Waiver Services

What Services Are Offered under Waiver?

Indiana has a very comprehensive list of programs available to Health and Wellness and TBI waiver recipients. Please see the section below for information pertaining to each service.

Adult Day Service

Adult Day Service (ADS) centers community-based group programs designed to meet the needs of individuals who benefit from structured, social integration through comprehensive, nonresidential programs. The purpose of ADS is to provide social engagement, recreational activities, supervision, support services, and personal care. Breakfast, lunch, and nutritious snacks are provided. Participants attend ADS on a scheduled basis. ADS is not available to waiver recipients who reside in an assisted living facility.

Adult Family Care

AFC is a comprehensive service in which a participant resides with an unrelated caregiver. The participant and up to three other participants who have physical and/or cognitive disabilities and are not members of the provider’s or primary caregiver’s family, reside in a home that is owned, rented, or managed by the AFC provider. Participants receiving AFC may also receive care management, adult day service, specialized medical equipment and supplies, and healthcare coordination through waiver.

Assisted Living

The assisted living service consists of therapeutic social and recreational programming, assistance with personal care and services, home and community assistance, and medication oversight (to the extent permitted under State law) provided in a congregate residential setting in conjunction with the provision of participant-paid room and board. Participants selecting the AL service may also receive case management and specialized medical equipment and supplies.

Attendant Care

Attendant care (ATTC) is provided to participants who meet nursing facility level-of-care. ATTC provides direct, hands-on care to participants to assist with activities of daily living (ADLs).

Attendant care includes all nonskilled ADL care, which includes but is not limited to the following:

Assistance with personal care

Assistance with mobility

Assistance with elimination

Assistance with safety


Case Management

Case management is a process of assessment, planning, facilitation, advocacy, collaboration, and monitoring of the holistic needs of each individual participant. Case managers will monitor an individuals' progress from identifying his or her needs to meeting goals and/or preferences identified by him or her. Case managers will direct collaboration and coordination with providers to ensure that services are within the participant’s preferences and adjust service plans according to an individual's changing needs.

Community Transition

Community transition services include reasonable setup expenses for participants who transition from an institution to their own home, where the person is directly responsible for his or her own living expenses in the community. Community transition services will not be reimbursable on any subsequent move. To clarify, “own home” is defined as any dwelling – including a house, apartment, condominium, trailer, or other lodging – that is owned, leased, or rented by the participant or the participant’s guardian or family, or a home that is owned or operated by the agency providing supports.

Items purchased through community transition are the property of the participant individual receiving the service, and the participant takes the property with him or her when moving to another residence, even if the residence from which he or she is moving is owned by a provider agency. Nursing facilities are not reimbursed for community transition.

The following activities are allowed under community transition services:

Reimbursement for community transition is limited to a lifetime cap of $1,500. Community transition funds must be used within 3 months of discharge from a facility. If all $1,500 is not used within 3 months, the remaining funds will be made available should the participant admit to a nursing facility in the future and need the funds to transition back home.

Home and Community Assistance (Homemaker)

Home and community assistance (HCA) provides help with instrumental activities of daily living (IADL) for waiver participants in their home.

The following activities are allowed under HCA:

Home-Delivered Meals

A home-delivered meal is a nutritionally balanced meal that is delivered either weekly or biweekly to the client's home. A client can received up to two meals per day through waiver.

Environmental (Home) Modification - Assessments

The home modification assessment will assess the client's home for physical adaptations to the home to ensure the health, welfare, and safety of the individual and promote greater independence in the home. This service is used to objectively determine the specifications for a home modification to ensure accurate bids and workmanship. All participants must receive a home modification assessment prior to a home modification being completed, as well as an inspection of the work upon completion.

Environmental (Home) Modification

Home modifications are physical adaptations to the home that are necessary to ensure the health, welfare, and safety of the participant, and which enable the participant to function with greater independence in their home. Without these home modifications, the participant would require institutionalization.

Modifications allowed under the home modifications service may include but are not limited to the following:

Integrated Healthcare Coordination

Integrated healthcare coordination is designed improve a participant's health status and quality of life, delay/prevent deterioration of health, manage chronic conditions in collaboration with physicians, and integrate medical and social services. Healthcare coordination includes medical coordination provided by an RN, LPN, or licensed social worker (LSW) to manage the individual's healthcare, including physician consults, medication ordering, and development and nursing oversight of a healthcare support plan.

Nonmedical Transportation

Nonmedical transportation services are offered to enable waiver participants to gain access to waiver and other nonmedical community services, activities, and resources.

Transportation services are reimbursed in three different ways:

Nutritional Supplements

Nutritional (dietary) supplements include liquid supplements, such as Boost or Ensure, to maintain an individual’s health, so that they are able to remain in the community. Nutritional supplements must be prescribed by a physician, physician assistant, or nurse practitioner. Approved nutritional supplement expenditures are reimbursed through the local AAA or through an independent case management company, which maintains all receipts and verifies the delivery of services.

Personal Emergency Response System

The personal emergency response system (PERS) is an electronic device that enables waiver participants to secure help in an emergency. The participant may wear a portable help button to allow for mobility. The system is connected to the person’s phone and programmed to signal a response center if the button is activated. The response center is staffed 24 hours a day, 7 days a week by trained professionals.

Pest Control

Pest control services are designed to prevent, suppress, or eradicate issues with pests including roaches, mosquitoes, bed bugs, and fleas; insect-like organisms, such as mites and ticks; and vertebrates, such as rats and mice. Reimbursement for approved pest control expenditures is through the local AAA or through an independent case management company, which maintains all receipts and verifies the delivery of services.

Respite Care

Respite services are provided temporarily or periodically in the place of the usual caregiver. Respite can occur in home and community-based settings other than adult family care and assisted living.

The following activities are allowed under respite services:

Specialized Medical Equipment and Supplies

The specialized medical equipment and supplies service includes medically prescribed items required by an individual’s service plan, which assist the participant in maintaining his or her health and safety and enable the participant to function with greater independence in the home.

The following are allowable activities under specialized medical equipment and supplies:

Structured Family Caregiving

Structured family caregiving is an arrangement in which a participant lives with a primary caregiver who provides daily care and support based on the participant’s daily care needs. The primary caregiver may be a family member or a nonfamily member who lives with the participant in the home of the participant or the primary caregiver. Caregivers must be qualified to meet all federal and state regulatory guidelines and be able to provide care and support to the participant based on his or her assessed needs. Caregivers receive training and are paid a daily stipend for the care and support they provide.

Vehicle Modification

Vehicle modifications are the addition of adaptive equipment or structural changes to a motor vehicle that will allow a participant to have safe transportation in a motor vehicle. Justification is required to demonstrate that the modification is necessary to meet the participant’s need(s).

The following are allowable under the vehicle modifications service:

The vehicle to be modified must meet all the following: