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Home & Community-Based Services: State-Only Funded Programs in Indiana

States may be required to contribute match funding to some federally funded long-term care (LTC) programs and to different extents. In FY 2003 states spent 21.4% of total state expenditure on Medicaid (NASBO, 2004). Total expenditures for HCBS are increasing and totaled $16.4 billion in FY 2001, with states paying between 1.7% and 13.3% of total health care expenditures on HCBS in FY 2001 (Milbank 2003). Medicaid spending grew quickly in the early 2000s, forcing state legislatures and officials to investigate ways to contain Medicaid costs rather than expanding services (Coleman et al 2003).

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Program Name: Community & Home Options to Institutional Care for the Elderly (CHOICE)¹,³,⁴,¹⁵,⁴⁸

Administrative Agency: Family & Social Services Administration (FSSA)

Population Served: Elderly 65+, physically disabled adults

Annual Expenditure: $32,539,954 FY 06 (may include Federal funds)

Funding Source: General revenue + Federal funds

Number of People Served: 3,418 FY06 (may include Federally funded clients)

Eligibility Criteria: Unable to perform 2 ADLs. Individuals who do not meet the financial & functional eligibility requirements of Medicaid & individuals waiting placement on the Medicaid HCBS program, &/or individuals receiving Medicaid HCBS services. No income or asset limit

Further Information: Cost control: cost cap $2,286/mth. Service limits applied. Waiting list - 5,561 (FY99) wait time up to 22 mths. Co-pay on sliding fee scale (individuals with income at/below $1107/mth, 150% FPL pay nothing, individuals with incomes at/above $2584/mth, 351% FPL, pay full cost of services). Quality control: case manager contact clients every 90 days, client satisfaction survey, annual state review. Consumer direction Some pilot consumer directed programs. Other information 25% of waiver participants are also CHOICE beneficiaries. Intended as a program for older people, 20% of CHOICE funds are spent on younger beneficiaries. AAAs are a single entry point.

Abbreviations:

AAAs - Area Agencies on Aging.

ADL - Activities of Daily Living.

AT - Assistive Technology. Dept - Department.

FY - Financial Year.

HCBS - Home & Community-Based Services.

LTC - Long Term Care. Mth - month. Rehab - Rehabilitation.

Mth - month.

Rehab - Rehabilitation.

SCI - Spinal Cord Injury.

SSBG - Soical Services Block Grant.

TBI - Traumatic Brain Injury.

Wk - week.

Yr - year.

Footnotes:

(a) Note that some figures listed are the yearly appropriation, not expenditure.

(b) Sources of funding are listed in the language with which they are reported.

(c) The figures for number of participants are not necessarily figures for unduplicated participants.

Notes:

(1) The definitions of the services provided in programs may differ between states.

(2) Unless otherwise stated, programs are statewide.

(3) Programs where it is known that funding may come from a variety of sources, including non-state only funds (e.g. Older Americans Act) are indicated by the program name in italics.

(4) The table does not include Mental Health Services programs.

(5) All information is the most up-to-date found from secondary sources noted in the references.

(6) N/A means the information has not been found (not available).

(7) all programs primarily aim to support people to live in the community, therefore there may be additional state only funded programs but these are not directly to support HCBS.

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