PERSONAL CARE SERVICES PROVIDER IN INDIANA

SUPPORTING DAILY INDEPENDENCE THROUGH PERSONALIZED HANDS-ON ASSISTANCE

Personal Care Services in Indiana help individuals with disabilities, chronic health conditions, or aging-related limitations perform Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). These services promote participant independence, health, and dignity while reducing reliance on institutional care. Personal Care Services are authorized under Indiana Medicaid State Plan benefits and Home and Community-Based Services (HCBS) Waiver programs.

1. GOVERNING AGENCIES

Agency: Indiana Family and Social Services Administration (FSSA) — Office of Medicaid Policy and Planning (OMPP) and Division of Aging

Role: Administers Medicaid funding for Personal Care Services, oversees provider enrollment, service standards, and reimbursement processes

Agency: Indiana Division of Disability and Rehabilitative Services (DDRS)

Role: Oversees service authorization for Personal Care Services under certain HCBS waivers

Agency: Centers for Medicare & Medicaid Services (CMS)

Role: Provides federal oversight ensuring Medicaid-funded Personal Care Services align with HCBS Settings Rule, participant-centered planning, and quality standards

2. PERSONAL CARE SERVICE OVERVIEW

Personal Care Services provide direct assistance with daily activities that participants cannot perform independently due to functional limitations, disabilities, or health conditions.

Approved providers may deliver:

• Assistance with ADLs: Bathing, grooming, dressing, toileting, eating, transferring, and mobility

• Support with IADLs: Light housekeeping, meal preparation, laundry, and medication reminders

• Safety supervision and cueing to assist participants in completing daily tasks independently

• Basic health monitoring (e.g., reporting changes in condition to supervisors)

• Support during community participation (e.g., outings, appointments)

All services must be authorized in the participant’s Individualized Support Plan (ISP) and/or Medicaid-approved service plan.

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 Personal Care Services provider through the Indiana Medicaid Provider Enrollment Portal

• Maintain general liability and professional liability insurance

• Develop participant-centered service delivery policies, incident reporting procedures, and staff training protocols

• Ensure all staff meet background screening, health screening, and personal care training standards

4. INDIANA PROVIDER ENROLLMENT PROCESS

Initial Interest and Application:

• Submit Provider Enrollment Application through the Indiana Medicaid Provider Portal for Personal Care Services under HCBS Waivers or Medicaid State Plan

Application and Documentation Submission:

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

Program Readiness Review:

• FSSA reviews provider readiness, including participant protections, service documentation systems, emergency response planning, and staffing models

Approval & Medicaid Enrollment:

• Upon approval, providers are assigned billing codes for personal care services, typically billed in 15-minute units

5. REQUIRED DOCUMENTATION

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

• IRS EIN confirmation

• NPI confirmation

• Proof of general liability and professional liability insurance

• Personal Care Services Policy & Procedure Manual including:

  • Participant intake, service planning, and ADL/IADL assistance protocols

  • Safety supervision procedures, emergency preparedness, and critical incident reporting

  • Participant rights, HIPAA confidentiality, and grievance policies

  • Staff credentialing, background checks, competency evaluations, and training documentation

  • Medicaid billing, service tracking, and audit-readiness systems

6. STAFFING REQUIREMENTS

Role: Personal Care Services Program Supervisor

Requirements: Background in nursing, social work, human services, or personal assistance program management preferred; supervisory experience; background screening clearance

Role: Personal Care Aides / Direct Support Professionals (DSPs)

Requirements: High school diploma or GED; CPR/First Aid certification preferred; training in personal care assistance, infection control, and participant rights; background clearance

All staff must complete:

• ADL/IADL assistance and personal hygiene care training

• HIPAA compliance and participant confidentiality training

• Emergency response and abuse prevention training

• Annual competency evaluations and continuing education updates

7. MEDICAID WAIVER PROGRAMS AND STATE PLAN COVERAGE

Personal Care Services are reimbursable through:

• Indiana Medicaid State Plan Personal Care Services

• HCBS Waiver Programs:

  • Community Integration and Habilitation (CIH) Waiver

  • Family Supports Waiver (FSW)

  • Aged and Disabled (A&D) Waiver

  • Traumatic Brain Injury (TBI) Waiver

Approved providers may deliver:

• In-home personal assistance with ADLs and IADLs

• Supervision and safety monitoring to support independent living

• Support during community activities, employment, or volunteer participation

• Personal care support integrated into daily routines and ISP goals

8. TIMELINE TO LAUNCH

Phase: Business Formation, Policy Development, and Staff Hiring

Timeline: 1–2 months

Phase: Staff Credentialing, Training, and Service Planning Setup

Timeline: 2–3 months

Phase: Indiana Medicaid Enrollment and Readiness Review

Timeline: 60–90 days

Phase: Medicaid Billing Setup and Personal Care Service Launch

Timeline: 30–45 days

9. CONTACT INFORMATION

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

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

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 PERSONAL CARE SERVICES PROVIDER

WCG assists personal care agencies, home care providers, and HCBS waiver providers in launching Medicaid-compliant Personal Care Services across Indiana.

Scope of Work:

• Business registration, Medicaid enrollment, and compliance setup support

• Development of Personal Care Services Policy & Procedure Manual

• Staff credentialing templates, intake forms, and daily service logs

• Medicaid billing system setup and audit-ready claims management assistance

• Website, domain, and professional branding setup

• Participant rights protections, emergency planning templates, and quality assurance tools

• Partnership development with waiver case managers, hospitals, and community organizations

Continue To Our Client Portal To Get Started

Our Client Portal offers a wealth of resources that you can explore related to various programs and state requirements.