Indiana Waiver Invitation 30-Day Response Window: What to Do When Your Slot Opens

After years on the waitlist, the waiver invitation letter arrives — and the clock starts immediately. Indiana's BDS waiver invitation process has strict response deadlines that families cannot miss, and the consequence of missing them is automatic rescission of the waiver slot.

The Invitation Timeline

When a waiver slot becomes available and your name comes up (based on your Original Level of Care date), BDS sends a formal invitation letter. From that point:

30 days to respond. The family must confirm to BDS that they want to accept the waiver slot. This isn't optional — if BDS doesn't hear from you within 30 days, the slot is automatically rescinded. Make sure your contact information with BDS is current, and check your mail consistently.

21 days for medical certification. After confirming interest, a physician must submit the updated Confirmation of Diagnosis (State Form 54727). This form confirms the individual's diagnosis and when the condition manifested. The physician needs current medical records to complete it accurately, so families should have these records organized before the invitation arrives — not after.

The interRAI Assessment

Since February 2026, BDS uses the interRAI assessment suite to determine medical eligibility (Level of Care) and assign a support level that drives the individual's budget. The interRAI replaced the legacy LOCSI screening tool, and the impact has been dramatic.

Under the old tool, Level of Care denials ran at 0.2% — essentially a formality. Under interRAI, denials have jumped to 6%. That's a thirtyfold increase. The interRAI evaluates functional needs more granularly, so documentation should connect the individual's diagnosis to daily support needs.

If you receive a Level of Care denial, a formal appeal must be filed with FSSA within 33 days of the notice date to secure an administrative fair hearing.

Preparing for the Assessment

Families who've been on the waitlist for years sometimes let documentation lapse. When the invitation arrives, you need current records ready:

• Recent medical evaluations and diagnoses
• Behavioral logs showing daily support needs
• Functional assessments documenting limitations in self-care, communication, mobility, and safety
• School records including IEP present levels and transition assessments (if the individual is still in school)
• Any psychiatric or psychological evaluations

The interRAI assessor looks at what the individual can and cannot do independently. Documentation that describes the disability in medical terms without connecting it to daily functional limitations may not be enough to meet the ICF/IID Level of Care standard.

Case Management Changes Under the Waiver Reset

As of August 1, 2026, all waiver case management must be provided by one of five designated statewide Case Management Organizations: Aging & In-Home Services of NE IN, Inc.; Indiana Professional Management Group (IPMG); Inspire Case Management; Unity of Indiana; or The Columbus Organization. If the individual was previously working with a different case manager, they needed to select one of these five by the deadline.

Additionally, BDS is targeting July 1, 2027 for the launch of a new Youth Waiver serving ages 0 to 21. Current FSW participants in that age range will transition to the Youth Waiver. The full waiver reset — including new adult waivers and elimination of legacy service levels — is targeted for 2028.

The Indiana IEP Transition to Adulthood Guide includes a Waiver Application Tracker with the full response sequence, the interRAI preparation checklist, and the appeal timeline if you're denied.

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