Waiver Amendments and Rate Increase Update

For the original publication, please click here. The following is a text version of the original publication. 
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To: Division of Disability and Rehabilitative Services waiver providers and consumers 
From: Nicole Norvell, Director, DDRS 
Re: Waiver Amendments and Rate Increase Update 
Date: November 15, 2013 

Indiana's Division of Disability and Rehabilitative Services (DDRS) has submitted requests for a 3rd Amendment to the Family Supports Waiver (FSW), IN.0387.R02.03, as well as a 5th Amendment to the Community Integration and Habilitation Waiver (CIH), IN.0378.R02.05 to the Centers for Medicare & Medicaid Services (CMS). The proposed effective date of each amendment is January 1, 2014. 

Family Supports Waiver 
The purpose of the 3rd Amendment to the Family Supports Waiver is to increase the waiver's annual expenditure cap from $16,250 to $16,545 per recipient, include the revised Quality Improvement System (QIS) and performance measures and accreditation requirements for day services offered under the waiver. While the revised waiver performance measures and revised QIS were already implemented across both waivers, this is the first amendment to the Family Supports Waiver since the new QIS was approved by CMS. 

Additionally, the number of unduplicated participants has been decreased for Waiver Year Four but increased for Waiver Year Five as part of this amendment. 

Community Integration and Habilitation Waiver 
The purpose of the 5th Amendment to the Community Integration and Habilitation Waiver is to revise one category and the overall capacity reserved for priority entrance to the waiver, add wellness coordination services and shift previously budgeted but unused funding to the Family Supports Waiver. 

Details of the requested waiver changes, including accreditation requirements, are outlined at the beginning of each amendment under the section titled “Purpose of Amendment.” Upon the approval of CMS, relevant changes will also be made within the DDRS Waiver Manual. The pending amendments are posted on the DDRS’ webpage Draft Policies for Public Comment.

DDRS is also requesting from CMS, for both waivers, that the previously announced 1 percent rate increase to waiver services be increased to 2 percent. The rate increase would also become effective January 1, 2014, restoring the rates that were reduced in 2010. 

1. Under the Family Supports Waiver, rate increases are applicable only to Respite Services, Facility Based Habilitation (Individual) and Community Based Habilitation (Individual). A higher expenditure cap will be implemented to ensure that these increased rates do not in any way reduce waiver services for the waiver participants.
2. Under the Community Integration and Habilitation Waiver, rate increases are applicable only to Residential Habilitation and Support - Level 1 and Residential Habilitation and Support – Level 2, Respite, Community Based Habilitation (Individual) and Community Based Habilitation (Individual).