An almost $1 billion shortfall in Indiana’s Medicaid program is fueling the implementation of a waitlist for the state’s home- and community-based services waiver program.
In January, the Indiana Family and Social Services Administration noted an “unanticipated growth in spending” in the Aged and Disabled waiver program in a forecast report, which “threatened the sustainability of the entire Medicaid program.” At the time, the agency indicated that it was evaluating a potential waitlist, adding that it would maintain the current A&D waiver slots at 50,000 and expand to 55,000 slots in 2025. That expansion was not mentioned in an updated release.
Last week, the FSSA announced that it was implementing a waiting list after the A&D waiver program reached maximum capacity. Overall, strategies the agency outlined to reign in spending are expected to have a $300 million impact over the biennium.
In a frequently asked questions document, the FSSA directed individuals to their local Area Agencies on Aging to explore options for long-term services and supports.
Indiana’s senior living advocacy groups urged the state to reconsider the use of a waitlist.
“The waiver is a vital tool that allows for aged and disabled Hoosiers to receive healthcare in the appropriate clinical setting,” Paul Peaper, president of the Indiana Health Care Association / Indiana Center for Assisted Living, told McKnight’s Senior Living. “Denying access to an assisted living setting via the implementation of the waitlist may paradoxically cost the state’s Medicaid program more as waitlisted Hoosiers are forced to seek services at a higher level of care.”
Indiana Assisted Living Association Executive Director Dan Kenyon said the waitlist is “causing stress for all involved.”
“The most pressing concerns that we are hearing revolve around current assisted living residents who have exhausted their personal finances and are having to begin the waiver application process,” Kenyon told McKnight’s Senior Living. “Providers, residents and their families are faced with the dilemma of not wanting to leave their assisted living home but not knowing if or when resources to pay for services will be available.”
The A&D waiver provides services to Medicaid-eligible individuals who are aged 65 or more years or those with intellectual or physical disabilities requiring skilled nursing care. The waiver can be used to provide assisted living, adult day and other services. During the COVID-19 pandemic, demand for HCBS grew exponentially, according to the state agency.
