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Remote Support in Indiana: Every Service It Fits, and How It Is Paid

In Indiana, remote supports consent is signed and dated by the individual, guardian, case manager and provider agency representative, as appropriate. Any Indiana provider agency can get Vista Enterprise™, the remote support solution, the way it gets an EHR or payroll system, with no state approval. Billing is separate. The agency’s own trained team responds and decides.

Can any Indiana agency buy a remote support solution?

Yes. Any Indiana provider or agency can get Vista Enterprise™, the remote support solution, which includes VistaLink™, the technology. Like an EHR or payroll system, getting it needs no approval from FSSA, the Division of Disability, Aging and Rehabilitative Services (DDARS), the Bureau of Disabilities Services (BDS), or anyone else.

Billing is a separate question. It depends on the program, the service, your agency’s provider status, and each person’s plan. The rest of this page walks through every place remote support fits in Indiana.

Where does remote support fit in Indiana?

Setting or programHow technology is usually paidWhat to know
CIH Waiver and Family Supports WaiverThe remote supports service, with equipment built into the hourly rateFor adults and for ages 14 to 17
CIH residential habilitation (RHS Daily)Part of the RHS Daily serviceNot billed on top of RHS Daily
ICF/IIDThe facility’s own costFederal staffing floor stays; the waiver remote supports service is not used in licensed ICFs/IID
Nursing homes and assisted livingThe facility’s own costResident privacy rules apply
Home care agenciesThe agency’s own costSupport between visits
Any agency, any settingThe agency’s own budgetNo approval needed to buy

What do Indiana’s waivers say about remote supports?

The Community Integration and Habilitation Waiver and the Family Supports Waiver, both approved effective August 1, 2026, include remote supports. Both waivers serve persons with a developmental disability, intellectual disability or autism and who have substantial functional limitations. Under both:

  • Who it is for. Remote supports serve adult waiver participants and individuals 14 to 17 years of age. For minors, remote supports foster developmentally appropriate independence and do not replace typical parental supervision.
  • Backup is chosen. Remote supports may be used with paid or unpaid backup support, as the service plan says. Paid backup comes from a residential habilitation provider, and unpaid backup can be a family member, friend or other person the individual chooses.
  • Device location comes from an assessment. Where devices go is set through the remote support provider’s assessment, with input from the individual and the Individualized Support Team (IST).
  • The provider is approved. The provider must be an entity approved by FSSA/DDARS/BDS (or its designee) to provide remote supports services and be enrolled as an active Medicaid provider. The provider shows the individual how the equipment works, and the service covers training for paid and unpaid backup support.
  • It does not overlap. Remote supports may not be used to monitor direct care staff and are never used to restrict a person in their home, community or body autonomy. In the CIH Waiver, remote supports may not be used at the same time as structured family caregiving or in the structured family caregiving home. In the CIH Waiver, remote supports and residential habilitation and support (RHS) Level 1 or Level 2 are not billed during the same time. In the Family Supports Waiver, remote supports and participant assistance and care (PAC) are not billed during the same time.

What has to happen before remote support starts in Indiana?

  1. The person plans it. The Person-Centered Individualized Support Plan (PCISP) is developed by the individual with support from the case manager, along with others of the individual’s choosing, who form the Individualized Support Team (IST).
  2. It goes in the PCISP. The PCISP includes remote supports, how they meet the person’s needs, the hours or days per week, and a backup plan.
  3. Everyone in the home consents. Informed consent comes from the individual using the service, their guardian, and the other people living in the home and their guardians. Consent documents are acknowledged in writing, signed and dated by the individual, guardian, case manager and provider agency representative, as appropriate.
  4. A remote supports care plan is attached. It explains how remote supports will be used, is updated at least once a year, and is attached to the PCISP.

How does Indiana pay for remote support?

From the agency’s own budget. Any agency can get Vista Enterprise™ as its own remote support solution, whether or not it bills a service. This is the route for nursing homes, assisted living and home care agencies.

Your agency gets Vista Enterprise™ directly, as its own remote support solution. Indiana then has two ways to pay for the remote supports a person uses:

1. The remote supports waiver service. In the CIH and Family Supports waivers, the provider is paid the full unit rate for each hour of remote supports when all service standards are met, and the hourly rate is divided among the waiver participants present in the home during any part of the hour who have remote supports on their plan. The cost of equipment is built into the rate. Internet, data plans and Wi-Fi are not paid separately; if internet is part of the remote support technology, it may be included in the rate. Remote supports are not paid when provided by the parent of a minor, a spouse, a relative or a legal guardian.

2. Inside residential habilitation (CIH Waiver). Remote supports are an allowable part of residential habilitation and support daily (RHS Daily), and are not billed in addition to it.

Sources, checked October 25, 2026: Community Integration and Habilitation Waiver, IN.0378.R05.02, effective August 1, 2026; Family Supports Waiver, IN.0387.R05.02, effective August 1, 2026; FSSA DDARS 2026 waiver approval announcement; IHCP Provider Reference Module, DDARS HCBS Waivers, version 12.2, September 24, 2026.

How do consent and privacy work in Indiana?

The person requests remote supports through person-centered planning. Where devices go is set through the remote support provider’s assessment, with input from the person and their IST, and the PCISP reflects the person’s control and use of the equipment. The Person-Centered Individualized Support Plan (PCISP) is developed by the person with their case manager and their Individualized Support Team (IST). When the person has a guardian, that person takes part in consent. Consent is informed and written down: the individual, guardian, case manager and provider agency representative sign and date it, as appropriate, and other people living in the home and their guardians consent too. To withdraw consent, the person tells their case manager; the IST meets, and use of remote supports in that setting stops. Use of the system may be restricted to certain hours through the PCISP, and the PCISP reflects how the person wants to inform visitors when video is used. The agency’s own trained team responds and decides, following the plan.

In Indiana’s CIH and Family Supports waivers, cameras are not permitted in bathrooms or bedrooms unless the individual gives clear permission and can turn the camera off, and camera use must be clearly outlined in the PCISP with the appropriate Human Rights Committee approval. No cameras are required in bedrooms, bathrooms or other personal spaces.

What if our staffing stays the same, as in an ICF or a fully staffed group home?

An agency in Indiana can keep every in-person shift and still use remote support, because technology can raise quality even with full staff.

Even a fully staffed overnight shift cannot be in every room at once, stay fully alert through every hour of the night, or carry every detail from one shift to the next. When nothing answers those human limits, they quietly become limits on the outcomes people supported can reach. That is a limit of people, not a failing of staff.

Enabling technology for human services helps with those gaps without replacing anyone. It gives trained people better information and more of their time for the moments that need a person in the room.

  • Fewer night checks that wake people up. For people whose plans do not call for hands-on checks through the night, a door opening on a schedule interrupts sleep and privacy. Non-wearable sensors the person agreed to can let overnight staff know when something may need a person. Whether a plan moves away from scheduled checks is decided through the person’s plan, by the person and their team, with input from the agency’s own nurse or clinician.
  • Better information. Plain-language daily reports on sleep, activity and safety events give nurses and the team a fuller picture than a shift note alone.
  • Closing gaps in data and judgment. A steady record across shifts means handoffs rest on more than memory, and a change that is hard to read in the middle of the night comes to a trained person with the facts in front of them.

Know the limits.

  • In Indiana, the CIH and Family Supports waivers say their remote supports service may not be used in ICFs/IID licensed under IC 16-28 and 410 IAC 16.2. People living in an ICF/IID are not on these waivers. An Indiana ICF/IID that wants to use technology as its own purchase should check its Indiana Department of Health licensing rules and the federal ICF/IID rules first.
  • Federal ICF rules set the staffing floor. In an intermediate care facility for individuals with intellectual disabilities (ICF/IID), federal rules require responsible direct care staff on duty around the clock when people are present, awake in some living units, plus minimum direct care staff ratios. Remote support adds to on-site staff. It does not replace them.
  • Privacy comes first. Federal rules require ICFs to give each person the opportunity for personal privacy. CMS guidance for surveyors says video or audio never takes the place of staff. No cameras are required in bedrooms, bathrooms or other personal spaces. Non-wearable sensors fit that approach.
  • The facility pays. An ICF/IID is paid as a facility, not through a person’s waiver plan, so an ICF that uses Vista Enterprise™ pays for it as its own operating cost.
  • ICF terms apply. In an ICF/IID, the person’s plan is the Individual Program Plan (IPP), developed by an interdisciplinary team that includes the person and the qualified intellectual disability professional (QIDP). A move away from scheduled night checks is decided by that team, including the person and their legal guardian where they have one, with input from the facility’s own nurse, and written into the IPP. If the change could affect the person’s protection or rights, the facility’s specially constituted committee reviews it, and it goes ahead only with written informed consent from the client, their legal guardian, or a parent if the client is a minor.
  • Group homes and privacy. Federal home and community-based settings rules give each person privacy in their sleeping or living unit. Any limit on that must be based on a specific assessed need, written into the person’s plan, and agreed to with informed consent.

Can nursing homes and assisted living in Indiana use remote support?

Yes. Nursing homes and assisted living communities get Vista Enterprise™ the same way any agency does, and the facility’s own trained team responds and decides.

  • Nursing homes. Federal rules give each resident a right to personal privacy and to be free from restraints that are not needed to treat medical symptoms, and require the facility to give each resident adequate supervision and assistance devices to prevent accidents. Better information can help staff see who needs them without waking everyone. Each resident decides whether devices go in and can say no, and a resident representative decides for the resident only as far as the resident, a court or state law gives them that role. CMS guidance for surveyors treats devices that alert staff when a resident moves as position change alarms, so the facility’s care team checks, in each care plan, that a device does not keep a resident from moving freely or disturb their sleep. Remote support does not prevent falls, and it is not a promise that every fall will be noticed. A trained person on the facility’s own team decides each step. Nursing homes are paid as facilities, so Vista Enterprise™ is the facility’s own purchase. In-person staffing rules do not change.
  • Assisted living. Assisted living is licensed by each state, not under the federal nursing home rules, so each community follows its own state’s licensing rules for resident rights, privacy and consent. Where Medicaid home and community-based services (HCBS) pay for a resident’s services there, the federal HCBS settings rules also apply, including privacy in the person’s sleeping or living unit, a door they can lock, and a say in choosing any roommate. Technology placed with each resident’s consent gives staff better information between scheduled visits.
  • In Indiana, nursing homes and assisted living communities follow the state’s own licensing rules alongside the federal ones.

How does remote support help home care agencies in Indiana?

Home care agencies send aides into people’s homes for set hours. Between visits, no one from the agency is there. Remote support helps with that gap: the person keeps their privacy, and the agency’s own trained team can learn when something may need attention and decide who should go.

  • Better visits. Aides arrive knowing how the night went.
  • Earlier notice. Changes in routine can show up before they become a crisis.
  • In Indiana, home care agencies follow the state’s own licensing rules.

Who else can remote support help in Indiana?

It is not all about disability. Remote support is enabling technology for human services as a whole. It works for people with intellectual and developmental disabilities (IDD), older adults, people with physical disabilities, people recovering from an illness or injury, faith-based organizations that run health ministries, and the staff and families who support them.

How does VistaLink™ fit Indiana’s rules?

VistaLink™ uses non-wearable sensors and a display in the home to send events to your agency’s own trained team, and it never acts alone. The agency’s own trained team responds and decides, following each person’s plan.

Your agency stays the provider. It confirms that its full setup meets Indiana’s rules for the service it bills, or the rules for its license if it bills nothing. For remote supports, that includes FSSA/DDARS approval as a remote support provider, the PCISP, the remote supports care plan and the signed consent.

Vista is not the direct service provider. The agency or facility is. Vista Enterprise™ supports the people who plan and give support: the person, their family or guardian where they have one, the provider’s own team, and any case manager or coordinator. It helps them follow the rights, privacy and consent rules that apply in that setting and state, and build each person’s plan around their own wants and needs. The agency’s own trained team responds and decides.

For states and government agencies

Vista can also work with Indiana’s Family and Social Services Administration (FSSA) and its Division of Disability, Aging and Rehabilitative Services (DDARS), and with other state and government agencies, for example through a procurement or a contract. Any single agency, in any state or anywhere in the world, can already get Vista Enterprise™ with no state approval.

Remote support for states and government agencies

What does remote support look like for an Indiana agency? (composite example)

This is a composite example built from common situations. It is not a real person.

A man on the Family Supports Waiver lives with his parents and wants to stay home on his own while they work. With his case manager and his Individualized Support Team (IST), he adds remote supports to his PCISP for set hours each week, with his mother as unpaid backup. He, his parents, his case manager and the provider sign the consent. Non-wearable sensors and a display in the home send events to a trained staff member at an approved remote support provider, who checks in the way his plan says and calls his mother when he needs someone in person.

Questions and answers

Can any Indiana agency buy a remote support solution?

Yes. Any Indiana provider or agency can get Vista Enterprise™, which includes VistaLink™. Like an EHR, it needs no FSSA, DDARS or BDS approval. Billing follows each program’s rules.

Which Indiana waivers include remote supports?

The Community Integration and Habilitation (CIH) Waiver and the Family Supports Waiver (FSW). Both serve persons with a developmental disability, intellectual disability or autism and who have substantial functional limitations.

Who can use remote supports in Indiana?

Adult waiver participants and individuals 14 to 17 years of age. For minors, remote supports foster developmentally appropriate independence and do not replace typical parental supervision.

Who signs remote supports consent in Indiana?

Informed consent documents are acknowledged in writing, signed and dated by the individual, guardian, case manager and provider agency representative, as appropriate. Other people living in the home, and their guardians, also give informed consent.

How does someone stop remote supports in Indiana?

The person notifies their case manager. The Individualized Support Team (IST) meets to discuss other supports, everyone affected is told right away, and use of remote supports in that setting stops.

How is remote supports paid in Indiana?

Through the remote supports waiver service, at an hourly unit rate divided among the waiver participants present in the home during any part of the hour who have remote supports on their plan. The equipment cost is built into the rate. In the CIH Waiver, remote supports can also be part of residential habilitation and support daily (RHS Daily), and is not billed on top of it.

Can an Indiana ICF, nursing home or assisted living facility use remote support?

Indiana’s CIH and Family Supports waivers say their remote supports service may not be used in ICFs/IID licensed under IC 16-28 and 410 IAC 16.2, and people living in an ICF/IID are not on these waivers. An Indiana ICF/IID that wants to use technology as its own purchase should check its Indiana Department of Health licensing rules and the federal ICF/IID rules first. Nursing homes and assisted living communities can use Vista Enterprise™ as their own tool alongside on-site staff; staffing rules still apply in full, and the facility pays for it as its own cost. No cameras are required in bedrooms, bathrooms or other personal spaces.

Who responds when remote support is in place?

Your agency’s own trained team responds and decides, following each person’s plan. VistaLink™ never acts alone.

Is remote support in Indiana only for disability services?

No. It fits any human service where staff cannot be everywhere at once: disability services, older adults, assisted living, nursing homes, home care and faith-based health ministries.

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