I/DD Waivers in Indiana

All states: Medicaid disability services map

Indiana I/DD services at a glance

Last verified against state sources: 2026-10-23.

Who runs I/DD services in Indiana?

Indiana's Family and Social Services Administration (FSSA) is both the Medicaid agency and the home of the state's I/DD program. Within FSSA, the Division of Disability, Aging and Rehabilitative Services (DDARS) runs the Bureau of Disabilities Services (BDS), which operates the two I/DD waivers under FSSA's Office of Medicaid Policy and Planning. Case management comes from five companies the state contracts with.

• Bureau of Disabilities Services (BDS): takes applications, decides initial eligibility through its service coordinators, and approves providers for the Community Integration and Habilitation (CIH) and Family Supports waivers. DDARS was formerly called the Division of Disability and Rehabilitative Services (DDRS), and some older state documents still use that name.
• Front door: people apply to BDS online through the BDS Gateway or with a paper application, with help from their local BDS district office.
• Case management: since August 1, 2026, all BDS waiver case management is provided by one of five companies that operate statewide under a contract with the state: Aging and In-Home Services of NE IN, Indiana Professional Management Group, Inspire Case Management, Unity of Indiana and The Columbus Organization. Details are on FSSA's waiver redesign page.

What Medicaid waivers serve people with I/DD in Indiana?

Indiana has two 1915(c) waivers for people with I/DD: the Community Integration and Habilitation (CIH) Waiver and the Family Supports Waiver. A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. CMS, the federal Medicaid agency, approved amendments to both waivers that took effect August 1, 2026, according to FSSA's approval announcement.

• Community Integration and Habilitation (CIH) Waiver (1915(c), control number IN.0378): the waiver that includes residential services. It serves children and adults who need an ICF/IID level of care, which means they would qualify for an intermediate care facility for individuals with intellectual disabilities. Services include hourly and daily Residential Habilitation and Support, Structured Family Caregiving, Day Habilitation, Adult Day Services, Prevocational Services, Extended Services (supported employment), Career Exploration and Planning, Facility Based Support Services, Respite, Behavioral Support Services, Wellness Coordination, Remote Supports, Transportation, Workplace Assistance and Case Management. People enter through reserved capacity categories, for example emergency placement, moving out of a nursing facility or state psychiatric hospital, Money Follows the Person, or aging out of children's services. The waiver amendment text plans for 9,438 participants in its first year, and the waiver year runs July 16 to July 15.
• Family Supports Waiver (1915(c), control number IN.0387): a capped waiver for children and adults with an intellectual disability, developmental disability or related condition that began before age 22. It is limited to $26,482 a year per person, and $1,575 of that must go to case management. Services include Participant Assistance and Care, Respite, Day Habilitation, Adult Day Services, Prevocational Services, Extended Services, Facility Based Support Services, Behavioral Support Services, Remote Supports, Therapies, Transportation, Workplace Assistance and Case Management. FSSA allotted 26,999 slots for July 16, 2026 to July 15, 2027.

BDS also runs the Health and Wellness and Traumatic Brain Injury (TBI) waivers, but those serve people who need nursing facility level of care or have a brain injury, so they are not counted as I/DD waivers here. Indiana's ICF/IID option is Supervised Group Living, community group homes that CIH reserves slots for people leaving.

Does Indiana pay for I/DD services through managed care?

No. CIH and Family Supports services are paid fee-for-service by FSSA, and providers send claims to the state's Medicaid claims system, run by Gainwell (CoreMMIS). The one managed piece is case management, which the state limits to five contracted companies.

• Case management contracts: Indiana uses a 1915(b)(4) waiver, the Fee for Service Selective Contracting Program, to limit case management to selected organizations. A 1915(b)(4) waiver lets a state choose which providers can deliver a service. Case management for CIH and Family Supports has been limited this way since January 1, 2022, and the current five companies took over on August 1, 2026.
• Who coordinates services: the case manager from one of the five companies coordinates the person's services. It is not a health plan and does not pay claims.

Is there a waiting list for I/DD services in Indiana?

Yes. Both I/DD waivers use a single statewide waiting list. As of September 2026, 11,455 people were waiting for the Family Supports Waiver, according to FSSA's waiting list page. FSSA does not publish a count for CIH.

• Family Supports order: people are invited first come, first served by application date. Slots are reserved for young adults ages 18 to 24 leaving school, military families, and people leaving the Health and Wellness waiver who no longer meet nursing facility level of care.
• Recent pace: FSSA issued 600 Family Supports invitations in September 2026, reaching people with waiting list dates up to February 7, 2023. In the July 2025 to July 2026 waiver year, Family Supports had 26,199 slots, 25,919 were filled, and 1,290 invitations were issued.
• CIH: under the August 2026 amendment text, all CIH applicants go on the same statewide list and are invited by application date when a reserved capacity slot they qualify for opens, such as emergency placement or a move out of an institution.

For a person's place on the list, families can contact BDS Help at bds.help@fssa.in.gov.

How do people apply for I/DD services in Indiana, and how are budgets set?

People apply to BDS online through the BDS Gateway or with a paper application, and the local BDS district office can help. A BDS service coordinator checks level of care using an FSSA-approved interRAI assessment. Family Supports budgets are capped at $26,482 a year, and CIH budgets are set by a formula based on the person's ICAP score.

• Eligibility: an intellectual disability, developmental disability or related condition that began before age 22, substantial limits in at least three of six life areas (self-care, learning, self-direction, capacity for independent living, language and mobility), ICF/IID level of care and Medicaid eligibility. A physician-signed 450B diagnosis form is also required.
• Assessment: interRAI is used for level of care. For CIH, the ICAP (Inventory for Client and Agency Planning) and an ICAP addendum produce an Algo score from 0 to 5.
• CIH budgets: the Algo score, together with the person's age, employment and living arrangement, sets an objective based allocation, the dollar budget for the person's services.
• Family Supports budgets: a flat annual cap of $26,482 per person, including $1,575 for case management.

What day and residential services can I/DD providers offer in Indiana?

Both waivers cover several day and employment services, billed mostly by the hour, and CIH covers residential services in the person's own home, a shared home or a family caregiver's home. Providers must be approved by DDARS and follow the state's provider rules in 460 IAC 6. Rates below are from the DDARS waiver provider module.

Day and employment services (CIH and Family Supports)

• Day Habilitation: skill-building for self-care, daily living, socializing and community participation, in the community or a DDARS-approved facility but not in the person's home. Providers need DDARS approval and national accreditation (for example CARF, CQL or the Joint Commission), and direct care staff must be registered with DDARS. Billed hourly (T2020) by staffing ratio: individual 1:1 ($36.88), small group 1:2 to 1:4, medium group 1:5 to 1:10 and large group 1:11 to 1:16 ($4.20, facility only).
• Prevocational Services: group and facility-based work readiness services, billed hourly (T2015) at rates by group size.
• Extended Services and Career Exploration and Planning: supported employment. Extended Services gives ongoing job support to people in competitive jobs and is billed hourly (T2025, $52.85). Career Exploration and Planning was added in 2024. The research did not find a published ratio.
• Facility Based Support Services: group supports in a provider facility, billed hourly (T1020). The research did not find a published ratio.
• Adult Day Services: community group programs covering health and social needs, with meals or snacks, billed per 15 minutes (S5100) or half day (S5101). Indiana has no state adult day license; providers are approved or certified by FSSA. We did not find the staffing ratios for adult day under CIH or Family Supports.

Residential services (CIH)

• Residential Habilitation and Support (RHS) Hourly: hourly supports in the person's own or family home. Level 1 is 35 or fewer hours a week and Level 2 is more. It is used for people with an Algo score of 0 to 2, or 3 to 5 without shared staffing or in the family home. It can be self-directed since January 1, 2026.
• Residential Habilitation and Support (RHS) Daily: a daily rate for people with an Algo score of 3 to 5 who live with housemates under shared staffing outside the family home. Rates are tiered by Algo level and household size (2 to 4 people).
• Structured Family Caregiving: the person lives with a principal caregiver, family or not, who receives a daily stipend. Only agencies can provide it, and they assess homes and support the caregivers.
• Supervised Group Living: Indiana's community ICF/IID group homes, paid under the Medicaid state plan rather than the waivers.

How are I/DD provider rates set and how do agencies enroll in Indiana?

FSSA sets a statewide fee schedule. Most rates are built from a cost model using Indiana wage data, benefits, a 15 percent allowance for administration and program support, and staffing ratios for group services. The last rate review, done with the actuarial firm Milliman, took effect July 1, 2023, and the state reviews rates every five years. New waiver providers cannot enroll right now because of a statewide moratorium.

• Rate method: equipment, home modifications and similar items use market prices. CIH daily residential rates are tiered by Algo level and household size. We did not find a rate change for I/DD services after July 1, 2023.
• Rescinded cut: a lower rate for hourly residential habilitation with a live-in caregiver, proposed for the August 2026 amendments, was withdrawn before approval, and the state says it will revisit the idea in a future amendment cycle.
• Enrollment path: outside a moratorium, new CIH and Family Supports providers start by emailing BDSProviderServices@fssa.in.gov. Incomplete applications are returned, and a second incomplete application within a year brings a two-year bar. After BDS approval, the agency enrolls with the Indiana Health Coverage Programs (IHCP). Details are in the DDARS HCBS waiver provider module.
• EVV: electronic visit verification (EVV) is required for CIH hourly residential habilitation, Family Supports Participant Assistance and Care, and hourly respite on both waivers, according to the IHCP list of codes that require EVV. Providers use the free state Sandata system or an approved alternate EVV system that sends data to the Sandata Aggregator. Daily services and self-directed codes are not on the list, and 24-hour congregate settings have an exception.
• Self-direction: some services can be self-directed through INCharge, with Palco as the fiscal/employer agent that handles payroll: Participant Assistance and Care on Family Supports, and hourly residential habilitation, respite and workplace assistance on CIH. See FSSA's self-direction page.

What is changing next for I/DD services in Indiana?

Indiana's Waiver Reset targets a new Youth Waiver for July 1, 2027 and new adult waivers in 2028. A moratorium on new waiver providers has been in effect since August 1, 2026. The Waiver Reset dates are targets, not final decisions.

• Waiver Reset: FSSA plans to replace the CIH, Family Supports, Health and Wellness and TBI waivers with new waivers, according to its waiver redesign page. BDS is aiming to start a Youth Waiver for ages 0 to 21 on July 1, 2027, beginning with Family Supports youth, and new adult waivers in 2028. These dates could change.
• New budgets: under the plan, CIH Algo levels would end, and each person's budget and some rates would come from an interRAI-based support level. FSSA says the support level framework is still being developed.
• Provider moratorium: the pause on new waiver providers began August 1, 2026 for an initial six months. We did not find a confirmed end date or extension; check IHCP bulletins or ask BDS.

Changes already in place: the five contracted case management companies took over on August 1, 2026, the same day the CIH and Family Supports amendments took effect, and self-direction for some CIH services began January 1, 2026.

Indiana I/DD sources

• Indiana FSSA: Bureau of Disabilities Services
• Indiana FSSA: HCBS waiver waiting list information
• Indiana FSSA: BDS waiver redesign (Waiver Reset)
• Indiana FSSA: 2026 waiver approval announcement
• Indiana FSSA: CIH waiver amendment text (January 2026 draft)
• Indiana FSSA: Family Supports waiver amendment text (February 2026 draft)
• Indiana Medicaid: DDARS HCBS waivers provider module
• Indiana Health Coverage Programs: Service codes that require EVV
• Indiana FSSA: HCBS self-direction
• Indiana FSSA: BDS developmental disabilities (provider moratorium notice)

Related reading

• Disability Services and Independent Living Guide
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Disability Services DayHab has a dilemma - how to solve it
• What is Active Support in Disability Services?
• I/DD services in every state (map)
• Indiana EVV requirements

Page history

• October 23, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.