IC 12-10-17.1
Chapter 17.1. Individuals in Need of Self-Directed In-Home Care
IC 12-10-17.1-1 Applicability of chapter
Sec. 1. This chapter does not apply to the following:
(1) An individual who provides attendant care services and who
is employed by and under the direct control of a home health
agency (as defined in IC 12-15-34-1).
(2) An individual who provides attendant care services and who
is employed by and under the direct control of a licensed
hospice program under IC 16-25.
(3) An individual who provides attendant care services and who
is employed by and under the control of an employer that is not
the individual who is receiving the services.
(4) A practitioner (as defined in IC 25-1-9-2) who is practicing
under the scope of the practitioner's license (as defined in
IC 25-1-9-3). As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-2 "Ancillary services" defined
Sec. 2. As used in this chapter, "ancillary services" means services
ancillary to the basic services provided to an individual in need of
self-directed in-home care who needs at least one (1) of the basic
services (as defined in section 4 of this chapter). The term includes
the following:
(1) Homemaker services, including shopping, laundry, cleaning,
and seasonal chores.
(2) Companion services, including transportation, letter writing,
mail reading, and escort services.
(3) Assistance with cognitive tasks, including managing
finances, planning activities, and making decisions. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-3 "Attendant care services" defined
Sec. 3. As used in this chapter, "attendant care services" means
those basic and ancillary services that the individual chooses to
direct and supervise a personal services attendant to perform and that
enable an individual in need of self-directed in-home care to live in
the individual's home and community rather than in an institution and
to carry out functions of daily living, self-care, and mobility. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-4 "Basic services" defined
Sec. 4. As used in this chapter, "basic services" means a function
that could be performed by the individual in need of self-directed
in-home care if the individual did not have a physical disability. The
term includes the following:
(1) Assistance in getting in and out of beds, wheelchairs, and
motor vehicles.
(2) Assistance with routine bodily functions, including:
(A) health related services (as defined in section 5 of this
chapter);
(B) bathing and personal hygiene;
(C) dressing and grooming; and
(D) feeding, including preparation and cleanup. As added by P.L.141-2006, SEC.44. Amended by P.L.99-2007,
SEC.67.
IC 12-10-17.1-5 "Health related services" defined
Sec. 5. As used in this chapter, "health related services" means
those medical activities that, in the written opinion of the attending
physician submitted to the case manager of the individual in need of
self-directed in-home care, could be performed by the individual if
the individual were physically capable, and if the medical activities
can be safely performed in the home, and:
(1) are performed by a person who has been trained or
instructed on the performance of the medical activities by an
individual in need of self-directed in-home care who is, in the
written opinion of the attending physician submitted to the case
manager of the individual in need of self-directed in-home care,
capable of training or instructing the person who will perform
the medical activities; or
(2) are performed by a person who has received training or
instruction from a licensed health professional, within the
professional's scope of practice, in how to properly perform the
medical activity for the individual in need of self-directed
in-home care. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-6 "Individual in need of self-directed in-home care" defined
Sec. 6. As used in this chapter, "individual in need of self-directed
in-home care" means an individual with a disability, or person
responsible for making health related decisions for the individual
with a disability, who:
(1) is approved to receive Medicaid waiver services under 42
U.S.C. 1396n(c), or is a participant in the community and home
options to institutional care for the elderly and disabled
program under IC 12-10-10;
(2) is in need of attendant care services because of impairment;
(3) requires assistance to complete functions of daily living,
self-care, and mobility, including those functions included in
attendant care services;
(4) chooses to self-direct a paid personal services attendant to
perform attendant care services; and
(5) assumes the responsibility to initiate self-directed in-home
care and exercise judgment regarding the manner in which
those services are delivered, including the decision to employ,
train, and dismiss a personal services attendant. As added by P.L.141-2006, SEC.44. Amended by P.L.99-2007,
SEC.68.
IC 12-10-17.1-7 "Licensed health professional" defined
Sec. 7. As used in this chapter, "licensed health professional"
means any of the following:
(1) A registered nurse.
(2) A licensed practical nurse.
(3) A physician with an unlimited license to practice medicine
or osteopathic medicine.
(4) A licensed dentist.
(5) A licensed chiropractor.
(6) A licensed optometrist.
(7) A licensed pharmacist.
(8) A licensed physical therapist.
(9) A licensed occupational therapist.
(10) A certified psychologist.
(11) A licensed podiatrist.
(12) A licensed speech-language pathologist or audiologist. As added by P.L.141-2006, SEC.44. Amended by P.L.197-2007,
SEC.3.
IC 12-10-17.1-8 "Personal services attendant" defined
Sec. 8. As used in this chapter, "personal services attendant"
means an individual who is registered to provide attendant care
services under this chapter and who has entered into a contract with
an individual and acts under the individual's direction to provide
attendant care services that could be performed by the individual if
the individual were physically capable. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-9 "Self-directed in-home health care" defined
Sec. 9. As used in this chapter, "self-directed in-home health care"
means the process by which an individual, who is prevented by a
disability from performing basic and ancillary services that the
individual would perform if the individual did not have a disability,
chooses to direct and supervise a paid personal services attendant to
perform those services in order for the individual to live in the
individual's home and community rather than an institution. As added by P.L.141-2006, SEC.44. Amended by P.L.99-2007,
SEC.69.
IC 12-10-17.1-10 Registration; prohibition
Sec. 10. (a) An individual may not provide attendant care services
for compensation from Medicaid or the community and home options
to institutional care for the elderly and disabled program for an
individual in need of self-directed in-home care services unless the
individual is registered under section 12 of this chapter.
(b) An individual who is a legally responsible relative of an
individual in need of self-directed in-home care, including a parent
of a minor individual and a spouse, is precluded from providing
attendant care services for compensation under this chapter. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-11 Registration requirement
Sec. 11. An individual who desires to provide attendant care
services must register with the division or with an organization
designated by the division. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-12 Registration by the division; duties of the division
Sec. 12. (a) The division shall register an individual who provides
the following:
(1) A personal resume containing information concerning the
individual's qualifications, work experience, and any credentials
the individual may hold. The individual must certify that the
information contained in the resume is true and accurate.
(2) The individual's limited criminal history check from the
Indiana central repository for criminal history information
under IC 10-13-3 or another source allowed by law.
(3) If applicable, the individual's state nurse aide registry report
from the state department of health. This subdivision does not
require an individual to be a nurse aide.
(4) Three (3) letters of reference.
(5) A registration fee. The division shall establish the amount
of the registration fee.
(6) Proof that the individual is at least eighteen (18) years of
age.
(7) Any other information required by the division.
(b) A registration is valid for two (2) years. A personal services
attendant may renew the personal services attendant's registration by
updating any information in the file that has changed and by paying
the fee required under subsection (a)(5). The limited criminal history
check and report required under subsection (a)(2) and (a)(3) must be
updated every two (2) years.
(c) The division and any organization designated under section 11
of this chapter shall maintain a file for each personal services
attendant that contains:
(1) comments related to the provision of attendant care services
submitted by an individual in need of self-directed in-home care
who has employed the personal services attendant; and
(2) the items described in subsection (a)(1) through (a)(4).
(d) Upon request, the division shall provide to an individual in
need of self-directed in-home care the following:
(1) Without charge, a list of personal services attendants who
are registered with the division and available within the
requested geographic area.
(2) A copy of the information of a specified personal services
attendant who is on file with the division under subsection (c).
The division may charge a fee for shipping, handling, and
copying expenses. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-13 Physician's written opinion
Sec. 13. The case manager of an individual in need of
self-directed in-home care shall maintain an attending physician's
written opinion submitted under section 5 of this chapter in a case
file that is maintained for the individual by the case manager. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-14 Employer; immunity; liability
Sec. 14. (a) A personal services attendant who is hired by the
individual in need of self-directed in-home care is an employee of the
individual in need of self-directed in-home care.
(b) The division is not liable for any actions of a personal services
attendant or an individual in need of self-directed in-home care.
(c) A personal services attendant and an individual in need of
self-directed in-home care are each liable for any negligent or
wrongful act or omission in which the person personally participates. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-15 Responsibilities of individuals in need of self-directed in-home care
Sec. 15. (a) Except as provided in subsection (b), an individual in
need of self-directed in-home care is responsible for recruiting,
hiring, training, paying, certifying any employment related
documents, dismissing, and supervising in the individual's home
during service hours a personal services attendant who provides
attendant care services for the individual.
(b) If an individual in need of self-directed in-home care is:
(1) less than twenty-one (21) years of age; or
(2) unable to direct in-home care because of a brain injury or
mental deficiency;
the individual's parent, spouse, legal guardian, or a person possessing
a valid power of attorney for the individual, may make employment,
care, and training decisions and certify any employment related
documents on behalf of the individual.
(c) An individual in need of self-directed in-home care or an
individual under subsection (b) and the individual's case manager
shall develop an authorized care plan. The authorized care plan must
include a list of weekly services or tasks that must be performed to
comply with the authorized care plan. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-16 Rules
Sec. 16. The division shall adopt rules under IC 4-22-2
concerning:
(1) the method of payment to a personal services attendant who
provides authorized services under this chapter; and
(2) record keeping requirements for personal attendant services. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-17 Contracts
Sec. 17. The individual in need of self-directed in-home care and
the personal services attendant must each sign a contract, in a form
approved by the division, that includes, at a minimum, the following
provisions:
(1) The responsibilities of the personal services attendant.
(2) The frequency the personal services attendant will provide
attendant care services.
(3) The duration of the contract.
(4) The hourly wage of the personal services attendant. The
wage may not be less than the federal minimum wage or more
than the rate that the recipient is eligible to receive under a
Medicaid home and community based services waiver or the
community and home options to institutional care for the
elderly and disabled program for attendant care services.
(5) Reasons and notice agreements for early termination of the
contract. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-18 Amendment of home and community based services waiver
program; payments not considered income
Sec. 18. (a) The office shall amend the home and community
based services waiver program under the state Medicaid plan to
provide for the payment for attendant care services provided by a
personal services attendant for an individual in need of self-directed
in-home care under this chapter, including any related record keeping
and employment expenses.
(b) The office shall not, to the extent permitted by federal law,
consider as income money paid under this chapter to or on behalf of
an individual in need of self-directed in-home care to enable the
individual to employ registered personal services attendants, for
purposes of determining the individual's income eligibility for
services under this chapter.
As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-19 Demonstration projects; research
Sec. 19. The division may:
(1) initiate demonstration projects to test new ways of providing
attendant care services; and
(2) research ways to best provide attendant care services in
urban and rural areas. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-20 Rules
Sec. 20. (a) The division and office may adopt rules under
IC 4-22-2 that are necessary to implement this chapter.
(b) The office shall apply for any federal waivers necessary to
implement this chapter. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-21 Rules
Sec. 21. The division shall adopt rules under IC 4-22-2 concerning
the following:
(1) The receipt, review, and investigation of complaints
concerning the:
(A) neglect;
(B) abuse;
(C) mistreatment; or
(D) misappropriation of property;
of an individual in need of self-directed in-home care by a
personal services attendant.
(2) Establishing notice and administrative hearing procedures
in accordance with IC 4-21.5.
(3) Appeal procedures, including judicial review of
administrative hearings.
(4) Procedures to place a personal services attendant who has
been determined to have been guilty of:
(A) neglect;
(B) abuse;
(C) mistreatment; or
(D) misappropriation of property;
of an individual in need of self-directed in-home care on the
state nurse aide registry. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1
Chapter 17.1. Individuals in Need of Self-Directed In-Home Care
IC 12-10-17.1-1 Applicability of chapter
Sec. 1. This chapter does not apply to the following:
(1) An individual who provides attendant care services and who
is employed by and under the direct control of a home health
agency (as defined in IC 12-15-34-1).
(2) An individual who provides attendant care services and who
is employed by and under the direct control of a licensed
hospice program under IC 16-25.
(3) An individual who provides attendant care services and who
is employed by and under the control of an employer that is not
the individual who is receiving the services.
(4) A practitioner (as defined in IC 25-1-9-2) who is practicing
under the scope of the practitioner's license (as defined in
IC 25-1-9-3). As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-2 "Ancillary services" defined
Sec. 2. As used in this chapter, "ancillary services" means services
ancillary to the basic services provided to an individual in need of
self-directed in-home care who needs at least one (1) of the basic
services (as defined in section 4 of this chapter). The term includes
the following:
(1) Homemaker services, including shopping, laundry, cleaning,
and seasonal chores.
(2) Companion services, including transportation, letter writing,
mail reading, and escort services.
(3) Assistance with cognitive tasks, including managing
finances, planning activities, and making decisions. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-3 "Attendant care services" defined
Sec. 3. As used in this chapter, "attendant care services" means
those basic and ancillary services that the individual chooses to
direct and supervise a personal services attendant to perform and that
enable an individual in need of self-directed in-home care to live in
the individual's home and community rather than in an institution and
to carry out functions of daily living, self-care, and mobility. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-4 "Basic services" defined
Sec. 4. As used in this chapter, "basic services" means a function
that could be performed by the individual in need of self-directed
in-home care if the individual did not have a physical disability. The
term includes the following:
(1) Assistance in getting in and out of beds, wheelchairs, and
motor vehicles.
(2) Assistance with routine bodily functions, including:
(A) health related services (as defined in section 5 of this
chapter);
(B) bathing and personal hygiene;
(C) dressing and grooming; and
(D) feeding, including preparation and cleanup. As added by P.L.141-2006, SEC.44. Amended by P.L.99-2007,
SEC.67.
IC 12-10-17.1-5 "Health related services" defined
Sec. 5. As used in this chapter, "health related services" means
those medical activities that, in the written opinion of the attending
physician submitted to the case manager of the individual in need of
self-directed in-home care, could be performed by the individual if
the individual were physically capable, and if the medical activities
can be safely performed in the home, and:
(1) are performed by a person who has been trained or
instructed on the performance of the medical activities by an
individual in need of self-directed in-home care who is, in the
written opinion of the attending physician submitted to the case
manager of the individual in need of self-directed in-home care,
capable of training or instructing the person who will perform
the medical activities; or
(2) are performed by a person who has received training or
instruction from a licensed health professional, within the
professional's scope of practice, in how to properly perform the
medical activity for the individual in need of self-directed
in-home care. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-6 "Individual in need of self-directed in-home care" defined
Sec. 6. As used in this chapter, "individual in need of self-directed
in-home care" means an individual with a disability, or person
responsible for making health related decisions for the individual
with a disability, who:
(1) is approved to receive Medicaid waiver services under 42
U.S.C. 1396n(c), or is a participant in the community and home
options to institutional care for the elderly and disabled
program under IC 12-10-10;
(2) is in need of attendant care services because of impairment;
(3) requires assistance to complete functions of daily living,
self-care, and mobility, including those functions included in
attendant care services;
(4) chooses to self-direct a paid personal services attendant to
perform attendant care services; and
(5) assumes the responsibility to initiate self-directed in-home
care and exercise judgment regarding the manner in which
those services are delivered, including the decision to employ,
train, and dismiss a personal services attendant. As added by P.L.141-2006, SEC.44. Amended by P.L.99-2007,
SEC.68.
IC 12-10-17.1-7 "Licensed health professional" defined
Sec. 7. As used in this chapter, "licensed health professional"
means any of the following:
(1) A registered nurse.
(2) A licensed practical nurse.
(3) A physician with an unlimited license to practice medicine
or osteopathic medicine.
(4) A licensed dentist.
(5) A licensed chiropractor.
(6) A licensed optometrist.
(7) A licensed pharmacist.
(8) A licensed physical therapist.
(9) A licensed occupational therapist.
(10) A certified psychologist.
(11) A licensed podiatrist.
(12) A licensed speech-language pathologist or audiologist. As added by P.L.141-2006, SEC.44. Amended by P.L.197-2007,
SEC.3.
IC 12-10-17.1-8 "Personal services attendant" defined
Sec. 8. As used in this chapter, "personal services attendant"
means an individual who is registered to provide attendant care
services under this chapter and who has entered into a contract with
an individual and acts under the individual's direction to provide
attendant care services that could be performed by the individual if
the individual were physically capable. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-9 "Self-directed in-home health care" defined
Sec. 9. As used in this chapter, "self-directed in-home health care"
means the process by which an individual, who is prevented by a
disability from performing basic and ancillary services that the
individual would perform if the individual did not have a disability,
chooses to direct and supervise a paid personal services attendant to
perform those services in order for the individual to live in the
individual's home and community rather than an institution. As added by P.L.141-2006, SEC.44. Amended by P.L.99-2007,
SEC.69.
IC 12-10-17.1-10 Registration; prohibition
Sec. 10. (a) An individual may not provide attendant care services
for compensation from Medicaid or the community and home options
to institutional care for the elderly and disabled program for an
individual in need of self-directed in-home care services unless the
individual is registered under section 12 of this chapter.
(b) An individual who is a legally responsible relative of an
individual in need of self-directed in-home care, including a parent
of a minor individual and a spouse, is precluded from providing
attendant care services for compensation under this chapter. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-11 Registration requirement
Sec. 11. An individual who desires to provide attendant care
services must register with the division or with an organization
designated by the division. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-12 Registration by the division; duties of the division
Sec. 12. (a) The division shall register an individual who provides
the following:
(1) A personal resume containing information concerning the
individual's qualifications, work experience, and any credentials
the individual may hold. The individual must certify that the
information contained in the resume is true and accurate.
(2) The individual's limited criminal history check from the
Indiana central repository for criminal history information
under IC 10-13-3 or another source allowed by law.
(3) If applicable, the individual's state nurse aide registry report
from the state department of health. This subdivision does not
require an individual to be a nurse aide.
(4) Three (3) letters of reference.
(5) A registration fee. The division shall establish the amount
of the registration fee.
(6) Proof that the individual is at least eighteen (18) years of
age.
(7) Any other information required by the division.
(b) A registration is valid for two (2) years. A personal services
attendant may renew the personal services attendant's registration by
updating any information in the file that has changed and by paying
the fee required under subsection (a)(5). The limited criminal history
check and report required under subsection (a)(2) and (a)(3) must be
updated every two (2) years.
(c) The division and any organization designated under section 11
of this chapter shall maintain a file for each personal services
attendant that contains:
(1) comments related to the provision of attendant care services
submitted by an individual in need of self-directed in-home care
who has employed the personal services attendant; and
(2) the items described in subsection (a)(1) through (a)(4).
(d) Upon request, the division shall provide to an individual in
need of self-directed in-home care the following:
(1) Without charge, a list of personal services attendants who
are registered with the division and available within the
requested geographic area.
(2) A copy of the information of a specified personal services
attendant who is on file with the division under subsection (c).
The division may charge a fee for shipping, handling, and
copying expenses. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-13 Physician's written opinion
Sec. 13. The case manager of an individual in need of
self-directed in-home care shall maintain an attending physician's
written opinion submitted under section 5 of this chapter in a case
file that is maintained for the individual by the case manager. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-14 Employer; immunity; liability
Sec. 14. (a) A personal services attendant who is hired by the
individual in need of self-directed in-home care is an employee of the
individual in need of self-directed in-home care.
(b) The division is not liable for any actions of a personal services
attendant or an individual in need of self-directed in-home care.
(c) A personal services attendant and an individual in need of
self-directed in-home care are each liable for any negligent or
wrongful act or omission in which the person personally participates. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-15 Responsibilities of individuals in need of self-directed in-home care
Sec. 15. (a) Except as provided in subsection (b), an individual in
need of self-directed in-home care is responsible for recruiting,
hiring, training, paying, certifying any employment related
documents, dismissing, and supervising in the individual's home
during service hours a personal services attendant who provides
attendant care services for the individual.
(b) If an individual in need of self-directed in-home care is:
(1) less than twenty-one (21) years of age; or
(2) unable to direct in-home care because of a brain injury or
mental deficiency;
the individual's parent, spouse, legal guardian, or a person possessing
a valid power of attorney for the individual, may make employment,
care, and training decisions and certify any employment related
documents on behalf of the individual.
(c) An individual in need of self-directed in-home care or an
individual under subsection (b) and the individual's case manager
shall develop an authorized care plan. The authorized care plan must
include a list of weekly services or tasks that must be performed to
comply with the authorized care plan. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-16 Rules
Sec. 16. The division shall adopt rules under IC 4-22-2
concerning:
(1) the method of payment to a personal services attendant who
provides authorized services under this chapter; and
(2) record keeping requirements for personal attendant services. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-17 Contracts
Sec. 17. The individual in need of self-directed in-home care and
the personal services attendant must each sign a contract, in a form
approved by the division, that includes, at a minimum, the following
provisions:
(1) The responsibilities of the personal services attendant.
(2) The frequency the personal services attendant will provide
attendant care services.
(3) The duration of the contract.
(4) The hourly wage of the personal services attendant. The
wage may not be less than the federal minimum wage or more
than the rate that the recipient is eligible to receive under a
Medicaid home and community based services waiver or the
community and home options to institutional care for the
elderly and disabled program for attendant care services.
(5) Reasons and notice agreements for early termination of the
contract. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-18 Amendment of home and community based services waiver
program; payments not considered income
Sec. 18. (a) The office shall amend the home and community
based services waiver program under the state Medicaid plan to
provide for the payment for attendant care services provided by a
personal services attendant for an individual in need of self-directed
in-home care under this chapter, including any related record keeping
and employment expenses.
(b) The office shall not, to the extent permitted by federal law,
consider as income money paid under this chapter to or on behalf of
an individual in need of self-directed in-home care to enable the
individual to employ registered personal services attendants, for
purposes of determining the individual's income eligibility for
services under this chapter.
As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-19 Demonstration projects; research
Sec. 19. The division may:
(1) initiate demonstration projects to test new ways of providing
attendant care services; and
(2) research ways to best provide attendant care services in
urban and rural areas. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-20 Rules
Sec. 20. (a) The division and office may adopt rules under
IC 4-22-2 that are necessary to implement this chapter.
(b) The office shall apply for any federal waivers necessary to
implement this chapter. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-21 Rules
Sec. 21. The division shall adopt rules under IC 4-22-2 concerning
the following:
(1) The receipt, review, and investigation of complaints
concerning the:
(A) neglect;
(B) abuse;
(C) mistreatment; or
(D) misappropriation of property;
of an individual in need of self-directed in-home care by a
personal services attendant.
(2) Establishing notice and administrative hearing procedures
in accordance with IC 4-21.5.
(3) Appeal procedures, including judicial review of
administrative hearings.
(4) Procedures to place a personal services attendant who has
been determined to have been guilty of:
(A) neglect;
(B) abuse;
(C) mistreatment; or
(D) misappropriation of property;
of an individual in need of self-directed in-home care on the
state nurse aide registry. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1
Chapter 17.1. Individuals in Need of Self-Directed In-Home Care
IC 12-10-17.1-1 Applicability of chapter
Sec. 1. This chapter does not apply to the following:
(1) An individual who provides attendant care services and who
is employed by and under the direct control of a home health
agency (as defined in IC 12-15-34-1).
(2) An individual who provides attendant care services and who
is employed by and under the direct control of a licensed
hospice program under IC 16-25.
(3) An individual who provides attendant care services and who
is employed by and under the control of an employer that is not
the individual who is receiving the services.
(4) A practitioner (as defined in IC 25-1-9-2) who is practicing
under the scope of the practitioner's license (as defined in
IC 25-1-9-3). As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-2 "Ancillary services" defined
Sec. 2. As used in this chapter, "ancillary services" means services
ancillary to the basic services provided to an individual in need of
self-directed in-home care who needs at least one (1) of the basic
services (as defined in section 4 of this chapter). The term includes
the following:
(1) Homemaker services, including shopping, laundry, cleaning,
and seasonal chores.
(2) Companion services, including transportation, letter writing,
mail reading, and escort services.
(3) Assistance with cognitive tasks, including managing
finances, planning activities, and making decisions. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-3 "Attendant care services" defined
Sec. 3. As used in this chapter, "attendant care services" means
those basic and ancillary services that the individual chooses to
direct and supervise a personal services attendant to perform and that
enable an individual in need of self-directed in-home care to live in
the individual's home and community rather than in an institution and
to carry out functions of daily living, self-care, and mobility. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-4 "Basic services" defined
Sec. 4. As used in this chapter, "basic services" means a function
that could be performed by the individual in need of self-directed
in-home care if the individual did not have a physical disability. The
term includes the following:
(1) Assistance in getting in and out of beds, wheelchairs, and
motor vehicles.
(2) Assistance with routine bodily functions, including:
(A) health related services (as defined in section 5 of this
chapter);
(B) bathing and personal hygiene;
(C) dressing and grooming; and
(D) feeding, including preparation and cleanup. As added by P.L.141-2006, SEC.44. Amended by P.L.99-2007,
SEC.67.
IC 12-10-17.1-5 "Health related services" defined
Sec. 5. As used in this chapter, "health related services" means
those medical activities that, in the written opinion of the attending
physician submitted to the case manager of the individual in need of
self-directed in-home care, could be performed by the individual if
the individual were physically capable, and if the medical activities
can be safely performed in the home, and:
(1) are performed by a person who has been trained or
instructed on the performance of the medical activities by an
individual in need of self-directed in-home care who is, in the
written opinion of the attending physician submitted to the case
manager of the individual in need of self-directed in-home care,
capable of training or instructing the person who will perform
the medical activities; or
(2) are performed by a person who has received training or
instruction from a licensed health professional, within the
professional's scope of practice, in how to properly perform the
medical activity for the individual in need of self-directed
in-home care. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-6 "Individual in need of self-directed in-home care" defined
Sec. 6. As used in this chapter, "individual in need of self-directed
in-home care" means an individual with a disability, or person
responsible for making health related decisions for the individual
with a disability, who:
(1) is approved to receive Medicaid waiver services under 42
U.S.C. 1396n(c), or is a participant in the community and home
options to institutional care for the elderly and disabled
program under IC 12-10-10;
(2) is in need of attendant care services because of impairment;
(3) requires assistance to complete functions of daily living,
self-care, and mobility, including those functions included in
attendant care services;
(4) chooses to self-direct a paid personal services attendant to
perform attendant care services; and
(5) assumes the responsibility to initiate self-directed in-home
care and exercise judgment regarding the manner in which
those services are delivered, including the decision to employ,
train, and dismiss a personal services attendant. As added by P.L.141-2006, SEC.44. Amended by P.L.99-2007,
SEC.68.
IC 12-10-17.1-7 "Licensed health professional" defined
Sec. 7. As used in this chapter, "licensed health professional"
means any of the following:
(1) A registered nurse.
(2) A licensed practical nurse.
(3) A physician with an unlimited license to practice medicine
or osteopathic medicine.
(4) A licensed dentist.
(5) A licensed chiropractor.
(6) A licensed optometrist.
(7) A licensed pharmacist.
(8) A licensed physical therapist.
(9) A licensed occupational therapist.
(10) A certified psychologist.
(11) A licensed podiatrist.
(12) A licensed speech-language pathologist or audiologist. As added by P.L.141-2006, SEC.44. Amended by P.L.197-2007,
SEC.3.
IC 12-10-17.1-8 "Personal services attendant" defined
Sec. 8. As used in this chapter, "personal services attendant"
means an individual who is registered to provide attendant care
services under this chapter and who has entered into a contract with
an individual and acts under the individual's direction to provide
attendant care services that could be performed by the individual if
the individual were physically capable. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-9 "Self-directed in-home health care" defined
Sec. 9. As used in this chapter, "self-directed in-home health care"
means the process by which an individual, who is prevented by a
disability from performing basic and ancillary services that the
individual would perform if the individual did not have a disability,
chooses to direct and supervise a paid personal services attendant to
perform those services in order for the individual to live in the
individual's home and community rather than an institution. As added by P.L.141-2006, SEC.44. Amended by P.L.99-2007,
SEC.69.
IC 12-10-17.1-10 Registration; prohibition
Sec. 10. (a) An individual may not provide attendant care services
for compensation from Medicaid or the community and home options
to institutional care for the elderly and disabled program for an
individual in need of self-directed in-home care services unless the
individual is registered under section 12 of this chapter.
(b) An individual who is a legally responsible relative of an
individual in need of self-directed in-home care, including a parent
of a minor individual and a spouse, is precluded from providing
attendant care services for compensation under this chapter. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-11 Registration requirement
Sec. 11. An individual who desires to provide attendant care
services must register with the division or with an organization
designated by the division. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-12 Registration by the division; duties of the division
Sec. 12. (a) The division shall register an individual who provides
the following:
(1) A personal resume containing information concerning the
individual's qualifications, work experience, and any credentials
the individual may hold. The individual must certify that the
information contained in the resume is true and accurate.
(2) The individual's limited criminal history check from the
Indiana central repository for criminal history information
under IC 10-13-3 or another source allowed by law.
(3) If applicable, the individual's state nurse aide registry report
from the state department of health. This subdivision does not
require an individual to be a nurse aide.
(4) Three (3) letters of reference.
(5) A registration fee. The division shall establish the amount
of the registration fee.
(6) Proof that the individual is at least eighteen (18) years of
age.
(7) Any other information required by the division.
(b) A registration is valid for two (2) years. A personal services
attendant may renew the personal services attendant's registration by
updating any information in the file that has changed and by paying
the fee required under subsection (a)(5). The limited criminal history
check and report required under subsection (a)(2) and (a)(3) must be
updated every two (2) years.
(c) The division and any organization designated under section 11
of this chapter shall maintain a file for each personal services
attendant that contains:
(1) comments related to the provision of attendant care services
submitted by an individual in need of self-directed in-home care
who has employed the personal services attendant; and
(2) the items described in subsection (a)(1) through (a)(4).
(d) Upon request, the division shall provide to an individual in
need of self-directed in-home care the following:
(1) Without charge, a list of personal services attendants who
are registered with the division and available within the
requested geographic area.
(2) A copy of the information of a specified personal services
attendant who is on file with the division under subsection (c).
The division may charge a fee for shipping, handling, and
copying expenses. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-13 Physician's written opinion
Sec. 13. The case manager of an individual in need of
self-directed in-home care shall maintain an attending physician's
written opinion submitted under section 5 of this chapter in a case
file that is maintained for the individual by the case manager. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-14 Employer; immunity; liability
Sec. 14. (a) A personal services attendant who is hired by the
individual in need of self-directed in-home care is an employee of the
individual in need of self-directed in-home care.
(b) The division is not liable for any actions of a personal services
attendant or an individual in need of self-directed in-home care.
(c) A personal services attendant and an individual in need of
self-directed in-home care are each liable for any negligent or
wrongful act or omission in which the person personally participates. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-15 Responsibilities of individuals in need of self-directed in-home care
Sec. 15. (a) Except as provided in subsection (b), an individual in
need of self-directed in-home care is responsible for recruiting,
hiring, training, paying, certifying any employment related
documents, dismissing, and supervising in the individual's home
during service hours a personal services attendant who provides
attendant care services for the individual.
(b) If an individual in need of self-directed in-home care is:
(1) less than twenty-one (21) years of age; or
(2) unable to direct in-home care because of a brain injury or
mental deficiency;
the individual's parent, spouse, legal guardian, or a person possessing
a valid power of attorney for the individual, may make employment,
care, and training decisions and certify any employment related
documents on behalf of the individual.
(c) An individual in need of self-directed in-home care or an
individual under subsection (b) and the individual's case manager
shall develop an authorized care plan. The authorized care plan must
include a list of weekly services or tasks that must be performed to
comply with the authorized care plan. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-16 Rules
Sec. 16. The division shall adopt rules under IC 4-22-2
concerning:
(1) the method of payment to a personal services attendant who
provides authorized services under this chapter; and
(2) record keeping requirements for personal attendant services. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-17 Contracts
Sec. 17. The individual in need of self-directed in-home care and
the personal services attendant must each sign a contract, in a form
approved by the division, that includes, at a minimum, the following
provisions:
(1) The responsibilities of the personal services attendant.
(2) The frequency the personal services attendant will provide
attendant care services.
(3) The duration of the contract.
(4) The hourly wage of the personal services attendant. The
wage may not be less than the federal minimum wage or more
than the rate that the recipient is eligible to receive under a
Medicaid home and community based services waiver or the
community and home options to institutional care for the
elderly and disabled program for attendant care services.
(5) Reasons and notice agreements for early termination of the
contract. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-18 Amendment of home and community based services waiver
program; payments not considered income
Sec. 18. (a) The office shall amend the home and community
based services waiver program under the state Medicaid plan to
provide for the payment for attendant care services provided by a
personal services attendant for an individual in need of self-directed
in-home care under this chapter, including any related record keeping
and employment expenses.
(b) The office shall not, to the extent permitted by federal law,
consider as income money paid under this chapter to or on behalf of
an individual in need of self-directed in-home care to enable the
individual to employ registered personal services attendants, for
purposes of determining the individual's income eligibility for
services under this chapter.
As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-19 Demonstration projects; research
Sec. 19. The division may:
(1) initiate demonstration projects to test new ways of providing
attendant care services; and
(2) research ways to best provide attendant care services in
urban and rural areas. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-20 Rules
Sec. 20. (a) The division and office may adopt rules under
IC 4-22-2 that are necessary to implement this chapter.
(b) The office shall apply for any federal waivers necessary to
implement this chapter. As added by P.L.141-2006, SEC.44.
IC 12-10-17.1-21 Rules
Sec. 21. The division shall adopt rules under IC 4-22-2 concerning
the following:
(1) The receipt, review, and investigation of complaints
concerning the:
(A) neglect;
(B) abuse;
(C) mistreatment; or
(D) misappropriation of property;
of an individual in need of self-directed in-home care by a
personal services attendant.
(2) Establishing notice and administrative hearing procedures
in accordance with IC 4-21.5.
(3) Appeal procedures, including judicial review of
administrative hearings.
(4) Procedures to place a personal services attendant who has
been determined to have been guilty of:
(A) neglect;
(B) abuse;
(C) mistreatment; or
(D) misappropriation of property;
of an individual in need of self-directed in-home care on the
state nurse aide registry. As added by P.L.141-2006, SEC.44.
