Second Regular Session of the 123rd General Assembly (2024)
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 this style type.
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 this style type reconciles conflicts
between statutes enacted by the 2023 Regular Session of the General Assembly.
HOUSE ENROLLED ACT No. 1067
AN ACT to amend the Indiana Code concerning human services.
Be it enacted by the General Assembly of the State of Indiana:
SECTION 1. IC 12-7-2-48.7 IS ADDED TO THE INDIANA CODE
AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE
UPON PASSAGE]: Sec. 48.7. "Covered population", for purposes
of IC 12-15-13-1.8, has the meaning set forth in IC 12-15-13-1.8(a).
SECTION 2. IC 12-9-4-8 IS ADDED TO THE INDIANA CODE
AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE
UPON PASSAGE]: Sec. 8. (a) As used in this section, "review team"
refers to the special service review team established by subsection
(c).
(b) As used in this section, "waiver" refers to the community
integration and habilitation waiver.
(c) The special service review team is established.
(d) The review team shall do the following:
(1) Subject to subsection (l)(2), review denied applications
from the director for the waivers that were received after
December 1, 2024, and before June 30, 2025, from Districts 1,
4, and 8 of the bureau of disabilities services districts,
including a review of the waiver application and any other
information submitted concerning the application.
(2) Subject to subsection (l)(2), review, at the director's
discretion, waiver applications received after December 1,
2024, and before June 30, 2025, for which a determination has
not been made by the director. The review team shall review
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the waiver application and information submitted concerning
the application.
(3) Maintain confidentiality of any protected health
information and personally identifiable information collected
during the review.
(4) Provide the following to the director:
(A) Concerning the review team's review of applications
under subdivision (1), an evaluation of information that
can be applied to the waiver at the systems level, including
the criteria that can be used to approve and deny waiver
applications.
(B) Concerning the review team's review of applications
under subdivision (2), and not later than thirty (30) days
from the review team's receipt of the application from the
director, additional information submitted concerning an
application.
(5) Issue a quarterly report to the council.
(e) The review team may, with consent of the applicant or
applicant's legal guardian, collect additional information related
to an application that was not submitted with the application. The
collection of information under this subsection:
(1) may be used by the review team to provide information,
referral, and resources to applicants concerning available
services and supports;
(2) does not create a responsibility on the bureau to
reconsider an application determination; and
(3) does not constitute a request to appeal an application
determination.
(f) The director shall appoint the members of the review team
and fill any vacancies on the review team. The review team must
consist of the following five (5) members who are knowledgeable
in the waiver requirements:
(1) A representative from The Arc of Indiana.
(2) A representative from a case management company that
is approved by the bureau of disabilities services to provide
waiver services.
(3) An individual who works as a behavior consultant that is
approved by the bureau of disabilities services to provide
waiver services.
(4) Two (2) individuals appointed by the director.
However, not more than one (1) member may be a state employee.
(g) The director shall appoint a member of the review team to
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serve as the chairperson.
(h) The director shall:
(1) notify the chairperson; and
(2) provide the waiver application and accompanying
information submitted with the application to the review team
to begin to review of the application;
not later than five (5) business days after a waiver application has
been denied. The director shall also notify the chairperson if the
director would like additional consultation on an application
described in subsection (d)(2).
(i) As used in this subsection, a "conflict of interest" has the
meaning set forth in 460 IAC 6-3-15.2 and includes a direct or
indirect financial interest with the applicant or a prior or current
relationship with the applicant. If a member appointed to the
review team under subsection (f)(1) through (f)(3) has a conflict of
interest with the applicant of a waiver application under review by
the review team, the member shall:
(1) inform the director of the conflict of interest; and
(2) recuse themself from review of the application for which
the member has a conflict of interest.
The director may appoint a member to the review team to fill the
vacancy of the recused member during the review of the
application for which the member has been recused.
(j) Each member of the review team who is not a state employee
is entitled to the following:
(1) The minimum salary per diem provided by
IC 4-10-11-2.1(b).
(2) Reimbursement for traveling expenses and other expenses
actually incurred in connection with the member's duties as
provided under IC 4-13-1-4 and in the state travel policies and
procedures established by the Indiana department of
administration and approved by the budget agency.
(k) A member of the review team who is a state employee is not
entitled to any of the following:
(1) The minimum salary per diem provided by
IC 4-10-11-2.1(b).
(2) Reimbursement for traveling expenses as provided under
IC 4-13-1-4.
(3) Other expenses actually incurred in connection with the
member's duties.
(l) The division shall do the following:
(1) Obtain consent from a waiver applicant or the applicant's
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legal guardian to share the waiver application and additional
information submitted with the waiver application with the
review team. An applicant or applicant's legal guardian must
voluntarily consent to sharing the application and information
with the review team. If an applicant or applicant's legal
guardian denies consent to share the application and
submitted information with the review team, the division may
not share the application and information with the review
team and the denial of consent may not affect a determination
on the applicant's waiver application.
(2) Provide members of the review team with the waiver
application and submitted information required under
subsection (d)(1) and (d)(2) for the applications where consent
has been obtained under subdivision (1).
(3) Provide administrative support for the review team
concerning the following:
(A) Contacting applicants who have provided consent
under this section.
(B) Accessing the application and information submitted
with the application.
(C) Receiving compensation as described in subsection (j).
The review team is responsible for any other administrative
tasks not specified in this subdivision, including scheduling
review team meetings and meeting the confidentiality
requirements specified in subsection (d)(3).
(4) Pay the expenses of the review team.
(m) An employee of the division who provides records in
accordance with subsection (l) in good faith is not subject to
liability in:
(1) a civil;
(2) an administrative;
(3) a disciplinary; or
(4) a criminal;
action that might otherwise be imposed as a result of the disclosure
of the records.
(n) This section expires December 31, 2026.
SECTION 3. IC 12-9-5-3.5 IS ADDED TO THE INDIANA CODE
AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE
JANUARY 1, 2025]: Sec. 3.5. (a) The division shall provide to the
division of disability and rehabilitative services advisory council
established by IC 12-9-4-2 quarterly updates regarding the
implementation of the recommendations made by the services for
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individuals with intellectual and other developmental disabilities
task force under IC 12-11-15.5 (before its expiration).
(b) This section expires December 31, 2027.
SECTION 4. IC 12-10-2-3 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE UPON PASSAGE]: Sec. 3. (a) The
commission consists of sixteen (16) members.
(b) Not more than eight (8) members may be from the same political
party. The members must be Indiana residents who are interested in the
problems of the aging and the aged.
(c) The governor shall appoint the members of the commission
using the following geographical distribution formula:
(1) One (1) member from each congressional district.
(2) The balance of the members appointed at large. to ensure that
the commission includes members representing the area
agencies on aging as follows:
(1) Three (3) members from the region served by Area 1
through Area 5.
(2) Three (3) members from the region served by Area 6
through Area 9.
(3) Three (3) members from the region served by Area 10
through Area 16.
However, Not not more than two (2) residents of the same county may
be appointed as members of the commission.
(d) Beginning July 1, 2024, the commission must contain:
(1) the executive director of the Indiana housing and
community development authority or the executive director's
designee;
(2) at least one (1) member who is a:
(A) direct provider of; or
(B) service worker employed to provide;
services provided through the division;
(3) at least one (1) member who is:
(A) a recipient; or
(B) the caregiver of a recipient;
of services provided through the division; and
(4) one (1) citizen nominated by one (1) or more organizations
that:
(A) represent individuals with mental illness; and
(B) have statewide membership.
SECTION 5. IC 12-10-2-4 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE UPON PASSAGE]: Sec. 4. (a) Subject to
subsection (c), the term of a member of the commission is four (4)
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years. The term of a member filling a vacancy is for the remainder of
the unexpired term.
(b) The term of a member of the commission expires July 1, but a
member continues in office until a successor is appointed.
(c) A member of the commission serves at the will of the
governor. The governor may terminate the appointment of a member
of the commission by notifying the member, the chairman of the
commission, and the director.
SECTION 6. IC 12-10-11-2, AS AMENDED BY HEA 1026-2024,
SECTION 80, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
UPON PASSAGE]: Sec. 2. (a) The board consists of the following
fifteen (15) seventeen (17) members:
(1) The director of the division of aging or the director's designee.
(2) The chairman of the Indiana state commission on aging or the
chairman's designee.
(3) Three (3) citizens nominated by two (2) or more organizations
that:
(A) represent senior citizens; and
(B) have statewide membership.
At least one (1) member appointed under this subdivision
must be a recipient, or the caregiver of a recipient, of services
provided under IC 12-10-10.
(4) One (1) citizen nominated by one (1) or more organizations
that:
(A) represent individuals with disabilities, including
individuals who are less than eighteen (18) years of age; and
(B) have statewide membership.
(5) One (1) citizen nominated by one (1) or more organizations
that:
(A) represent individuals with mental illness; including
dementia; and
(B) have statewide membership.
(6) One (1) provider who provides services under IC 12-10-10.
(7) One (1) licensed physician, physician assistant, or registered
nurse who specializes either in the field of gerontology or in the
field of disabilities.
(8) Two (2) home care services advocates or policy specialists
nominated by two (2) or more:
(A) organizations;
(B) associations; or
(C) nongovernmental agencies;
that advocate on behalf of home care consumers, including an
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organization listed in subdivision (3) that represents senior
citizens or persons with disabilities.
(9) Two (2) members of the senate, who may not be members of
the same political party, appointed by the president pro tempore
of the senate with the advice of the minority leader of the senate.
(10) Two (2) members of the house of representatives, who may
not be members of the same political party, appointed by the
speaker of the house of representatives with the advice of the
minority leader of the house of representatives.
(11) The executive director of the Indiana housing and
community development authority or the executive director's
designee.
(12) One (1) citizen nominated by one (1) or more
organizations that:
(A) represent direct service workers; and
(B) have statewide membership.
The members of the board listed in subdivisions (9) and (10) are
nonvoting members who serve two (2) year terms ending June 30 of
each odd-numbered year. A legislative member serves at the pleasure
of the appointing authority and may be reappointed to successive terms.
A vacancy among the legislative members shall be filled by the
appropriate appointing authority. An individual appointed to fill a
vacancy serves for the unexpired term of the individual's predecessor.
(b) The members of the board designated by subsection (a)(3)
through (a)(8) and (a)(12) shall be appointed by the governor for terms
of four (4) years. The initial term of the member appointed under
subsection (a)(12) is three (3) years and the length of each
successive term is four (4) years. The term of a member of the board
expires as follows:
(1) For a member appointed under subsection (a)(3) through
(a)(5), June 30, 2025, and every fourth year thereafter.
(2) For a member appointed under subsection (a)(6) through
(a)(8) and (a)(12), June 30, 2027, and every fourth year
thereafter.
A member described in this subsection may be reappointed to
successive terms. However, a member may continue to serve until a
successor is appointed. In case of a vacancy, the governor shall appoint
an individual to serve for the remainder of the unexpired term.
(c) The division shall establish notice and selection procedures to
notify the public of the board's nomination process described in this
chapter. Information must be distributed through:
(1) the area agencies on aging; and
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(2) all organizations, associations, and nongovernmental agencies
that work with the division on home care issues and programs.
SECTION 7. IC 12-11-15.5-4.8 IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE UPON PASSAGE]: Sec. 4.8. (a) As used in this section,
"buy-in program" refers to the Medicaid buy-in program for
working individuals with disabilities established by IC 12-15-41-3.
(b) Not later than May 1, 2024, the task force shall establish a
subcommittee of task force members to make recommendations to
the task force regarding the following:
(1) Modifications to the buy-in program to eliminate barriers
to employment and independence for individuals with
intellectual and developmental disabilities.
(2) Modifications to the buy-in program sliding scale of
premiums to increase workforce participation for individuals
participating in the buy-in program.
(3) How to reduce other public benefit related barriers to
employment and independence for individuals with
intellectual and developmental disabilities.
(c) Not later than October 1, 2024, the subcommittee shall
prepare and submit recommendations made by the subcommittee
to the task force.
SECTION 8. IC 12-11-15.5-6, AS ADDED BY P.L.262-2019,
SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
UPON PASSAGE]: Sec. 6. This chapter expires December 31, 2025.
2024.
SECTION 9. IC 12-15-1.3-15, AS AMENDED BY P.L.156-2020,
SECTION 54, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
UPON PASSAGE]: Sec. 15. (a) As used in this section, "division"
refers to the division of disability and rehabilitative services established
by IC 12-9-1-1.
(b) 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.
(c) 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.
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(2) A situation in which:
(A) The primary caregiver is at least eighty (80) years of age.
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 is evidence of 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. where other
available services through:
(A) the Medicaid program and other federal, state, and
local public programs; and
(B) supports that families and communities provide;
are insufficient to address the other health and safety risks, as
determined by the division director.
(d) The division shall report on a quarterly basis the following
information to the division of disability and rehabilitative services
advisory council established by IC 12-9-4-2 concerning each Medicaid
waiver for which the office has been approved under this section to
administer an emergency placement priority for individuals described
in this section:
(1) The number of applications for emergency placement priority
waivers.
(2) The number of individuals served on the waiver.
(3) The number of individuals on a wait list for the waiver.
(e) Before July 1, 2021, the division, in coordination with the task
force established by IC 12-11-15.5-2, shall establish new priority
categories for individuals served by a waiver.
(f) The office may adopt rules under IC 4-22-2 necessary to
implement this section.
SECTION 10. IC 12-15-13-1.8 IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE UPON PASSAGE]: Sec. 1.8. (a) As used in this section,
"covered population" means all Medicaid recipients who meet the
criteria set forth in subsection (b).
(b) An individual is a member of the covered population if the
individual:
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(1) is eligible to participate in the federal Medicare program
(42 U.S.C. 1395 et seq.) and receives nursing facility services;
or
(2) is:
(A) at least sixty (60) years of age;
(B) blind, aged, or disabled; and
(C) receiving services through one (1) of the following:
(i) The aged and disabled Medicaid waiver.
(ii) A risk based managed care program for aged, blind,
or disabled individuals who are not eligible to participate
in the federal Medicare program.
(iii) The state Medicaid plan.
(c) The office of the secretary may implement a risk based
managed care program for the covered population.
(d) The office of Medicaid policy and planning and the managed
care organizations that intend to participate in the risk based
managed care program established under subsection (c) shall
conduct a claims submission testing period before the risk based
managed care program is implemented under subsection (c).
(e) The office of Medicaid policy and planning shall convene a
workgroup for purposes of this section. The members of the
workgroup shall consist of the fiscal officer of the office of
Medicaid policy and planning, representatives of managed care
organizations that intend to participate in the risk based managed
care program established under subsection (c) who are appointed
by the director, and provider representatives appointed by the
director. The workgroup shall do the following:
(1) Develop a uniform billing format to be used by the
managed care organizations participating in the risk based
managed care program established under subsection (c).
(2) Seek and receive feedback on the claims submission testing
period conducted under subsection (d).
(3) Advise the office of Medicaid policy and planning on claim
submission education and training needs of providers
participating in the risk based managed care program
established under subsection (c).
(4) Develop a policy for defining "claims submitted
appropriately" for the purposes of subsection (g)(1) and
(g)(2).
(f) Subsections (g) through (k) apply during the first two
hundred ten (210) days after the risk based managed care program
for the covered population is implemented under subsection (c).
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(g) The office of Medicaid policy and planning shall establish a
temporary emergency financial assistance program for providers
that experience financial emergencies due to claims payment issues
while participating in the risk based managed care program
established under subsection (c). For purposes of the program
established under this subsection, a financial emergency exists:
(1) when the rate of denial of claims submitted in one (1)
billing period by the provider to a managed care organization
exceeds fifteen percent (15%) of claims submitted
appropriately by the provider to the managed care
organization under the risk based managed care program;
(2) when the provider, twenty-one (21) days after
appropriately submitting claims to a managed care
organization under the risk based managed care program, has
not received payment for at least twenty-five thousand dollars
($25,000) in aggregate claims from the managed care
organization;
(3) when, in the determination of the director, the claim
submission system of a managed care organization with which
the provider is contracted under the risk based managed care
program experiences failure or overload; or
(4) upon the occurrence of other circumstances that, in the
determination of the director, constitute a financial
emergency for a provider.
(h) To be eligible for a payment of temporary emergency
financial assistance under the program established under
subsection (g), a provider:
(1) must have participated in the claims submission testing
period conducted under subsection (d) for all managed care
organizations with which the provider is contracted under the
risk based managed care program established under
subsection (c); and
(2) must submit to the office of Medicaid policy and planning
a written request that includes all of the following:
(A) Documentation providing evidence of the provider's
financial need for emergency assistance.
(B) Evidence that the provider's billing staff participated
in claims submission education and training offered
through the risk based managed care program established
under subsection (c).
(C) Evidence that the provider participated in the claims
submission testing period conducted under subsection (d)
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for all managed care organizations with which the
provider is contracted under the risk based managed care
program established under subsection (c).
(D) Evidence of a consistent effort by the provider to
submit claims in accordance with the uniform billing
requirements developed under subsection (e)(1).
(i) The office of Medicaid policy and planning:
(1) shall determine whether a provider is experiencing a
financial emergency based upon the provider's submission of
a written request that meets the requirements of subsection
(h)(2); and
(2) shall make a determination whether a provider is
experiencing a financial emergency not more than seven (7)
calendar days after it receives a written request submitted by
a provider under subsection (h)(2).
(j) If the office of Medicaid policy and planning determines that
a provider is experiencing a financial emergency for purposes of
the program established under subsection (g), it shall direct each
managed care organization with which the provider is contracted
under the risk based managed care program established under
subsection (c) to provide a temporary emergency assistance
payment to the provider. A managed care organization directed to
provide a temporary emergency assistance payment to a provider
under this subsection shall provide the payment in not more than
seven (7) calendar days after the office directs the managed care
organization to provide the payment. The amount of the temporary
emergency assistance payment that a managed care organization
shall make to a provider under this subsection is equal to
seventy-five percent (75%) of the monthly average of the
provider's long-term services and supports Medicaid claims for the
six (6) month period immediately preceding the implementation of
the risk based managed care program under subsection (c),
adjusted in proportion to the ratio of the managed care
organization's covered population membership to the total covered
population membership of the risk based managed care program
established under subsection (c).
(k) Upon issuing any payment of a temporary emergency
assistance to a provider under subsection (j), a managed care
organization shall set up a receivable to reconcile the temporary
emergency assistance funds with actual claims payment amounts.
A managed care organization shall reconcile the temporary
emergency assistance payment funds with actual claims payment
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amounts on the first day of the month that is more than thirty-one
(31) days after the managed care organization issues the temporary
emergency assistance funds to the provider. If a temporary
emergency assistance payment is issued to a provider, managed
care organizations are still required to meet contract obligations
for reviewing and paying claims, specifically claims that total a
payment in excess of the temporary emergency assistance payment
reconciliation. However, if a managed care organization fails to
comply with a directive of the office of Medicaid policy and
planning under subsection (j) to provide a temporary emergency
assistance payment to a provider, the failure of the managed care
organization:
(1) is a violation of the claim processing requirements of the
managed care organization's contract; and
(2) makes the managed care organization subject to the
penalties set forth in the contract, including payment of
interest on the amount of the unpaid temporary emergency
assistance at the rate set forth in IC 12-15-21-3(7)(A).
SECTION 11. IC 12-21-2-3.5 IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2024]: Sec. 3.5. (a) This subsection applies if
the federal government selects the state of Indiana to participate
in the community mental health services demonstration program
described in IC 12-15-1.3-25(f). The office of the secretary and the
division shall include each community mental health center that is
able to meet all federal and state requirements concerning
programming and data reporting:
(1) before July 1, 2027, as a part of the community mental
health services demonstration program; or
(2) beginning July 1, 2027, as part of a state plan amendment
requiring Medicaid reimbursement for Medicaid eligible
certified community behavioral health clinic services upon the
completion of the demonstration program described in
subdivision (1).
(b) This subsection applies if the federal government does not
select the state of Indiana to participate in the community mental
health services demonstration program described in
IC 12-15-1.3-25(f). The office of the secretary and the division may
apply for a Medicaid state plan amendment or a Medicaid waiver
requiring Medicaid reimbursement for Medicaid eligible certified
community behavioral health clinic services provided by a
Medicaid behavioral health professional, including each
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community mental health center and a behavioral health
professional authorized to provide Medicaid services and employed
by a community mental health center or a certified community
behavioral health clinic.
SECTION 12. IC 34-30-2.1-129.5 IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE UPON PASSAGE]: Sec. 129.5. IC 12-9-4-8
(Concerning providing information to the special service review
team).
SECTION 13. [EFFECTIVE UPON PASSAGE] (a) Before May 1,
2024, the governor shall make the appointments to the Indiana
state commission on aging in accordance with IC 12-10-2-3(c), as
amended by this act.
(b) A member of the Indiana state commission on aging
appointed by the governor before March 1, 2024, under
IC 12-10-2-3(c) but who no longer meets the requirements for
appointment under IC 12-10-2-3(c), as amended by this act, shall
remain as a member of the commission until the earlier of the
following:
(1) The governor appoints a successor that meets the new
qualifications.
(2) April 30, 2024.
(c) This SECTION expires June 30, 2024.
SECTION 14. An emergency is declared for this act.
HEA 1067 — CC 1 Speaker of the House of Representatives
President of the Senate
President Pro Tempore
Governor of the State of Indiana
Date: Time:
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