Begin with the participant's priorities and written plan

A routine is a communication tool—not a new authorization

Write down how the participant prefers authorized support to happen, who communicates changes, and what the worker should do if something is unclear. Do not use a household checklist to expand duties, hours, or clinical care.

Indiana's current PathWays provider reference module, published June 15, 2026, describes Attendant Care as hands-on, nonskilled help related to activities of daily living. The exact support for one person depends on assessment, the person-centered service plan, authorization, and the delivery arrangement. A general list online cannot determine individual coverage.

The same Indiana module says long-term services and supports must be authorized from the member's current needs assessment and be consistent with the person-centered service plan. It also places ongoing planning and monitoring responsibilities with the service coordinator. If the plan and the household routine do not match, pause and ask the provider and coordinator which instruction controls.

12 questions to build a respectful daily routine

  1. What matters most to the participant? Record preferred wake-up times, pace, communication style, cultural practices, privacy expectations, and choices about who may be present. Use the participant's own words when possible.
  2. Which activities are actually authorized? Match the routine to the current plan rather than a generic job description. Indiana's module identifies direct help with activities such as personal care, mobility, elimination, and nutrition, but that does not mean every activity is authorized for every person.
  3. How much help does the participant want and need? Distinguish a verbal cue, setup, standby support, and hands-on assistance. Ask the worker to support the person's independence within the written plan instead of automatically taking over.
  4. How should personal care protect dignity? Confirm doors, coverings, preferred products, sequence, communication before touch, and any gender or cultural preferences the provider has agreed to honor.
  5. What are the approved mobility and transfer steps? Identify the equipment, positioning, space, and participant-specific training the worker must use. A family should not improvise a transfer method or ask an untrained worker to copy a technique that is not in the plan.
  6. What nutrition support is expected? Clarify the authorized nonclinical task, food preferences, safe setup, and relevant written instructions. Specialized feeding or swallowing concerns require program and professional guidance; they should not be treated as ordinary attendant-care tasks.
  7. What is the medication boundary? Indiana's PathWays module lists setting up and administering medications as activities not allowed under Attendant Care. If the plan describes reminders or another limited role, confirm the exact language with the provider and coordinator and follow it.
  8. What changes must be reported? Write down observable events the worker should report, whom to contact, and how quickly. The worker should document facts—not diagnose a condition or change a treatment plan.
  9. What should happen if a task feels unsafe or unclear? Give the worker a supervisor contact and a stop-and-ask process. Urgent medical concerns and emergencies belong with the appropriate healthcare or emergency service, not an administrative checklist.
  10. How will the visit be documented? Confirm required notes, visit verification, and correction steps. Our EVV family guide explains why a time record is different from the service authorization.
  11. Who is responsible for schedule changes and backup planning? Identify the provider's call-off number, the participant's preferred contact, and the agreed next step after a missed visit. Use our caregiver backup-plan guide to prepare questions without assuming unpaid help is available.
  12. When will the routine be reviewed? Set a date to confirm the routine still reflects the participant's preferences and current plan. Report changing needs promptly rather than waiting for the checklist date.

Keep agency-directed and participant-directed roles clear

In an agency-delivered arrangement, the provider manages its employees, supervision, training, scheduling, and service documentation within the authorized plan. Families should route employment and performance questions through the agency rather than informally rewriting the worker's duties.

CMS guidance on self-directed services explains that an eligible participant may have authority to recruit, hire, train, and supervise workers, supported by a person-centered process and available assistance. That authority is not automatic for every Medicaid member. Confirm that participant direction is available, chosen, and recorded before treating the participant or representative as the employer.

Indiana's PathWays resources page lists health-plan and Member Support Services contacts. A PathWays member who knows their plan can contact that plan for benefit and coordination questions; someone unsure of their plan can use the state-listed support contact. For another Indiana program or private-pay arrangement, use the responsible program or written agreement instead of assuming PathWays rules apply.

Use one page, plain language, and specific contacts

A routine is easier to follow when it is short and concrete. Put the participant's preferred name and communication approach at the top. Then list the authorized routines in normal time order, the level of help, the supervisor and coordinator contacts, the backup sequence, and the review date.

Leave out diagnoses, financial information, and unrelated personal details that the worker does not need. Store the page through the provider's approved process and ask who may access it. Do not send health or eligibility records through a general website inquiry.

When needs change, our Indiana service-plan review guide can help a family prepare factual observations and questions. A provider may communicate observations, but it cannot independently approve more Medicaid hours or guarantee a particular decision.

Questions about Indiana attendant care?

Veracity Systems LLC DBA Hoosier Care Givers can discuss Indiana personal attendant and related in-home support within its scope and current capacity. Start a service inquiry with the county, requested support, schedule, funding source, and current authorization status if known. Veracity does not determine program eligibility or promise authorization, staffing, or a start date.

Families comparing support categories can read our Indiana in-home service comparison. Prospective employees can review caregiver opportunities and submit the secure caregiver application. Advertised caregiver pay is $18–$21 per hour, depending on state, role, experience, and assignment; employment and any particular rate are not guaranteed.

Frequently asked questions

Does an attendant-care routine replace the authorized service plan?

No. A household checklist can explain preferences and practical details, but it cannot add tasks, hours, or services. The current person-centered service plan and authorization control what Medicaid-funded support may be delivered.

Can an Indiana attendant set up or administer medication?

Indiana's current PathWays provider module lists setting up and administering medications among activities not reimbursable as Attendant Care. Confirm any permitted reminder or observation role in the written plan and agency instructions; do not ask a worker to perform an unauthorized clinical task.

Who should update the routine when needs change?

Tell the provider about day-to-day delivery questions and contact the responsible service coordinator or health plan about changes that may affect the person-centered service plan or authorization. A provider cannot independently promise more Medicaid hours or a broader scope.

Does every Indiana attendant-care participant self-direct workers?

No. Agency-delivered and participant-directed arrangements have different roles. Self-direction applies only when that option is available, chosen, and authorized for the participant. Ask the service coordinator which model is documented.

What should a family do if a scheduled worker cannot come?

Follow the confirmed backup and contact plan. Identify who must be called, which needs cannot safely wait, and when to use appropriate medical or emergency help. Never assume an unconfirmed person is available.

Authoritative resources

Sources reviewed October 31, 2026. Confirm current requirements and the participant's specific authorization with the responsible program, health plan, service coordinator, and provider.

General-information notice: This article is educational and does not provide individualized medical, legal, eligibility, employment, coverage, or service-plan advice. Program rules, authorizations, provider capacity, and individual needs vary and may change. Follow the current written plan and obtain guidance from the responsible program, health plan, coordinator, provider, and qualified professionals.