CHAPTER 13. LONG TERM CARE OMBUDSMAN PROGRAM
IC 12-10-13
Chapter 13. Long Term Care Ombudsman Program
IC 12-10-13-1
Repealed
(Repealed by P.L.139-1993, SEC.24.)
IC 12-10-13-2
Repealed
(Repealed by P.L.139-1993, SEC.24.)
IC 12-10-13-3
Home care services
Sec. 3. As used in this chapter, "home care services" meansin-home services funded through any of the following:
(1) The office of Medicaid policy and planning.
(2) A county office.
(3) The division.
As added by P.L.2-1992, SEC.4. Amended by P.L.139-1993, SEC.5;P.L.4-1993, SEC.39; P.L.5-1993, SEC.52.
IC 12-10-13-3.3
Legal representative
Sec. 3.3. As used in this chapter, "legal representative" means:
(1) a guardian;
(2) a health care representative acting under IC 16-36-1;
(3) an attorney-in-fact for health care appointed underIC 30-5-5-16;
(4) an attorney-in-fact appointed under IC 30-5-5 who does nothold health care powers; or
(5) the personal representative of the estate;
of a resident of a long term facility or client of home care services.
As added by P.L.139-1993, SEC.6. Amended by P.L.1-1994, SEC.54.
IC 12-10-13-3.6
Long term care facility
Sec. 3.6. As used in this chapter, "long term care facility" meanseither of the following:
(1) A facility licensed under or subject to IC 16-28-2.
(2) An adult care home.
As added by P.L.139-1993, SEC.7. Amended by P.L.2-1995, SEC.47.
IC 12-10-13-4
Office
Sec. 4. As used in this chapter, "office" refers to the long termcare ombudsman office established by this chapter. The termincludes individuals approved to act in the capacity of ombudsmenby the long term care ombudsmen office.
As added by P.L.2-1992, SEC.4. Amended by P.L.139-1993, SEC.8.
IC 12-10-13-4.5
Ombudsman
Sec. 4.5. As used in this chapter, "ombudsman" means anemployee of the office or an individual approved by the office toinvestigate and resolve complaints and concerns regarding the health,safety, welfare, or rights of residents or clients under 42 U.S.C. 3027and this chapter.
As added by P.L.139-1993, SEC.9.
IC 12-10-13-5
Repealed
(Repealed by P.L.139-1993, SEC.24.)
IC 12-10-13-6
State ombudsman
Sec. 6. As used in this chapter, "state ombudsman" refers to theindividual who directs the long term care ombudsman office.
As added by P.L.2-1992, SEC.4. Amended by P.L.139-1993, SEC.10.
IC 12-10-13-7
Establishment of office
Sec. 7. The division shall establish the long term care ombudsmanoffice in compliance with 42 U.S.C. 3027.
As added by P.L.2-1992, SEC.4.
IC 12-10-13-8
State ombudsman; appointment
Sec. 8. Subject to sections 10 through 12 of this chapter, thedirector of the division shall appoint the state long term careombudsman to direct the office on a full-time basis.
As added by P.L.2-1992, SEC.4. Amended by P.L.139-1993, SEC.11.
IC 12-10-13-9
Vacancy
Sec. 9. The director shall appoint an acting state ombudsmanwithin thirty (30) days of a vacancy in the position of stateombudsman. The acting state ombudsman has the powers and dutiesof the state ombudsman.
As added by P.L.2-1992, SEC.4.
IC 12-10-13-10
Qualifications
Sec. 10. The state ombudsman must have familiarity with thefollowing:
(1) Gerontology or long term care.
(2) The legal system.
(3) Dispute or problem resolution techniques, includinginvestigation, mediation, and negotiation.
As added by P.L.2-1992, SEC.4.
IC 12-10-13-11
State ombudsman; eligibility; employment by health facility orhome care service organization
Sec. 11. The director may not appoint as state ombudsman anindividual who has been employed by a long term care facility or ahome care service organization within one (1) year preceding thedirector's proposed appointment.
As added by P.L.2-1992, SEC.4. Amended by P.L.139-1993, SEC.12.
IC 12-10-13-12
State ombudsman; eligibility; pecuniary interest in health facilityor home care service organization
Sec. 12. The state ombudsman and a member of the stateombudsman's immediate family may not have had a pecuniaryinterest in a long term care facility or a home care serviceorganization within three (3) years preceding the director's proposedappointment.
As added by P.L.2-1992, SEC.4. Amended by P.L.139-1993, SEC.13.
IC 12-10-13-13
Technical experts; staff
Sec. 13. The state ombudsman may employ technical experts andother employees to carry out the purposes of the office.
As added by P.L.2-1992, SEC.4.
IC 12-10-13-14
Investigation and resolution of complaints and concerns
Sec. 14. (a) The office shall receive, investigate, and attempt toresolve complaints and concerns that:
(1) are made by or on behalf of a patient, resident, or client ofa long term care facility or a home care service, except for anindividual with a developmental disability who is receivingwaiver services; and
(2) involve the health, safety, welfare, or rights of a resident orclient.
(b) At the conclusion of an investigation of a complaint, the officeshall report the office's findings to the complainant.
As added by P.L.2-1992, SEC.4. Amended by P.L.139-1993, SEC.14;P.L.272-1999, SEC.32.
IC 12-10-13-15
Report of findings
Sec. 15. At the conclusion of an investigation of a complaint, theoffice shall report the office's findings to the complainant.
As added by P.L.2-1992, SEC.4.
IC 12-10-13-16
Decision not to investigate; notice
Sec. 16. If the office does not investigate a complaint, the officeshall notify the complainant of the decision not to investigate and the
reasons for the decision.
As added by P.L.2-1992, SEC.4. Amended by P.L.139-1993, SEC.15.
IC 12-10-13-16.2
Ombudsman; access to persons, places, records, and otherinformation
Sec. 16.2. In accordance with this chapter, an ombudsman mustbe provided access to the following:
(1) Long term care facilities, entities that provide home careservices, and the residents or clients of the long term carefacilities or entities that provide home care services.
(2) As provided in section 16.4 of this chapter, a resident's orclient's medical, financial, and social records.
(3) If the resident or client is incapable of giving consent, asdetermined by the attending physician or as otherwisedetermined under state law, the name, address, and telephonenumber of the resident's or client's legal representative.
As added by P.L.139-1993, SEC.16.
IC 12-10-13-16.4
Ombudsman; access to medical, financial, and social records ofresident or client; consent
Sec. 16.4. (a) An ombudsman must be provided access to aresident's or client's medical, financial, and social records. Except asprovided in subsections (c) and (d), the ombudsman must obtainconsent under subsection (b) before having access to the records.
(b) Consent to have access to a resident's or client's medical,financial, and social records shall be given in one (1) of thefollowing forms:
(1) In writing by the resident or client.
(2) Orally by the resident or client in the presence of a witness.
(3) In writing by the legal representative of the resident or clientif:
(A) the resident or client is incapable of giving consent, asdetermined by the attending physician or as otherwisedetermined under state law; and
(B) the legal representative has the authority to give consent.
(c) If consent to have access to a resident's or client's medical,financial, and social records cannot be obtained under subsection (b),an ombudsman may inspect the records of a resident or client if theresident or client is incapable of giving consent, as determined by theattending physician or as otherwise determined under state law, and:
(1) has no legal representative;
(2) has a legal representative but the legal representative cannotbe contacted within three (3) days; or
(3) has a legal representative but the legal representative doesnot have the authority to give consent to have access to therecords.
(d) If an ombudsman has:
(1) been denied access to a resident's or client's medical,
financial, and social records by the resident's or client's legalrepresentative;
(2) reasonable cause to believe that the resident's or client'slegal representative is not acting in the best interests of theresident or client; and
(3) received written approval from the state ombudsman;
the ombudsman may inspect the records of the resident or client.
As added by P.L.139-1993, SEC.17.
IC 12-10-13-16.5
Ombudsman; access to records of long term care facility or homecare service
Sec. 16.5. An ombudsman shall be given appropriate access to therecords of a long term care facility or home care service.
As added by P.L.139-1993, SEC.18.
IC 12-10-13-16.6
Ombudsman; access to records of state or local government agencyor entity
Sec. 16.6. A state or local government agency or entity that hasrecords that are relevant to a complaint or an investigation conductedby an ombudsman shall provide the ombudsman with access to therecords.
As added by P.L.139-1993, SEC.19.
IC 12-10-13-16.7
Long term care facility, home care service, or employee; disclosureof records; immunity from liability
Sec. 16.7. A long term care facility or home care service or anemployee of a long term care facility or home care service is immunefrom:
(1) civil or criminal liability; and
(2) actions taken under a professional disciplinary procedure;
for the release or disclosure of records to an ombudsman under thischapter.
As added by P.L.139-1993, SEC.20.
IC 12-10-13-16.8
Coordination among government agencies; toll free telephonenumber for reporting problems; nondisclosure of identity ofcomplainant, resident, or client
Sec. 16.8. The office shall do the following:
(1) Promote effective coordination between the office and thefollowing:
(A) Programs that provide legal services for the elderly.
(B) The adult protective services program.
(C) The attorney general's division of Medicaid fraud.
(D) The state department of health.
(E) Indiana protection and advocacy services.
(2) Establish a statewide toll free telephone line to receive
reports of problems about long term care facilities or home careservices.
(3) Ensure that the identity of a complainant, resident, or clientwill not be disclosed without:
(A) the complainant's, resident's, or client's written consent;or
(B) a court order.
As added by P.L.139-1993, SEC.21.
IC 12-10-13-17
Rules
Sec. 17. The director of the division shall adopt rules underIC 4-22-2 necessary to carry out this chapter.
As added by P.L.2-1992, SEC.4. Amended by P.L.2-1993, SEC.86;P.L.139-1993, SEC.22.
IC 12-10-13-18
Civil immunity
Sec. 18. A representative of the office is not civilly liable for thegood faith performance of official duties.
As added by P.L.2-1992, SEC.4.
IC 12-10-13-19
Annual report; distribution
Sec. 19. (a) The office shall prepare a report each year on theoperations of the office.
(b) A copy of the report shall be provided to the following:
(1) The governor.
(2) The general assembly. The report must be in an electronicformat under IC 5-14-6.
(3) The division.
(4) The federal Commissioner on Aging.
(5) Each area agency on aging.
(6) The state department of health.
As added by P.L.2-1992, SEC.4. Amended by P.L.28-2004, SEC.93.
IC 12-10-13-20
Violations
Sec. 20. A person who:
(1) intentionally prevents the work of the office;
(2) knowingly offers compensation to the office in an effort toaffect the outcome of an investigation or a potentialinvestigation; or
(3) retaliates against a resident, a client, an employee, oranother person who files a complaint or provides information tothe office;
commits a Class B misdemeanor.
As added by P.L.2-1992, SEC.4. Amended by P.L.139-1993, SEC.23.