Bill Text: IN SB0594 | 2011 | Regular Session | Introduced
Bill Title: Home and community based services.
Spectrum: Partisan Bill (Democrat 1-0)
Status: (Introduced - Dead) 2011-01-20 - First reading: referred to Committee on Health and Provider Services [SB0594 Detail]
Download: Indiana-2011-SB0594-Introduced.html
Citations Affected: IC 12-8-1-17; IC 12-9.1-1-4; IC 12-10;
IC 12-15-2.1.
Synopsis: Home and community based services. Requires the division
of aging to: (1) implement a program and standards for identifying,
recruiting, training, certifying, and enrolling individuals to be
independent providers of home and community based care services;
and (2) establish a network of independent providers of home and
community based services with certain requirements. Allows spouses
and parents of individuals who are at risk of being institutionalized to
provide limited attendant care services that may be reimbursed.
Requires the office of the secretary of family and social services to
calculate certain savings, report the calculations to specified persons,
and use the savings to provide home and community based services to
additional individuals. Requires the dissemination of specified
information as part of: (1) a nursing facility's notification to applicants;
(2) the nursing facility preadmission screening program; and (3) the
hospital discharge process. Requires homemaker services attendants to
register with the division of aging for the state registry for self-directed
in-home care. Allows an area agency on aging to make presumptive
eligibility determinations for the aged and disabled Medicaid waiver
under specified circumstances. Specifies that this act is subject to
available funding for certain services.
Effective: July 1, 2011.
January 20, 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
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A BILL FOR AN ACT to amend the Indiana Code concerning
human services.
(1) IC 12-9.1-1-4.
(2) IC 12-10-11.5-6.
(3) IC 12-10-12-10.
(4) IC 12-10-12-16.
(5) IC 12-10-12-28.5.
(6) IC 12-10-17.1-10 through IC 12-10-17.1-21.
(7) IC 12-15-2.1.
(b) The legislation described in subsection (a) is subject to funding available to the office of the secretary of family and social services, including federal funds. The office of the secretary shall ensure that the cost of the services provided under the legislation described in subsection (a) does not exceed funding made available to the office of the secretary for a program established under the
legislation described in subsection (a).
(c) This section expires July 1, 2016.
(b) Not later than July 1, 2012, the division shall:
(1) implement a program and standards for identifying, recruiting, training, certifying, and enrolling individuals to be independent providers of home and community based care services for individuals; and
(2) establish a network of independent providers of home and community based care services for individuals.
(c) The division may contract with a state educational institution or an area agency on aging in implementing the program described in subsection (b).
(d) The division shall consult with the following in developing the program and standards described in subsection (b):
(1) The area agencies on aging.
(2) Indiana Association for Home and Hospice Care.
(3) Indiana Home Care Task Force.
(4) Organizations representing senior citizens with statewide membership.
(5) Organizations representing persons with disabilities with statewide membership.
(e) The division shall do the following:
(1) Create and maintain a statewide registry that lists independent home and community based services providers who have been trained and certified by the division, and provide the list of names by each area agencies on aging region.
(2) Identify liability and health insurance options for independent home and community based services providers.
(3) Establish fiscal intermediary services within the division for individuals who are consumers of self-directed home and community based care services through the community and home options to institutional care for the elderly and disabled program (CHOICE) and the Medicaid aged and disabled waiver.
(4) Create in service training and professional enrichment programs with the area agencies on aging for maintaining the skills and quality of services by independent home and
community based services providers.
(5) Maintain a self-directed care hotline and support services
to address emergencies and other needs of individuals who are
consumers of self-directed home and community based care
services.
(f) The division may review options to participate in federal
programs that support the establishment and development of
networks for home and community based services, including
provisions of the federal Patient Protection and Affordable Care
Act.
(1) The number of individuals during the course of each state fiscal year who would have been served in a health facility.
(2) The average cost to serve each individual in a health facility or other institution under the Medicaid program if home and community based services were not implemented.
(b) The secretary shall annually report to:
(1) the governor;
(2) the budget agency;
(3) the budget committee;
(4) the select joint commission on Medicaid oversight;
(5) the community and home options to institutional care for the elderly and disabled (CHOICE) advisory board established by IC 12-10-11-1; and
(6) the executive director of the legislative services agency;
the savings
(c) The office of the secretary shall use the savings
(1) That the applicant is required under state law to apply to the agency serving the county of the applicant's residence for participation in a nursing facility preadmission screening program.
(2) That the applicant's failure to participate in the nursing facility preadmission screening program could result in the applicant's ineligibility for Medicaid reimbursement for per diem in any nursing facility for not more than one (1) year.
(3) That the nursing facility preadmission screening program consists of an assessment of the applicant's need for care in a nursing facility made by a team of individuals familiar with the needs of individuals seeking admission to nursing facilities.
(4) The contact information for the agency that provides services in the area in which the nursing facility is located.
(5) A list developed by the office and the agency of all long term care options that may be available to the individual in the area.
(b) The notification must be signed by the applicant or the applicant's parent or guardian if the applicant is not competent before admission.
(c) If the applicant is admitted:
(1) the nursing facility shall retain one (1) signed copy of the notification for one (1) year; and
(2) the nursing facility shall deliver one (1) signed copy to the agency serving the county in which the applicant resides.
(d) A person who violates this section commits a Class A infraction.
(1) The individual's medical needs.
(2) The availability of services, other than services provided in a nursing facility, that are appropriate to the individual's health and social needs to maintain the individual in the least restrictive environment.
(3) The cost effectiveness of providing services appropriate to the individual's needs that are provided outside of, rather than within, a nursing facility.
(b) The assessment must be conducted in accordance with rules adopted under IC 4-22-2 by the director of the division in cooperation
with the office.
(c) Communication among members of a screening team or between
a screening team and the division, the office, or the agency during the
prescreening process may be conducted by means including any of the
following:
(1) Standard mail.
(2) Express mail.
(3) Facsimile machine.
(4) Secured electronic communication.
(d) A representative of the agency serving the area in which the
individual's residence is located shall explain and provide a written
copy of the results of the assessment to the individual or the
individual's parent or guardian if the individual is not competent,
in the least time practicable after the completion of the assessment.
(e) In the explanation required in subsection (d), the
representative shall include the services identified in subsection
(a)(2).
(1) give the patient a list of all the long term care options that:
(B) are located near the patient's home or permanent residence whenever possible;
(2) provide the patient with contact information for the agency that provides services in the area in which the hospital is located;
(3) disclose any long term care facility on the list in which:
(A) the hospital;
(B) the hospital's:
(i) governing board;
(ii) chief executive officer; or
(iii) chief financial officer; or
(C) any physician on the hospital's staff;
has any contractual or financial interest; and
(4) inform the patient in writing that a representative from the agency is available to provide additional information and counseling at no cost to the patient concerning long term care
options.
(b) Subject to rules adopted by the division under IC 4-22-2, an agency may under this chapter train and certify an individual who is a legally responsible relative of an individual who is at risk of being institutionalized and in need of self-directed in-home care
(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 or a homemaker services attendant may renew the
(c) The division and any organization designated under section 11 of this chapter shall maintain a file for each personal services attendant and homemaker 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 or homemaker 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 or homemaker 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 or homemaker services attendant who is on file with the division under subsection (c). The division may charge a fee for shipping, handling, and copying expenses.
(b) The division is not liable for any actions of a personal services attendant, a homemaker services attendant, or an individual in need of self-directed in-home care.
(c) A personal services attendant, a homemaker 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.
service hours a personal services attendant or homemaker 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.
(1) the method of payment to a personal services attendant or homemaker services attendant who provides authorized services under this chapter; and
(2) record keeping requirements for personal attendant and homemaker attendant services.
(1) The responsibilities of the personal services attendant or homemaker services attendant.
(2) The frequency the personal services attendant or homemaker services attendant will provide attendant care services.
(3) The duration of the contract.
(4) The hourly wage of the personal services or homemaker 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.
(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 or homemaker services attendants, for purposes of determining the individual's income eligibility for services under this chapter.
(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 or homemaker 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 or homemaker 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.
JULY 1, 2011]:
Chapter 2.1. Presumptive Eligibility for Aged and Disabled
Medicaid Waiver Applicants
Sec. 1. (a) An area agency on aging case manager and case
manager supervisor may determine that an applicant who meets
the following conditions is presumptively eligible for the Medicaid
aged and disabled waiver:
(1) The applicant or the applicant's legal guardian has
completed the required Medicaid application form.
(2) The applicant meets the medical eligibility requirements
in IC 12-10-11.5-4(2)(B).
(3) The applicant is at risk for being institutionalized if the
applicant does not receive immediate long term care services.
(b) The area agency on aging's determination that an individual
is presumptively eligible for the Medicaid aged and disabled waiver
under subsection (a):
(1) must be based on information submitted by the applicant;
and
(2) authorizes the immediate commencement of the provision
of services needed by the applicant in compliance with rules
adopted by the office under section 4 of this chapter.
Sec. 2. The office shall apply to the United States Department of
Health and Human Services for an amendment to the Medicaid
aged and disabled waiver if an amendment is necessary to
implement this chapter.
Sec. 3. The area agency on aging shall:
(1) notify the office of the presumptive eligibility
determination not later than five (5) business days after the
date on which the determination is made; and
(2) forward the application to the county office in the county
in which the applicant resides for a final eligibility
determination in the manner specified by the office.
Sec. 4. The office:
(1) shall adopt rules under IC 4-22-2 concerning the services
an individual may receive if the individual is determined to be
presumptively eligible for the Medicaid aged and disabled
waiver under this chapter; and
(2) may adopt rules under IC 4-22-2 to implement this
chapter.
