Attendant care, FSSA oversight weakened in final hours


By Whitney Downard | Indiana Capital Chronicle

As the final minutes ticked by for the 2024 legislative session, legislators walked back previous proposals to tighten oversight of the Family and Social Services Administration (FSSA) and increase payments to families caring for disabled children.

Additionally, a priority Senate bill on reducing fines and fees easily passed both chambers.

Earlier in the week, a bill on state funds included several “accountability” reports for the agency, which reported a nearly $1 billion shortfall for the next 18 months of their operating budget.

But not everyone was happy with the final version, which passed the House unanimously.

“We really had an opportunity this session to make a large leap in helping those families. We’re leaving this session without addressing the needs of those needy families,” said Rep. Cherrish Pryor, D-Indianapolis. “I will be supporting the bill because we’re doing some things. We’re really not doing enough but I guess a little bit of something is better than a whole lot of nothing.”

The bill had a tougher time in the Senate, where it passed on a 42-5 vote. The senators who spoke against the bill didn’t mention attendant care or FSSA oversight as an issue.

Background on attendant care, FSSA
In response to the $1 billion deficit, FSSA announced a series of cost-saving measures that included halting a 2% Medicaid index, or increase.

However, the House amendments on reporting and pass-through payments moved from Senate Bill 256 to House Bill 1120 in the waning hours after the Senate ruled that the additions weren’t germane to the underlying bill.

House Bill 1120 also makes several tweaks to property tax law, including language on deductions and assessments for certain classes of Hoosiers, such as veterans, among other provisions.

Rather than requiring that a specific percentage of funds be passed through to families, the bill now states that FSSA “shall” set a required minimum percentage of reimbursement for personal care services, which includes structured family caregiving and attendant care.

Previously, the House had passed language mandating that 80% of funds paid by FSSA go to families in response to reports of caregivers receiving less than half of attendant care funds.

“I know in the House-passed version … we had 80%. I can tell you right now, (that’s) probably not workable,” Thompson told members of the rules committee.”My guess is in the 50 to 70 (percent) — taking a ballpark guess — of where it would fall.”

Additionally, the agency must prepare and present a plan for monitoring Medicaid expenses to the Medicaid Oversight Committee and not the State Budget Committee. That report must include: monitoring plans, plans to improve transparency for Medicaid expenditures and “an explanation of the issues that led to the deviations in the … Medicaid projections” along with planned improvements.

Rep. Jeff Thompson, R-Lizton, listens to discussion on the House floor on March 8, 2024. (Whitney Downard/Indiana Capital Chronicle)
Lastly, FSSA must include “information concerning the transition” from attendant care to structured family caregiving — a weaker requirement than previously introduced by House Republicans.

In a statement, Rep. Ed Delaney called the cutting of enhanced reporting standards previously in Senate Bill 256 a “cover up.”

“When the Republican administration makes a billion-dollar mistake, the Republican legislature has choices to make. They can try to get to the root of it and hold people accountable, or they can try to bury the issue. They can make sure that families with seriously disabled children are protected from this error, or they can let the poorest among us suffer,” the Indianapolis Democrat said. “… Hoosier taxpayers deserve to know what exactly happened to their hard-earned money. It is telling that provisions to increase fiscal transparency were removed behind closed doors during the least transparent part of the legislative process.”

Other action on SB4

Lawmakers additionally approved Senate Bill 4, a priority for Senate Republicans. The bill would establish a review of unused state government funds and allow agencies to cut fines or fees through an internal process — rather than requiring an appearance before the State Budget Committee.

Rules with a fiscal impact of more than $1 million are subject to additional scrutiny and requirements under the final version of the bill — entirely new language that Democrats noted hadn’t been mentioned in a brief conference committee earlier this week.

“It is really now this session’s poster child for a failing conference committee session,” Rep. Matt Pierce, D-Bloomington, said. “What is the point of having these meetings? How are you supposed to understand as a member of the public — as a fellow member of this body — what are the issues at stake within Senate Bill 4?”

“And so now we have a bill adding in all this stuff that never got a hearing or discussion in the house (and) adding in some new bureaucracy. So now the agencies have to jump through yet another hoop when they’re attempting to do something,” Pierce continued.

Pierce and two dozen of his Democrat colleagues voted against the bill, which cleared the chamber on a 68-25 vote. The bill faced no opposition in the Senate and moved on a 46-0 vote.

The Indiana Capital Chronicle covers state government and the state legislature. For more, visit

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