their needs, aspirations and opportunities for the achievement of self-determination, interdependence, productivity, integration and inclusion in all facets of community life can be identified and explored. Additionally, the P-C-I-S-P drives the development of the POC/service plan. The P-C-I-S-P is the new plan that identifies the array of services and supports needed for the individual.

If you are applying for the Family Supports Waiver (F-S-W--) program, you have two application options available:

                                    1. The B-D-S Gateway, an online application available 24/7. If you choose this option, you will be directed to the B-D-S website where you will be able to complete the application online.

                                    2. Completing and returning an Application for Developmental Disability Services (State Form 55068) to the local B-D-S office. If you choose this option, you will need to download the State Form 55068 and return it to the local B-D-S office. A BDS staff member will then discuss eligibility requirements with you, including documentation of an intellectual/developmental disability, Medicaid eligibility, and initial level of care (L-O-C--).

                                    If you are not a Medicaid member, you will need to apply for Medicaid through the local Division of Family Resources (D-F-R--) office.

                                    If you are applying for the Community Integration and Habilitation (C-I-H--) program, you will need to meet specific reserved waiver capacity (priority) criteria. If you meet these criteria, you will be advised of available services and a funded priority slot.

                                    In either case, you will need to develop a Plan of Care/Service Plan (POC/service plan) that identifies the supports and services that will be used to implement desired outcomes and ensure your health and welfare while the POC/service plan identifies those supports and services that are funded by the waiver.

                                    The POC/service plan is developed by the individual-chosen case manager a minimum of six weeks prior to the initial start date of services and then six weeks prior to the end date of each annual service plan. The POC/service plan is routinely developed to cover a time frame of 12 consecutive months.

                                    The POC/service plan is used to coordinate waiver services and other services. The case manager is responsible for ensuring that all identified services and supports have been implemented as identified in the P-C-I-S-P and the POC/service plan. The case manager is also responsible for monitoring and coordinating services on an ongoing basis and is required to record a case note for each encounter with, or on behalf of, the individual.

For those interested in applying for the Family Supports Waiver and Community Integration and Habilitation Waiver programs, there are two options available. The first is through the B-D-S Gateway, an online application that is accessible 24/7. The second option is to complete and return an Application for Developmental Disability Services (State Form 55068) to your local B-D-S office. During the application process, our dedicated B-D-S staff will discuss the various eligibility requirements. This includes documentation of an intellectual or developmental disability, Medicaid eligibility, and initial level of care determination. If the applicant is not currently a member of Medicaid, they will be referred to their local Division of Family Resources (D-F-R--) office to apply for Medicaid. For those applying for the C-I-H Waiver program, if they meet certain reserved waiver capacity criteria, they will be advised of the available services and a funded priority slot. Medicaid eligibility will also be discussed during this time. It is important to note that applicants under the age of 18 will be required to submit a plan of care or service plan approval letter to the Family and Social Services Administration (F-S-S-A-) Division of Family Resources (D-F-R--). Moving on to Section 5 of the DDRS HCBS Waivers, we want to highlight some important information for children ages 1 through 18. According to Section 1902(a)(10)(A)(i)(V-I-I--) and (MA 9, MA 2), transitional medical assistance is available. Additionally, for individuals in Sec 1634 states such as Indiana who are aged, blind, or disabled, those who are eligible for Supplemental Security Income (S-S-I--) will be automatically enrolled in the Indiana Health Coverage Programs (I-H-C-P-). This means they will not need to file a separate Indiana Application for Health Coverage. Furthermore, for those who receive S-S-I and are deemed disabled by the Social Security Administration, they will not be required to undergo a separate determination of disability from Indiana's Medical Review Team (M-R-T--). For individuals who receive Social Security Disability Income (S-S-D-I-), they will also not be required to undergo a separate determination of disability from Indiana's M-R-T--. As a reminder, a financial eligibility determination will still be required for all applicants. Thank you for your attention and we hope this information has been helpful. Please continue to the next slide for more important details on the F-S-W and C-I-H Waiver programs.

This section will discuss the application process for the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs. There are two options for applying: the B-D-S Gateway, an online application available 24/7, or completing and returning an Application for Developmental Disability Services to the local B-D-S office. Our B-D-S staff will review the eligibility requirements, including documentation of an intellectual/developmental disability, Medicaid eligibility, and initial level of care. Non-Medicaid members will be referred to the local Division of Family Resources office to apply. For C-I-H Waiver program applicants who meet specific reserved waiver capacity criteria, they will be informed of available services and receive a funded priority slot. We will also discuss Medicaid eligibility and, for applicants under the age of 18, the requirement to submit a plan of care or service plan approval letter to the Family and Social Services Administration Division of Family Resources.

Moving on to section 5.9, we will cover the initial service plan implementation for F-S-W and C-I-H Waiver. It is important to note that an individual cannot start receiving waiver services under these programs without the approval of their initial Plan of Care (P-O-C--) or service plan by the state's waiver specialist. This plan is determined through the Person-Centered Individualized Support Plan (P-C-I-S-P) development process. If the waiver specialist issues an initial approval letter with certain conditions, those conditions must be resolved before the start of the individual's waiver services. For applicants under the age of 18, if their Medicaid eligibility is approved pending waiver approval, the case manager will notify the local Division of Family Resources caseworker when the waiver has been approved. It is important to remember that once waiver services begin, individuals may be referred to as beneficiaries or members for Medicaid purposes.

Thank you for your attention to section 5 of our presentation on the Family Supports Waiver and Community Integration and Habilitation Waiver programs. In our final section, we will cover the ongoing process of maintaining and monitoring waiver services.

Welcome to section 13 of our presentation on the Family Supports Waiver (F-S-W--) and Community Integration and Habilitation (C-I-H--) Waiver programs. In this section, we will be discussing the objective-based allocation (O-B-A--) methodology for the C-I-H Waiver program.  The O-B-A methodology is used by the Family and Social Security Administration (F-S-S-A-) Division of Disability and Rehabilitative Services (D-D-R-S-) to determine the level of supports an individual needs to live in a community setting while receiving services under the C-I-H Waiver.  This methodology was developed in 2007 in collaboration with advocates, providers, and industry professionals. It involved extensive research, cost reporting by providers, modeling, assessment validation, pilots, and best practices.  The parameters for the algorithm (Algo) were determined through modeling, which combines the overall Algo determined by the Inventory for Client and Agency Planning (I-C-A-P-) and the ICA.  Section 6.1 focuses specifically on the development of the O-B-A for the C-I-H Waiver. This included baseline research, provider cost reporting, modeling, assessment validation, pilots, and best practices.  The use of modeling allowed us to determine the parameters for the algorithm development.  It's important to note that the O-B-A is determined by combining the overall Algo with the results from the I-C-A-P and I-C-A--. This ensures an accurate and fair assessment of an individual's needs for living in a community setting while receiving services under the C-I-H Waiver.  Thank you for your attention to this important section of our presentation. In the next section, we will discuss the results of the O-B-A and how they impact the allocation of supports for individuals under the C-I-H Waiver program.

We have now completed our presentation on the Family Supports Waiver and Community Integration and Habilitation Waiver programs. To wrap things up, we would like to discuss the application process. There are two options available: the B-D-S Gateway, an online application that is accessible 24/7, or filling out and returning an Application for Developmental Disability Services to your local B-D-S office. During the application process, B-D-S staff will go over the eligibility requirements with you. This includes providing documentation of an intellectual or developmental disability, proving Medicaid eligibility, and determining your initial level of care. If you are not currently a Medicaid member, you will be directed to your local Division of Family Resources office to apply for Medicaid. For those applying to the C-I-H Waiver program, there are specific criteria for reserved waiver capacity that must be met. If these criteria are met, you will be informed about the available services and given a funded priority slot. Medicaid eligibility will also be discussed during this process. Applicants under the age of 18 will need to submit a plan of care or service plan approval letter to the Family and Social Services Administration. Moving on to the Indiana Administrative Code, particularly Section 6 regarding Objective-Based Allocation for the C-I-H Waiver, we have Table 1 which outlines the Algo level descriptors. These descriptors indicate the level of care needed for each individual. Level 0, the low level, indicates a high level of independence with minimal support required. On the other hand, level 2, the regular level, indicates a moderate level of independence with frequent support needed. In conclusion, we hope this presentation has given you a better understanding of the Family Supports Waiver and Community Integration and Habilitation Waiver programs. Thank you for your attention and please feel free to contact your local B-D-S office for further information on the application process. Thank you.