Bill Text: IN SB0218 | 2011 | Regular Session | Introduced
Bill Title: Developmental disabilities.
Spectrum: Slight Partisan Bill (Republican 2-1)
Status: (Engrossed - Dead) 2011-03-28 - First reading: referred to Committee on Public Health [SB0218 Detail]
Download: Indiana-2011-SB0218-Introduced.html
Citations Affected: IC 5-10-8-7.3; IC 12-7-2; IC 12-12.7-2-17;
IC 12-28-5; IC 21-38-6; IC 27-8-27.
Synopsis: Developmental disabilities. Changes the definition of
"developmental disabilities" to conform to the federal definition.
Repeals the community residential council and gives the duties of the
council to the division of disability and rehabilitative services. Changes
the requirement for third party payors for the first steps program.
Eliminates priority criteria for formal categories for developmental
disability waiver slots.
Effective: July 1, 2011.
January 5, 2011, read first time and referred to Committee on Health and Provider
Services.
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana Constitution) is being amended, the text of the existing provision will appear in this style type, additions will appear in this style type, and deletions will appear in
Additions: Whenever a new statutory provision is being enacted (or a new constitutional provision adopted), the text of the new provision will appear in this style type. Also, the word NEW will appear in that style type in the introductory clause of each SECTION that adds a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type or
A BILL FOR AN ACT to amend the Indiana Code concerning
human services.
(1) covered under a self-insurance program established under section 7(b) of this chapter to provide group health coverage; or
(2) entitled to services under a contract with a prepaid health care delivery plan that is entered into or renewed under section 7(c) of this chapter.
(b) As used in this section, "early intervention services" means services provided to a first steps child under IC 12-12.7-2 and 20 U.S.C. 1432(4).
(c) As used in this section, "first steps child" means an infant or toddler from birth through two (2) years of age who is enrolled in the Indiana first steps program and is a covered individual.
(d) As used in this section, "first steps program" refers to the program established under IC 12-12.7-2 and 20 U.S.C. 1431 et seq. to
meet the needs of:
(1) children who are eligible for early intervention services; and
(2) their families.
The term includes the coordination of all available federal, state, local,
and private resources available to provide early intervention services
within Indiana.
(e) As used in this section, "health benefits plan" means a:
(1) self-insurance program established under section 7(b) of this
chapter to provide group health coverage; or
(2) contract with a prepaid health care delivery plan that is
entered into or renewed under section 7(c) of this chapter.
(f) A health benefits plan that provides coverage for early
intervention services shall reimburse the first steps program for
payments made by the program for early intervention services that are
covered under the health benefits plan. a monthly fee established by
the division of disability and rehabilitative services established by
IC 12-9-1-1. The monthly fee shall be provided instead of claims
processing of individual claims.
(g) The reimbursement required under subsection (f) may not be
applied to any annual or aggregate lifetime limit on the first steps
child's coverage under the health benefits plan.
(h) The first steps program may pay required deductibles,
copayments, or other out-of-pocket expenses for a first steps child
directly to a provider. A health benefits plan shall apply any payments
made by the first steps program to the health benefits plan's
deductibles, copayments, or other out-of-pocket expenses according to
the terms and conditions of the health benefits plan.
(h) The monthly fee required under subsection (f) may not be
reduced or denied as a result of:
(1) a required deductible;
(2) copayments;
(3) coinsurance; or
(4) other out-of-pocket expenses.
(1) For purposes of IC 12-9-4, the meaning set forth in IC 12-9-4-1.
(2) For purposes of IC 12-12-8, the meaning set forth in IC 12-12-8-2.5.
(3) For purposes of IC 12-13-4, the meaning set forth in IC 12-13-4-1.
(4) For purposes of IC 12-15-41 and IC 12-15-42, the Medicaid work incentives council established by IC 12-15-42-1.
(5) For purposes of IC 12-12.7-2, the meaning set forth in IC 12-12.7-2-2.
(6) For purposes of IC 12-21-4, the meaning set forth in IC 12-21-4-1.
(1) The division of disability and rehabilitative services established by IC 12-9-1-1.
(2) The division of aging established by IC 12-9.1-1-1.
(3) The division of family resources established by IC 12-13-1-1.
(4) The division of mental health and addiction established by IC 12-21-1-1.
(b) The term refers to the following:
(1) For purposes of the following statutes, the division of disability and rehabilitative services established by IC 12-9-1-1:
(A) IC 12-9.
(B) IC 12-11.
(C) IC 12-12.
(D) IC 12-12.5.
(E) IC 12-12.7.
(F) IC 12-28-5.
(2) For purposes of the following statutes, the division of aging established by IC 12-9.1-1-1:
(A) IC 12-9.1.
(B) IC 12-10.
(3) For purposes of the following statutes, the division of family resources established by IC 12-13-1-1:
(A) IC 12-13.
(B) IC 12-14.
(C) IC 12-15.
(D) IC 12-16.
(E) IC 12-17.2.
(F) IC 12-18.
(G) IC 12-19.
(H) IC 12-20.
(4) For purposes of the following statutes, the division of mental health and addiction established by IC 12-21-1-1:
(A) IC 12-21.
(B) IC 12-22.
(C) IC 12-23.
(D) IC 12-25.
(c) With respect to a particular state institution, the term refers to the division whose director has administrative control of and responsibility for the state institution.
(d) For purposes of IC 12-24, IC 12-26, and IC 12-27, the term refers to the division whose director has administrative control of and responsibility for the appropriate state institution.
Percentage of Copayment Maximum
Federal Income Per Monthly
Poverty Level Treatment Cost Share
At But Not
Least More Than
0% 250% $ 0 $ 0
251% 350% $ 3 $ 24
351% 450% $ 6 $ 48
451% 550% $ 15 $ 120
551% 650% $ 25 $ 200
651% 750% $ 50 $ 400
751% 850% $ 75 $ 600
851% 1000% $ 100 $ 800
1001% $ 120 $ 960
(b) A cost participation plan used by the division for families to participate in the cost of the programs and services provided under this chapter:
(1) must:
(A) be based on income and ability to pay;
(B) provide for a review of a family's cost participation amount:
(i) annually; and
(ii) within thirty (30) days after the family reports a
reduction in income; and
(C) allow the division to waive a required copayment if other
medical expenses or personal care needs expenses for any
member of the family reduce the level of income the family
has available to pay copayments under this section;
(2) may allow a family to voluntarily contribute payments that
exceed the family's required cost participation amount;
(3) must require the family to allow the division access to all
health care coverage information that the family has concerning
the infant or toddler who is to receive services;
(4) must require families to consent to the division billing third
party payors for early intervention services provided; and
(5) may allow the division to waive the billing to third party
payors if the family is able to demonstrate financial or personal
hardship on the part of the family member. and
(6) must require the division to waive the family's monthly
copayments in any month for those services for which it receives
payment from the family's health insurance coverage.
(c) Funds received through a cost participation plan under this
section must be used to fund programs described in section 18 of this
chapter.
(1) Determine the current and projected needs of each geographic area of Indiana for residential services for individuals with a developmental disability.
(2) Determine how the provision of developmental or vocational services for residents in these geographic areas affects the availability of developmental or vocational services to individuals with a developmental disability living in their own homes.
(3) Develop standards for licensure of supervised group living facilities regarding the following:
(A) A sanitary and safe environment for residents and employees.
(B) Classification of supervised group living facilities.
(C) Any other matters that will ensure that the residents will receive a residential environment.
(4) Develop standards for the approval of entities providing supported living services.
(b) An entity that provides supported living services must be approved by the
(1) meet the standards established under section 10 of this chapter; and
(2) are necessary to provide adequate services to individuals with a developmental disability in that geographic area.
(1) Both of the supervised group living facilities meet all standards for licensure as provided in section 10(3) of this chapter.
(2) Both of the supervised group living facilities are built on land that is owned by one (1) private entity.
(3) The
(1) the license of a supervised group living facility; or
(2) the approval of an entity that provides supported living services;
that no longer meets the standards established under section 10 of this chapter after following the procedures prescribed by IC 4-21.5-3. If a hearing is provided for or authorized to be held by the
(b) The
(b) After June 30, 2011, rules of the former community residential council (repealed) are considered rules of the division.
rehabilitative services. The monthly fee shall be provided instead
of claims processing of individual claims.
(1) a required deductible;
(2) copayments;
(3) coinsurance; or
(4) other out-of-pocket expenses.
(1) a required deductible;
(2) copayments;
(3) coinsurance; or
(4) other out-of-pocket expenses.
(b) As used in this SECTION, "office" refers to the office of Medicaid policy and planning established by IC 12-8-6-1.
(c) As used in this SECTION, "waiver" refers to any waiver administered by the office and the division under section 1915(c) of the federal Social Security Act.
effect. The office shall file the affidavit under this subsection not later
than five (5) days after the office is notified that the waiver amendment
is approved.
(g) If the office receives approval for the amendment to the waiver
under this SECTION from the United States Department of Health and
Human Services and the governor receives the affidavit filed under
subsection (f), the office shall implement the amendment to the waiver
not more than sixty (60) days after the governor receives the affidavit.
(d) Before October 1, 2011, the office shall apply to the United
States Department of Health and Human Services for approval to
amend a waiver to set an emergency placement priority for
individuals in the following situations:
(1) Death of a primary caregiver where alternative placement
in a supervised group living setting:
(A) is not available; or
(B) is determined by the division to be an inappropriate
option.
(2) A situation in which:
(A) the primary caregiver is at least eighty (80) years of
age and is no longer able to care for the individual; and
(B) alternate placement in a supervised group living setting
is not available or is determined by the division to be an
inappropriate option.
(3) There is evidence of abuse or neglect in the current
institutional or home placement, and alternate placement in
a supervised group living setting is not available or is
determined by the division to be an inappropriate option.
(4) There are other health and safety risks, as determined by
the division director, and alternate placement in a supervised
group living setting is not available or is determined by the
division to be an inappropriate option.
(h) (e)The office may adopt rules under IC 4-22-2 necessary to
implement this SECTION.
(i) (f) This SECTION expires July 1, 2016.
