Family Supports Waiver (FSW)


The FSW program provides Medicaid HCBS to participants residing in a range of community settings as an alternative to care in an intermediate care facility for persons with intellectual/developmental disability (known as an ICF/IDD) or related conditions. The FSW serves persons with intellectual/developmental disabilities, intellectual/developmental disabilities, or autism who have substantial functional limitations, as defined in 42 Code of Federal Regulations (CFR) 435.1010. Participants may choose to live in their own home, family home, or community setting appropriate to their needs. Participants develop an Individualized Support Plan (ISP) using a person-centered planning process guided by an individual support team (IST). The IST comprises the participant, the participant’s Case Manager, and anyone else of the participant’s choosing, but typically family and friends. The participant with the IST selects services, chooses service providers, and develops a Plan of Care/Cost Comparison Budget (POC/CCB).

Goals and Objectives

The FSW accomplishes the following:

  • Provides access to meaningful and necessary home and community-based services and supports
  • Seeks to implement services and supports in a manner that respects the participant’s personal beliefs and customs
  • Ensures that services are cost-effective
  • Facilitates the participant’s involvement in the community where he or she lives and works
  • Facilitates the participant’s development of social relationships in his or her home and work communities
  • Facilitates the participant’s independent living
*Taken from Section 4.5 of the BDDS HCBS Waiver Provider Manual

Community-Based Habilitation

Community-Based Habilitation Services − Individual services are services provided outside of the Participant’s home that support learning and assistance in the areas of self-care, sensory/motor development, socialization, daily living skills, communication, community living, and social skills. Community-based activities are intended to build relationships and natural supports.

Participant Assistance and Care

Participant Assistance and Care (PAC) Services are provided in order to allow participants (consumers) with intellectual/developmental disabilities to remain and live successfully in their own homes, function and participate in their communities, and avoid institutionalization. PAC services support and enable the participant in activities of daily living, self- care, and mobility with the hands-on assistance, prompting, reminders, supervision, and monitoring needed to ensure the health, safety, and welfare of the participant.


Respite Care Services are services provided to participants unable to care for themselves. Respite Care services are furnished on a short-term basis in order to provide temporary relief to those unpaid persons normally providing care. Respite can be provided in the participant’s home or place of residence, in the respite caregiver’s home, in a camp setting, in a DDRS- approved day habilitation facility, or in a non-private residential setting (such as a respite home).


Transportation Services (as specified in the FSW) enable waiver participants to gain access to any non-medical community services, resources/destinations, or places of employment, maintain or improve their mobility within the community, increase independence and community participation, and prevent institutionalization as specified by the ISP and POC.