Families encouraged by recent FSSA changes on attendant care transition
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Families of medically complex children cheered a move last week from the Family and Social Services Administration (FSSA) to address two concerns about the transition from attendant care services to Structured Family Caregiving.
The alterations came after six mothers met with Gov. Eric Holcomb and FSSA Secretary Dan Rusyniak on April 29 and presented their concerns along with nine requests to ease the transition. Later that week, during a scheduled update for families, FSSA announced that respite nursing services would be an allowable waiver service pending federal approval—one of the requests made by families.
The other request granted last week automatically places any Medicaid waiver recipient receiving at least 41 hours of “authorized” attendant care a week in the Tier 3 of the Structured Family Caregiving program. In contrast to attendant care, in which families receiver hourly wages for the care they provide, Structured Family Caregiving in a per diem payment.
To read all of the requests made by families and responses from FSSA, click here.
“The news from FSSA is incredibly encouraging to medically complex families,” said Jennifer Dewitt, a mom and caregiver, in a statement. “There is still much progress to be made, and we are yet awaiting news from FSSA as to our other requests including the sad statistic that we still have families this minute that are without any services due to continued lack of timely communication by FSSA to families, providers, and care managers.”
Last week, Dewitt said FSSA had already taken action to reduce attendant care hours paid out to parents, such as holding approvals “hostage” for things such as home modifications, specialized equipment and generators for medical devices. The group asked FSSA to halt that practice.
In a response to their requests, FSSA said that such approvals “are not being intentionally delayed” and that they are reviewing service plans — rather than automatically approving them, as was done previously—to be compliant with federal oversight.
Dewitt and the other five moms who presented their concerns are part of Indiana Families United for Care, a group spurred into action during the 2024 legislative session when FSSA announced it would end the attendant care program for parents of medically complex children in its current form. Roughly 1,600 children will be impacted.
The state previously shared that costs from the program jumped from $9.3 million two years ago to $172 million and that some families were getting paid for more than 60 hours of care a week in a program with few guardrails to prevent abuse.
Families will transition from attendant care to Structured Family Caregiving by July 1, the same day the state ends the Aged & Disabled Waiver to move elderly Hoosiers to PathWays for Aging and disabled Hoosiers into the new Health & Wellness Waiver.
FSSA will host four more 30-minute information sessions on the following dates in the coming weeks, each starting at 3 p.m. The links to the Teams meetings for each date are:
The Indiana Capital Chronicle is an independent, not-for-profit news organization that covers state government, policy and elections.