COMMUNITY INTEGRATION SERVICES PROVIDER IN INDIANA

PROMOTING INDEPENDENCE, SOCIAL CONNECTIONS, AND PARTICIPANT-DRIVEN COMMUNITY PARTICIPATION

Community Integration Services in Indiana help individuals with disabilities or long-term support needs develop skills, engage in meaningful activities, and connect with their communities. These services are authorized under Indiana Medicaid Home and Community-Based Services (HCBS) Waiver programs, supporting greater independence, social inclusion, and quality of life.

1. GOVERNING AGENCIES

Agency: Indiana Family and Social Services Administration (FSSA) — Division of Disability and Rehabilitative Services (DDRS) and Division of Aging

Role: Oversees Community Integration provider enrollment, service authorizations, quality monitoring, and participant protections under HCBS Waivers

Agency: Indiana Office of Medicaid Policy and Planning (OMPP)

Role: Administers Medicaid funding for Community Integration Services and manages provider enrollment, reimbursement, and claims processing

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight ensuring Community Integration Services comply with the HCBS Settings Rule, person-centered planning standards, and quality requirements

2. COMMUNITY INTEGRATION SERVICE OVERVIEW

Community Integration Services focus on helping participants gain, retain, or improve self-help, socialization, and adaptive skills necessary to live and participate actively in their community.

Approved providers may deliver:

• Individualized community-based activities based on the participant’s interests, needs, and goals

• Support for accessing recreational, educational, volunteer, civic, cultural, and employment-related opportunities

• Skill development for independent community navigation (e.g., using public transportation, accessing libraries, grocery stores)

• Self-advocacy training to help participants express preferences and make choices

• Assistance with building and maintaining relationships outside the home or service setting

• Safety training for navigating various community environments

All services must be goal-driven, based on the participant’s Individualized Support Plan (ISP), and promote community inclusion rather than center-based or segregated activities.

3. LICENSING & PROVIDER APPROVAL REQUIREMENTS

Prerequisites:

• Register business entity with the Indiana Secretary of State

• Obtain EIN from the IRS and NPI (Type 2)

• Enroll as a Medicaid HCBS Waiver provider through the Indiana Medicaid Provider Enrollment Portal

• Meet FSSA DDRS service-specific standards for Community Integration

• Maintain general liability insurance and professional liability insurance

• Develop comprehensive policies for participant safety, community activity planning, staff training, emergency response, and documentation

• Ensure all direct support staff meet background screening, health screening, and competency training requirements

4. INDIANA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit Provider Enrollment Application through Indiana Medicaid Provider Portal for Community Integration Services under the appropriate waivers

Application and Documentation Submission:

• Provide Articles of Incorporation, EIN/NPI confirmation, insurance certificates, staff credentialing documentation, and operational service delivery policies

Program Readiness Review:

• FSSA (DDRS) conducts readiness review including service activity plans, staff training documentation, safety procedures, participant rights protections, and billing protocols

Approval & Medicaid Enrollment:

• Upon approval, providers are assigned billing codes for community-based integration supports, typically billed hourly

5. REQUIRED DOCUMENTATION

• Articles of Incorporation or Business License (Indiana Secretary of State)

• IRS EIN confirmation

• NPI confirmation

• Proof of general and professional liability insurance

• Community Integration Services Policy & Procedure Manual including:

  • Participant intake, assessment, goal setting, and service planning protocols

  • Community activity safety planning, supervision protocols, and travel policies

  • Emergency response and critical incident reporting procedures

  • Participant rights, HIPAA confidentiality, and grievance procedures

  • Staff credentialing, background checks, training records, and competency assessments

  • Medicaid billing, service tracking, and documentation audit systems

6. STAFFING REQUIREMENTS

Role: Program Director / Community Integration Supervisor

Requirements: Bachelor’s degree in human services, education, or a related field preferred; background screening clearance; community-based service experience preferred

Role: Community Integration Specialists / Direct Support Professionals (DSPs)

Requirements: High school diploma or GED minimum; training in community navigation, participant safety, and self-advocacy facilitation; background screening clearance

All staff must complete:

• HCBS Settings Rule and person-centered planning training

• HIPAA compliance, abuse prevention, and participant rights training

• Community safety, transportation, and emergency response training

• Annual continuing education and competency reassessments

7. MEDICAID WAIVER PROGRAMS

Community Integration Services are available under the following Indiana Medicaid Waivers:

• Community Integration and Habilitation (CIH) Waiver

• Family Supports Waiver (FSW)

Approved providers may deliver:

• Community outings aligned with participants’ personal interests and employment goals

• Volunteer and educational support participation

• Individual or small group community integration activities

• Self-advocacy skill development and peer interaction opportunities

8. TIMELINE TO LAUNCH

Phase: Business Formation, Compliance Preparation, and Staffing Setup

Timeline: 1–2 months

Phase: Staff Hiring, Credentialing, and Service Planning Development

Timeline: 1–2 months

Phase: Indiana Medicaid Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing Setup and Community Integration Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

Indiana Family and Social Services Administration (FSSA) — Division of Disability and Rehabilitative Services (DDRS)

Website: https://www.in.gov/fssa/ddrs/

Indiana Medicaid Provider Portal

Website: https://www.in.gov/medicaid/providers/

Centers for Medicare & Medicaid Services (CMS)

Website: https://www.cms.gov/

WAIVER CONSULTING GROUP’S START-UP ASSISTANCE SERVICE — INDIANA COMMUNITY INTEGRATION SERVICES PROVIDER

WCG supports day service agencies, employment support providers, and community-based organizations in launching Medicaid-compliant Community Integration Services across Indiana.

Scope of Work:

• Business registration, Medicaid enrollment, and waiver compliance guidance

• Development of Community Integration Services Policy & Procedure Manual

• Staff credentialing templates, participant intake forms, and community activity tracking systems

• Medicaid billing system setup and audit-ready claims management

• Website, domain, and branding setup

• Person-centered goal planning templates and community mapping tools

• Quality assurance systems for service tracking, satisfaction surveys, and rights protections

• Partnership development with schools, vocational programs, and community agencies

Continue To Our Client Portal To Get Started

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