Indiana CIH Waiver: Eligibility, Priority Categories, and How to Apply
Indiana's Community Integration and Habilitation (CIH) waiver is the state's comprehensive Medicaid HCBS waiver for individuals with intellectual and developmental disabilities who need 24-hour residential support or are in crisis. Unlike the Family Supports Waiver, which operates a chronological waitlist, CIH access is strictly needs-based — and understanding the priority categories is the difference between getting services and waiting indefinitely.
How CIH Differs from the Family Supports Waiver
The Family Supports Waiver (FSW) is designed for individuals living in the family home, with an annual service budget capped at $26,482 per person. The CIH waiver has no comparable annual budget cap — services are authorized based on the individual's assessed needs, which can include 24-hour residential habilitation, day services, and intensive behavioral support.
CIH serves individuals who cannot safely remain in a family home or who face an emergency that makes continued home-based care impossible. The Bureau of Disabilities Services (BDS), operating under DDARS, administers both waivers, but the access pathways are fundamentally different.
Needs-Based Access Categories
CIH does not maintain a standard chronological waitlist. Access requires demonstrating that the individual meets one of the state's defined emergency or priority categories. As of 2026, these include:
Death of primary caregiver. The person's sole or primary caregiver has died, and no alternative caregiver can provide the level of support the individual requires. Documentation typically includes a death certificate and a written statement explaining the care gap.
Supervised Group Living (SGL) transition. The individual is transitioning out of a Supervised Group Living facility. Under current BDS policy implemented in January 2026, the individual must have resided in the SGL facility for at least 365 consecutive days before qualifying for CIH transition services.
Aging out of state systems. The individual is aging out of services funded by the Department of Education (DOE) or the Department of Child Services (DCS), and their needs exceed what the FSW can provide.
Other health and safety risk. The individual's health or safety is at substantial risk, and immediate care cannot be provided in any other manner.
The Application Process
To apply for CIH access, submit a CIH Needs-Based Access Request form to the local BDS District Office. The application must include documentation supporting the specific priority category — medical records, caregiver health documentation, school exit letters, or proof of SGL residency duration.
BDS staff will verify eligibility, including that the applicant meets the diagnostic criteria (intellectual or developmental disability with onset before age 22) and the clinical level-of-care standard (substantial functional limitations in at least three of six major life areas, evaluated using the interRAI assessment tool).
Once approved, the individual enters the waiver system and must select a Case Management Organization from the list BDS provides.
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Reserve Capacity and Slot Management
Indiana's HCBS waivers operate under federally approved slot caps. When both FSW and CIH reached maximum capacity in late 2025, newly eligible individuals — even those meeting CIH emergency criteria — may face processing delays as BDS manages slot turnover.
Reserve capacity refers to slots held back from the general pool for specific priority populations. For CIH, this means a portion of available slots are reserved for the emergency categories listed above, rather than distributed chronologically. When a slot opens (through natural attrition — recipients leaving the waiver, aging into other programs, or passing away), BDS allocates it based on the priority hierarchy.
Families should check their status regularly through the BDS Waitlist Web Portal and respond to any correspondence within the stated deadline. The 30-day invitation and 21-day updated-diagnosis deadlines apply to FSW priority correspondence.
The August 2026 Waiver Amendments
The August 1, 2026 amendments affect both FSW and CIH. Key changes for CIH participants include the 40-hour weekly aggregate cap on PAC, respite, and Workplace Assistance for paid care by non-legally-responsible relatives or legal guardians (transportation is excluded), the 6-hour annual cap on benefits counseling services, and the 7-day case note completion requirement for case managers. Families relying on paid relative caregivers under CIH should recalculate their weekly service plans to stay within the new aggregate limits.
For a complete walkthrough of the waiver system, including FSW application, CIH priority navigation, and the August 2026 rule changes, our Indiana SSI at 18 & Adult Disability Benefits Guide covers the full BDS waiver landscape.
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