Recipients and providers funded through the Medicaid Waiver need your help.  Please consider reading about our issue and signing our petition.  On June 18, 2025 a DDRS Advisory Board met to discuss the future of the Medicaid Waiver (click here for video) and during this meeting discussed a cap of service hours for recreational therapy through these waivers of no more than 6 hours a month to start at the beginning of 2026, which previously was the minimum offering for service hours.  This decrease in service time is a drastic change from the current structure that individuals can request as many recreational therapy hours that they need along with other services that are needed/provided through the waiver which include Direct Support Staff (DSP), Participant Assistance and Care (PAC), Behavioral Services, Music Therapy, Case Management, to name a few.  Recreational therapists currently provide services to the populations supported through the Community Integration and Habitation Waiver (CIH) and the Family Supports Waiver (FSW).  The waiver provides access to a budget that funds their services and providers of choice for their individualized needs.   

` The Community Integration and Habitation Waiver (CIH) and the Family Supports Waiver (FSW) combined support over 32,000 individuals with varying disabilities and needs across Indiana.  Indiana currently is not providing full coverage of necessary services to many of the individuals already receiving waiver funding due to lack of availability, high turnover rates, and lack of services in rural areas; so putting caps or additional limitations on necessary services restricts the individuals ability for their choice and needs to be considered.  NCTRC, the national governing body for recreational therapists, has 467 certified therapists in Indiana with a significant percentage working in waiver due to its access across the entire state.  This change not only affects the recipient’s of services, but also the providers.  At the end of this petition is a running list of providers that are currently offering recreational therapy services in Indiana through the 2 Medicaid Waivers (CIH and FSW) that will be impacted by the potential changes that will arise with the proposed  service hour cap. Please help us add to this list if there are any recreational therapy providers we have missed.  

 Recreational Therapy is “a systematic process that utilizes recreation and other activity-based interventions to address the assessed needs of individuals with illnesses, disabling conditions, and/or adverse circumstances to promote psychological and physical health, recovery, and well-being. Recreational Therapy aims to restore, remediate, or rehabilitate the client’s level of functioning and independence in life activities. Recreational Therapists work in a variety of clinical and community settings and utilize their unique expertise to help individuals overcome barriers to well-being and/or participation in meaningful leisure activities.” (atra-online.com, 2025).  One of the settings recreational therapists provide services in Indiana is through 2 of the 4 medicaid waivers offered within Community and Home-Based Services through the Division of Disability and Rehabilitative Services (DDRS), whose main intention and purpose is to facilitate partnerships that enhance quality of life and provide continuous, life-long support (in.gov, 2025).  Within DDRS, the Bureau of Disabilities Services (BDS) administers individualized, integrated, community-based services.  BDS also has statutory authority over the state’s home and community-based services for individuals with intellectual and developmental disabilities and persons 59 and younger with physical disabilities.       

 The previously mentioned cap proposal for recreational therapy services limits the amount of time the individual and/or support team can choose is necessary for their specific goals to live their best life.  The 6 hour per month for recreational therapy restricts a necessary goal-based service that not only promotes positive growth but decreases possible government and Medicaid expenditures within the specific areas of medication cost, hospital visits, and incarcerations.  Recreational therapy helps reduce these costs through annual assessments and evaluation, and goal-driven, evidence-based interventions that promote better health and lifestyle changes to decrease medication use by incorporating skills and education tools to promote healthy eating and regular physical activity.  This can also help decrease hospital stays and emergency room visits, with ambulance transportation.  Recreational therapist also provide social and emotional support that promotes choices that can avoid incarceration or unnecessary court fees and support.  Recreational therapy is also one of the first services by choice for families and support teams due to the service’s ability to provide support with connection and success across multiple life domains.  This can positively impact the individuals ability to attend a day program or live independently and/or with direct support staff.  

 Recreational therapist are required to have a minimum of a bachelor’s degree (some with graduate level degrees) and a national certification through NCTRC that requires annual continuing education to maintain.  When providing service, therapist’s offer a structure that follows an Assessment, Planning, Implementation, and Evaluation process.  Recreational therapist’s working through the waiver rely on the community resources such as community centers, parks, museums, and individualized resources to follow this structure.  Each therapist reviews and updates goals and treatment plans and connects with the team for planning and training needs.  Recreational therapy time cannot limit time or rush the therapeutic process with hopes for the same outcome.  Having adequate time for therapeutic interventions and social group outings provides increased focus for growth, processing through emotions and barriers and creating a supportive therapeutic bond that can continue to push limits.  All the pictures listed are from group and one on one recreational therapy sessions that all exceed the suggested service limitation.  Most of these opportunities will require extreme adjustments that forfeit consistency to support the proposed change stays as it is.  Individuals currently receiving recreational therapy will be most impacted. 

 

 

 

 

Bureau of Disabilities Services website states “they envision a community where all people have equal access and opportunity to realize their good life and are committed to partnering with individuals, families and professionals to ensure person centered services that empower people with disabilities and their families by connecting them to the resources and supports to live their best life.” (in.gov, 2025). Their core value is that all people have the right to live, love, work, learn, play and pursue their dreams.  The changes proposed in this meeting do not promote ‘best life’ practices and we request your help to get our voice heard.  We appreciate your support with signing and sharing this petition.  If you are interested in doing more, here are 3 steps you can take to action to further support our voice:

1. Write a letter to your local legislature (how to find yours) about your thoughts on changes with access to recreational therapy on the Medicaid Waiver 
2. Call the BDDS number and/or your local FSSA office and tell them why you choose recreational therapy and your thoughts on limiting access
3. Comment or leave a testimonial on the petition and share the petition

Here are other links you can follow to continue to support Recreational Therapy and Individuals served on the Medicaid Waiver:

ATRA advocacy tool kit

ASHA

The Arc

Thank you again for your consideration and added voice to support our cause.  We value what we do for our individuals and your signature and advocacy is valued now, more than ever.  

Running List of Recreational Therapy Providers that will be Impacted by the Limits in Service Hours through the Community Integration and Habitation Waiver and the Family Supports Waiver.

Accessabilities, Inc

Adec, Inc

All About You Therapy, Inc

Apex Behavioral Services, LLC

Assisted Independence LLC

Aw Holdings, LLC

Behavior Services & Therapy Inc

Bridges Of Indiana, Inc

Caroline Ann Kracium

Crossroads Rehabilitation Center, Inc

Diversified Therapies and Services, LLC

Ellison Behavior Consulting

Embracing Abilities Inc

Ferraro Behavior Services, LLC

Flow Recreation LLC

Foster, Julie, CTRS

France, Ginny L

GeTRec’d

Guiding Recreation LLC

Hillcroft Services, Inc

Janus Developmental Services, Inc

Kids Play Gym

LEL Home Services, LLC

Logan Community Resources, Inc

Mandy McQueeney

Maple Seed Farms, Inc

Meaningful Day Services, Inc

Morse, Katherine M

New Hope Of Indiana, Inc

New Leaf Recreation LLC

New Star Inc

New Wave Behavior Management LLC

Noble Of Indiana

North Node Wellness, Inc

Northern Indiana Therapies, LLC

Outside The Box, Inc

Outward Bound Support Services, LLC

Positive Pathways Counseling and Consulting, LLC

Pure Abilities LLC

Residential Services Incorporated

Rheta Denise Conner

Stone Belt Arc, Inc

Supportive Community Innovations LLC

Sweet Behavior, LLC

Sycamore Rehabilitation Services

The Arc Of Northeast Indiana