FSW and CIH Waivers
Families across Indiana who use Medicaid Waiver programs will see several updates in January 2026. These changes include the 2026 waiver amendments while others are part of a new waiver redesign process taking place in July 2027 designed to improve access, consistency, and health and safety for individuals receiving home and community-based services.
Here’s what families should know:
The Family Supports Waiver (FSW) and Community Integration and Habilitation Waiver (CIH) will continue to see updates with service caps and a new eligibility assessment tool.
- New assessment tools will be age appropriate and used to determine eligibility for individuals with intellectual disabilities.
- Initial assessments using the new tool will be completed by state staff.
- Re-determinations using the new assessment tool will still be handled by the waiver case manager.
- Service caps remain in place for programs like recreation therapy, music therapy, and behavioral supports.
Self-Direction Expansion
Self-direction allows individuals to have more control over who provides their care and how funds are used. Updates include:
- Available under all waivers.
- About 10% of participants across all waivers are expected to self-direct their services.
- Individuals must be able to direct their own care and manage their own service plan budget.
- Legally Responsible Individuals (LRIs)—such as parents of minor children—and legal guardians cannot be paid caregivers.
Example: If a mom is listed as a representative for her 19-year-old child, she cannot be paid as a self-directed caregiver. The dad also cannot be paid under that arrangement.
Budget Authority
Participants will have more say in how budgets are managed:
- Annual budgets are based on case hours × hourly rate = annual budget, minus a 10% administrative cost.
- Individuals must pay overtime when applicable.
- Case managers will determine eligibility for self-direction participation.
- FSSA retains the authority to terminate self-direction if necessary.
Waiver Redesign Timeline
Indiana’s Waiver Redesign is scheduled for July 2027, covering the A&D, H&W, FSW, and CIH waivers.
Families can expect:
- A mix of existing services to be available across waivers, such as Attendant Care and Music Therapy.
- Service outcomes focused on inclusion, connection, and community.
- Continued prioritization of health and safety in all program changes.
What This Means for Families
By providing these breakdowns, Tendercare aims to simplify updates for families navigating care through Medicaid. We will continue monitoring FSSA updates closely to help families understand how these changes may impact their services.
If you have questions about your child’s waiver or self-direction options, connect with your waiver case manager or contact our office. We’re here to help you stay informed and supported every step of the way.
Did you know we have a member of our team dedicated to advocacy and community relations?
Contact us today if you have questions or need guidance with your Medicaid Waiver!
