2013 Indiana Code
TITLE 12. HUMAN SERVICES
ARTICLE 11. SERVICES FOR INDIVIDUALS WITH DISABILITIES
CHAPTER 1.1. BUREAU OF DEVELOPMENTAL DISABILITIES SERVICES; COMMUNITY BASED SERVICES
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IC 12-11-1.1
Chapter 1.1. Bureau of Developmental Disabilities Services;
Community Based Services
IC 12-11-1.1-1
Establishment; services; approving entities and providers;
supported living service arrangements; community based services;
administration
Sec. 1. (a) The bureau of developmental disabilities services is
established within the division.
(b) The bureau shall plan, coordinate, and administer the
provision of individualized, integrated community based services for
individuals with a developmental disability and their families, within
the limits of available resources. The planning and delivery of
services must be based on future plans of the individual with a
developmental disability rather than on traditional determinations of
eligibility for discrete services, with an emphasis on the preferences
of the individual with a developmental disability and that individual's
family.
(c) Services for individuals with a developmental disability must
be services that meet the following conditions:
(1) Are provided under public supervision.
(2) Are designed to meet the developmental needs of
individuals with a developmental disability.
(3) Meet all required state and federal standards.
(4) Are provided by qualified personnel.
(5) To the extent appropriate, are provided in home and
community based settings in which individuals without
disabilities participate.
(6) Are provided in conformity with a service plan developed
under IC 12-11-2.1-2.
(d) The bureau shall approve entities to provide community based
services and supports as follows:
(1) Beginning July 1, 2011, the bureau shall ensure that an
entity approved to provide day services, identified day
habilitation, including facility based or community based
habilitation, prevocational services, or employment services
under home and community based services waivers is
accredited by an approved national accrediting body described
in subsection (j).
(2) Beginning July 1, 2012, the bureau shall ensure that an
entity approved to provide residential habilitation and support
services under home and community based services waivers is
accredited by an approved national accrediting body. However,
if an entity is accredited to provide home and community based
services under subdivision (1) other than residential habilitation
and support services, the bureau may extend the time that the
entity has to comply with this subdivision until the earlier of the
following:
(A) The completion of the entity's next scheduled
accreditation survey.
(B) July 1, 2015.
(e) Subject to subsection (k), the bureau shall initially approve,
reapprove, and monitor community based residential, habilitation,
and employment service providers that provide alternatives to
placement of individuals with a developmental disability in state
institutions and health facilities licensed under IC 16-28 for
individuals with a developmental disability. The services must
simulate, to the extent feasible, patterns and conditions of everyday
life that are as close as possible to normal. The community based
service categories include the following:
(1) Supervised group living programs, which serve at least four
(4) individuals and not more than eight (8) individuals, are
funded by Medicaid, and are licensed by the community
residential facilities council.
(2) Supported living service arrangements to meet the unique
needs of individuals in integrated settings. Supported living
service arrangements providing residential services may not
serve more than four (4) unrelated individuals in any one (1)
setting. However, a program that:
(A) is in existence on January 1, 2013, as a supervised group
living program described in subdivision (1); and
(B) has more than four (4) individuals residing as part of the
program;
may convert to a supported living service arrangement under
this subdivision and continue to provide services to up to the
same number of individuals in the supported living setting.
(f) To the extent that services described in subsection (e) are
available and meet the individual's needs, an individual is entitled to
receive services in the least restrictive environment possible.
(g) Community based services under subsection (e)(1) or (e)(2)
must consider the needs of and provide choices and options for:
(1) individuals with a developmental disability; and
(2) families of individuals with a developmental disability.
(h) The bureau shall administer a system of service coordination
to carry out this chapter.
(i) The bureau may issue orders under IC 4-21.5-3-6 against a
provider that violates rules issued by the bureau for programs in
which the provider is providing services in accordance with section
11 of this chapter.
(j) For purposes of subsections (d) and (k), "approved national
accrediting body" means any of the following:
(1) The Commission on Accreditation of Rehabilitation
Facilities (CARF), or its successor.
(2) The Council on Quality and Leadership In Supports for
People with Disabilities, or its successor.
(3) The Joint Commission on Accreditation of Healthcare
Organizations (JCAHO), or its successor.
(4) The National Committee for Quality Assurance, or its
successor.
(5) The ISO-9001 human services QA system.
(6) The Council on Accreditation, or its successor.
(7) An independent national accreditation organization
approved by the secretary.
(k) An entity that is accredited by an approved national
accrediting body is not subject to reapproval surveys or routine
monitoring surveys by the division, bureau, or bureau of quality
improvement services, including any reapproval survey under a home
and community based services waiver. However, the bureau may
perform validation surveys and complaint investigations of an entity
accredited by an approved national accrediting body.
As added by P.L.272-1999, SEC.33. Amended by P.L.243-2003,
SEC.11; P.L.99-2007, SEC.70; P.L.22-2010, SEC.1; P.L.153-2011,
SEC.11; P.L.154-2012, SEC.1; P.L.130-2013, SEC.1.
IC 12-11-1.1-2
Medicaid funding; payment for services
Sec. 2. (a) Except as specified by the terms of the Medicaid
program:
(1) an individual who receives services under this chapter; and
(2) the parents of the individual, if the individual is less than
eighteen (18) years of age;
are liable for the cost of services and supports.
(b) The bureau shall make every effort to assure that
individualized service plans developed for individuals with a
developmental disability maximize the amount of Medicaid funding
available to meet the needs of the individual.
(c) The bureau may provide reimbursement for services identified
in an individual's individual service plan that are not eligible for
Medicaid reimbursement and for which the individual does not have
the resources to pay.
As added by P.L.272-1999, SEC.33. Amended by P.L.99-2007,
SEC.71.
IC 12-11-1.1-3
Contracts to provide services
Sec. 3. The division may contract with:
(1) community mental retardation and other developmental
disabilities centers;
(2) corporations; or
(3) individuals;
that are approved by the division to provide the services described in
this chapter.
As added by P.L.272-1999, SEC.33.
IC 12-11-1.1-4
Continuing eligibility for Medicaid
Sec. 4. An individual with a developmental disability who is
eligible for Medicaid remains eligible for Medicaid if transferred to
community based services described in section 1(e) of this chapter.
As added by P.L.272-1999, SEC.33. Amended by P.L.99-2007,
SEC.72.
IC 12-11-1.1-5
Continuing approved placement of individuals in certain facilities
Sec. 5. The bureau may continue the approved placement of an
individual with a developmental disability in a child caring
institution licensed under IC 31-27, a county home regulated by
IC 12-30-3, or a health facility licensed under IC 16-28 if:
(1) the individual was placed in the institution, home, or facility
before July 1, 1985; and
(2) the placement continues to be appropriate for the individual,
as determined by the bureau.
As added by P.L.272-1999, SEC.33. Amended by P.L.145-2006,
SEC.70; P.L.99-2007, SEC.73.
IC 12-11-1.1-6
Individuals with autism not excluded
Sec. 6. An individual who has been diagnosed to have autism may
not be excluded from services for individuals with a developmental
disability because the individual has autism.
As added by P.L.272-1999, SEC.33. Amended by P.L.99-2007,
SEC.74.
IC 12-11-1.1-7
Community residential facilities operated by division
Sec. 7. Subject to the availability of money, the division may
operate community residential facilities for individuals with a
developmental disability who are hard to place, if private providers
cannot be found to operate facilities for those individuals. Placement
of individuals in these facilities is governed by IC 12-11-2.1.
As added by P.L.272-1999, SEC.33. Amended by P.L.99-2007,
SEC.75.
IC 12-11-1.1-8
Repealed
(Repealed by P.L.188-2013, SEC.7.)
IC 12-11-1.1-9
Rules
Sec. 9. The director of the division may adopt rules under
IC 4-22-2 to carry out this chapter.
As added by P.L.272-1999, SEC.33.
IC 12-11-1.1-10
Provider assessment
Sec. 10. (a) The office may assess providers of community based
services to individuals with a developmental disability who
otherwise qualify to receive ICF/MR (as defined in IC 16-29-4-2)
based services in an amount not to exceed six percent (6%) of all
service revenue included on the annual plan of care excluding
resident living allowances.
(b) The assessments shall be paid to the office not later than the
tenth day of the month for each month that the individual is in
service. The office or the office's designee may withhold Medicaid
payments to a provider described in subsection (a) that fails to pay
an assessment within thirty (30) days after the due date. The amount
withheld may not exceed the amount of the assessments due.
(c) The community services quality assurance fund is created. The
fund shall be administered by the office.
(d) Revenue from the assessments under this section shall be
deposited into the fund. Money in the fund must be used for
community services for persons with developmental disabilities.
(e) Money in the fund at the end of a state fiscal year does not
revert to the state general fund.
(f) If federal financial participation to match the assessments in
subsection (a) becomes unavailable under federal law, the authority
to impose the assessments terminates on the date that the federal
statutory, regulatory, or interpretive change takes effect.
As added by P.L.259-2003, SEC.1. Amended by P.L.246-2005,
SEC.101.
IC 12-11-1.1-11
Issuance of citation for violations; requirements; remedies;
considerations in determining remedy
Sec. 11. (a) Upon a determination by the bureau that a provider
has violated this article or a rule adopted under this article, the
director shall issue a citation under IC 4-21.5-3-6 to the provider.
The citation must state the following:
(1) The nature of the violation.
(2) The classification of the violation.
(3) The corrective actions required of the provider to remedy
the breach and to protect clients of the provider.
(4) Any penalty imposed on the provider.
(b) A person aggrieved by a citation issued under this section may
request a review under IC 4-21.5-3-7. If a request for a hearing is not
filed within the fifteen (15) day period, the determination contained
in the citation is final.
(c) The bureau may impose the following remedies for a violation
of this article or a rule adopted under this article:
(1) Issuance of an order for immediate correction of the
violation.
(2) Imposition of a fine not to exceed ten thousand dollars
($10,000).
(3) Suspension of new clients by the provider for a period not
to exceed ninety (90) days.
(4) Revocation of the provider's license or issuance of a
probationary license.
(5) A requirement that the provider comply with any plan of
correction approved or directed by the division.
(d) In determining appropriate remedies under this section for a
violation, the bureau shall consider the following:
(1) Whether the violation occurred for reasons beyond the
provider's control.
(2) Whether the provider has demonstrated that the provider has
taken the appropriate steps to reasonably ensure that the
violation will not recur.
(3) The history of violations by the provider.
(4) The effect of the violation on the client.
(5) The degree of the violation.
As added by P.L.153-2011, SEC.12.
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