FSSA announcement on waiting lists, HIP payments

2024 Medicaid Waiver Changes

The long awaited July 1 transition date for Indiana’s Medicaid Waiver program has arrived.

The Aged & Disabled Waiver (A&D) has now been split into two waiver programs, PathWays for Aging for those aged 60 and older, and the Health & Wellness (H&W) Waiver for those aged 59 and younger.

Both waivers have a designated number of available slots available. A slot can only be used by one person during the July 1, 2024 – June 30, 2025, waiver year and cannot be reused by a different person if a member no longer needs services, for example if they die or move out of state.

  • PathWays for Aging Waiver: 39,842 slots, of which 29,268 are filled by Hoosiers already receiving services. 10,574 slots remain for newly eligible individuals.
  • Health & Wellness Waiver: 16,127 slots, of which 13,190 are filled by Hoosiers already receiving services. 2,937 slots remain for newly eligible individuals.

Waiting Lists Update

In April, FSSA established a waiting list for the former A&D Waiver. Currently, 9,015 people are on the waiting list for the PathWays Waiver, and 3,762 are on the waiting list for the H&W Waiver.

Beginning this month, FSSA will invite a group of individuals to continue the process to begin receiving services each month as follows:

  • 125 individuals per month to H&W Waiver – 1,500 people July 1, 2024 – June 30, 2025
  • 800 individuals per month to PathWays Waiver – 9,600 people July 1, 2024 – June 30, 2025

Individuals invited to proceed will receive a letter with further details.

Based on these numbers, people who apply for the H&W Waiver will face a 30 month waiting list and people who apply for the PathWays Waiver will face an 11 month waiting list.

The Arc of Indiana is concerned that planning is not taking place to fill all available PathWays and H&W waiver slots. It appears FSSA is not planning to fill 975 available PathWays slots and 1,437 H&W slots.

Transition to Structured Family Caregiving or New Attendant Care Caregiver

Effective July 1, legally responsible individuals (parents of minor children and spouses) are no longer permitted to provide Attendant Care. Two options were offered: Structured Family Caregiving (SFC) or Attendant Care from a caregiver who is not a legally responsible individual.

After July 1, all H&W waiver members 17 and younger who select SFC for the first time will be assessed by care managers to determine the appropriate tier of service. Families who transitioned to SFC before the July 1 start were placed in a tier based on the Attendant Care hours they were already utilizing. In mid-2025, a new SFC Level of Service Assessment will be in place.

The Arc of Indiana remains concerned about how the Level of Service Assessment will be put in place for medically complex children.

Healthy Indiana Plan Payments Continued Pause

FSSA’s plan to resume premiums and copayments for Indiana’s Healthy Indiana Plan (HIP) on July 1, that had been paused during the COVID pandemic, has again been paused due to a federal ruling.
Click here to learn more.

Learn More: The Arc of Indiana 2024 Medicaid Waiver Changes

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