LEGISLATIVE SERVICES AGENCY
OFFICE OF FISCAL AND MANAGEMENT ANALYSIS
FISCAL IMPACT STATEMENT
LS 7677 NOTE PREPARED: Jan 15, 2025
BILL NUMBER: HB 1391 BILL AMENDED:
SUBJECT: Services for the Aged and Disabled.
FIRST AUTHOR: Rep. Clere BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State
DEDICATED
XFEDERAL
Summary of Legislation: CHOICE Program: This bill amends the definition of "community and home care
services" for purposes of Community and Home Options to Institutional Care for the Elderly and Disabled
Program (CHOICE). It allows a local Area Agency on Aging (AAA) to conduct certain: (1) outreach and
education activities; and (2) evidence based activities and programs.
This bill requires the Division of Aging (Division) to develop and implement a process to reimburse an AAA
from CHOICE funding for conducting these activities. It requires the Division to reimburse an AAA in
accordance with this process. It prohibits the Division from requiring a CHOICE provider to be certified
under a Medicaid waiver program. It requires the Office of the Secretary of Family and Social Services
(FSSA), in negotiating reimbursement rates for CHOICE services, to consider the location and availability
of service providers.
Level of Care Assessments: This bill allows FSSA, a managed care organization that has contracted with the
Office of Medicaid Policy and Planning, and a person who has contracted with a certain managed care
organization or the FSSA to contract with an AAA to provide and receive reimbursement for a level of care
assessment for the: (1) Health and Wellness Medicaid waiver; (2) Traumatic Brain Injury Medicaid waiver;
and (3) risk based managed care program for the covered population.
Effective Date: July 1, 2025.
Explanation of State Expenditures: CHOICE Program: The bill has several provisions affecting services,
reimbursement, and providers within the CHOICE Program. This could increase claims, yet any increase in
expenditures resulting from newly negotiated rates, expanded service offerings for individuals with dementia,
or access to additional providers, must be within the amount appropriated to the CHOICE Program. The
CHOICE Program was appropriated $48.8 M per year for FY 2024 and FY 2025.
The bill impacts workload for the FSSA, including FSSA’s Division of Aging, to negotiate reimbursement
rates, implement new service reimbursement procedures, and update requirements regarding the selection
HB 1391 1 of providers for the CHOICE Program. These requirements should be able to be implemented using existing
staffing and resources.
Level of Care Assessments: Currently, level of care assessments are conducted by an AAA until July 2025.
At that time, responsibility for completing level of care assessments will be transferred to Maximus (the
state’s enrollment broker). This bill allows an AAA to enter into a contract to continue conducting level of
care assessments.
Additional Information: The CHOICE Program is administered through Indiana’s AAAs and provides home
and community-based services to assist individuals in maintaining their independence in their own homes
or communities. CHOICE Program applicants must be at least 60 years of age or have a disability, must meet
specific asset/resource requirements, and must be found to be at risk of losing their independence (usually
indicated by difficulties with activities of daily living such as bathing, dressing, walking, transferring, or
using medications). CHOICE Program funds may not be used if other funding such as Medicare or Medicaid
is available to meet the individual’s needs.
There are a total of 15 AAAs in Indiana covering 16 geographic regions. The AAAs serve as the primary
access point for: home and community based waiver programs, the Older Americans Act, the Social Services
Block Grant, and the CHOICE Program. The AAAs also serve as the primary provider of case management
services for Medicaid members receiving state plan long-term care services and those participating in the
state’s Aged and Disabled waiver program.
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: PeopleSoft Financials data;
https://www.in.gov/fssa/da/community-and-home-options-to-institutional-care-for-the-elderly-and-disabled;
https://www.in.gov/fssa/da/files/AAA_Map.pdf;
https://www.in.gov/pathways/provider-frequently-asked-questions/#How_will_enrollment_work_for_clie
nts_not_currently_in_a_waiver__but_may_be_eligible_for_waiver_services_.
Fiscal Analyst: Jason Barrett, 317-232-9809.
HB 1391 2