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Indiana - Respite Care Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

The Indiana Family and Social Services Administration (FSSA) funds Respite Care Services through the Family Supports Waiver (FSW), the Community Integration and Habilitation (CIH) Waiver, and the PathWays for Aging program to provide short-term relief to unpaid caregivers. The service can be delivered in the participant's home, a DDRS-approved day habilitation facility, or a non-private residential setting.

Approval requires applicants to first obtain Division of Disability and Rehabilitative Services (DDRS) approval as a Respite Agency or hold an active Indiana Home Health Agency license before submitting an application through the Office of Medicaid Policy and Planning (OMPP) Certification Portal. Providers seeking to serve the aging population must also secure network contracts with the designated Managed Care Entities (MCEs) administering the PathWays program.

1. Service Definition and Scope

Respite Care Services in Indiana provide temporary relief to unpaid persons normally providing care for a Medicaid waiver participant. The service ensures the participant's health and safety while the primary caregiver is absent.

Indiana strictly limits how and when respite can be utilized, explicitly prohibiting its use as a daily childcare substitute or a replacement for skilled nursing.

2. Regulatory and Oversight Agencies

Multiple divisions within the Indiana Family and Social Services Administration (FSSA) oversee the certification, enrollment, and monitoring of Respite Care providers.

The Bureau of Developmental Disabilities Services (BDDS) manages the waivers for individuals with intellectual and developmental disabilities, while the Office of Medicaid Policy and Planning (OMPP) handles the overarching provider certification process.

3. Gatekeeping Prerequisites: Who Can Even Apply

Indiana does not issue a standalone "Respite License." Instead, an applicant must meet specific structural preconditions to be recognized as an eligible entity before the OMPP Certification Portal will accept an application.

For the PathWays for Aging program, providers face an additional managed care contracting gate, meaning state certification alone does not guarantee the ability to bill for services.

4. Licensure and Certification Requirements

Providers must comply with the Indiana Administrative Code governing Supported Living Services and Supports. These rules dictate the operational and financial standards for agencies.

Agencies must maintain continuous compliance with these standards to retain their DDRS approval and Medicaid enrollment status.

5. Medicaid Provider Enrollment

Enrolling as a Respite Care provider in Indiana is a multi-step process that begins with OMPP certification and concludes with IHCP enrollment.

Providers must execute specific state agreements and utilize the state's designated online portals to submit their credentials.

6. Staffing, Training and Background Checks

Direct care staff providing respite services must meet strict background and training requirements before delivering care to waiver participants.

Agencies are responsible for maintaining personnel files that prove continuous compliance with these mandates.

7. Documentation, Policies and Records

The OMPP Certification Portal requires specific, correctly formatted documents to be uploaded during the application process.

Failure to provide exact, agency-specific policies is a primary reason for application rejection.

8. Billing, Rates and Claims

Respite Care Services are billed through the IHCP Provider Healthcare Portal using specific procedure codes tied to the participant's authorized waiver budget.

Rates are established by FSSA and are subject to legislative updates and waiver amendments.

9. Approval Sequence and Timeline

The approval sequence requires sequential clearance from OMPP, IHCP, and finally the specific waiver operating division or managed care entity.

Providers receive feedback during the initial OMPP review phase if document corrections are needed.

10. Common Denials and Survey Findings

The state explicitly lists common errors that cause OMPP Certification Portal applications to be delayed, expired, or denied.

Attention to detail regarding document expiration dates and agency names is critical to passing the initial review.

11. Key Contacts and Resources

Providers should utilize the official state portals and contact centers for application assistance and waiver-specific guidance.

Managed care contracting requires direct outreach to the individual health plans administering the PathWays program.

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