DDRS Waiver Manual

Developing initial, annual, and update Cost Comparison Budgets using the State-approved process.
Disseminating information including all Notices of Action and forms to the participant and the
Individual Support Team (IST) within five business days of the IST meeting.
Completing, submitting, and following up on incident reports in a timely fashion using the Stateapproved
process, including notifying the family/guardian of the incident outcome, all of which must
be verifiable by documented supervisory oversight and monitoring of the Case Management agency.
Monitoring participants’ health and welfare.
Monitoring participants’ satisfaction and service outcomes.
Monitoring claims reimbursed through the approved Medicaid Management Information System
(MMIS) and pertaining to waiver-funded services.
Maintaining files in accordance with State standards.
Cultivating and strengthening informal and natural supports for each participant.
Identifying resources and negotiating the best solutions to meet identified needs.
Limitations
The following limitations apply to Case Management services:
Case Management services are required under both the Family Supports Waiver and the Community
Integration and Habilitation Waiver.
In addition, Indiana maintains a conflict-free Case Management policy. This covers conflict of interest
in terms of provision of services as well as in relationship to the participant being served. Conflict-free
means
o Case Management agencies may not be an approved provider of any other waiver service.
o The owners of one Case Management agency may not own multiple Case Management agencies.
o The owners of one Case Management agency may not be a stakeholder of any other waiver
service agency.
o There may be no financial relationship between the referring Case Management agency, its staff,
and the provider of other waiver services.
In addition, Case Managers must not be
o Related by blood or marriage to the participant
o Related by blood or marriage to any paid caregiver of the participant
o Financially responsible for the participant or
o Authorized to make financial or health-related decisions on behalf of the participant.
Activities Not Allowed
The Case Management services agency may not own or operate another waiver service agency, nor may the
Case Management agency be an approved provider of any other waiver service.
Reimbursement is not available through Case Management services for the following activities or any other
activities that do not fall under the previously listed definition:
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