Frequently Asked Questions
What is the admissions process to have my son or daughter live at the farm?
Hannah & Friends will establish a committee of up to 5 individuals from varying backgrounds who will review each application for residential living. Guidelines and criteria are established to assist the committee to ensure our mission and vision are supportive of the individuals applying and to ensure we can meet the full scope of needs for each person.
How old are the individuals you will have living at the farm?
Hannah & Friends will serve adults of the age of 18 and older.
How will Hannah & Friends be paid for my son or daughter to live at the farm?
Hannah & Friends has submitted an application to the Family Social Services Administration to become a residential provider under the Bureau of Developmental Disabilities Services. This program is funded by Indiana Medicaid and is called the Medicaid Waiver Program or Home and Community Based Supports. Hannah & Friends will accept individuals for residential living who have a Developmental Disabilities Waiver (DD Waiver), Autism Waiver and will accept individuals with a Support Services Waiver (SS Waiver) for day program. All residents living at Hannah & Friends will have the option to attend day services at the farm.
What types of programs and services will be available to my child?
Hannah & Friends is committed to bringing the hopes and dreams of the residents to realization to create meaningful days. Our residents will lead us in developing our programs. For example our individuals may love to cook and garden so we will develop a program that can expand those desires into appropriate side by side learning and teaching activities. Hannah & Friends will have facilities to offer programs such as Adult Day Services, recreational activities and social opportunities as well as community integration and volunteering.
Hannah & Friends will offer up to 24 hour staffing, day program and provide for all health and safety needs of each individual. Each home will have a full range of support services for each of our residents where they can live meaningful lives as well as have a social and community life of their choosing.
Will jobs be available for my son or daughter?
Hannah & Friends will have a diverse group of individuals some of whom will work in the community and others who will choose to remain at the farm and work at the farm in jobs we work together to create. Hannah & Friends has facilities to provide work opportunities such as cooking in our rec center or working in the barn brushing horses and feeding the animals, helping to stock the barn of supplies and other handy jobs a person desires.
Will the residents go out into the community?
The residents will choose the activities of their day and also have offerings at the Recreation Center or at their homes of things to do they enjoy which improve the quality of their lives.
What do I do if my son or daughter is on the Medicaid Waiver waiting list and has 6 years or more until they receive a waiver?
Hannah & Friends is building the farm over a period of 10 years. The application process will continue to be open as long as Hannah & Friends continues to build the farm.
Where do I start to ensure my child will live at Hannah & Friends Farm?
Since Hannah & Friends will accept private funding and Medicaid Waiver funding each person will be required to have one of these sources to pay for services. In order to obtain Medicaid Waiver services please contact your local BDDS (Bureau of Developmental Disabilities office.)
Is this a permanent residence? What if my child wants to leave?
Placement at Hannah & Friends Farm is a choice in the community. Each person can choose to reside here as long as he or she is happy with their living arrangements. If an individual makes a different choice for residential services then the individual will move from the farm with the support of his or her team in a planned and supportive manner.
When a resident leaves the farm to live somewhere else does that mean someone else can move into the home that individual left?
Our homes are built to have up to 4 residents. Naturally if we have an opening in a home we would like to consider someone for the placement. Our admissions committee would be notified and would advise.
What will happen to my son or daughter if something happens to me?
Your loved one would rely upon the support team to assist in making decisions about daily living choices and follow any pre made arrangements for guardianship, fiscal intermediary etc. If the individual receives one of the waivers then the support team for the individual would continue to work together to ensure every need and every plan for your loved one is met for the rest of his or her life.
What type of support will be available to parents of the residents?
Hannah & Friends invites parents to be involved in the lives of the residents and of the happenings at the farm to promote a family atmosphere. Reference materials and family group meetings will also be available.
What support will there be for families whose children do not live at the farm?
Hannah & Friends is committed to Awareness and Compassion for persons with intellectual differences. The Eck Recreation Center was created to bring the community to the farm to enjoy the differences in all of us. The center will offer community happenings for different and non-different people and we encourage participation from everyone as equals in the community.
Hannah & Friends will hold a monthly parent group where parents and siblings can come together to talk about their experiences and to exchange resources with one another.
Will other organizations be involved in the use of the farm or is the farm exclusively for the residents at Hannah & Friends?
The acutal homes are private residences and are not offered to the community for use. The Eck Recreation Center is designed for inclusion of the community with our residents. The rec center can be used to host events that are beneficial to the community agencies involved in the service to people with intellectual differences such as movie night, sports night, sledding and hot chocolate day and other planned activities.
What is Medicaid?
Medicaid is a federal and state medical assistance program that makes reimbursements for reasonable and necessary medical care to people meeting eligibility requirements. The program is state administered by the Office of Medicaid Policy and Procedure (OMPP), a part of the Family and Social Services Administration (FSSA).
What is the Medicaid Waiver Services Program?
The Medicaid Waiver program began in 1981, in response to the national trend toward providing Home and Community-Based Services (HCBS). In the past, Medicaid paid only for institutionally based long term care services, such as nursing facilities and group homes. This new program “waived” the requirement of an admission into an institution in order for Medicaid to pay for the Home and Community-Based Services (HCBS).
Indiana applied for permission to offer Medicaid Waivers from the Centers’ for Medicare and Medicaid Services (CMS). The Medicaid Waivers make use of federal Medicaid funds (plus state matching funds) for Home and Community-Based Services (HCBS), as an alternative to institutional care, under the condition that the overall cost of supporting people in the home or community is no more than the institutional cost for those people.
The Office of Medicaid Policy and Planning (OMPP) is responsible for the development and operation of the Waivers, in agreement with the Division of Aging and the Division of Disability and Rehabilitative Services. Each Division works to create the service definitions and standards for services and providers and then certifies provider applicants in order to provide the Waiver services.
The goals of Waiver services are to provide to the person meaningful and necessary services and supports, to respect the person's personal beliefs and customs, and to ensure that services are cost-effective.
Who is Eligible for Medicaid Waiver Services?
A resident of Indiana must meet a combination of state and federal requirements in order to be eligible for a Medicaid Waiver. Specifically, a person must meet categorical eligibility (aged, blind, or disabled), financial, and non-financial eligibility requirements. When a person becomes ‘targeted’ for the Waiver, some of the Medicaid eligibility requirements are removed, such as the family income is not considered as part of the financial consideration for children under age 18.
Where Can You Live and Receive Waiver Services?
Waiver services are individually tailored supports that enable children and adults to live successfully in home and community settings. These settings include:
- Family Home: A person can live in his/her family home, or in the home of his/her extended family or guardian.
- House/Apartment: A person can live in his/her own home with or without a housemate(s). "Own home" means a home that is not licensed as a foster care home or as an ICF/MR (group home) or nursing facility.
- Foster Care: A person can live in a specialized Waiver approved foster care home.
- Assisted Living Facility: A person can live in a Waiver approved Assisted Living Facility (only available under the Aged and Disabled Waiver).
What Are the Different Types of Waivers?
There are two different types of Indiana Medicaid Home and Community-Based (HCBS) Waiver Services Programs. One type, for children and adults whose needs are primarily medical in nature, is called the Nursing Facility Level of Care Waiver also know as the Medical Model Waivers and includes two Waivers – the Aged and Disabled Waiver (A&D) and the Traumatic Brain Injury Waiver (TBI).
The other type, for children and adults with developmental disabilities, is the Intermediate Care Facility for the Mentally Retarded (ICF/MR) Level of Care Waiver also known as the Developmental Disability or DD Waivers. There are three Indiana Medicaid Waivers requiring ICF/MR Level of Care - the Autism Waiver, the Developmental Disabilities Waiver, and the Support Services Waiver. Hannah & Friends Farm will utilize these waivers.
Frequently Used Terms
The following terms are related to Medicaid Waivers and other Home and Community-Based Services.
Autism Waiver
The Autism Waiver provides community supports and services to persons with Autism, including the Autism Spectrum Disorder, who meet eligibility requirements. The Waiver is designed to provide services for the person living with family, or in other community settings to assist him/her gain and maintain optimum levels of self-determination and community integration.
Case Management
Waiver case management is a comprehensive service that includes specific tasks and activities designed to coordinate all services required in the person’s place of care. Case management is required in conjunction with the provision of any Home and Community-Based Services.
Cost Comparison Budget / Plan of Care (CCB/POC)
The Cost Comparison Budget (CCB) details the cost of each Waiver service and total cost of the Medicaid services for each person. The Cost Comparison Budget is based upon the Plan of Care (POC). The POC includes written explanation of the person’s need for the Waiver services; what provider will be used; how the services protect the person’s health and safety; the person’s needs that will not be met; and a description of emergency back-up plans. The person receiving services or a guardian must approve and sign the CCB.
Developmental Disability (DD) State Definition
A severe, chronic disability which: 1) is attributable to a mental or physical impairment or combination of mental and physical impairments; 2) is manifested before the person attains age 22; 3) is likely to continue indefinitely; 4) results in substantial limitations in three or more of the seven areas of major life activity: self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, and economic self-sufficiency; and 5) reflects the person's need for a combination and sequence of special, interdisciplinary, or generic care treatments or services which are of lifelong or extended duration, and are individually planned and coordinated. All criteria must be met for a person to be eligible for Developmental Disability (DD) services.
Developmental Disabilities (DD) Waiver
This Waiver provides services that enable persons to remain in their homes or in community settings and assists those people who transition from state operated facilities or other institutions into community settings. This Waiver is designed to provide supports for persons to gain and maintain optimum levels of self-determination and community integration while allowing flexibility in the provision of those supports.
Home and Community-Based Services (Medicaid Waivers)
Support services provided in a person's residence or community in order to maintain or restore participation in community activities in order to prevent admission into a nursing facility or group home.
Individualized Support Plan (ISP)
The ISP translates the person’s long and short-range goals into reality by creatively using all available resources to accomplish those goals. It is based at least partly upon the Person Centered Planning process.
Person Center Planning (PCP)
Person Centered Planning is a process for a person with developmental disabilities and family/guardian to direct the planning and allocation of resources to meet the person’s life goals. This personal life plan is based on the person’s preferences, dreams and needs; shows how the person makes decisions; how the person is and can be productive; what the person likes and dislikes; supports long-term hopes and dreams; documents and explains what supports are needed for this lifestyle; documents a short-term support plan based on reasonable costs and needs; includes a range of responsibilities for all participants; and includes a range of supports including funded and community natural supports. Person Centered Planning should be conducted as often as the needs of the person change, or at least annually. Usually, the facilitator for the Person Centered Planning is a case manager.
Provider
A generic term describing any person, organization or company enrolled to deliver specific services. Qualifications vary depending on the type of service.
Waiver Program
This program allows Indiana’s Medicaid programs to pay for services that are provided in a person’s home or other community setting rather than a Medicaid funded facility/institution. Persons must qualify for institutional care in order to be eligible for home and community-based services. Waiver refers to the waiving of certain federal requirements that otherwise apply to Medicaid program services.
State of Indiana and Federal Agencies
Bureau of Developmental Disabilities Services (BDDS)
A part of Family and Social Services Administration/Division of Disability and Rehabilitative Services (DDRS), BDDS administers a variety of services for persons with developmental disabilities, which include the Autism, the Developmental Disabilities, and the Support Services Waiver. There are eight District Offices serving specific counties. The Service Coordinators determine eligibility for developmental disabilities’ services and facilitate the determination of Level of Care for ICF/MR services.
Bureau of Quality Improvement Services (BQIS)
A part of the Family and Social Services Administration/Division of Disability and Rehabilitative Services, BQIS researches trends in service delivery, quality improvement and best practices, analyzes quality data, and assures compliance with quality standards for the Autism, Developmental Disabilities and Support Services Waivers.
Developmental Disabilities Waiver Ombudsman
By law, the Ombudsman receives, investigates, and attempts to resolve complaints and concerns that are made by or on behalf of people with developmental disabilities in any Medicaid Waiver program.
Division of Disability and Rehabilitative Services (DDRS)
A part of the Family and Social Services Administration, DDRS assists people with disabilities and their families who need support to attain employment, self-sufficiency or independence. The Bureaus of Developmental Disabilities Services and Quality Improvement Services are under DDRS’ responsibilities. The DDRS implements the ICF/MR Level of Care Medicaid Waivers and other services for people with developmental disabilities.
Division of Family Resources (DFR) and Indiana Department of Child Services (DCS): The part of FSSA that provides Medicaid and Children’s Services, including the First Steps program for infants and toddlers with developmental delays. Offices in each county serve as a single point of entry for many of the social services available to Hoosiers. Some of these services include Temporary Assistance to Needy Families (TANF), Medicaid, Medicaid-Disability, Food Stamps and Hoosier Healthwise. Office of Medicaid Policy and Planning (OMPP)
For more information regarding Hannah & Friends Farm, please contact Stephanie Sarell at stephanie@hannahandfriends.org or 574-807-1362
Hannah & Friends
51250 Hollyhock Road
South Bend, IN 46637
