Medicaid Waiver Services Description
Pages 20-22 of the Indiana Medicaid Home
and Community Based Services Consumer Guide
Revised 2007 09 21
Check here for Periodic updates
ICF/MR Level of Care Waivers
Autism, Developmental Disabilities, Support Services Waivers
Services Descriptions
All services must be identified in the Person Centered Plan and be outlined in the Individualized Support Plan.
Adult Day Services (ADS): (Autism, DD, Support Services Waivers) Structured, non-residential, community based group programs designed to meet the needs of adults with disabilities through individual plans of care. ADS provides a variety of health, social, recreational and therapeutic activities, supervision, support, meals, and in some cases personal care.
Adult Foster Care: (Autism, DD Waivers) Twenty-four hour care consisting of personal care, homemaker, chore, attendant care, companion services, provided in a private home by a caregiver who is not related to the individual(s). Foster care homes are limited to a maximum of four people with DD.
Applied Behavior Analysis: (Autism Waiver) A therapy service that is a highly intensive individualized instruction and behavior intervention to assist an individual in developing skills with social value. It is provided to people between the ages of two and seven.
Behavior Support Services / Crisis Assistance: (Autism, DD and Support Services Waivers) Training, supervision, or assistance in appropriate expression of emotions and desires, compliance, assertiveness, acquisition of socially appropriate behaviors, and the reduction of inappropriate behaviors.
Community Transition Services: (Autism, DD Waivers) Reasonable, one-time set-up expenses for an individual who makes the initial transition from an institution to his/her own home in the community. Items purchased are the property of the individual receiving the service and the individual takes the property with him/her in the event of a move to another residence. Expenses may include: security deposits, essential furnishings and moving expenses, deposits for utilities, pest eradication, allergen control or one-time cleaning prior to occupancy. There is an allowance of up to $1,000 for this one-time only service.
Crisis Assistance: (Autism, DD, Support Services Waivers) See Behavior Support Services.
Day Services: (Autism, DD, Support Services Waivers) Services outside of an individual's home that support, in general, learning and assistance in any of the following areas: self-care, receptive and expressive language, learning, mobility, self-direction and capacity for independent living, including development of employment skills. These activities are directly related to the Individualized Support Plan (ISP). Each individual receiving Day Services works toward acquiring the skills to become an active member of the community. The continuum of services within Day Services provides opportunities in the community based services to become more independent and more integrated within the community. Day Services can be delivered to an individual one-on-one or in a group setting and in the community, work setting. (This service includes the previously offered Waiver services: Community Habilitation and Participation, Pre-Vocational Services, Supported Employment Follow Along Services, Transportation)
Environmental Modifications: (Autism, DD Waivers) Necessary adaptations to the home ensuring the health, safety, and welfare of the individual, and enable the individual to function with greater independence in the home. There is a lifetime cap of $15,000 for these modifications.
Environmental Modifications Maintenance: (Autism, DD Waivers) A $500 per year maximum amount is available permitted for maintenance and repair of prior modifications.
Family and Caregiver Training: (Autism, DD, Support Services Waivers) Service provides training and education related to treatment regimes, use of equipment, community integration, parenting, family dynamics, stress management, behavior interventions and mental health, conferences to a parent, other family members or unpaid primary caregiver. Airfare, meals, hotel are not allowed. This service must be related to the enhancement of the unpaid caregivers' or family members' ability to give care to the person receiving Waiver services.
Music Therapy: (Autism, DD, Support Services Waivers) Systematic application of music in the treatment of the physiological and psychological aspects of a disability and focusing on the acquisition of nonmusical skills and behaviors.
Occupational Therapy: (Autism, DD, Support Services Waivers) Evaluation and training programs in areas of gross and fine motor function, self-care and sensory and perceptual motor function. It includes assessments; planning and reporting, direct therapeutic intervention, design, fabrication, and adaptation of materials, and equipment to meet personal needs in assisting independence. (A Medicaid Prior Authorization denial must be obtained before this service can be provided through the Waiver.)
Personal Emergency Response System Supports: (Autism, DD, Support Services Waivers) An electronic device that enables the person to secure help in case of an emergency.
Physical Therapy: (Autism, DD, Support Services Waivers) Treatment and training designed to preserve and improve abilities for independent functioning, such as gross motor skills, fine motor skills, range of motion, strength, muscle tone, and mobility. (A Medicaid Prior Authorization denial must be obtained before this service can be provided through the Waiver.)
Recreational Therapy: (Autism, DD, Support Services Waivers) Medically approved recreation program with the purpose to restore, remediate, or rehabilitate in order to improve functioning and independence, as well as reduce or eliminate the effects of a disability.
Rent and Food for Unrelated Live-In Caregiver Services: (Autism, DD Waivers) Reimbursement directly to the person receiving Waiver services in order to offset rent and food expenses for an unrelated caregiver living in the person's home.
Residential Habilitation and Support: (Autism, DD Waivers) Services and supports which are designed to ensure the health, safety and welfare of a person, and to assist in the acquisition, retention and/or improvement in skills necessary to support the person to live successfully in his/her home. Includes personal care, meals, shopping, bill paying, etc. Up to 24-hour assistance can be provided, as needed. (This service includes previously offered Waiver services: Community Habilitation and Participation, Independence Assistance Services, Health Care Coordination, Transportation)
Respite Care: (Autism, DD, Support Services Waivers) Periodic, short-term care to a person when the family member or the primary caregiver cannot be there or needs a rest from his/her care responsibilities. Does not include "child care" to enable caregiver to work or attend school. Does include camp settings.
Specialized Medical Equipment and Supplies / Adaptive Aids and Devices: (Autism, DD, Support Services Waivers) Devices, controls, or appliances, specified in the plan of care, which enable individuals to increase their ability to perform activities of daily living, or to perceive, control, or communicate with the environment in which they live. Items that are not of direct medical or remedial benefit are excluded. Examples include communications equipment, computer adaptations, wheelchairs, environmental controls, safety restraints, or other equipment that increase the person's independence. (Equipment and services that are available under the Medicaid State Plan are not allowed under this Waiver service.) Includes Vehicle Modifications: Vehicle Modification may be authorized when necessary to increase a person's ability to function in a home and community-based setting to ensure accessibility. The necessity for such service must be documented in the Plan of Care by a physician's order. There is a lifetime maximum of $15,000 for vehicle modifications. There is an allowable annual maintenance fee. (A separate prior approval must be obtained before any modifications can be completed.)
Speech / Language Therapy: (Autism, DD, Support Services Waivers) Service seeks to improve, maintain, or slow regression of the person's ability to communicate. (A Medicaid Prior Authorization denial must be obtained before this service can be provided through the Waiver.)
Supported Employment Follow Along: (Autism, DD, Support Services Waivers) Supports for persons to establish and maintain employment in work settings in which people without disabilities are employed. No longer a separate service, see definition for Day Services.
Therapy Services (Psychological Therapy): (Autism, DD, Support Services Waivers) Services provided by a psychologist that lead to changes from a less adaptive state to a more adaptive state in the person's thoughts, feelings, and behavior. Includes group, family and individual counseling and substance abuse counseling. (This service is not available if services are available through the Medicaid State Plan.)
