Darcy Tower, our Director of Advocacy & Community Relations, has created a video and an easy-to-understand breakdown of the proposed waiver changes for December 2025.
Feedback is now closed for these changes. FSSA is reviewing, and we’ll update you when we have more information!
If you haven’t heard about the newest changes effective July 2025, please click here.
#1 Attendant Care & Extraordinary Care
- FSSA is expanding Attendant Care to allow legally responsible individuals to provide the service if the waiver individual meets FSSA’s proposed definition of “Extraordinary Care.”
- The current definition of Extraordinary Care is “care provided by the parent of a minor child or a spouse that the individual is unable to perform independently to meet his or her intensive nursing care needs under the supervision of an interdisciplinary team. Intensive nursing care needs includes continuous ventilator care, tracheostomy care, Total Parenteral Nutrition (TPN), or other comparable nursing services approved by the Family and Social Services Administration (FSSA). The care must exceed the range of activities that a legally responsible individual would ordinarily perform in the household.
- Tendercare worked with families to provide feedback linked here.
- If the waiver individual is determined to meet Extraordinary Care, the LRI may provide up to 40 hrs. per week of Attendant Care. The waiver care manager will work with the individual/representative to determine the number of hours needed to support the individual’s ADLs through Attendant Care. FSSA could determine the needs are less than 40 hours.
#2 Services on FSW
- The “Extraordinary Care” definition will apply to the Family Supports Waiver, specifically, Participant Assistance and Care (PAC).
- Individuals who currently receive services on the Family Supports Waiver or who transition to the Family Supports Waiver, who meet extraordinary care, may receive up to 40 hrs. of PAC delivered by their LRI.
#3 Self-Direction
- FSSA is revamping its current Self-Direction service on the Health and Wellness Waiver and PathWays Waiver and expanding it to include Family Supports Waiver and Community Integration and Habilitation Waiver.
- Self-Direction allows a waiver individual or representative to hire their own caregiver who is paid through Indiana’s fiscal intermediary vendor.
- The waiver individual or representative is responsible for training the self-directed caregiver, completing and submitting the caregiver’s timesheets.
- Legally Responsible Individuals are not allowed to provide self-direction because they are unable to pay themselves.
- Self Direction services on the Health and Wellness and PathWays Waiver include: Attendant Care, Homemaker, Respite.
- FSSA is expanding Self-Direction to allow for individuals to have budget authority. FSSA will determine the reimbursement rate for the service, but the waiver individual/representative may determine if a higher rate is paid to the caregiver in return for less hours of care provided.
#4 Health & Wellness NEW Services
- Benefits Counseling: This service will allow people to better understand the benefits they receive (like Medicaid or supplemental nutrition assistance) and help them understand how they can explore working without being at risk of losing services they rely on.
- Add Extended Services— This service will allow someone on the H&W waiver to receive ongoing employment support after the end of their time with Vocational Rehabilitation, if needed, to maintain success at work.
