Indiana state officials are working to establish a second short-term residential facility designed to stabilize intellectually disabled adults who require temporary, around-the-clock supervision. The initiative follows the closure of a co-ed facility in Marion in 2024 and aims to address a significant service gap, particularly for women, according to the Indiana Family and Social Services Administration (FSSA). However, this proposal has renewed concerns among disability advocates who fear the move signals a potential return to institutionalization, especially in light of recent changes to Medicaid disability waiver assessments.
FSSA recently issued a request for proposals (RFP) seeking a provider to operate a 10-20 bed short-term residential facility. This new center is intended to replace the previously shuttered co-ed facility and address the service gap. The facility, known as a comprehensive rehabilitative management needs facility, would offer intermediate-level care for intellectually disabled adults who have severe behavioral, psychiatric, or medical needs demanding intensive, coordinated, and continuous clinical support. According to the state’s RFP, these facilities are crucial for ensuring that individuals with acute or high-risk needs receive timely, structured, and clinically informed services. The aim is to promote stabilization and prepare individuals for a successful transition back to a less restrictive community setting.
Adults eligible for admission to this type of facility are those who cannot be effectively served within traditional group homes or standard community-based settings, the RFP states. It also notes that Indiana’s current service system lacks sufficient capacity to provide the specialized level of standardization and active treatment these individuals require. Currently, the only comprehensive rehabilitative management needs facility for intellectually or developmentally disabled adults in Indiana is male-only. The voluntary closure of a separate co-ed facility in 2024 exacerbated the problem, meaning individuals, especially females, may experience extended stays in inappropriate environments or delays in stabilization, according to the state’s RFP. The RFP indicates that a second facility will address this gap, providing high-quality, short-term intensive services for individuals experiencing complex crises, regardless of gender. The state is looking for a secure campus-style environment that provides residents with access to outdoor and recreational spaces, alongside clinical support and other programming. A spokesperson for FSSA confirmed that the current per diem rate for a Medicaid-certified and licensed comprehensive rehabilitative management needs facility is $703.
Despite the state's stated need, the request for proposals has heightened concerns among disability advocates. They believe the state’s new assessments for Medicaid disability waivers, which are designed to help disabled people remain in their communities, might be signaling a move towards institutionalization. FSSA has reportedly denied a higher rate of disability waivers this year since implementing interRAI assessments. These assessments are used to determine eligibility for various Medicaid waivers, including those for family supports and community integration and habilitation. Jan Steck Huffman, a parent and disability advocate, expressed that families need to know if individuals could be referred to this institution due to insufficient waiver budgets to support them safely in the community. Huffman urged FSSA to disclose the projected total cost, explain the selection process for individuals, and guarantee that interRAI results or inadequate waiver funding would not lead to institutionalization. She emphasized that Indiana should first invest in community-based services that allow people with disabilities to remain in their homes, with their families, and in their communities. The Arc of Indiana, a group advocating for disability rights, has also contacted FSSA for clarification on the issue. Tom Crishon, the organization’s chief legal officer, affirmed The Arc of Indiana's commitment to ensuring people with disabilities can access the services and supports needed to live in their homes and communities.
