LEGISLATIVE SERVICES AGENCY
OFFICE OF FISCAL AND MANAGEMENT ANALYSIS
FISCAL IMPACT STATEMENT
LS 6566 NOTE PREPARED: Dec 12, 2024
BILL NUMBER: HB 1262 BILL AMENDED:
SUBJECT: Home- and Community-Based Services Waivers.
FIRST AUTHOR: Rep. Greene BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State
DEDICATED
XFEDERAL
Summary of Legislation: The bill requires the Office of the Secretary of Family and Social Services to
apply to the United States Department of Health and Human Services for an amendment to each home- and
community-based services (HCBS) Medicaid waiver to exclude the income and resources of a spouse when
determining an individual's eligibility for the waiver.
Effective Date: July 1, 2025.
Explanation of State Expenditures: The bill will increase workload for the FSSA to apply for an
amendment to each HCBS waiver. The bill’s requirements are within the FSSA’s routine administrative
functions and should be able to be implemented using existing staffing and resources. Medicaid is a shared
state and federal program and some state administrative costs are reimbursed 50% by the federal government.
Additional Information - The enrollment impact of excluding spousal income and assets for HCBS waivers
is indeterminate, but potentially allows more people to join the waiver or the waiting list for a waiver slot.
The HCBS waivers and the estimated users and expenditures per participant for the first year of the waivers
is shown in the table below.
Waiver Unduplicated
Participants
FY 2025 Expenditures
per Participant
Community Integration and Habilitation 10,216 $72,851.81
Traumatic Brain Injury 200 $42,065.73
Health and Wellness 16,127 $33,510.51
Indiana Pathways for Aging 39,842 $38,250.71
Currently, a spouse living in the community (a “community spouse”) may keep all personal income. Jointly
owned income is split between spouses with the community spouse allowed to keep their share. Most assets
HB 1262 1 are considered jointly owned, regardless of the listed owner of the asset, and half of the value is assigned to
each spouse. Homes are non-countable assets if the spouse, a child, or the applicant will live in the house.
Explanation of State Revenues:
Explanation of Local Expenditures:
Explanation of Local Revenues:
State Agencies Affected: Family and Social Services Administration.
Local Agencies Affected:
Information Sources: https://www.medicaid.gov/medicaid/eligibility/index.html;
https://www.in.gov/iltcp/files/Spousal-Impov.pdf;
Appendix J: Cost Neutrality Demonstration from the Traumatic Brain Injury waiver amendment number
IN4197R0503, approved effective date 7/1/24, the Community Integration and Habilitation waiver
amendment number IN0378R0408, approved effective date 7/1/24, and the Health and Wellness waiver
amendment number IN4197R0503, approved effective date 7/1/24.
Fiscal Analyst: Karen Rossen, 317-234-2106.
HB 1262 2