Changes to Indiana’s Long-Term Care Assessment Process Starting July 1, 2025

Beginning July 1, 2025, Indiana is implementing the next phase of changes to how individuals are assessed for long-term care services. These updates are designed to streamline access to support for those needing nursing facility care or home- and community-based services through state programs.

What is Changing on July 1, 2025?

The Indiana Family and Social Services Administration (FSSA) is implementing the next phase of the Indiana Level of Care Assessment Representative (LCAR) program, with Maximus as the designated vendor. Maximus will now be responsible for conducting all assessments and making determinations about an individual’s need for nursing facility level of care. This applies to individuals seeking admission to a nursing facility, or those looking for home- and community-based services through the Indiana PathWays for Aging, Health & Wellness, and Traumatic Brain Injury programs.

Previously, organizations like CICOA, your local Area Agency on Aging, played a direct role in conducting these assessments. Starting July 1, 2025, while Area Agencies on Aging will no longer conduct the assessments themselves, we remain your crucial first point of contact and an ongoing source of support.

Why is this Change Happening?

FSSA is engaged in a multi-year effort to reform its long-term services and support programs. The goal of the Level of Care Assessment Representative program is to create a single, statewide entry point for these assessments. This aims to enhance efficiency and provide consistent, accurate determinations for individuals across Indiana.

How Does This Impact Individuals and Families Seeking Services?

• For New Applicants Seeking Home- and Community-Based Services (PathWays for Aging, Health & Wellness, Traumatic Brain Injury waiver programs):
  • If you are seeking new home- and community-based services, you or someone assisting you (like our agency) can contact Maximus directly (1-833-597-2777) to request an assessment.
  • Maximus’s trained evaluators will then conduct your assessment. They will use an appropriate assessment tool to determine if you meet the criteria for nursing facility level of care.
  • You will receive the outcome of your assessment by mail, typically within 11 calendar days of your request.
  • For individuals under age 60 who meet the criteria, our agency will be notified, and we will proceed with facilitating your service planning and connecting you to appropriate community resources.
  • For individuals 60 or older who meet the criteria, Maximus will complete the intake counseling process for the PathWays for Aging waiver.
  • CICOA can help with Medicaid application assistance during this process.
  • CICOA as your local Area Agency on Aging can still help you initiate this process and navigate the steps involved. We are here to guide you.
• For Individuals Already Enrolled in the PathWays for Aging Program:
  • Your Managed Care Entity will ensure that Maximus has the information necessary to complete the assessment. Maximus will provide a determination recommendation based on those results. This is designed to avoid duplicating efforts.
• For Individuals Receiving Services through the Health & Wellness program:
  • Your case manager will coordinate with Maximus for your annual reassessments or any reassessments needed due to health changes.
• For Individuals Seeking Nursing Facility Admission:
  • Maximus will also provide preadmission screening and assessments for those entering a nursing facility.
• Counseling on Your Options:
  • The Level of Care Assessment Representative (Maximus) will offer specific intake counseling for individuals aged 60 and older who qualify for nursing facility level of care. This counseling helps you understand your options for nursing facilities or home- and community-based programs like PathWays for Aging or Program of All-Inclusive Care for the Elderly (PACE).
  • It’s important to note that if you have already received options counseling from CICOA, you are not required to engage in the LCAR’s intake counseling. Intake counseling may be provided either by CICOA’s Aging & Disability Resource Center or Maximus. Our agency continues to provide comprehensive options counseling to help you explore all available long-term services and supports and make informed choices.

What Remains the Same? Our Ongoing Role and Support

CICOA, as your Area Agency on Aging, remains a vital source of support for older adults and people with disabilities in our community. While the assessment process is shifting, our commitment to you is unwavering. We will continue to:

• Offer Information and Referrals: We are still your go-to resource for information about a wide range of services for older adults and people with disabilities of any age. We can connect you to resources, answer your questions and guide you through the process of accessing care.
• Provide Case Management: We will continue to facilitate and coordinate service planning, especially for individuals on the Health & Wellness and Traumatic Brain Injury programs, ensuring your needs are met.
• Assist with Referrals to the Level of Care Assessment Representative: If you need an assessment, we can still assist you in submitting a referral to Maximus and help you understand what to expect.
• Assist with Medicaid Applications: CICOA’s options counselors can help you navigate this process if you are pursuing a Medicaid waiver.
• Navigate Waitlist Questions: We offer support for individuals while they are placed on the waitlist and guide individuals as they are invited off of the waitlist for services.
• Advocate for You: We will continue to advocate on your behalf to ensure you receive the services and support you need.

The criteria for determining nursing facility level of care are not changing. These criteria are established by state and federal guidelines.

Where Can You Get More Information?

For comprehensive details about the Indiana Level of Care Assessment Representative process, including frequently asked questions and contact information for Maximus, please visit the official FSSA resource page:

https://www.in.gov/fssa/ddrs/home/in-level-of-care-assessment-representative

You can also contact Maximus directly:

• Website: https://inlcar.com/
• Phone Number: 1-833-597-2777
• Email Address: INLCAR@maximus.com

As always, please do not hesitate to reach out to CICOA’s Aging & Disability Resource Center with any questions or concerns. We are here to support you every step of the way.

CICOA: 317-803-6131