IC 12-10-10
Chapter 10. Community and Home Options to Institutional Care
for the Elderly and Disabled Program
IC 12-10-10-1 "Case management" defined
Sec. 1. As used in this chapter, "case management" means an
administrative function conducted locally by an area agency on aging
that includes the following:
(1) Assessment of an individual to determine the individual's
functional impairment level and corresponding need for
services.
(2) Development of a care plan addressing an eligible
individual's needs.
(3) Supervision of the implementation of appropriate and
available services for an eligible individual.
(4) Advocacy on behalf of an eligible individual's interests.
(5) Monitoring the quality of community and home care
services provided to an eligible individual.
(6) Reassessment of the care plan to determine the continuing
need and effectiveness of the community and home care
services provided to an eligible individual under this chapter.
(7) Provision of information and referral services to individuals
in need of community and home care services. As added by P.L.2-1992, SEC.4. Amended by P.L.150-1995, SEC.5;
P.L.154-1995, SEC.1.
IC 12-10-10-1.5 "Activities of daily living" defined
Sec. 1.5. As used in this chapter, "activities of daily living" refers
to an activity described in the long term care services eligibility
screen. As added by P.L.150-1995, SEC.6.
IC 12-10-10-2 "Community and home care services" defined
Sec. 2. As used in this chapter, "community and home care
services" means services provided within the limits of available
funding to an eligible individual. The term includes the following:
(1) Homemaker services and attendant care, including personal
care services.
(2) Respite care services and other support services for primary
or family caregivers.
(3) Adult day care services.
(4) Home health services and supplies.
(5) Home delivered meals.
(6) Transportation.
(7) Attendant care services provided by a registered personal
services attendant under IC 12-10-17.1 to persons described in
IC 12-10-17.1-6.
(8) Other services necessary to prevent institutionalization of
eligible individuals when feasible. As added by P.L.2-1992, SEC.4. Amended by P.L.150-1995, SEC.7;
P.L.154-1995, SEC.2; P.L.255-2001, SEC.10; P.L.141-2006,
SEC.43.
IC 12-10-10-3 "Individual with a disability" defined
Sec. 3. As used in this chapter, "individual with a disability"
refers to an individual with a severe chronic disability that is
attributable to a mental or physical impairment or combination of
mental and physical impairments that is likely to continue
indefinitely. As added by P.L.2-1992, SEC.4. Amended by P.L.99-2007, SEC.63.
IC 12-10-10-4 "Eligible individual" defined
Sec. 4. (a) As used in this chapter, "eligible individual" means an
individual who:
(1) is a resident of Indiana;
(2) is:
(A) at least sixty (60) years of age; or
(B) an individual with a disability;
(3) has assets that do not exceed five hundred thousand dollars
($500,000), as determined by the division; and
(4) qualifies under criteria developed by the board as having an
impairment that places the individual at risk of losing the
individual's independence, as described in subsection (b).
(b) For purposes of subsection (a), an individual is at risk of
losing the individual's independence if the individual is unable to
perform two (2) or more activities of daily living. The use by or on
behalf of the individual of any of the following services or devices
does not make the individual ineligible for services under this
chapter:
(1) Skilled nursing assistance.
(2) Supervised community and home care services, including
skilled nursing supervision.
(3) Adaptive medical equipment and devices.
(4) Adaptive nonmedical equipment and devices. As added by P.L.2-1992, SEC.4. Amended by P.L.150-1995, SEC.8;
P.L.246-2005, SEC.99; P.L.99-2007, SEC.64.
IC 12-10-10-4.5 "Long term care services eligibility screen" defined
Sec. 4.5. (a) As used in this chapter, "long term care services
eligibility screen" refers to the long term care services eligibility
screen used by the division in making eligibility determinations
under this chapter.
(b) The long term care services eligibility screen must conform
with the activities of daily living standard established by this chapter.
As added by P.L.150-1995, SEC.9.
IC 12-10-10-5 "Program" defined
Sec. 5. As used in this chapter, "program" refers to the community
and home options to institutional care for the elderly and disabled
program established by this chapter. As added by P.L.2-1992, SEC.4.
IC 12-10-10-6 Establishment of program; administration; duties of division
Sec. 6. The community and home options to institutional care for
the elderly and disabled program is established. The division shall
administer the program and shall do the following:
(1) Adopt rules under IC 4-22-2 for the coordination of the
program.
(2) Administer state and federal money for the program.
(3) Develop and implement a process for the management and
operation of the program locally through the area agencies on
aging based upon criteria developed by the division.
(4) Approve the selection of community and home care services
providers based upon criteria developed by the division.
(5) Review and approve community and home care services
plans developed by services providers.
(6) Provide training and technical assistance for the staff
providers.
(7) Select or contract with agencies throughout Indiana to
provide community and home care services.
(8) Assist the office in applying for Medicaid waivers from the
United States Department of Health and Human Services to
fund community and home care services needed by eligible
individuals under this chapter.
(9) Have self-directed care options and services available for an
eligible individual who chooses self-directed care services. As added by P.L.2-1992, SEC.4. Amended by P.L.150-1995, SEC.10;
P.L.154-1995, SEC.3; P.L.112-1997, SEC.2; P.L.47-2009, SEC.1.
IC 12-10-10-6.3 Long term care eligibility screen; publication; public inspection
Sec. 6.3. (a) The division shall file for publication in the Indiana
Register a copy of the long term care services eligibility screen.
(b) The division shall:
(1) keep on file in the division's office; and
(2) make available for public inspection during regular business
hours;
a copy of the long term care services eligibility screen.
(c) The division shall provide a copy of the long term care
services eligibility screen to any individual upon request. As added by P.L.150-1995, SEC.11. IC 12-10-10-6.5 Restrictions on adoption of rules or criteria governing eligibility
Sec. 6.5. (a) The division shall not adopt any rule governing the
eligibility of an individual under this chapter that is more restrictive
than the definition of eligible individual in section 4 of this chapter.
(b) The division and the board shall not adopt an eligibility
criterion that is more restrictive than the definition of eligible
individual described in section 4 of this chapter.
(c) Any:
(1) eligibility rule adopted by the division; or
(2) eligibility criterion adopted by the division or the board;
must be specific to the program established under this chapter and
may not be defined by reference to a rule, guideline, or procedure for
another program or service, for a service provided under a Medicaid
waiver, or for institutional care. As added by P.L.150-1995, SEC.12.
IC 12-10-10-7 Agency conducting case management not to provide services;
exception
Sec. 7. (a) Except as provided in subsection (b), the case
management under this chapter of an individual leading to
participation in the program may not be conducted by any agency
that delivers services under the program.
(b) If the division determines that there is no alternative agency
capable of delivering services to the individual, the area agency on
aging that performs the assessment under the program may also
deliver the services. As added by P.L.2-1992, SEC.4. Amended by P.L.150-1995, SEC.13;
P.L.154-1995, SEC.4.
IC 12-10-10-8 Distribution of funds for home health services
Sec. 8. Except as provided in section 9 of this chapter, state
money for home health services under this chapter must be
distributed only to licensed health care professionals, facilities, and
agencies. As added by P.L.2-1992, SEC.4.
IC 12-10-10-9 Eligible individuals' relatives training program; reimbursement
for provision of services by relative
Sec. 9. (a) The division shall establish a program to train relatives
of eligible individuals to provide homemaker and personal care
services to those eligible individuals.
(b) Relatives of eligible individuals who complete the training
program established under this section are eligible for reimbursement
under this chapter or under the Medicaid program for the provision
of homemaker and personal care services to those eligible
individuals. Reimbursement under the Medicaid program is limited
to those cases in which the provision of homemaker and personal
care services to an eligible individual by a relative results in financial
hardship to the relative. As added by P.L.2-1992, SEC.4.
IC 12-10-10-10 Services funding; source
Sec. 10. Federal social services block grant money shall be used
to fund services under this chapter that are not otherwise
reimbursable under the Medicaid program. As added by P.L.2-1992, SEC.4.
IC 12-10-10-11 Reporting requirement; contents; submission to board and general
assembly; funding
Sec. 11. (a) Before October 1 of each year, the division, in
conjunction with the office of the secretary, shall prepare a report for
review by the board and the general assembly. The report must
include the following information regarding clients and services of
the community and home options to institutional care for the elderly
and disabled program and other long term care home and community
based programs:
(1) The amount and source of all local, state, and federal dollars
spent.
(2) The use of the community and home options to institutional
care for the elderly and disabled program in supplementing the
funding of services provided to clients through other programs.
(3) The number and types of participating providers.
(4) An examination of:
(A) demographic characteristics; and
(B) impairment and medical characteristics.
(5) A comparison of costs for all publicly funded long term care
programs.
(6) Client care outcomes.
(7) A determination of the estimated number of applicants for
services from the community and home options to institutional
care for the elderly and disabled program who have:
(A) one (1) assessed activity of daily living that cannot be
performed;
(B) two (2) assessed activities of daily living that cannot be
performed; and
(C) three (3) or more assessed activities of daily living that
cannot be performed;
and the estimated effect of the results under clauses (A), (B),
and (C) on program funding, program savings, client access,
client care outcomes, and comparative costs with other long
term care programs.
(b) After receiving the report described in subsection (a), the
board may do the following:
(1) Review and comment on the report.
(2) Solicit public comments and testimony on the report.
(3) Incorporate its own opinions into the report.
(c) The board shall submit the report in an electronic format under
IC 5-14-6 along with any additions made under subsection (b) to the
general assembly after November 15 and before December 31 each
year.
(d) Funding for the report must come entirely from:
(1) funds already available for similar purposes;
(2) discretionary funds available to the division or the office of
the secretary;
(3) reversion funds; and
(4) private funds and grants. As added by P.L.150-1995, SEC.14. Amended by P.L.2-1996,
SEC.233; P.L.28-2004, SEC.91.
IC 12-10-10-12 Negotiation of reimbursement rates
Sec. 12. (a) The office of the secretary, in consultation with the
local area agencies on aging, shall negotiate reimbursement rates for
services provided under this chapter.
(b) Payments for services under this chapter may not be counted
in a Medicaid recipient's spend down requirement in IC 12-15. As added by P.L.246-2005, SEC.100.
IC 12-10-10
Chapter 10. Community and Home Options to Institutional Care
for the Elderly and Disabled Program
IC 12-10-10-1 "Case management" defined
Sec. 1. As used in this chapter, "case management" means an
administrative function conducted locally by an area agency on aging
that includes the following:
(1) Assessment of an individual to determine the individual's
functional impairment level and corresponding need for
services.
(2) Development of a care plan addressing an eligible
individual's needs.
(3) Supervision of the implementation of appropriate and
available services for an eligible individual.
(4) Advocacy on behalf of an eligible individual's interests.
(5) Monitoring the quality of community and home care
services provided to an eligible individual.
(6) Reassessment of the care plan to determine the continuing
need and effectiveness of the community and home care
services provided to an eligible individual under this chapter.
(7) Provision of information and referral services to individuals
in need of community and home care services. As added by P.L.2-1992, SEC.4. Amended by P.L.150-1995, SEC.5;
P.L.154-1995, SEC.1.
IC 12-10-10-1.5 "Activities of daily living" defined
Sec. 1.5. As used in this chapter, "activities of daily living" refers
to an activity described in the long term care services eligibility
screen. As added by P.L.150-1995, SEC.6.
IC 12-10-10-2 "Community and home care services" defined
Sec. 2. As used in this chapter, "community and home care
services" means services provided within the limits of available
funding to an eligible individual. The term includes the following:
(1) Homemaker services and attendant care, including personal
care services.
(2) Respite care services and other support services for primary
or family caregivers.
(3) Adult day care services.
(4) Home health services and supplies.
(5) Home delivered meals.
(6) Transportation.
(7) Attendant care services provided by a registered personal
services attendant under IC 12-10-17.1 to persons described in
IC 12-10-17.1-6.
(8) Other services necessary to prevent institutionalization of
eligible individuals when feasible. As added by P.L.2-1992, SEC.4. Amended by P.L.150-1995, SEC.7;
P.L.154-1995, SEC.2; P.L.255-2001, SEC.10; P.L.141-2006,
SEC.43.
IC 12-10-10-3 "Individual with a disability" defined
Sec. 3. As used in this chapter, "individual with a disability"
refers to an individual with a severe chronic disability that is
attributable to a mental or physical impairment or combination of
mental and physical impairments that is likely to continue
indefinitely. As added by P.L.2-1992, SEC.4. Amended by P.L.99-2007, SEC.63.
IC 12-10-10-4 "Eligible individual" defined
Sec. 4. (a) As used in this chapter, "eligible individual" means an
individual who:
(1) is a resident of Indiana;
(2) is:
(A) at least sixty (60) years of age; or
(B) an individual with a disability;
(3) has assets that do not exceed five hundred thousand dollars
($500,000), as determined by the division; and
(4) qualifies under criteria developed by the board as having an
impairment that places the individual at risk of losing the
individual's independence, as described in subsection (b).
(b) For purposes of subsection (a), an individual is at risk of
losing the individual's independence if the individual is unable to
perform two (2) or more activities of daily living. The use by or on
behalf of the individual of any of the following services or devices
does not make the individual ineligible for services under this
chapter:
(1) Skilled nursing assistance.
(2) Supervised community and home care services, including
skilled nursing supervision.
(3) Adaptive medical equipment and devices.
(4) Adaptive nonmedical equipment and devices. As added by P.L.2-1992, SEC.4. Amended by P.L.150-1995, SEC.8;
P.L.246-2005, SEC.99; P.L.99-2007, SEC.64.
IC 12-10-10-4.5 "Long term care services eligibility screen" defined
Sec. 4.5. (a) As used in this chapter, "long term care services
eligibility screen" refers to the long term care services eligibility
screen used by the division in making eligibility determinations
under this chapter.
(b) The long term care services eligibility screen must conform
with the activities of daily living standard established by this chapter.
As added by P.L.150-1995, SEC.9.
IC 12-10-10-5 "Program" defined
Sec. 5. As used in this chapter, "program" refers to the community
and home options to institutional care for the elderly and disabled
program established by this chapter. As added by P.L.2-1992, SEC.4.
IC 12-10-10-6 Establishment of program; administration; duties of division
Sec. 6. The community and home options to institutional care for
the elderly and disabled program is established. The division shall
administer the program and shall do the following:
(1) Adopt rules under IC 4-22-2 for the coordination of the
program.
(2) Administer state and federal money for the program.
(3) Develop and implement a process for the management and
operation of the program locally through the area agencies on
aging based upon criteria developed by the division.
(4) Approve the selection of community and home care services
providers based upon criteria developed by the division.
(5) Review and approve community and home care services
plans developed by services providers.
(6) Provide training and technical assistance for the staff
providers.
(7) Select or contract with agencies throughout Indiana to
provide community and home care services.
(8) Assist the office in applying for Medicaid waivers from the
United States Department of Health and Human Services to
fund community and home care services needed by eligible
individuals under this chapter.
(9) Have self-directed care options and services available for an
eligible individual who chooses self-directed care services. As added by P.L.2-1992, SEC.4. Amended by P.L.150-1995, SEC.10;
P.L.154-1995, SEC.3; P.L.112-1997, SEC.2; P.L.47-2009, SEC.1.
IC 12-10-10-6.3 Long term care eligibility screen; publication; public inspection
Sec. 6.3. (a) The division shall file for publication in the Indiana
Register a copy of the long term care services eligibility screen.
(b) The division shall:
(1) keep on file in the division's office; and
(2) make available for public inspection during regular business
hours;
a copy of the long term care services eligibility screen.
(c) The division shall provide a copy of the long term care
services eligibility screen to any individual upon request. As added by P.L.150-1995, SEC.11. IC 12-10-10-6.5 Restrictions on adoption of rules or criteria governing eligibility
Sec. 6.5. (a) The division shall not adopt any rule governing the
eligibility of an individual under this chapter that is more restrictive
than the definition of eligible individual in section 4 of this chapter.
(b) The division and the board shall not adopt an eligibility
criterion that is more restrictive than the definition of eligible
individual described in section 4 of this chapter.
(c) Any:
(1) eligibility rule adopted by the division; or
(2) eligibility criterion adopted by the division or the board;
must be specific to the program established under this chapter and
may not be defined by reference to a rule, guideline, or procedure for
another program or service, for a service provided under a Medicaid
waiver, or for institutional care. As added by P.L.150-1995, SEC.12.
IC 12-10-10-7 Agency conducting case management not to provide services;
exception
Sec. 7. (a) Except as provided in subsection (b), the case
management under this chapter of an individual leading to
participation in the program may not be conducted by any agency
that delivers services under the program.
(b) If the division determines that there is no alternative agency
capable of delivering services to the individual, the area agency on
aging that performs the assessment under the program may also
deliver the services. As added by P.L.2-1992, SEC.4. Amended by P.L.150-1995, SEC.13;
P.L.154-1995, SEC.4.
IC 12-10-10-8 Distribution of funds for home health services
Sec. 8. Except as provided in section 9 of this chapter, state
money for home health services under this chapter must be
distributed only to licensed health care professionals, facilities, and
agencies. As added by P.L.2-1992, SEC.4.
IC 12-10-10-9 Eligible individuals' relatives training program; reimbursement
for provision of services by relative
Sec. 9. (a) The division shall establish a program to train relatives
of eligible individuals to provide homemaker and personal care
services to those eligible individuals.
(b) Relatives of eligible individuals who complete the training
program established under this section are eligible for reimbursement
under this chapter or under the Medicaid program for the provision
of homemaker and personal care services to those eligible
individuals. Reimbursement under the Medicaid program is limited
to those cases in which the provision of homemaker and personal
care services to an eligible individual by a relative results in financial
hardship to the relative. As added by P.L.2-1992, SEC.4.
IC 12-10-10-10 Services funding; source
Sec. 10. Federal social services block grant money shall be used
to fund services under this chapter that are not otherwise
reimbursable under the Medicaid program. As added by P.L.2-1992, SEC.4.
IC 12-10-10-11 Reporting requirement; contents; submission to board and general
assembly; funding
Sec. 11. (a) Before October 1 of each year, the division, in
conjunction with the office of the secretary, shall prepare a report for
review by the board and the general assembly. The report must
include the following information regarding clients and services of
the community and home options to institutional care for the elderly
and disabled program and other long term care home and community
based programs:
(1) The amount and source of all local, state, and federal dollars
spent.
(2) The use of the community and home options to institutional
care for the elderly and disabled program in supplementing the
funding of services provided to clients through other programs.
(3) The number and types of participating providers.
(4) An examination of:
(A) demographic characteristics; and
(B) impairment and medical characteristics.
(5) A comparison of costs for all publicly funded long term care
programs.
(6) Client care outcomes.
(7) A determination of the estimated number of applicants for
services from the community and home options to institutional
care for the elderly and disabled program who have:
(A) one (1) assessed activity of daily living that cannot be
performed;
(B) two (2) assessed activities of daily living that cannot be
performed; and
(C) three (3) or more assessed activities of daily living that
cannot be performed;
and the estimated effect of the results under clauses (A), (B),
and (C) on program funding, program savings, client access,
client care outcomes, and comparative costs with other long
term care programs.
(b) After receiving the report described in subsection (a), the
board may do the following:
(1) Review and comment on the report.
(2) Solicit public comments and testimony on the report.
(3) Incorporate its own opinions into the report.
(c) The board shall submit the report in an electronic format under
IC 5-14-6 along with any additions made under subsection (b) to the
general assembly after November 15 and before December 31 each
year.
(d) Funding for the report must come entirely from:
(1) funds already available for similar purposes;
(2) discretionary funds available to the division or the office of
the secretary;
(3) reversion funds; and
(4) private funds and grants. As added by P.L.150-1995, SEC.14. Amended by P.L.2-1996,
SEC.233; P.L.28-2004, SEC.91.
IC 12-10-10-12 Negotiation of reimbursement rates
Sec. 12. (a) The office of the secretary, in consultation with the
local area agencies on aging, shall negotiate reimbursement rates for
services provided under this chapter.
(b) Payments for services under this chapter may not be counted
in a Medicaid recipient's spend down requirement in IC 12-15. As added by P.L.246-2005, SEC.100.
IC 12-10-10
Chapter 10. Community and Home Options to Institutional Care
for the Elderly and Disabled Program
IC 12-10-10-1 "Case management" defined
Sec. 1. As used in this chapter, "case management" means an
administrative function conducted locally by an area agency on aging
that includes the following:
(1) Assessment of an individual to determine the individual's
functional impairment level and corresponding need for
services.
(2) Development of a care plan addressing an eligible
individual's needs.
(3) Supervision of the implementation of appropriate and
available services for an eligible individual.
(4) Advocacy on behalf of an eligible individual's interests.
(5) Monitoring the quality of community and home care
services provided to an eligible individual.
(6) Reassessment of the care plan to determine the continuing
need and effectiveness of the community and home care
services provided to an eligible individual under this chapter.
(7) Provision of information and referral services to individuals
in need of community and home care services. As added by P.L.2-1992, SEC.4. Amended by P.L.150-1995, SEC.5;
P.L.154-1995, SEC.1.
IC 12-10-10-1.5 "Activities of daily living" defined
Sec. 1.5. As used in this chapter, "activities of daily living" refers
to an activity described in the long term care services eligibility
screen. As added by P.L.150-1995, SEC.6.
IC 12-10-10-2 "Community and home care services" defined
Sec. 2. As used in this chapter, "community and home care
services" means services provided within the limits of available
funding to an eligible individual. The term includes the following:
(1) Homemaker services and attendant care, including personal
care services.
(2) Respite care services and other support services for primary
or family caregivers.
(3) Adult day care services.
(4) Home health services and supplies.
(5) Home delivered meals.
(6) Transportation.
(7) Attendant care services provided by a registered personal
services attendant under IC 12-10-17.1 to persons described in
IC 12-10-17.1-6.
(8) Other services necessary to prevent institutionalization of
eligible individuals when feasible. As added by P.L.2-1992, SEC.4. Amended by P.L.150-1995, SEC.7;
P.L.154-1995, SEC.2; P.L.255-2001, SEC.10; P.L.141-2006,
SEC.43.
IC 12-10-10-3 "Individual with a disability" defined
Sec. 3. As used in this chapter, "individual with a disability"
refers to an individual with a severe chronic disability that is
attributable to a mental or physical impairment or combination of
mental and physical impairments that is likely to continue
indefinitely. As added by P.L.2-1992, SEC.4. Amended by P.L.99-2007, SEC.63.
IC 12-10-10-4 "Eligible individual" defined
Sec. 4. (a) As used in this chapter, "eligible individual" means an
individual who:
(1) is a resident of Indiana;
(2) is:
(A) at least sixty (60) years of age; or
(B) an individual with a disability;
(3) has assets that do not exceed five hundred thousand dollars
($500,000), as determined by the division; and
(4) qualifies under criteria developed by the board as having an
impairment that places the individual at risk of losing the
individual's independence, as described in subsection (b).
(b) For purposes of subsection (a), an individual is at risk of
losing the individual's independence if the individual is unable to
perform two (2) or more activities of daily living. The use by or on
behalf of the individual of any of the following services or devices
does not make the individual ineligible for services under this
chapter:
(1) Skilled nursing assistance.
(2) Supervised community and home care services, including
skilled nursing supervision.
(3) Adaptive medical equipment and devices.
(4) Adaptive nonmedical equipment and devices. As added by P.L.2-1992, SEC.4. Amended by P.L.150-1995, SEC.8;
P.L.246-2005, SEC.99; P.L.99-2007, SEC.64.
IC 12-10-10-4.5 "Long term care services eligibility screen" defined
Sec. 4.5. (a) As used in this chapter, "long term care services
eligibility screen" refers to the long term care services eligibility
screen used by the division in making eligibility determinations
under this chapter.
(b) The long term care services eligibility screen must conform
with the activities of daily living standard established by this chapter.
As added by P.L.150-1995, SEC.9.
IC 12-10-10-5 "Program" defined
Sec. 5. As used in this chapter, "program" refers to the community
and home options to institutional care for the elderly and disabled
program established by this chapter. As added by P.L.2-1992, SEC.4.
IC 12-10-10-6 Establishment of program; administration; duties of division
Sec. 6. The community and home options to institutional care for
the elderly and disabled program is established. The division shall
administer the program and shall do the following:
(1) Adopt rules under IC 4-22-2 for the coordination of the
program.
(2) Administer state and federal money for the program.
(3) Develop and implement a process for the management and
operation of the program locally through the area agencies on
aging based upon criteria developed by the division.
(4) Approve the selection of community and home care services
providers based upon criteria developed by the division.
(5) Review and approve community and home care services
plans developed by services providers.
(6) Provide training and technical assistance for the staff
providers.
(7) Select or contract with agencies throughout Indiana to
provide community and home care services.
(8) Assist the office in applying for Medicaid waivers from the
United States Department of Health and Human Services to
fund community and home care services needed by eligible
individuals under this chapter.
(9) Have self-directed care options and services available for an
eligible individual who chooses self-directed care services. As added by P.L.2-1992, SEC.4. Amended by P.L.150-1995, SEC.10;
P.L.154-1995, SEC.3; P.L.112-1997, SEC.2; P.L.47-2009, SEC.1.
IC 12-10-10-6.3 Long term care eligibility screen; publication; public inspection
Sec. 6.3. (a) The division shall file for publication in the Indiana
Register a copy of the long term care services eligibility screen.
(b) The division shall:
(1) keep on file in the division's office; and
(2) make available for public inspection during regular business
hours;
a copy of the long term care services eligibility screen.
(c) The division shall provide a copy of the long term care
services eligibility screen to any individual upon request. As added by P.L.150-1995, SEC.11. IC 12-10-10-6.5 Restrictions on adoption of rules or criteria governing eligibility
Sec. 6.5. (a) The division shall not adopt any rule governing the
eligibility of an individual under this chapter that is more restrictive
than the definition of eligible individual in section 4 of this chapter.
(b) The division and the board shall not adopt an eligibility
criterion that is more restrictive than the definition of eligible
individual described in section 4 of this chapter.
(c) Any:
(1) eligibility rule adopted by the division; or
(2) eligibility criterion adopted by the division or the board;
must be specific to the program established under this chapter and
may not be defined by reference to a rule, guideline, or procedure for
another program or service, for a service provided under a Medicaid
waiver, or for institutional care. As added by P.L.150-1995, SEC.12.
IC 12-10-10-7 Agency conducting case management not to provide services;
exception
Sec. 7. (a) Except as provided in subsection (b), the case
management under this chapter of an individual leading to
participation in the program may not be conducted by any agency
that delivers services under the program.
(b) If the division determines that there is no alternative agency
capable of delivering services to the individual, the area agency on
aging that performs the assessment under the program may also
deliver the services. As added by P.L.2-1992, SEC.4. Amended by P.L.150-1995, SEC.13;
P.L.154-1995, SEC.4.
IC 12-10-10-8 Distribution of funds for home health services
Sec. 8. Except as provided in section 9 of this chapter, state
money for home health services under this chapter must be
distributed only to licensed health care professionals, facilities, and
agencies. As added by P.L.2-1992, SEC.4.
IC 12-10-10-9 Eligible individuals' relatives training program; reimbursement
for provision of services by relative
Sec. 9. (a) The division shall establish a program to train relatives
of eligible individuals to provide homemaker and personal care
services to those eligible individuals.
(b) Relatives of eligible individuals who complete the training
program established under this section are eligible for reimbursement
under this chapter or under the Medicaid program for the provision
of homemaker and personal care services to those eligible
individuals. Reimbursement under the Medicaid program is limited
to those cases in which the provision of homemaker and personal
care services to an eligible individual by a relative results in financial
hardship to the relative. As added by P.L.2-1992, SEC.4.
IC 12-10-10-10 Services funding; source
Sec. 10. Federal social services block grant money shall be used
to fund services under this chapter that are not otherwise
reimbursable under the Medicaid program. As added by P.L.2-1992, SEC.4.
IC 12-10-10-11 Reporting requirement; contents; submission to board and general
assembly; funding
Sec. 11. (a) Before October 1 of each year, the division, in
conjunction with the office of the secretary, shall prepare a report for
review by the board and the general assembly. The report must
include the following information regarding clients and services of
the community and home options to institutional care for the elderly
and disabled program and other long term care home and community
based programs:
(1) The amount and source of all local, state, and federal dollars
spent.
(2) The use of the community and home options to institutional
care for the elderly and disabled program in supplementing the
funding of services provided to clients through other programs.
(3) The number and types of participating providers.
(4) An examination of:
(A) demographic characteristics; and
(B) impairment and medical characteristics.
(5) A comparison of costs for all publicly funded long term care
programs.
(6) Client care outcomes.
(7) A determination of the estimated number of applicants for
services from the community and home options to institutional
care for the elderly and disabled program who have:
(A) one (1) assessed activity of daily living that cannot be
performed;
(B) two (2) assessed activities of daily living that cannot be
performed; and
(C) three (3) or more assessed activities of daily living that
cannot be performed;
and the estimated effect of the results under clauses (A), (B),
and (C) on program funding, program savings, client access,
client care outcomes, and comparative costs with other long
term care programs.
(b) After receiving the report described in subsection (a), the
board may do the following:
(1) Review and comment on the report.
(2) Solicit public comments and testimony on the report.
(3) Incorporate its own opinions into the report.
(c) The board shall submit the report in an electronic format under
IC 5-14-6 along with any additions made under subsection (b) to the
general assembly after November 15 and before December 31 each
year.
(d) Funding for the report must come entirely from:
(1) funds already available for similar purposes;
(2) discretionary funds available to the division or the office of
the secretary;
(3) reversion funds; and
(4) private funds and grants. As added by P.L.150-1995, SEC.14. Amended by P.L.2-1996,
SEC.233; P.L.28-2004, SEC.91.
IC 12-10-10-12 Negotiation of reimbursement rates
Sec. 12. (a) The office of the secretary, in consultation with the
local area agencies on aging, shall negotiate reimbursement rates for
services provided under this chapter.
(b) Payments for services under this chapter may not be counted
in a Medicaid recipient's spend down requirement in IC 12-15. As added by P.L.246-2005, SEC.100.
