Providing care for a loved one with disabilities or needing aging assistance is a noble act. If you're a resident of Indiana considering becoming a family caregiver, you might have questions about reimbursement rates under the state's Medicaid waiver program.

This article post dives into the details of Indiana's Medicaid waiver reimbursement rates for family caregivers participating in two key programs: Structured Family Caregiving and Attendant Care.

Understanding Indiana's Medicaid Waiver Programs

Indiana offers several Medicaid waiver programs that allow individuals with disabilities or those needing aging assistance to receive care services in their homes and communities, avoiding the need for a nursing facility. These programs are a lifeline for many families, and Indiana recognizes the crucial role family caregivers play in this system.

Here's a quick rundown of some relevant terms you might encounter:

• Indiana Medicaid Waiver Manual: This document outlines the guidelines and regulations for each waiver program, including eligibility criteria and service details. You can find it on the Indiana Family and Social Services Administration (FSSA) website: https://www.in.gov/medicaid/providers/files/modules/ddrs-hcbs-waivers.pdf

• Family and Social Services Administration (FSSA): The FSSA oversees Indiana's Medicaid program, including the waiver programs. You can find more information on their website: https://www.in.gov/fssa/

• Centers for Medicare & Medicaid Services (CMS): This federal agency sets national standards for Medicaid programs. You can learn more about CMS and Medicaid waivers here: https://www.cms.gov/training-education/partner-outreach-resources/american-indian-alaska-native/ltss-ta-center/information/state-medicaid-plans-and-waivers

• Case Management: A case manager helps participants in the waiver program navigate the system, develop a care plan, and connect with appropriate services. Your Medicaid case manager also determines how many hours of care an age or disabled Hoosier is eligible for.

There are several Medicaid waiver programs in Indiana, each catering to specific needs. Some popular ones include:

• Aged and Disabled Waiver: This program supports elderly individuals and those with disabilities who require nursing facility-level care but can receive it safely at home.

• Family Supports Waiver: This program assists children and adults with developmental disabilities, including autism spectrum disorder. You can find more information about this program here: https://www.in.gov/medicaid/members/home-and-community-based-services/family-supports-waiver/

• Traumatic Brain Injury (TBI) Waiver: This program caters to individuals with a traumatic brain injury who require support services.

• Community Integration and Habilitation (CIH) Waiver: This program helps individuals with intellectual disabilities live in community settings with support services.

While specific details may vary between programs, the core concept of reimbursing family caregivers for their time and effort is consistent.

Reimbursement Rates for Indiana's Structured Family Caregiving Program

The Structured Family Caregiving Program allows qualified individuals to receive services and supports at home with a family member acting as their primary caregiver. There are three levels of care in this program, each with a designated daily reimbursement rate paid to the provider agency. Below is the Medicaid Indiana Fee Schedule (to agencies):

• Level 1: $77.54/day

• Level 2: $99.71/day

• Level 3: $133.44/day

It's important to note that Indiana Medicaid doesn't mandate a specific percentage of the reimbursement to be passed on to the family caregiver. Provider agencies have the discretion to determine wages and benefits for caregivers within the program.

Indiana medicaid waiver reimbursement rates 2023 were substantially lower, so it's important that as a family caregiver you see a good payment and Indiana Medicaid rate increase as well as the agency.

Here are some resources to learn more about the Structured Family Caregiving Program and Pay Rates:

• Indiana Medicaid Waiver Pay Rates: https://www.in.gov/fssa/files/SFC-ATTC-side-by-side.pdf

• Structuredfamilycaregivingindiana.com

• Paid.care/Indiana

Reimbursement Rates for Indiana's Attendant Care Program

The Attendant Care Program allows individuals to receive assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs) from a qualified caregiver employed or contracted by a Medicaid provider agency.

The reimbursement rate for Attendant Care is $34.36 per hour of direct service provided to the agency. Similar to the Structured Family Caregiving Program, the agency has the responsibility to determine how much of the rate from the Indiana Medicaid Fee Schedule 2024 goes to the family caregiver

Here are some of the services typically covered under Attendant Care:

• Activities of Daily Living (ADLs): Bathing, dressing, toileting, eating, etc.

• Instrumental Activities of Daily Living (IADLs): Meal preparation, housekeeping, transportation to appointments.

• Medication oversight (as permitted by state law)

• Mobility assistance

• Accompaniment to appointments

• Respite care for the primary caregiver

It's important to understand that there might be a wait list for some Indiana Medicaid waiver programs so ask your Medicaid case manager about the Indiana Medicaid Waiver Waiting List.

It's also important to constantly stay up to date on Indiana medicaid home health reimbursement rates as Indiana medicaid reimbursement rates frequently change!