The CIH waiver in Indiana (Community Integration and Habilitation) is the state’s most comprehensive Medicaid waiver for people with intellectual and developmental disabilities, and it can fund residential supports, day services, therapies and more. To qualify, a person generally needs a developmental disability that began before age 22, must meet an institutional level of care, and must meet Medicaid financial rules. Because CIH is in high demand and reached capacity in late 2025, how and when someone gets in matters as much as whether they qualify.
Key takeaways
- CIH serves people with intellectual or developmental disabilities that began before age 22 who meet ICF/IID level of care.
- Unlike Family Supports, CIH has no fixed dollar cap. Budgets are based on individual need.
- CIH can pay for Residential Habilitation and Support, day habilitation, respite, therapies, transportation and more.
- Entry has generally depended on meeting priority criteria and having a funded slot available.
- 2026 brought capacity limits, a waiting list, a new assessment tool and an August amendment.
What the CIH waiver in Indiana is
CIH is a Medicaid home and community-based services waiver managed by the Bureau of Disabilities Services (BDS) within FSSA. Its purpose is to help people with significant support needs live in their own homes, with family, or in small community settings rather than in an institution. Many adults in Indianapolis who live in a supported home with round-the-clock staff are funded through CIH.
CIH is often compared with the Family Supports Waiver. The simplest difference: Family Supports provides limited, non-residential services under an annual cap, while CIH is designed for people who need more intensive support and does not have a fixed dollar cap. CIH budgets are based on each person’s assessed needs.
Who qualifies for CIH
According to Indiana Medicaid’s CIH page, a person generally must:
- Have an intellectual disability, or a related condition such as autism, cerebral palsy or epilepsy, diagnosed before age 22
- Have a disability expected to continue indefinitely that substantially limits functioning in major life areas
- Meet ICF/IID level of care, which includes needing access to 24-hour assistance as needed
- Live in, or be moving to, a community (non-institutional) setting
- Have income no greater than 300% of the maximum SSI amount (parental income is not counted for children under 18)
Level of care is reviewed at application and at least once a year. Since January 1, 2026, BDS has used the interRAI family of assessments for FS and CIH. The state says eligibility rules did not change; the assessment tool did.
Priority criteria and funded slots
Meeting the eligibility rules is not always enough to start services. Indiana’s CIH fact sheets have described priority criteria, and a person has needed to meet at least one, along with a funded slot being available. Examples listed by BDS have included:
- Death of a primary caregiver when no other caregiver is available
- A caregiver over the age of 80 when no other caregiver is available
- Aging out of Department of Education, Department of Child Services or Supervised Group Living services
- Transitioning to the community from a nursing facility or state-operated facility
- Evidence of abuse or neglect in a current institutional or group living placement
- An extraordinary health and safety risk approved by the Division Director
These groups are adjusted over time. The August 2026 amendment, for example, added a reserved group for people moving from an institution under the Money Follows the Person program and removed some others. Ask your BDS district office which criteria apply today.
What CIH covers
CIH offers a broad menu. Your case manager helps choose services that match your goals and needs, and they appear on your plan. Services include:
- Residential Habilitation and Support (RHS): staff support at home with daily living, skills, safety and community life, offered hourly or daily
- Structured Family Caregiving: support for a person living with a trained family or host caregiver
- Day habilitation and prevocational services
- Respite for unpaid family caregivers
- Behavioral support services and intensive behavioral intervention
- Therapies: occupational, physical, speech, psychological, music and recreational
- Transportation, remote supports, personal emergency response systems and specialized medical equipment
- Wellness coordination, community transition services and workplace assistance
In Indianapolis, Aken provides BDDS waiver services including Residential Habilitation and Support services in Indianapolis, day habilitation and respite care.
What changed for CIH in 2026
Capacity and the waiting list
According to The Arc of Indiana, the CIH and Family Supports waivers reached maximum capacity in December 2025, and in February 2026 people who had been invited to start the process were placed on a new waiting list. The Arc also reports that, under a BDS process beginning January 2026, people moving from Supervised Group Living to CIH must first live in that setting for 365 consecutive days before applying.
The August 2026 amendment
FSSA’s CIH fact sheet for August 2026 outlines the main updates:
- Revised definitions for Residential Habilitation and Support, with a reduced rate for live-in caregivers
- Paid relatives and legal guardians (who are not legally responsible individuals) are limited to 40 hours per week across RHS Hourly, Respite and Workplace Assistance
- Paid family caregiving limited to RHS, Respite, Structured Family Caregiving, Transportation and Workplace Assistance
- Structured Family Caregiving home visits required quarterly
- Remote Supports must be delivered by awake, alert professionals
- Case management moved to contracted companies, with case notes due within seven calendar days
Provider enrollment pause
Indiana Medicaid placed a six-month moratorium, effective August 1, 2026, on new provider certifications and enrollments for certain waiver services, including CIH. This affects new providers, not families already receiving services from an enrolled agency.
Looking ahead: Waiver Reset
FSSA plans to replace CIH, Family Supports, Health and Wellness and TBI with new waivers. A Youth Waiver is targeted for July 1, 2027, and new adult waivers for 2028. The state says interRAI will assign people to support levels that shape budgets, current eligibility will carry over, and current recipients will not need to reapply. The state has also said the reset is unlikely to end waiting lists. Details are still being decided.
How to apply and prepare
- Contact your BDS district office or apply online through the BDS Gateway. Apply for Medicaid separately if needed.
- Gather records showing the disability began before age 22: school evaluations, medical records and psychological testing.
- Document caregiver circumstances, such as a caregiver’s age or health, that may relate to priority criteria.
- Stay in touch with your case manager about the 2026 changes and your annual review.
- Plan for the long term. Aging parents in Marion, Hamilton and Hendricks counties often start planning years before they expect a change.
For an introduction to the system, read What is BDDS and how can it help your family. Questions about services or payment? Call us to talk through your options.
Frequently asked questions
What is the difference between the CIH and Family Supports waivers?
Family Supports offers limited, non-residential services under an annual cap. CIH is more comprehensive, includes residential supports, and budgets are based on individual need rather than a fixed cap.
Is there a waiting list for the CIH waiver in Indiana?
Yes. CIH reached capacity in December 2025, and invited applicants were placed on a waiting list in February 2026. Entry has generally depended on priority criteria and funded slots.
Can a family member be paid under CIH?
Relatives and legal guardians may be paid for certain services, limited to 40 hours a week under the August 2026 amendment. Legally responsible individuals, such as a parent of a minor or a spouse, cannot be paid on CIH.
Does CIH pay for a group home?
CIH funds supports in community settings, such as Residential Habilitation and Support in a person’s home or a small shared home. Traditional Supervised Group Living is funded differently. Ask your case manager what fits.
Aken Home Health and Home Care serves Indianapolis and surrounding counties. Call our office at 317-734-3934 (Mon to Fri, 8am to 5pm) or our 24/7 line at 574-320-4705, or request a free consultation.
