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HCBS Waiver Waiting List Information

The PathWays Waiver for individuals aged 60 and older and the Health and Wellness Waiver for individuals 59 and younger provide home and community-based services to eligible Hoosiers who meet nursing facility level of care and Medicaid eligibility requirements.

As approved by the federal government, 55,969 total slots are available between the two waivers during the timeframe July 1, 2024, through June 30, 2025. The Family and Social Services Administration reached its federally approved capacity for the prior waiver year in April 2024 and implemented a waiting list.

When the new waiver year began on July 1, 2024, FSSA began inviting a group of individuals from the Health and Wellness Waiver and PathWays Waiver waiting lists each month as long as capacity remains. Based on the number of slots, the number of people on the waiting list, and the steps that must be taken, FSSA increased the number of monthly invitations effective October 2024 and will continue to monitor the invitation process.

Individuals are invited each month from the waiting list in the following order:

  1. Those transitioning from Nursing Facilities, CHOICE, and Discharge from Hospital receive first priority of targeted waiver invitations each month, per the waivers approved by the Centers for Medicare and Medicaid Services, regardless of the date they were assessed for nursing facility level of care;
  2. Individuals on the waiting list without a priority status receive the remaining targeted waiver invitations based on the original level of care assessment date

Individuals invited to proceed from the waiting list will receive a letter, samples below, with further details on next steps.

The information below shows the number of individuals invited each month from the waiting list followed by FAQs.

Health and Wellness Waiver

  Priority Status   
Month Transition from Nursing Facility Discharge from Hospital Transition from CHOICE Invited Based on Original Level of Care date*Last Original Level of Care date Invited* Total Invitations Sent**
July 2024 42 16 16 57  131
August 2024 6 11 12 102  131
September 2024685115 134
October 202414139463 499
November 20241351883392/13/2024500
       
Total for Waiver Year
(July 1, 2024 - June 30, 2025)		 203 66 50 1,076  1,395

* Original Level of Care date for the waiver equates to the Date of Application
** Total invitations sent each month were increased to 500 in October 2024. These include slots planned for release plus the slots that were declined or otherwise not utilized in prior months.

PathWays Waiver

  Priority Status   
Month Transition from Nursing Facility Discharge from Hospital Transition from CHOICE Invited Based on Original Level of Care date*Last Original Level of Care date Invited* Total Invitations Sent**
July 2024 161 19 105 574  859
August 2024 13 17 25 819   874
September 202421810869 908
October 20247234131,083 1,202
November 202434137221,1004/1/20241,500
       
Total for Waiver Year
(July 1, 2024 - June 30, 2025)		 608 115 175 4,445  5,343

* Original Level of Care date for the waiver equates to the Date of Application
** Total invitations sent each month were increased to 1,500 in November 2024. These include slots planned for release plus the slots that were declined or otherwise not utilized in prior months.

Frequently Asked Questions

  • What is my spot on the waiting list? When will I be invited from the waiting list?

    Individuals on the PathWays Waiver and Health and Wellness Waiver waiting lists do not have a static place in line. The waiting list is fluid, as individuals are added on a daily basis with varying level of care criteria and dates that impact how individuals are invited. Please see the text above this FAQ for information on how invitations are sent, first for approved priority categories and then based on the original level of care date.

    In order to increase transparency and help individuals, families, and other stakeholders get more information about the latest invitations, FSSA has added the latest LOC date to be invited to the monthly dashboards above.

    If you have questions about your place on the waiting list, you can reach out to your local Area Agency on Aging. If after reaching out to your AAA you still have questions, you can reach out to FSSA at medicaid@fssa.in.gov. Please note that for the reasons outlined above, your AAA will not be able to tell you about your place on the waiting list (nor will FSSA) but can provide information regarding your original level of care date or priority category status.

  • How do I know when I’ve been invited off the waiting list?

    You will receive a letter in the mail from FSSA and your AAA options counselor will reach out to you to continue the process to determine if you remain eligible to access waiver services.

  • What do I do when I’m invited off the waiting list?

    When you are invited, your AAA options counselor will conduct a face-to-face assessment which includes a new level of care assessment to determine if you meet the criteria to join the waiver. Additionally, if you have not applied for Medicaid, you will need to apply for it. If you meet the level of care and are eligible for and have active Medicaid, you will join either the Health and Wellness Waiver or PathWays Waiver depending on your age (under 60 or 60+). Please communicate with your options counselor for detailed information about the steps you need to take to receive waiver services. FSSA has created these checklists to assist you with the invitation process: Health and Wellness Checklist, PathWays Waiver Waiting List for those on PathWays and PathWays Waiver Waiting List for those NOT on PathWays Program.

  • I applied for the waiver months ago and am still waiting. I’ve heard that others who applied after me have already been invited. Why is this the case?

    Everyone on the waiting list is eligible for an invitation in an order determined by their original level of care assessment date and any applicable priority category. Therefore, those with earlier LOC assessment dates will be invited sooner than those with later LOC assessment dates, and individuals who are in a priority category are moved to the front of the waiting list.

    Hypothetical scenario: Kurt joined the waiting list in May. Terry joined the waiting list in June. Jane joined the waiting list in July.

    1. In August, Jane is invited first because she is in a priority category as she is discharging from a nursing facility.
    2. In August, Terry is also invited because his LOC date is 12/02/2023 and the waiver has capacity to invite everyone with an LOC date before 12/14/2023.
    3. Kurt is still on the waiting list because his LOC date, 4/30/2024, is later.

    FSSA cannot estimate the exact date for when Kurt will be invited because more people like Jane and Terry join the waiting list every day. However, FSSA publishes the most recent LOC date to be invited after each monthly round of invitations, which may help Kurt and his care manager estimate when he might be invited.

  • What do I need to be eligible for the waiver? What’s the difference between functional eligibility and Medicaid eligibility?

    You must have preliminary eligibility, as determined by a waiver level of care phone screening, to be placed on the waiting list and then later be invited off the waiting list. Once you have been invited off the waiting list, you must have both functional eligibility as determined by the LOC assessment and Medicaid eligibility in order to be fully eligible for Medicaid Waiver and begin to receive services. If you meet LOC criteria during your LOC assessment, you are considered to have “functional eligibility.” Functional eligibility is different from Medicaid eligibility and is a determination of your need for support with activities of daily living such as eating, bathing, and getting dressed. Medicaid eligibility is primarily a determination about your financial need.  You may have one but not the other, but both categories of eligibility are required to receive waiver services. If you are on the waiting list, you are encouraged to apply for Medicaid if you haven’t already.

  • How are waiver slots counted?

    Slots are counted on an annual basis according to the waiver year. A waiver year runs from July 1 to June 30. Once a slot has been assigned to an eligible person, that slot cannot be reassigned to a different person during the same waiver year. For example, if the individual receiving an HCBS waiver slot moves out of state or passes away during the waiver year, that individual’s waiver slot cannot be made available to another eligible individual during that same waiver year.

Additional FAQs about joining the Waiting List are located here and FAQs about the Waiting List invitations are here.

Last updated: 11/14/2024