Direct support professionals serving Indiana's Family Supports waiver must now be listed on the state's DSP registry, and Participant Assistance and Care services need hourly shift notes, under waiver changes effective for services on or after Jan. 1, 2026. Indiana's Medicaid program announced on Jan. 22, 2026, that federal regulators had approved the changes to the waiver, which serves people with intellectual and developmental disabilities.
What the waiver changes require
Under a 2023 state law, direct support professionals serving waiver participants must now be listed on the state's Home and Community Support Professional Training Registry. Getting listed requires competency-based training of up to 16 hours across 12 core areas, with periodic recertification. Paid caregivers providing Participant Assistance and Care must now document what they did in each hour of a shift. The amendment adds self-direction for some services, a new Benefits Counseling service and a restructured behavioral support model. It also closes facility-based prevocational services to new enrollees and lets parents of minors or spouses be paid for up to 40 hours a week in cases of extraordinary medical need.
Why this matters for providers and DSPs
Unregistered staff can no longer provide these services, and hourly notes add paperwork to every shift. Indiana agencies need to track registry status and build the new documentation into training and scheduling.