INDIANA
C-Indiana's system, honestly. A letter grade is a summary, not a verdict on your family — a low grade doesn't mean nothing is available, it means the path is narrower. What's behind it is below.
Do this first
Apply through the BDS Gateway at bddsgateway.fssa.in.gov, which is open 24/7, or send paper State Form 55068 to your local Bureau of Disabilities Services office. Ask to be placed on the list for both the Family Supports Waiver and the Community Integration and Habilitation waiver — they are different waivers with different waits, and most Indiana families take Family Supports first while waiting for CIH. If an invitation letter arrives, act on it immediately: since November 2025 there is a deadline to complete the steps, and an invitation can lapse.
Last verified 2026-07-03
HOW WE GRADE INDIANA
Full methodology (v2.1) →Indiana's strongest area is hcbs spending per capita; what pulls the grade down most is institutional vs. community balance.
Waitlist Burden
30% of grade40/100136 people waiting per 100,000 residents
Nobody waiting scores 100. 225 per 100,000 scores 0.
Source:KFF State Health Facts, People Waiting for HCBS by Target … (FY2025 (KFF Medicaid HCBS Waiver Program Survey, FY 2025))US Census Bureau Vintage 2025 state population estimates (2025-07)
HCBS Spending Per Capita
25% of grade77/100$565 spent per resident
$200 per resident scores 0. $675 scores 100.
Source:CMS / Mathematica — Medicaid LTSS Annual Expenditures and … (CY2023)
Self-Direction Index
20% of grade75/10075 out of 100 on the self-direction index
Scored directly on its own 0–100 scale.
Source:CMS approved 1915(c) waiver application (2026-08-05)CMS approved 1915(c) waiver application (2026-08-05)
Waiver Program Count & Breadth
15% of grade55/10055 out of 100 on program breadth
Scored directly on its own 0–100 scale.
Source:Medicaid.gov State Waivers List, Authority=1915(c), Status… (Section 1915(c) counts: Medicaid.gov State Waivers List retrieved 2026-08-05. Target populations & 1915(k): KFF Medicaid HCBS Survey 2025 (FY2025). 1915(i): CMS SPA database retrieved 2026-08-05.)KFF Medicaid Home Care (HCBS) in 2025, Appendix Table 2 (Section 1915(c) counts: Medicaid.gov State Waivers List retrieved 2026-08-05. Target populations & 1915(k): KFF Medicaid HCBS Survey 2025 (FY2025). 1915(i): CMS SPA database retrieved 2026-08-05.)KFF Medicaid Home Care (HCBS) in 2025, Appendix Table 1 (Section 1915(c) counts: Medicaid.gov State Waivers List retrieved 2026-08-05. Target populations & 1915(k): KFF Medicaid HCBS Survey 2025 (FY2025). 1915(i): CMS SPA database retrieved 2026-08-05.)
Each factor is scored against a fixed bar, not against the other states, so Indiana's grade moves when Indiana moves. Think we have it wrong? Every number above links to its source — email hello@spectrumpathways.ai and we will correct it in public.
WHAT THINGS ARE CALLED IN INDIANA
Use these exact words when you search, call, or fill out forms — they're what Indiana's own offices use.
- Medicaid here is
- Indiana Medicaid (Hoosier Healthwise / HIP)
- The DD agency is
- Bureau of Developmental Disabilities Services (FSSA)
- You contact
- BDS district office
- The plan is
- Individualized Support Plan (ISP)
- Self-direction is
- Self-Directed Attendant Carecontrolling your own budget and hiring your own people
- A denial arrives as a
- Notice of Actionthe letter that gives you the right to appeal
WHO TO CONTACT, IN ORDER
Five different offices, and they don't talk to each other. Disability services, health coverage, and income each run through a separate agency — applying to one does not start the others. Ask each office for the name of the person you spoke to and write down the date; if something is later denied, that record is what an appeal is built on.
- 1
Developmental disability services
This is the office that decides whether your child is eligible for disability services. Ask for "intake" or "eligibility determination" by name. In Indiana, you contact BDS district office.
Indiana FSSA Division of Disability and Rehabilitative Services (BDS)
- 2
Health coverage — Indiana Medicaid (Hoosier Healthwise / HIP)
Almost every waiver and personal-care route requires this first, and it is decided by a different office from the one above. Apply in parallel rather than waiting.
- 3
Help at home, and who can be paid for it
Unless you say otherwise, services come the traditional way: the agency picks and pays the providers. Self-direction — where you get a budget and hire your own people — is opt-in almost everywhere and is not offered automatically. Here it is called Self-Directed Attendant Care. Ask for it by that name.
- 4
Income — SSI
Federal, so it's the same everywhere: 1-800-772-1213 (TTY 1-800-325-0778). There is no minimum age — you can apply for a newborn. Until 18, the parents' income is deemed to the child, so an early denial is usually about that rather than the child's disability. In many states an SSI award also opens Medicaid automatically — ask when you call.
- 5
If you get told no
Every state has a Protection & Advocacy agency by federal law — free legal help on disability services and appeals. Most families never hear of it, and it is the number to have before a deadline, not after. Yours is Indiana Disability Rights.
Indiana Disability Rights · 1-800-622-4845
RUNNING IT YOURSELF
In many states you can control the budget and hire your own people — including, sometimes, family. Most families are never told this is an option. Here's what we've verified for Indiana; where we haven't verified an answer we say so — it does not mean the answer is no, and it is worth asking.
Can you control the budget?
Yes, but per service rather than one pot — each self-directed service gets its own budget, calculated as your authorised hours multiplied by the rate
Can a family member be paid to provide care?
Not if you self-direct and you are a parent of a minor or a spouse — Indiana statute precludes it. Ask about 'Extraordinary Care' on the Family Supports Waiver, which may pay a parent through the agency route instead. Other relatives can be paid either way
Who is legally the employer of the people you hire?
You are — under INCharge you hire, pay and manage your own staff instead of a provider agency, with Palco as the financial management service
How freely can money move between services?
Not verified yet — ask, don't assume the answer is no.
Can the budget buy things, not just staff time?
Not verified yet — ask, don't assume the answer is no.
Is your case manager independent of your providers?
Not verified yet — ask, don't assume the answer is no.
Deadlines reflect this state’s rules as researched; they can change — always confirm the current deadline with your state agency or Protection & Advocacy office before relying on it.
HOW TO GET SERVICES & APPEAL IN INDIANA
- FFS/waiver: request state fair hearing with OALP within 33 days of notice/effective date (whichever is later)
- Managed care (HIP/Hoosier Healthwise/Hoosier Care Connect): exhaust MCO internal appeal (60 days) then state fair hearing within 120 days
KEY AGENCIES & RESOURCES
NOTABLE WAIVERS
Family Supports Waiver (FSW)
SourceChildren and adults with IDD; capped annual budget (~$19-20k).
Waitlist: Multi-year waitlist by application date — apply the day of diagnosis.
Community Integration and Habilitation (CIH) Waiver
SourcePeople with IDD meeting priority criteria (aging caregiver, crisis, transition).
Waitlist: No date-based line — entry through defined priority criteria only.
Health & Wellness Waiver
SourceSeniors and adults with physical disabilities (formerly Aged & Disabled).
Waitlist: Apply through local AAA/ADRC.
Full milestone guide
View the Indiana Roadmap →
Six age-based stages — state-correct programs, benefits, and milestones from birth through adulthood.
Compare with the rest of the Midwest
Waiver rules, waitlists and self-direction options vary sharply between neighbouring states. Grades come from the same published methodology.
The words Indiana will use
Every one of these appears on an application, in a denial letter, or in a case manager's notes. Plain-English definitions, no jargon.
- HCBS Waiver (Home and Community-Based Services)
- Katie Beckett Waiver (TEFRA)
- EPSDT (Early and Periodic Screening, Diagnostic and Treatment)
- Self-Determination (Self-Direction)
- Person-Centered Planning
- Respite Care
- Supported Employment
- ABLE Account (Achieving a Better Life Experience)
- Special Needs Trust (Supplemental Needs Trust)
- IEP (Individualized Education Program)
