2014 Indiana Code TITLE 12. HUMAN SERVICES ARTICLE 15. MEDICAID CHAPTER 32. COMMUNITY RESIDENTIAL FACILITIES FOR THE DEVELOPMENTALLY DISABLED
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IC 12-15-32
Chapter 32. Community Residential Facilities for the
Developmentally Disabled
IC 12-15-32-1
Facility defined
Sec. 1. As used in this chapter, "facility" means a facility licensed
under IC 12-28-5 and certified under Title XIX of the Social Security
Act (42 U.S.C. 1396 et seq.) as an intermediate care facility for the
mentally retarded.
As added by P.L.2-1992, SEC.9.
IC 12-15-32-2
Reimbursement for cost of services provided; authorization
Sec. 2. The office shall reimburse community residential facilities
for the developmentally disabled for the cost of the Medicaid services
that are provided by the facility to individuals who are eligible for
Medicaid.
As added by P.L.2-1992, SEC.9.
IC 12-15-32-3
Repealed
(Repealed by P.L.78-1994, SEC.4.)
IC 12-15-32-4
Reimbursement rate criteria; necessary factors
Sec. 4. The criteria for reimbursement under this chapter must
include the following:
(1) The method of determining initial rates of reimbursement.
(2) The method of determining the maximum rate of
reimbursement.
(3) The frequency of rate reviews.
(4) The method of depreciating the buildings comprising the
facilities.
(5) The establishment of a maximum depreciation expense.
(6) The inclusion of first aid supplies as a part of the room
charge.
(7) The establishment of maximum costs of equipment
purchases or repairs that may be allowed as depreciation
expenses.
(8) The establishment of limitations on allowable interest
expenses.
(9) The establishment of a limit on the duration of financing.
As added by P.L.2-1992, SEC.9. Amended by P.L.78-1994, SEC.3.
IC 12-15-32-4.5
Reimbursement for staff hours of employees
Sec. 4.5. (a) This section applies to a community residential
facility for the developmentally disabled licensed as a child rearing
residence that:
(1) is a home exclusively for children;
(2) has a behavior management program staffed by:
(A) a behavior management consultant; or
(B) personnel;
to develop and monitor behavioral training, developmental
training, and support in specific areas for all residents who
function on a similar level; and
(3) does not have more than six (6) beds.
(b) A community residential facility for the developmentally
disabled is entitled to Medicaid reimbursement within available
appropriations for staff hours of employees:
(1) hired to work at least two thousand eighty (2,080) paid staff
hours per year per employee; and
(2) when the reimbursement requested is for not more than
twelve (12) staff hours per resident per day.
As added by P.L.255-1996, SEC.7.
IC 12-15-32-5
Special interim rates
Sec. 5. The office may establish a special interim rate for each
community residential facility to ensure that the reasonable special
costs involved in the initial year of operation of a facility are
reimbursed.
As added by P.L.2-1992, SEC.9.
IC 12-15-32-6
Facility residents; personal allowance; range of amounts
Sec. 6. The office shall allow a resident of a facility who is
receiving Medicaid to retain a personal allowance of fifty-two dollars
($52) each month.
As added by P.L.2-1992, SEC.9. Amended by P.L.294-2001, SEC.5.
IC 12-15-32-6.5
Payment calculation for federal SSI recipient; exemption from
income eligibility consideration
Sec. 6.5. (a) If a resident of a facility:
(1) is a recipient of assistance under the federal Supplemental
Security Income (SSI) program; and
(2) receives an income that is less than the amount described in
section 6 of this chapter;
the office shall pay to the individual an amount equal to the
difference between the amount of the monthly personal allowance
described in section 6 of this chapter and the amount of income,
including assistance under the federal Supplemental Security Income
(SSI) program received by the individual.
(b) Money paid to an individual under subsection (a) is exempt
from income eligibility consideration.
As added by P.L.294-2001, SEC.6. Amended by P.L.26-2003, SEC.2.
IC 12-15-32-7
Rules; functioning level of resident; personal allowance
Sec. 7. The secretary may adopt rules under IC 4-22-2 to do the
following:
(1) Establish criteria based on the functioning level of the
residents.
(2) Determine the personal allowance to which each resident is
entitled.
As added by P.L.2-1992, SEC.9.
IC 12-15-32-8
Personal allowance; income eligibility consideration; exemption
Sec. 8. A personal allowance is exempt from income eligibility
consideration by the office.
As added by P.L.2-1992, SEC.9.
IC 12-15-32-9
Personal allowance; individuals employed as part of habilitation
plan or working in sheltered workshop or day activity center
Sec. 9. The personal allowance for one (1) month for an individual
described in section 6 of this chapter whose employment is part of the
individual's habilitation plan or who is working in a sheltered
workshop or day activity center is the amount that a person would be
entitled to retain under section 6 of this chapter plus an amount equal
to one-half (1/2) of the remainder of:
(1) gross earned income for that month; minus
(2) the sum of:
(A) sixteen dollars ($16); plus
(B) the amount withheld from the individual's paycheck for
that month for payment of state income tax, federal income
tax, and the tax prescribed by the Federal Insurance
Contribution Act (26 U.S.C. 3101 et seq.); plus
(C) transportation expenses for that month.
As added by P.L.2-1992, SEC.9.
IC 12-15-32-10
Placement in facility; diagnostic evaluations
Sec. 10. (a) An applicant for Medicaid who desires to be placed in
a community residential facility must first receive a diagnostic
evaluation to be provided by the division of disability and
rehabilitative services.
(b) Subsequent diagnostic evaluations by the division of disability
and rehabilitative services shall be provided at least every twelve (12)
months to review the individual's need for services.
(c) The office shall consider the evaluations in determining the
appropriateness of placement.
As added by P.L.2-1992, SEC.9. Amended by P.L.4-1993, SEC.118;
P.L.5-1993, SEC.131; P.L.141-2006, SEC.55.
IC 12-15-32-11
Assessment upon total annual revenue of certain nonstate facilities;
Medicaid assessment account; unavailability of federal matching
funds
Sec. 11. (a) The office may assess community residential facilities
for the developmentally disabled (as defined in IC 12-7-2-61) and
intermediate care facilities for the mentally retarded (ICF/MR) (as
defined in IC 16-29-4-2) that are not operated by the state in an
amount not to exceed ten percent (10%) of the total annual revenue
of the facility for the facility's preceding fiscal year.
(b) The assessments shall be paid to the office of Medicaid policy
and planning in equal monthly amounts on or before the tenth day of
each calendar month. The office 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) Revenue from the assessments shall be credited to a special
account within the state general fund to be called the Medicaid
assessment account. Money in the account may be used only for
services for which federal financial participation under Medicaid is
available to match state funds. An amount equivalent to the federal
financial participation estimated to be received for services financed
from assessments under subsection (a) shall be used to finance
Medicaid services provided by facilities described in subsection (a).
(d) 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.27-1992, SEC.26. Amended by P.L.2-1993,
SEC.102; P.L.291-2001, SEC.216; P.L.6-2002, SEC.6.
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