Ruth Hevelone has twin boys with autism in Kokomo, and this summer she watched one of them, Sammy, get dropped from Medicaid even though nothing about his condition had changed. Sammy relies on a Medicaid waiver that funds 40 hours of therapy a week and access to nine different specialists, and losing it meant his family's entire support system was suddenly at risk.
According to WISH-TV, the Indiana Family and Social Services Administration notified Hevelone's family on June 1 that Sammy had been removed from Medicaid. The removal came after paperwork the family submitted on May 22 — including mortgage records, 30 days of bank statements and 30 days of pay stubs — went unprocessed, and FSSA canceled his coverage as a result. Sammy had already waited three years to obtain the waiver in the first place.
The lapse hit the family's finances directly. The waiver allows Hevelone's husband to work as a full-time home health aide for the children, but the coverage gap meant he lost several months of income before the family started receiving that income again on August 5. Sammy was ultimately re-enrolled within hours, but only after Will Colteryahn, a former FSSA employee of 12 years who is now running for state representative, sent a single email on the family's behalf.
A Second Kokomo Mother, A Similar Story
Hevelone isn't alone in Kokomo. Trisha Norfleet, who has two sons with autism enrolled in a Medicaid waiver, told the station that one of her sons was also removed from Medicaid. Norfleet said parental income is usually disregarded when a child has a waiver, yet FSSA has continued collecting parental income information for what the agency describes as possible future changes — even though the agency says that income is not currently used to determine eligibility.
Colteryahn, who helped Hevelone resolve Sammy's case, said a new assessment tool is behind the rise in denials families are experiencing. FSSA's Bureau of Disability Services changed the assessment process used to evaluate waiver eligibility criteria, and the agency says the resulting denial rate has climbed from 0.02% under the old system to 6% under the current one — even as FSSA maintains that eligibility criteria for Indiana's waiver programs have not changed.
Why the Assessment Tool Changed
The shift traces back to December 31, 2025, when FSSA's Bureau of Disability Services replaced its adult-focused evaluation tools with the age-appropriate interRAI assessment suite, including a tool for children ages 0 to 3 and another for ages 4 to 17, according to IN.gov. FSSA describes the new tool as scientifically proven to better determine a person's level of care, and says the process is more accurate, more consistent and better aligned with federal requirements. The agency has also said that trained human professionals — not artificial intelligence or machine learning — make the actual eligibility determinations.
Karly Sciortino-Poulter, director of the Arc Advocacy Network at the Arc of Indiana, which advocates for families with disabilities, said she has handled more Medicaid appeals in the last two years than in the preceding ten years combined. The Arc has also flagged that FSSA waiver amendments taking effect this month standardized service definitions across Indiana's waivers and capped certain therapies, such as recreational and music therapy, at six non-rollover hours per month, while also limiting combined paid caregiver hours for legally responsible family members to 40 hours per week per participant.
Part of a Larger Pattern of Coverage Drops
The Hevelone and Norfleet cases fit into a much larger trend across Indiana. State data analyzing 1.7 million Medicaid renewals between March 2025 and June 2026 found that procedural coverage closures — caused by unprocessed paperwork or unanswered notices, the same kind of breakdown that hit Sammy Hevelone — substantially outnumbered cases where enrollees were formally found ineligible, per The Lund Report. FSSA has acknowledged that its processing errors can trigger automated termination of Medicaid coverage when paperwork isn't processed and uploaded in time.
That backdrop helps explain why this month's coverage denials feel connected to Indiana's broader fiscal turnaround. FSSA Secretary Mitch Roob reported that the state returned $310 million to the general fund after enacting strict fiscal controls to reverse a previously projected $1 billion Medicaid deficit, as Hoodline has previously reported on FSSA's spending crackdown. That fiscal recovery has come alongside a 23% drop in statewide Medicaid enrollment even though overall state spending fell by only 2%.
Local Fallout From the State's Overhaul
The overhaul has rippled beyond individual families. FSSA centralized all Level of Care assessment and determination duties under a single statewide vendor, Maximus, in July 2025, removing local Area Agencies on Aging from the process of evaluating waiver eligibility. That consolidation contributed to Indianapolis nonprofit CICOA Aging & In-Home Solutions permanently eliminating 90 care coordination jobs — local case managers who had previously helped families navigate complex waiver applications and appeals.
FSSA declined to comment on the Hevelone and Norfleet cases individually, citing privacy reasons, but the agency said it is reviewing individual waiver cases for correctness, consistency and fairness. Indiana's I-Team sent both families' cases to FSSA as part of its reporting. FSSA also said its waiver program requires periodic reviews to confirm continuing eligibility, a standard practice the agency says it is following even amid the surge in procedural denials.
Open questions remain about how many of these procedural denials get reversed on appeal, and whether FSSA's systems can process renewal paperwork quickly enough to prevent gaps in care for families like the Hevelones and Norfleets in Kokomo. For now, families continue to describe a system where a single missed upload — not a change in a child's medical needs — can mean the difference between full therapeutic support and none at all.
