By Indy Senior Advisor Care Team · July 31, 2026
Indiana funds an in-home services program with no income limit called CHOICE. Most Indianapolis families have never heard of it. Here is who qualifies, what it actually pays for, and why the waiting list is the part that matters most.
A Program Almost Nobody Mentions
When a parent starts needing help at home, most families in Marion or Hamilton County hear about exactly two options: pay privately, or qualify for Medicaid. There is a third one sitting between them that rarely comes up in a hospital hallway conversation, and it is funded entirely with Indiana state dollars.
It is called CHOICE, which stands for Community and Home Options to Institutional Care for the Elderly and Disabled. The Indiana General Assembly created it in 1987 through House Enrolled Act 1094. It started as a three-county pilot in 1988 and reached all 92 Indiana counties by 1992. It has been running quietly ever since.
CHOICE is not administered by a state office you call directly. Indiana routes it through the state's 16 Area Agencies on Aging. For Marion, Hamilton, Hendricks, Johnson, Boone and Hancock counties, plus Morgan and Shelby, that agency is CICOA Aging & In-Home Solutions, designated as Area 8. One agency covers all six counties this site serves, so there is no county-by-county hunt.
The reason it stays invisible is structural. No facility markets it, because CHOICE does not pay facility rent. No hospital discharge planner leads with it, because it is not a discharge benefit. It is a program you have to go find.
It Is Not Medicaid, and That Is the Whole Point
The single most useful thing to understand about CHOICE is that it has no income limit. FSSA states this plainly: there are no income limits for the program. A retired couple with a solid pension can be eligible. That is not true of anything else in Indiana's long-term care landscape.
There is a cost share instead. Anyone above 150 percent of the Federal Poverty Level pays a portion of the cost of their own services, on a sliding scale. There is also a separate cost share based on countable assets. So higher income does not disqualify you, it just means you pay more of the bill yourself.
There is an asset ceiling. For anyone applying after June 30, 2017, countable assets cannot exceed $250,000, and the Division of Aging excludes an additional $20,000 in countable assets when it runs that calculation. That is a far more forgiving number than the $2,000 resource limit that governs long-term care Medicaid.
The trade-off is that CHOICE is a payer of last resort. FSSA's rule is explicit: CHOICE funds may not be used if other funding such as Medicare or Medicaid is available to meet the individual's needs. If your parent is already on the PathWays Waiver, CHOICE is not going to layer on top of it for the same service. CHOICE exists for the family that earns too much for Medicaid and not enough to buy their way through the problem.
What Actually Qualifies Someone
Three things have to be true. The person has to be an Indiana resident. They have to be at least 60 years old, or be a person with a disability, defined in the program's governing statute as a severe chronic impairment likely to continue indefinitely. And they have to be assessed as at risk of losing their independence.
That third condition is where the assessment lives. The standard is an inability to perform two or more assessed activities of daily living, or fewer than two if the agency determines, using established criteria, that a targeted intervention would significantly reduce the likelihood that independence is lost. Activities of daily living here means bathing, dressing, eating, toileting, medication setup, and moving around safely.
That second half of the rule is worth reading twice. A parent who is failing at only one ADL can still qualify if the right small intervention would head off a larger collapse. Families routinely assume they are not sick enough yet and never call. The statute was written to catch people earlier than that.
The assessment itself is run by CICOA staff and can happen in the home, at CICOA's office at 8440 Woodfield Crossing Blvd. in Indianapolis, or at another agreed location. Significant deterioration over the previous six months is also taken into account, so document what has changed since winter rather than describing only today.
What It Pays For, and What That Buys
The service menu is broad: attendant care, homemaker services, home-delivered meals, adult day services, respite, care management, skilled nursing, home health aide, transportation, personal emergency response systems, environmental and vehicle modifications, specialized medical equipment, handy chore work, and pest control.
Statewide spending shows what families actually use. In state fiscal year 2024, attendant care was the largest single CHOICE expenditure at roughly $10.8 million, followed by care management at about $6.6 million, home and community assistance at $3.2 million, and home-delivered meals at $1.2 million. Hands-on help and someone coordinating it are the two things the program mostly buys.
Now the honest part about scale. For participants receiving actual services rather than care management alone, CHOICE averaged about $1,201 per month per person in SFY 2024. Against the 2025 CareScout median of $35 an hour for non-medical home care in Indiana, that is on the order of 34 hours a month. Roughly eight hours a week.
Eight hours a week is not a care plan. It is a hinge. It can be the difference between a daughter in Fishers keeping her job and quitting it, or between a shower happening safely twice a week and not happening at all. Go in expecting a supplement to what the family already does, and the program looks like what it is. Go in expecting it to replace privately paid in-home care and you will be disappointed.
The Waiting List Is the Real Constraint
CHOICE has a fixed state appropriation, so when demand rises, the agencies queue people. Statewide, the CHOICE waiting list grew 85.6 percent between the end of SFY 2023 and the end of SFY 2024, from 1,177 people to 2,184.
Central Indiana absorbed a disproportionate share of that. Area 8, CICOA's territory, went from 96 people waiting on June 30, 2023 to 359 on June 30, 2024. That was the second-largest waiting list of any of Indiana's 16 Area Agencies on Aging at that date. Nearly a quadrupling in twelve months.
There is a detail in the same FSSA report that we are not going to pretend to explain. Area 8 was budgeted $5,503,342 in CHOICE grant funding for SFY 2024 and spent $4,486,603 of it, leaving just over $1.0 million unspent, the largest unspent balance of any Indiana AAA that year. The report documents the number without giving a cause. Rate increases that year were steep, including a more than 47 percent jump in the attendant care rate, and the agencies were absorbing a lot of change at once. We do not know why the money and the list moved in opposite directions, and we would rather say so than guess.
The practical instruction is the same either way: get the assessment scheduled before you need the service. A place on a list you did not join is worth nothing, and there is no penalty for being assessed and then not needing help for another eight months.
How CHOICE Fits Next to the PathWays Waiver
For many central Indiana families, CHOICE functions as the bridge. A parent needs help now, the Medicaid waiver process is going to take months, and CHOICE can start something in the meantime without a Medicaid determination.
The state tracks that handoff. In SFY 2024, 68 CHOICE participants moved from a CHOICE service plan onto the Aged and Disabled Medicaid waiver, down from 128 the year before. FSSA attributed part of the drop to the waiting list that opened on the Aged and Disabled waiver in April 2024. The state also said that as people are invited off that waiting list, those coming from a CHOICE service plan get priority status for the invitation.
One timing note matters for anyone reading older material. That fiscal year closed on June 30, 2024, exactly one day before Indiana replaced the Aged and Disabled Waiver with the PathWays Waiver for Hoosiers 60 and older and the Health and Wellness Waiver for people under 60. So every waiver figure in that report describes the old structure. FSSA had not published a CHOICE annual report covering the post-PathWays period as of this writing, which means nobody has current published numbers on how the two programs interact under managed care. Ask CICOA directly rather than trusting a secondhand figure.
Keep the room-and-board distinction straight while you are at it. Neither CHOICE nor PathWays pays rent in an assisted living community. Room and board assistance in a licensed Residential Care Facility runs through RCAP, a separate Medicaid category entirely, and a community can hold a PathWays agreement, an RCAP agreement, both, or neither. Indiana has no broad state subsidy that simply pays assisted living rent.
What to Do This Week
Call CICOA's Aging and Disability Resource Center at 317-803-6131 or 800-432-2422 and say you want an options counseling appointment and a CHOICE eligibility screening. Those are two different things and asking for both by name saves a callback. If you are outside CICOA's eight counties, the state's Area Agency on Aging line is 800-986-3505.
Have your parent available for that call. CICOA asks that the person receiving services be present by phone to give consent for screening, or at minimum that they have been told a referral is coming. An adult child cannot simply enroll a competent parent from a different area code.
Bring three things to the conversation: a specific list of which daily tasks are failing and how often, what changed in the last six months, and a rough picture of countable assets against that $250,000 ceiling. Vague worry produces vague answers. Two falls since March and a missed medication three times last week produces an assessment.
And ask about the waiting list explicitly. Ask where the list stands today, how the agency prioritizes it, and whether anything else in CICOA's stack, such as home-delivered meals or caregiver support, can start while you wait. If the answer is a long queue, that is real information and it should change how you plan the next six months rather than stop the process. Our advisors can help you think through what happens if home stops working in the meantime.
