DDRS Waiver Manual

For waiver terminations due to institutionalization or death, the termination Data Entry Worksheet
(DEW) entered by the Case Manager and accepted by the State auto-generates the Notice of Action
(NOA). For all other reasons, the termination DEW is reviewed by a Waiver Specialist who determines
the appropriate next action.
Within three calendar days of a processed termination, the Case Manager must provide the individual or
guardian with a copy of the NOA form, the Appeal Rights as an HCBS Waiver Services Recipient
instructions, and an explanation of the termination. As appropriate, other service options are to be
discussed with the individual and guardian.
Section 7.8: Waiver Slot Retention after Termination and Re-Entry
The following situations related to waiver slot retention after Termination are contingent upon review
and approval by the State.
Upon review and approval of the State, if an individual who has been terminated from waiver services
wishes to return to the program, he or she may do so within the same waiver year of his or her
termination, if otherwise eligible. The individual shall return to the waiver without going on a waiting
list. “Within the same waiver year” is considered as follows:
Community Integration and Habilitation Waiver (CIH): October 1 through September 30
Family Supports Waiver (FSW): April 1 through March 31
An individual who has been interrupted from the waiver program within the past 30 calendar days may
resume the waiver with the same level of care approval date and Cost Comparison Budget (POC/CCB) if
the individual’s condition has not significantly changed and the POC/CCB continues to meet his or her
needs.
The Case Manager must certify that the individual continues to meet level of care criteria
The Case Manager must complete a “Re-Start” Data Entry Worksheet (DEW), enter it in the
INsite database, and submit it electronically to the FSSA/DDRS case management database.
The information will be reviewed by a Waiver Specialist and automatically transmitted to the
FSSA/Office of Medicaid Policy and Planning (OMPP) to enter into the IndianaAIM database.
If an individual who has been terminated from the waiver program longer than 30 calendar days wishes
to return to the program and is otherwise eligible,
The Case Manager is responsible for developing the level of care packet and POC/CCB following
the same processes described in Section 7.1: Level of Care Re-Evaluation and Section 5.7: Initial
Plan of Care/Cost Comparison Budget (POC/CCB) Development, minus the need for a new
Confirmation of Waiver Start form.
The Case Manager is to indicate a “Re-Entry” POC/CCB when electronically transmitting them
to the State waiver specialist via the FSSA/DDRS case management database (INsite).
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