From: Nicole Norvell, Director, Division of Disability and Rehabilitative Services
Re: Community Integration and Habilitation Waiver Renewal
Date: October 1, 2014
Effective October 1, 2014, the Centers for Medicare and Medicaid (CMS) has approved the state of Indiana’s request to renew the Community Integration and Habilitation Waiver (CIH), which is administered by the Division of Disability and Rehabilitative Services (DDRS).
The CIH renewal also includes the first Preliminary Transition plan required by CMS to ensure that the Home and Community Based Service (HCBS) programs offered by the state follow CMS’ final rule on HCBS settings, CMS-2249 & CMS-2296, published January 16, 2014. For more information about the CIH Waiver or the CIH Waiver transition plan, please visit the DDRS website.
Changes that were approved in the CIH Waiver renewal, IN.0378.R03.00, include:
Quality Improvement strategies throughout the application reflect changes required per CMS directives as well as clarifications of current practices and data sources within the State. Quality Improvement under Appendices G and I contains additional performance measures for the new sub-assurances
The removal of references to “mental retardation” replaced with “Individuals with Intellectual Disabilities (IID)”
Details on FSSA as the single state Medicaid Agency and the current roles and revised organizational structure of the State Medicaid Agency within the Single State Medicaid Agency.
DDRS posted Home and Community-Based Settings Waiver Transition Plan for public comment and the comments were summarized and incorporated within the CIH waiver renewal.
Level of Care no longer requires ongoing confirmation of a diagnosis after the initial enrollment into the waiver.
HCBS Taxonomy of services are added to each service, as required by CMS
Clarification was added to current roles, responsibilities and processes for incident reporting, restraints, restrictive interventions, and prohibition of seclusion, medication management and administration, and state oversight responsibilities.
Supplemental or Enhanced Payments - Removed
The requirement for a minimum of three hours is removed from Adult Day Services
Case Management - Added accreditation requirement and a revised requirement that case notes need to be at least monthly (no longer weekly) or more often as encounters occur.
Community Transition Funds – now allowable with– Individual (CHIO) and Structured Family Caregiving (SFC)
Music Therapy – added ability to render in groups and divide billing unit rate among the total number in group
Recreational Therapy – added ability to render in groups and divide billing unit rate among the total number in group
Residential Habilitation and Support (RHS) Level 3 – Removed
Structured Family Caregiving - now allows legal guardian to provide the service and removed requirement that daily notes be electronic
Wellness Coordination – change name of “Risk Mitigation Tool” to “State-approved risk assessment tool”
The Approved Services within the CIH Waiver are:
Adult Day Services
Behavioral Support Services
Community-Based Habilitation (Group & Individual)
Facility Based Support
Facility Based Habilitation (Group & Individual)
Family and Caregiver Training
Intensive Behavioral Intervention
Personal Emergency Response System
Rent & Food for Unrelated Live-In Caregiver
Residential Habilitation and Support
Specialized Medical Equipment and Supplies
Structured Family Caregiving
Supported Employment Follow Along
Wellness Coordination and