Indiana 2024 Regular Session

Indiana House Bill HB1386 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	~~HB1386.1~~
2		-	~~January 30, 2024~~
	1	+
	2	+	Introduced Version
3	3		HOUSE BILL No. 1386
4	4		_____
5		-	DIGEST OF HB 1386 (Updated January 30, 2024 11:33 am - DI 147)
6		-	Citations Affected: IC 4-21.5; IC 11-12; IC 12-7; IC 12-8; IC 12-9.1;
7		-	IC 12-10; IC 12-11; IC 12-15; IC 16-39; IC 31-37; IC 34-30; IC 35-52;
8		-	noncode.
	5	+	DIGEST OF INTRODUCED BILL
	6	+	Citations Affected: IC 4-21.5-3-6; IC 12-7-2; IC 12-8; IC 12-9.1-4;
	7	+	IC 12-10; IC 12-15; IC 31-37-19-29; IC 34-30-2.1-129.4.
9	8		Synopsis: Medicaid matters. Sets forth the powers and duties of the
10	9		office of the secretary of family and social services (office of the
11	10		secretary) concerning Medicaid home and community based services
12	11		waivers. Defines "home and community based services waiver".
13	12		Requires a provider of services under a home and community based
14	13		services waiver to follow any waiver requirements under federal law
15	14		and developed by the office of the secretary. Establishes requirements
16	15		for home and community based services waivers. Relocates provisions
17	16		requiring reimbursement for assisted living services for individuals
18	17		who are aged and disabled and receiving services under a Medicaid
19	18		waiver. Specifies that: (1) these provisions apply to an individual
20	19		receiving services under a home and community based services waiver;
21		-	and (2) reimbursement is required for certain services that are part of
22		-	the individual's home and community based service plan. Relocates
23		-	provisions establishing limitations concerning assisted living services
24		-	provided in a home and community based services program. Relocates
25		-	a provision requiring the office of the secretary to annually determine
26		-	any state savings generated by home and community based services.
27		-	Removes a provision allowing the division of aging to adopt rules
28		-	concerning an appeals process for a housing with services
29		-	establishment provider's determination that the provider is unable to
30		-	meet the health needs of a resident and allows the office of the
31		-	secretary to adopt rules concerning the appeals process. Requires an
	20	+	and (2) reimbursement is required for certain services determined to be
	21	+	medically necessary for the individual. Relocates provisions
	22	+	establishing limitations concerning assisted living services provided in
	23	+	a home and community based services program. Relocates a provision
	24	+	requiring the office of the secretary to annually determine any state
	25	+	savings generated by home and community based services. Removes
	26	+	a provision allowing the division of aging to adopt rules concerning an
	27	+	appeals process for a housing with services establishment provider's
	28	+	determination that the provider is unable to meet the health needs of a
	29	+	resident and allows the office of the secretary to adopt rules concerning
	30	+	the appeals process. Requires an individual who provides attendant
	31	+	care services for compensation from Medicaid to register with the
	32	+	office of the secretary. Removes the requirement that the division of
	33	+	aging administer programs established under Medicaid waivers for
32	34		(Continued next page)
33	35		Effective: July 1, 2024.
34		-	Barrett, Schaibley, Criswell,
35		-	Shackleford
	36	+	Barrett
36	37		January 11, 2024, read first time and referred to Committee on Public Health.
37		-	January 30, 2024, amended, reported — Do Pass.
38		-	HB 1386—LS 7038/DI 147 Digest Continued
39		-	individual who provides attendant care services for compensation from
40		-	Medicaid to register with the office of the secretary. Removes the
41		-	requirement that the division of aging administer programs established
42		-	under Medicaid waivers for in-home services for treatment of medical
43		-	conditions. Provides that provisions of law concerning the statewide
44		-	waiver ombudsman apply to an individual who has a developmental
45		-	disability and receives services administered by the bureau of
46		-	disabilities services. (Current law specifies that these provisions apply
47		-	to an individual who has a developmental disability and receives
48		-	services under the federal home and community based services
49		-	program). Specifies that these provisions do not apply to an individual
50		-	served by the long term care ombudsman program. Changes references
51		-	from "statewide waiver ombudsman" to "statewide bureau of
52		-	disabilities services ombudsman". Requires certain facilities to provide
53		-	notice within a specified time to the division of family resources
54		-	(division) that a delinquent child will be released from the facility.
55		-	Requires the division to take action necessary to ensure that the
56		-	delinquent child, if eligible, participates in the Medicaid program upon
57		-	the child's release and receives services required by federal law.
	38	+	2024 IN 1386—LS 7038/DI 147 Digest Continued
	39	+	in-home services for treatment of medical conditions. Requires certain
	40	+	facilities to provide notice within a specified time to the division of
	41	+	family resources (division) that a delinquent child will be released from
	42	+	the facility. Requires the division to take action necessary to ensure that
	43	+	the delinquent child, if eligible, participates in the Medicaid program
	44	+	upon the child's release and receives services required by federal law.
58	45		Specifies that an insurer may not deny a Medicaid claim solely due to
59	46		a lack of prior authorization in accordance with federal law. Requires
60	47		an insurer to respond to a state inquiry regarding a Medicaid claim not
61	48		later than 60 days after receiving the inquiry. Specifies, for purposes of
62	49		a provision concerning Medicaid third party liability, that the state is
63	50		considered to have acquired the rights of the person to payment by any
64	51		other party for accumulated and future health care items or services.
65	52		(Current law provides that the state is considered to have acquired
66	53		these rights for the health care items or services.) Repeals a provision
67	54		providing that licensed home health agencies and licensed personal
68	55		services agencies are approved to provide certain services under a
69	56		Medicaid waiver granted to the state under federal law that provides
70	57		services for treatment of medical conditions. Repeals provisions
71	58		requiring the division of aging to submit a plan, before October 1,
72	59		2017, to the general assembly to expand the scope and availability of
73	60		home and community based services for individuals who are aged and
74	61		disabled. Makes conforming amendments.
75		-	HB 1386—LS 7038/DI ~~147HB~~ 1386—LS 7038/DI 147 ~~January 30, 2024~~
	62	+	2024 IN 1386—LS 7038/DI 1472024 IN 1386—LS 7038/DI 147 Introduced
76	63		Second Regular Session of the 123rd General Assembly (2024)
77	64		PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
78	65		Constitution) is being amended, the text of the existing provision will appear in this style type,
79	66		additions will appear in this style type, and deletions will appear in this style type.
80	67		Additions: Whenever a new statutory provision is being enacted (or a new constitutional
81	68		provision adopted), the text of the new provision will appear in this style type. Also, the
82	69		word NEW will appear in that style type in the introductory clause of each SECTION that adds
83	70		a new provision to the Indiana Code or the Indiana Constitution.
84	71		Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
85	72		between statutes enacted by the 2023 Regular Session of the General Assembly.
86	73		HOUSE BILL No. 1386
87	74		A BILL FOR AN ACT to amend the Indiana Code concerning
88	75		human services.
89	76		Be it enacted by the General Assembly of the State of Indiana:
90	77		1 SECTION 1. IC 4-21.5-3-6, AS AMENDED BY P.L.241-2023,
91	78		2 SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
92	79		3 JULY 1, 2024]: Sec. 6. (a) Notice shall be given under this section
93	80		4 concerning the following:
94	81		5 (1) A safety order under IC 22-8-1.1.
95	82		6 (2) Any order that:
96	83		7 (A) imposes a sanction on a person or terminates a legal right,
97	84		8 duty, privilege, immunity, or other legal interest of a person;
98	85		9 (B) is not described in section 4 or 5 of this chapter or
99	86		10 IC 4-21.5-4; and
100	87		11 (C) by statute becomes effective without a proceeding under
101	88		12 this chapter if there is no request for a review of the order
102	89		13 within a specified period after the order is issued or served.
103	90		14 (3) A notice of program reimbursement or equivalent
104	91		15 determination or other notice regarding a hospital's
105		-	HB 1386—LS 7038/DI 147 2
	92	+	2024 IN 1386—LS 7038/DI 147 2
106	93		1 reimbursement issued by the office of Medicaid policy and
107	94		2 planning or by a contractor of the office of Medicaid policy and
108	95		3 planning regarding a hospital's year end cost settlement.
109	96		4 (4) A determination of audit findings or an equivalent
110	97		5 determination by the office of Medicaid policy and planning or by
111	98		6 a contractor of the office of Medicaid policy and planning arising
112	99		7 from a Medicaid postpayment or concurrent audit of a hospital's
113	100		8 Medicaid claims.
114	101		9 (5) A license suspension or revocation under:
115	102		10 (A) IC 24-4.4-2;
116	103		11 (B) IC 24-4.5-3;
117	104		12 (C) IC 28-1-29;
118	105		13 (D) IC 28-7-5;
119	106		14 (E) IC 28-8-4.1; or
120	107		15 (F) IC 28-8-5.
121	108		16 (6) An order issued by the secretary or the secretary's designee
122	109		17 against providers regulated by the office of the secretary, the
123	110		18 division of aging, or the bureau of disabilities services and not
124	111		19 licensed by the Indiana department of health under IC 16-27 or
125	112		20 IC 16-28.
126	113		21 (b) When an agency issues an order described by subsection (a), the
127	114		22 agency shall give notice to the following persons:
128	115		23 (1) Each person to whom the order is specifically directed.
129	116		24 (2) Each person to whom a law requires notice to be given.
130	117		25 A person who is entitled to notice under this subsection is not a party
131	118		26 to any proceeding resulting from the grant of a petition for review
132	119		27 under section 7 of this chapter unless the person is designated as a
133	120		28 party in the record of the proceeding.
134	121		29 (c) The notice must include the following:
135	122		30 (1) A brief description of the order.
136	123		31 (2) A brief explanation of the available procedures and the time
137	124		32 limit for seeking administrative review of the order under section
138	125		33 7 of this chapter.
139	126		34 (3) Any other information required by law.
140	127		35 (d) An order described in subsection (a) is effective fifteen (15) days
141	128		36 after the order is served, unless a statute other than this article specifies
142	129		37 a different date or the agency specifies a later date in its order. This
143	130		38 subsection does not preclude an agency from issuing, under
144	131		39 IC 4-21.5-4, an emergency or other temporary order concerning the
145	132		40 subject of an order described in subsection (a).
146	133		41 (e) If a petition for review of an order described in subsection (a) is
147	134		42 filed within the period set by section 7 of this chapter and a petition for
148		-	HB 1386—LS 7038/DI 147 3
	135	+	2024 IN 1386—LS 7038/DI 147 3
149	136		1 stay of effectiveness of the order is filed by a party or another person
150	137		2 who has a pending petition for intervention in the proceeding, an
151	138		3 administrative law judge shall, as soon as practicable, conduct a
152	139		4 preliminary hearing to determine whether the order should be stayed in
153	140		5 whole or in part. The burden of proof in the preliminary hearing is on
154	141		6 the person seeking the stay. The administrative law judge may stay the
155	142		7 order in whole or in part. The order concerning the stay may be issued
156	143		8 after an order described in subsection (a) becomes effective. The
157	144		9 resulting order concerning the stay shall be served on the parties and
158	145		10 any person who has a pending petition for intervention in the
159	146		11 proceeding. It must include a statement of the facts and law on which
160	147		12 it is based.
161		-	13 SECTION 2. IC 11-12-5-9, AS ADDED BY P.L.185-2015,
162		-	14 SECTION 7, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
163		-	15 JULY 1, 2024]: Sec. 9. (a) This section is effective beginning
164		-	16 September 1, 2015. July 1, 2024.
165		-	17 (b) For an offender who is incarcerated for less than thirty (30) days,
166		-	18 a sheriff, in consultation with the county executive or a person
167		-	19 designated by the county executive, may:
168		-	20 (1) assist an offender in applying for Medicaid; and
169		-	21 (2) act as the offender's Medicaid authorized representative as
170		-	22 described in IC 11-10-3-7;
171		-	23 so that the offender might be eligible for coverage when the offender
172		-	24 is subsequently released from the county jail.
173		-	25 (c) Before discharge or release from a county jail or juvenile
174		-	26 facility described in IC 12-15-1-20.4 of an offender incarcerated for
175		-	27 at least thirty (30) days, the sheriff, in consultation with the county
176		-	28 executive or a person designated by the county executive in the county
177		-	29 in which the incarcerated person is located shall assist the offender in
178		-	30 applying for Medicaid, if eligible, as the authorized representative as
179		-	31 described in IC 11-10-3-7 or as a health navigator under the
180		-	32 requirements of IC 27-19-2-12, so that the offender might be eligible
181		-	33 for coverage when the offender is subsequently released from the
182		-	34 county jail or juvenile facility.
183		-	35 (d) The sheriff shall provide the assistance described in subsection
184		-	36 (c) in sufficient time to ensure that the offender will be able to receive
185		-	37 coverage at the time the offender is released from the county jail or
186		-	38 juvenile facility.
187		-	39 (e) A county executive may contract with any entity that complies
188		-	40 with IC 27-19-2-12, including a hospital or outreach eligibility worker,
189		-	41 to assist with Medicaid applications under this section. A county
190		-	42 executive may develop intergovernmental agreements with other
191		-	HB 1386—LS 7038/DI 147 4
192		-	1 counties to provide both authorized representative and health navigator
193		-	2 services required under this section. Upon a determination that an
194		-	3 incarcerated individual qualifies for Medicaid coverage, the office of
195		-	4 the secretary of family and social services, division of family resources,
196		-	5 shall authorize and then immediately suspend Medicaid coverage for
197		-	6 those inmates not requiring immediate medical attention.
198		-	7 SECTION 3. IC 12-7-2-18.1, AS ADDED BY P.L.149-2023,
199		-	8 SECTION 4, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
200		-	9 JULY 1, 2024]: Sec. 18.1. "Assisted living services", for purposes of
201		-	10 IC 12-10-11.5, IC 12-8-1.6, has the meaning set forth in
202		-	11 IC 12-10-11.5-8(a). IC 12-8-1.6-1.
203		-	12 SECTION 4. IC 12-7-2-107.7 IS ADDED TO THE INDIANA
204		-	13 CODE AS A NEW SECTION TO READ AS FOLLOWS
205		-	14 [EFFECTIVE JULY 1, 2024]: Sec. 107.7. "Home and community
206		-	15 based services waiver", for purposes of IC 12-8-1.6, has the
207		-	16 meaning set forth in IC 12-8-1.6-2.
208		-	17 SECTION 5. IC 12-7-2-117.1, AS AMENDED BY P.L.141-2006,
209		-	18 SECTION 20, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
210		-	19 JULY 1, 2024]: Sec. 117.1. (a) "Individual in need of self-directed
211		-	20 in-home care", for purposes of IC 12-8-1.7, has the meaning set
212		-	21 forth in IC 12-8-1.7-2.
213		-	22 (b) "Individual in need of self-directed in-home care", for purposes
214		-	23 of IC 12-10-17.1, has the meaning set forth in IC 12-10-17.1-6.
215		-	24 SECTION 6. IC 12-7-2-122.6 IS ADDED TO THE INDIANA
216		-	25 CODE AS A NEW SECTION TO READ AS FOLLOWS
217		-	26 [EFFECTIVE JULY 1, 2024]: Sec. 122.6. "Level of services", for
218		-	27 purposes of IC 12-8-1.6, has the meaning set forth in IC 12-8-1.6-3.
219		-	28 SECTION 7. IC 12-7-2-135.3 IS AMENDED TO READ AS
220		-	29 FOLLOWS [EFFECTIVE JULY 1, 2024]: Sec. 135.3. (a)
221		-	30 "Ombudsman", for purposes of IC 12-10-13, has the meaning set forth
222		-	31 in IC 12-10-13-4.5.
223		-	32 (b) "Ombudsman", for purposes of IC 12-11-13, has the
224		-	33 meaning set forth in IC 12-11-13-2.
225		-	34 SECTION 8. IC 12-7-2-149.1, AS AMENDED BY P.L.10-2019,
226		-	35 SECTION 55, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
227		-	36 JULY 1, 2024]: Sec. 149.1. "Provider" means the following:
228		-	37 (1) For purposes of IC 12-10-7, the meaning set forth in
229		-	38 IC 12-10-7-3.
230		-	39 (2) For purposes of the following statutes, an individual, a
231		-	40 partnership, a corporation, or a governmental entity that is
232		-	41 enrolled in the Medicaid program under rules adopted under
233		-	42 IC 4-22-2 by the office of Medicaid policy and planning:
234		-	HB 1386—LS 7038/DI 147 5
235		-	1 (A) IC 12-14-1 through IC 12-14-8.
236		-	2 (B) IC 12-15, except IC 12-15-32, IC 12-15-33, and
237		-	3 IC 12-15-34.
238		-	4 (C) IC 12-17.6.
239		-	5 (3) Except as provided in subdivisions (4) and (6), for purposes
240		-	6 of IC 12-17.2, a person who operates a child care center or child
241		-	7 care home under IC 12-17.2.
242		-	8 (4) For purposes of IC 12-17.2-3.5, a person that:
243		-	9 (A) provides child care; and
244		-	10 (B) is directly paid for the provision of the child care under the
245		-	11 federal Child Care and Development Fund voucher program
246		-	12 administered under 45 CFR 98 and 45 CFR 99.
247		-	13 The term does not include an individual who provides services to
248		-	14 a person described in clauses (A) and (B), regardless of whether
249		-	15 the individual receives compensation.
250		-	16 (5) For purposes of IC 12-21-1 through IC 12-29-2, an
251		-	17 organization:
252		-	18 (A) that:
253		-	19 (i) provides mental health services, as defined under 42
254		-	20 U.S.C. 300x-2(c);
255		-	21 (ii) provides addiction services; or
256		-	22 (iii) provides children's mental health services;
257		-	23 (B) that has entered into a provider agreement with the
258		-	24 division of mental health and addiction under IC 12-21-2-7 to
259		-	25 provide services in the least restrictive, most appropriate
260		-	26 setting; and
261		-	27 (C) that is operated by one (1) of the following:
262		-	28 (i) A city, town, county, or other political subdivision of the
263		-	29 state.
264		-	30 (ii) An agency of the state or of the United States.
265		-	31 (iii) A political subdivision of another state.
266		-	32 (iv) A hospital owned or operated by a unit of government
267		-	33 or a building authority that is organized for the purpose of
268		-	34 constructing facilities to be leased to units of government.
269		-	35 (v) A corporation incorporated under IC 23-7-1.1 (before its
270		-	36 repeal August 1, 1991) or IC 23-17.
271		-	37 (vi) An organization that is exempt from federal income
272		-	38 taxation under Section 501(c)(3) of the Internal Revenue
273		-	39 Code.
274		-	40 (vii) A university or college.
275		-	41 (6) For purposes of IC 12-17.2-2-10, the following:
276		-	42 (A) A person described in subdivision (4).
277		-	HB 1386—LS 7038/DI 147 6
278		-	1 (B) A child care center licensed under IC 12-17.2-4.
279		-	2 (C) A child care home licensed under IC 12-17.2-5.
280		-	3 (7) For purposes of IC 12-11-13, an authorized provider entity
281		-	4 that delivers services administered by the bureau of
282		-	5 disabilities services.
283		-	6 SECTION 9. IC 12-8-1.6 IS ADDED TO THE INDIANA CODE
284		-	7 AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
285		-	8 JULY 1, 2024]:
286		-	9 Chapter 1.6. Medicaid Home and Community Based Services
287		-	10 Waivers
288		-	11 Sec. 1. As used in this chapter, "assisted living services" refers
289		-	12 to services covered under a home and community based services
290		-	13 waiver and provided in any of the following entities:
291		-	14 (1) A residential care facility licensed under IC 16-28.
292		-	15 (2) Any other housing with services establishment.
293		-	16 Sec. 2. (a) As used in this chapter, "home and community based
294		-	17 services waiver" refers to a federal Medicaid waiver granted to the
295		-	18 state under 42 U.S.C. 1396n(c) to provide home and community
296		-	19 based long term care services and supports to individuals with
297		-	20 disabilities.
298		-	21 (b) The term does not include home and community services
299		-	22 offered as part of the approved Medicaid state plan.
300		-	23 Sec. 3. As used in this chapter, "level of services" means a
301		-	24 determination of the type of services an individual may receive
302		-	25 under a Medicaid waiver based on the individual's impairment and
303		-	26 dependence and the corresponding reimbursement rate for the
304		-	27 determined level of care.
305		-	28 Sec. 4. (a) The office of the secretary has all powers necessary
306		-	29 and convenient to administer a home and community based
307		-	30 services waiver.
308		-	31 (b) The office of the secretary shall do the following:
309		-	32 (1) Administer money appropriated or allocated to the office
310		-	33 of the secretary by the state, including money appropriated or
311		-	34 allocated for a home and community based services waiver.
312		-	35 (2) Take any action necessary to implement a home and
313		-	36 community based services waiver, including applying to the
314		-	37 United States Department of Health and Human Services for
315		-	38 approval to amend or renew the waiver, implement a new
316		-	39 Medicaid waiver, or amend the Medicaid state plan.
317		-	40 (3) Ensure that a home and community based services waiver
318		-	41 is subject to funding available to the office of the secretary.
319		-	42 (4) Ensure, in coordination with the budget agency, that the
320		-	HB 1386—LS 7038/DI 147 7
321		-	1 cost of a home and community based services waiver does not
322		-	2 exceed the total amount of funding available by the budget
323		-	3 agency, including state and federal funds, for the Medicaid
324		-	4 programs established to provide services under a home and
325		-	5 community based services waiver.
326		-	6 (5) Establish and administer a program for a home and
327		-	7 community based services waiver to provide an eligible
328		-	8 individual with care that does not cost more than services
329		-	9 provided to a similarly situated individual residing in an
330		-	10 institution.
331		-	11 (6) Within the limits of available resources, provide service
332		-	12 coordination services to individuals receiving services under
333		-	13 a home and community based services waiver, including the
334		-	14 development of an individual service plan that:
335		-	15 (A) addresses an individual's needs;
336		-	16 (B) considers the individual's family resources and access
337		-	17 to community and natural support; and
338		-	18 (C) is consistent with the person centered care approach
339		-	19 for receiving services under a waiver.
340		-	20 (7) Monitor services provided by a provider that:
341		-	21 (A) provides services to an individual using funds provided
342		-	22 by the office of the secretary or under the authority of the
343		-	23 office of the secretary; or
344		-	24 (B) entered into one (1) or more provider agreements to
345		-	25 provide services under a home and community based
346		-	26 services waiver.
347		-	27 (8) Establish and administer a complaint process for:
348		-	28 (A) an individual receiving; or
349		-	29 (B) a provider described in subdivision (7) providing;
350		-	30 services under a home and community based services waiver.
351		-	31 (c) The office of the secretary may do the following:
352		-	32 (1) At the office's discretion, delegate any of its authority
353		-	33 under this chapter to any division or office within the office of
354		-	34 the secretary of family and social services.
355		-	35 (2) Issue administrative orders under IC 4-21.5-3-6 regarding
356		-	36 the provision of a home and community based services
357		-	37 waiver.
358		-	38 Sec. 5. (a) The office of the secretary shall establish:
359		-	39 (1) eligibility criteria for an individual to receive; and
360		-	40 (2) certification criteria for a provider of;
361		-	41 services under a home and community based services waiver.
362		-	42 (b) The eligibility criteria established under subsection (a) may
363		-	HB 1386—LS 7038/DI 147 8
364		-	1 vary based on the targeted need of each home and community
365		-	2 based services waiver.
366		-	3 (c) An individual who is determined by the office of the
367		-	4 secretary to be ineligible for services under a home and community
368		-	5 based services waiver may appeal the determination under
369		-	6 IC 4-21.5.
370		-	7 Sec. 6. The office of the secretary shall serve as the placement
371		-	8 authority for individuals receiving services under a home and
372		-	9 community based services waiver and an individual service plan.
373		-	10 Sec. 7. Subject to the availability of applicable waiver slots and
374		-	11 funding, the office of the secretary shall provide access to home
375		-	12 and community based services that are appropriate and necessary
376		-	13 for an individual determined to be eligible by the office of the
377		-	14 secretary for services under a home and community based services
378		-	15 waiver.
379		-	16 Sec. 8. A provider of services under a home and community
380		-	17 based services waiver shall follow any waiver requirements under
381		-	18 federal law and developed by the office of the secretary, including
382		-	19 the planning process, service plan, and home and community based
383		-	20 setting requirements set forth in 42 CFR 441.301.
384		-	21 Sec. 9. A home and community based services waiver, including
385		-	22 the delivery and receipt of services provided under the home and
386		-	23 community based services waiver, must meet the following
387		-	24 requirements:
388		-	25 (1) Be provided under public supervision.
389		-	26 (2) Be individualized and designed to meet the needs of
390		-	27 individuals eligible to receive services under the home and
391		-	28 community based services waiver.
392		-	29 (3) Meet applicable state and federal standards.
393		-	30 (4) Be provided by qualified personnel.
394		-	31 (5) Be provided, to the extent appropriate, with services
395		-	32 provided under the home and community based services
396		-	33 waiver that are provided in a home and community based
397		-	34 setting where nonwaiver individuals receive services.
398		-	35 (6) Be provided in accordance with an individual's service
399		-	36 plan.
400		-	37 Sec. 10. (a) As used in this section, "office" includes the
401		-	38 following:
402		-	39 (1) The office of the secretary of family and social services.
403		-	40 (2) A managed care organization that has contracted with the
404		-	41 office of Medicaid policy and planning under IC 12-15.
405		-	42 (3) A person that has contracted with a managed care
406		-	HB 1386—LS 7038/DI 147 9
407		-	1 organization described in subdivision (2).
408		-	2 (b) Under a home and community based services waiver that
409		-	3 provides services to an individual who is aged or disabled, the
410		-	4 office shall reimburse for the following services provided to the
411		-	5 individual by a provider of assisted living services, if included in
412		-	6 the individual's home and community based service plan:
413		-	7 (1) Assisted living services.
414		-	8 (2) Integrated health care coordination.
415		-	9 (3) Transportation.
416		-	10 (c) If the office approves an increase in the level of services for
417		-	11 a recipient of assisted living services, the office shall reimburse the
418		-	12 provider of assisted living services for the level of services for the
419		-	13 increase as of the date that the provider has documentation of
420		-	14 providing the increase in the level of services.
421		-	15 (d) The office may reimburse for any home and community
422		-	16 based services provided to a Medicaid recipient beginning on the
423		-	17 date of the individual's Medicaid application.
424		-	18 (e) The office may not do any of the following concerning
425		-	19 assisted living services provided in a home and community based
426		-	20 services program:
427		-	21 (1) Require the installation of a sink in the kitchenette within
428		-	22 any living unit of an entity that participated in the Medicaid
429		-	23 home and community based services program before July 1,
430		-	24 2018.
431		-	25 (2) Require all living units within a setting that provides
432		-	26 assisted living services to comply with physical plant
433		-	27 requirements that are applicable to individual units occupied
434		-	28 by a Medicaid recipient.
435		-	29 (3) Require a provider to offer only private rooms.
436		-	30 (4) Require a housing with services establishment provider to
437		-	31 provide housing when:
438		-	32 (A) the provider is unable to meet the health needs of a
439		-	33 resident without:
440		-	34 (i) undue financial or administrative burden; or
441		-	35 (ii) fundamentally altering the nature of the provider's
442		-	36 operations; and
443		-	37 (B) the resident is unable to arrange for services to meet
444		-	38 the resident's health needs.
445		-	39 (5) Require a housing with services establishment provider to
446		-	40 separate an agreement for housing from an agreement for
447		-	41 services.
448		-	42 (6) Prohibit a housing with services establishment provider
449		-	HB 1386—LS 7038/DI 147 10
450		-	1 from offering studio apartments with only a single sink in the
451		-	2 unit.
452		-	3 (7) Preclude the use of a shared bathroom between adjoining
453		-	4 or shared units if the participants consent to the use of a
454		-	5 shared bathroom.
455		-	6 (8) Reduce the scope of services that may be provided by a
456		-	7 provider of assisted living services under the aged and
457		-	8 disabled Medicaid waiver in effect on July 1, 2021.
458		-	9 (f) The office of the secretary may adopt rules under IC 4-22-2
459		-	10 that establish the right, and an appeals process, for a resident to
460		-	11 appeal a provider's determination that the provider is unable to
461		-	12 meet the health needs of the resident as described in subsection
462		-	13 (e)(4). The process:
463		-	14 (1) must require an objective third party to review the
464		-	15 provider's determination in a timely manner; and
465		-	16 (2) may not be required if the provider is licensed by the
466		-	17 Indiana department of health and the licensure requirements
467		-	18 include an appellate procedure for such a determination.
468		-	19 Sec. 11. (a) The office of the secretary shall annually determine
469		-	20 any state savings generated by home and community based services
470		-	21 under this chapter by reducing the use of institutional care.
471		-	22 (b) The office of the secretary shall annually report to the
472		-	23 governor, the budget agency, the budget committee, the interim
473		-	24 study committee on public health, behavioral health, and human
474		-	25 services established by IC 2-5-1.3-4, and the executive director of
475		-	26 the legislative services agency the savings determined under
476		-	27 subsection (a). A report under this subsection to the executive
477		-	28 director of the legislative services agency must be in an electronic
478		-	29 format under IC 5-14-6.
479		-	30 (c) Savings determined under subsection (a) may be used to fund
480		-	31 the state's share of additional home and community based
481		-	32 Medicaid waiver slots.
482		-	33 Sec. 12. The office of the secretary may adopt rules under
483		-	34 IC 4-22-2 to implement this chapter.
484		-	35 SECTION 10. IC 12-8-1.7 IS ADDED TO THE INDIANA CODE
485		-	36 AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
486		-	37 JULY 1, 2024]:
487		-	38 Chapter 1.7. Individuals in Need of Self-Directed In-Home Care
488		-	39 Sec. 1. As used in this chapter, "attendant care services" means
489		-	40 the basic and ancillary services that the individual chooses to direct
490		-	41 and supervise a personal services attendant to perform and that
491		-	42 enable an individual in need of self-directed in-home care to live in
492		-	HB 1386—LS 7038/DI 147 11
493		-	1 the individual's home and community rather than in an institution
494		-	2 and to carry out functions of daily living, self-care, and mobility.
495		-	3 Sec. 2. As used in this chapter, "individual in need of
496		-	4 self-directed in-home care" means an individual with a disability,
497		-	5 or person responsible for making health related decisions for the
498		-	6 individual with a disability, who:
499		-	7 (1) is approved to receive Medicaid waiver services under 42
500		-	8 U.S.C. 1396n(c);
501		-	9 (2) is in need of attendant care services because of
502		-	10 impairment;
503		-	11 (3) requires assistance to complete functions of daily living,
504		-	12 self-care, and mobility, including those functions included in
505		-	13 attendant care services;
506		-	14 (4) chooses to self-direct a paid personal services attendant to
507		-	15 perform attendant care services; and
508		-	16 (5) assumes the responsibility to initiate self-directed in-home
509		-	17 care and exercise judgment regarding the manner in which
510		-	18 those services are delivered, including the decision to employ,
511		-	19 train, and dismiss a personal services attendant.
512		-	20 Sec. 3. As used in this chapter, "personal services attendant"
513		-	21 means an individual who is registered to provide attendant care
514		-	22 services under this chapter and who has entered into a contract
515		-	23 with an individual and acts under the individual's direction to
516		-	24 provide attendant care services that could be performed by the
517		-	25 individual if the individual were physically capable.
518		-	26 Sec. 4. The office of the secretary shall have self-directed care
519		-	27 options and services available for an eligible individual who:
520		-	28 (1) receives services under a home and community based
521		-	29 services waiver (as defined in IC 12-8-1.6-2); and
522		-	30 (2) chooses self-directed care services.
523		-	31 Sec. 5. (a) An individual may not provide attendant care services
524		-	32 for compensation from Medicaid for an individual in need of
525		-	33 self-directed in-home care services unless the individual is
526		-	34 registered under this chapter.
527		-	35 (b) Except in instances of extraordinary care, an individual who
528		-	36 is a legally responsible relative of an individual in need of
529		-	37 self-directed in-home care, including a parent of a minor individual
530		-	38 and a spouse, is precluded from providing attendant care services
531		-	39 for compensation under this chapter.
532		-	40 Sec. 6. (a) The office of the secretary shall register an individual
533		-	41 to provide services under this chapter who provides the following:
534		-	42 (1) A personal resume containing information concerning the
535		-	HB 1386—LS 7038/DI 147 12
536		-	1 individual's qualifications, work experience, and any
537		-	2 credentials the individual may hold. The individual must
538		-	3 certify that the information contained in the resume is true
539		-	4 and accurate.
540		-	5 (2) The individual's:
541		-	6 (A) limited criminal history check from the Indiana central
542		-	7 repository for criminal history information under
543		-	8 IC 10-13-3;
544		-	9 (B) expanded criminal history check (as defined in
545		-	10 IC 20-26-2-1.5); or
546		-	11 (C) criminal history check from another source allowed by
547		-	12 law.
548		-	13 (3) If applicable, the individual's state nurse aide registry
549		-	14 report from the Indiana department of health. This
550		-	15 subdivision does not require an individual to be a nurse aide.
551		-	16 (4) Three (3) letters of reference.
552		-	17 (5) A registration fee. The office of the secretary shall
553		-	18 establish the amount of the registration fee.
554		-	19 (6) Proof that the individual is at least eighteen (18) years of
555		-	20 age.
556		-	21 (7) Any other information required by the office of the
557		-	22 secretary.
558		-	23 (b) A registration is valid for two (2) years. A personal services
559		-	24 attendant may renew the personal services attendant's registration
560		-	25 by updating any information in the file that has changed and by
561		-	26 paying the fee required under subsection (a)(5). The limited
562		-	27 criminal history check and state nurse aid registry report required
563		-	28 under subsection (a)(2) and (a)(3) must be updated every two (2)
564		-	29 years.
565		-	30 (c) The office of the secretary shall maintain a file for each
566		-	31 personal services attendant that contains:
567		-	32 (1) comments related to the provision of attendant care
568		-	33 services submitted by an individual in need of self-directed
569		-	34 in-home care who has employed the personal services
570		-	35 attendant; and
571		-	36 (2) the items described in subsection (a)(1) through (a)(4).
572		-	37 (d) Upon request, the office of the secretary shall provide to an
573		-	38 individual in need of self-directed in-home care the following:
574		-	39 (1) Without charge, a list of personal services attendants who
575		-	40 are registered with the office of the secretary and available
576		-	41 within the requested geographic area.
577		-	42 (2) A copy of the information of a specified personal services
578		-	HB 1386—LS 7038/DI 147 13
579		-	1 attendant who is on file with the office of the secretary under
580		-	2 subsection (c). The office of the secretary may charge a fee for
581		-	3 shipping, handling, and copying expenses.
582		-	4 (e) The limited criminal history check requirement described in
583		-	5 subsection (a)(2) may be satisfied by fulfilling the components of an
584		-	6 expanded criminal history check under IC 20-26-2-1.5 and is
585		-	7 subject to the conditions described in IC 16-27-2-4(c).
586		-	8 Sec. 7. The case manager of an individual in need of
587		-	9 self-directed in-home care shall maintain an attending physician's
588		-	10 written opinion in a case file that is maintained for the individual
589		-	11 by the case manager.
590		-	12 Sec. 8. (a) A personal services attendant who is hired by the
591		-	13 individual in need of self-directed in-home care is an employee of
592		-	14 the individual in need of self-directed in-home care.
593		-	15 (b) The office of the secretary is not liable for any actions of a
594		-	16 personal services attendant or an individual in need of self-directed
595		-	17 in-home care.
596		-	18 (c) A personal services attendant and an individual in need of
597		-	19 self-directed in-home care are each liable for any negligent or
598		-	20 wrongful act or omission in which the person personally
599		-	21 participates.
600		-	22 Sec. 9. (a) Except as provided in subsection (b), an individual in
601		-	23 need of self-directed in-home care is responsible for recruiting,
602		-	24 hiring, training, paying, certifying any employment related
603		-	25 documents, dismissing, and supervising in the individual's home
604		-	26 during service hours a personal services attendant who provides
605		-	27 attendant care services for the individual.
606		-	28 (b) If an individual in need of self-directed in-home care is:
607		-	29 (1) less than twenty-one (21) years of age; or
608		-	30 (2) unable to direct in-home care because of a brain injury or
609		-	31 mental deficiency;
610		-	32 the individual's parent, spouse, legal guardian, or a person
611		-	33 possessing a valid power of attorney for the individual may make
612		-	34 employment, care, and training decisions and certify any
613		-	35 employment related documents on behalf of the individual.
614		-	36 (c) An individual in need of self-directed in-home care or an
615		-	37 individual under subsection (b) and the individual's case manager
616		-	38 shall develop an authorized care plan. The authorized care plan
617		-	39 must include a list of weekly services or tasks that must be
618		-	40 performed to comply with the authorized care plan.
619		-	41 Sec. 10. The individual in need of self-directed in-home care and
620		-	42 the personal services attendant must each sign a contract, in a form
621		-	HB 1386—LS 7038/DI 147 14
622		-	1 approved by the office of the secretary, that includes, at a
623		-	2 minimum, the following provisions:
624		-	3 (1) The responsibilities of the personal services attendant.
625		-	4 (2) The frequency the personal services attendant will provide
626		-	5 attendant care services.
627		-	6 (3) The duration of the contract.
628		-	7 (4) The hourly wage of the personal services attendant. The
629		-	8 wage may not be less than the federal minimum wage or more
630		-	9 than the rate that the recipient is eligible to receive under a
631		-	10 Medicaid home and community based services waiver.
632		-	11 (5) Reasons and notice agreements for early termination of
633		-	12 the contract.
634		-	13 Sec. 11. (a) The office of the secretary shall amend the home and
635		-	14 community based services waiver program under the Medicaid
636		-	15 state plan to provide for the payment for attendant care services
637		-	16 provided by a personal services attendant for an individual in need
638		-	17 of self-directed in-home care under this chapter, including any
639		-	18 related record keeping and employment expenses.
640		-	19 (b) The office of the secretary shall not, to the extent permitted
641		-	20 by federal law, consider as income money paid under this chapter
642		-	21 to or on behalf of an individual in need of self-directed in-home
643		-	22 care to enable the individual to employ registered personal services
644		-	23 attendants for purposes of determining the individual's income
645		-	24 eligibility for services under this chapter or IC 12-8-1.6.
646		-	25 Sec. 12. The office of the secretary shall adopt rules under
647		-	26 IC 4-22-2 concerning the following:
648		-	27 (1) The method of payment to a personal services attendant
649		-	28 who provides authorized services under this chapter.
650		-	29 (2) Record keeping requirements for personal attendant
651		-	30 services.
652		-	31 (3) The receipt, review, and investigation of complaints
653		-	32 concerning the:
654		-	33 (A) neglect;
655		-	34 (B) abuse;
656		-	35 (C) mistreatment; or
657		-	36 (D) misappropriation of property;
658		-	37 of an individual in need of self-directed in-home care by a
659		-	38 personal services attendant.
660		-	39 (4) Establishing notice and administrative hearing procedures
661		-	40 in accordance with IC 4-21.5.
662		-	41 (5) Appeal procedures, including judicial review of
663		-	42 administrative hearings.
664		-	HB 1386—LS 7038/DI 147 15
665		-	1 (6) Procedures to place a personal services attendant who has
666		-	2 been determined to have been guilty of:
667		-	3 (A) neglect;
668		-	4 (B) abuse;
669		-	5 (C) mistreatment; or
670		-	6 (D) misappropriation of property;
671		-	7 of an individual in need of self-directed in-home care on the
672		-	8 state nurse aide registry.
673		-	9 (7) Any rules necessary to implement this chapter.
674		-	10 SECTION 11. IC 12-9.1-4-1, AS ADDED BY P.L.141-2006,
675		-	11 SECTION 38, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
676		-	12 JULY 1, 2024]: Sec. 1. The division shall administer money
677		-	13 appropriated or allocated to the division by the state, including money
678		-	14 appropriated or allocated from the following:
679		-	15 (1) The federal Older Americans Act (42 U.S.C. 3001 et seq.).
680		-	16 (2) The United States Department of Agriculture (7 U.S.C. 612C
681		-	17 et seq.).
682		-	18 (3) Medicaid waiver in-home services for the elderly and disabled
683		-	19 (42 U.S.C. 1396 et seq.) for treatment of medical conditions.
684		-	20 (4) (3) Money appropriated or allocated to the division to
685		-	21 administer a program under this title.
686		-	22 (5) (4) Other funding sources that are designated by the general
687		-	23 assembly or available from the federal government under grants
688		-	24 that are consistent with the duties of the division.
689		-	25 SECTION 12. IC 12-9.1-4-2, AS ADDED BY P.L.141-2006,
690		-	26 SECTION 38, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
691		-	27 JULY 1, 2024]: Sec. 2. The division shall administer the following
692		-	28 programs:
693		-	29 (1) Programs established under any of the following statutes:
694		-	30 (A) This article.
695		-	31 (B) IC 12-10.
696		-	32 (2) Programs under IC 12-30, to the extent the division has
697		-	33 responsibilities for programs under IC 12-30.
698		-	34 (3) Medicaid waivers for in-home services for treatment of
699		-	35 medical conditions.
700		-	36 SECTION 13. IC 12-9.1-4-3 IS REPEALED [EFFECTIVE JULY
701		-	37 1, 2024]. Sec. 3. Notwithstanding any other law:
702		-	38 (1) home health agencies licensed under IC 16-27-1 are approved
703		-	39 to provide home health services; and
704		-	40 (2) personal services agencies licensed under IC 16-27-4 are
705		-	41 approved to provide personal services;
706		-	42 under any federal waiver granted to the state under 42 U.S.C. 1315 or
707		-	HB 1386—LS 7038/DI 147 16
708		-	1 42 U.S.C. 1396n that provides services for treatment of medical
709		-	2 conditions.
710		-	3 SECTION 14. IC 12-10-11.5-6 IS REPEALED [EFFECTIVE JULY
711		-	4 1, 2024]. Sec. 6. (a) The office of the secretary of family and social
712		-	5 services shall annually determine any state savings generated by home
713		-	6 and community based services under this chapter by reducing the use
714		-	7 of institutional care.
715		-	8 (b) The secretary shall annually report to the governor, the budget
716		-	9 agency, the budget committee, the interim study committee on public
717		-	10 health, behavioral health, and human services established by
718		-	11 IC 2-5-1.3-4, and the executive director of the legislative services
719		-	12 agency the savings determined under subsection (a). A report under
720		-	13 this subsection to the executive director of the legislative services
721		-	14 agency must be in an electronic format under IC 5-14-6.
722		-	15 (c) Savings determined under subsection (a) may be used to fund the
723		-	16 state's share of additional home and community based Medicaid waiver
724		-	17 slots.
725		-	18 SECTION 15. IC 12-10-11.5-8 IS REPEALED [EFFECTIVE JULY
726		-	19 1, 2024]. Sec. 8. (a) As used in this chapter, "assisted living services"
727		-	20 refers to services covered under a waiver and provided in any of the
728		-	21 following entities:
729		-	22 (1) A residential care facility licensed under IC 16-28.
730		-	23 (2) Any other housing with services establishment.
731		-	24 (b) As used in this section, "level of services" means a
732		-	25 determination of the type of services an individual may receive under
733		-	26 a Medicaid waiver based on the individual's impairment and
734		-	27 dependence and the corresponding reimbursement rate for the
735		-	28 determined level of care.
736		-	29 (c) As used in this section, "office" includes the following:
737		-	30 (1) The office of the secretary of family and social services.
738		-	31 (2) A managed care organization that has contracted with the
739		-	32 office of Medicaid policy and planning under IC 12-15.
740		-	33 (3) A person that has contracted with a managed care organization
741		-	34 described in subdivision (2).
742		-	35 (d) Under a Medicaid waiver that provides services to an individual
743		-	36 who is aged or disabled, the office shall reimburse for the following
744		-	37 services provided to the individual by a provider of assisted living
745		-	38 services:
746		-	39 (1) Assisted living services.
747		-	40 (2) Integrated health care coordination.
748		-	41 (3) Transportation.
749		-	42 (e) If the office approves an increase in the level of services for a
750		-	HB 1386—LS 7038/DI 147 17
751		-	1 recipient of assisted living services, the office shall reimburse the
752		-	2 provider of assisted living services for the level of services for the
753		-	3 increase as of the date that the provider has documentation of providing
754		-	4 the increase in the level of services.
755		-	5 (f) The office may reimburse for any home and community based
756		-	6 services provided to a Medicaid recipient beginning on the date of the
757		-	7 individual's Medicaid application.
758		-	8 (g) The office may not do any of the following concerning assisted
759		-	9 living services provided in a home and community based services
760		-	10 program:
761		-	11 (1) Require the installation of a sink in the kitchenette within any
762		-	12 living unit of an entity that participated in the Medicaid home and
763		-	13 community based service program before July 1, 2018.
764		-	14 (2) Require all living units within a setting that provides assisted
765		-	15 living services to comply with physical plant requirements that
766		-	16 are applicable to individual units occupied by a Medicaid
767		-	17 recipient.
768		-	18 (3) Require a provider to offer only private rooms.
769		-	19 (4) Require a housing with services establishment provider to
770		-	20 provide housing when:
771		-	21 (A) the provider is unable to meet the health needs of a
772		-	22 resident without:
773		-	23 (i) undue financial or administrative burden; or
774		-	24 (ii) fundamentally altering the nature of the provider's
775		-	25 operations; and
776		-	26 (B) the resident is unable to arrange for services to meet the
777		-	27 resident's health needs.
778		-	28 (5) Require a housing with services establishment provider to
779		-	29 separate an agreement for housing from an agreement for
780		-	30 services.
781		-	31 (6) Prohibit a housing with services establishment provider from
782		-	32 offering studio apartments with only a single sink in the unit.
783		-	33 (7) Preclude the use of a shared bathroom between adjoining or
784		-	34 shared units if the participants consent to the use of a shared
785		-	35 bathroom.
786		-	36 (8) Reduce the scope of services that may be provided by a
787		-	37 provider of assisted living services under the aged and disabled
788		-	38 Medicaid waiver in effect on July 1, 2021.
789		-	39 (h) The division may adopt rules under IC 4-22-2 that establish the
790		-	40 right, and an appeals process, for a resident to appeal a provider's
791		-	41 determination that the provider is unable to meet the health needs of
792		-	42 the resident as described in subsection (g)(4). The process:
793		-	HB 1386—LS 7038/DI 147 18
794		-	1 (1) must require an objective third party to review the provider's
795		-	2 determination in a timely manner; and
796		-	3 (2) may not be required if the provider is licensed by the Indiana
797		-	4 department of health and the licensure requirements include an
798		-	5 appellate procedure for such a determination.
799		-	6 SECTION 16. IC 12-10-17.1-6, AS AMENDED BY P.L.99-2007,
800		-	7 SECTION 68, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
801		-	8 JULY 1, 2024]: Sec. 6. As used in this chapter, "individual in need of
802		-	9 self-directed in-home care" means an individual with a disability, or
803		-	10 person responsible for making health related decisions for the
804		-	11 individual with a disability, who:
805		-	12 (1) is approved to receive Medicaid waiver services under 42
806		-	13 U.S.C. 1396n(c), or is a participant in the community and home
807		-	14 options to institutional care for the elderly and disabled program
808		-	15 under IC 12-10-10;
809		-	16 (2) is in need of attendant care services because of impairment;
810		-	17 (3) requires assistance to complete functions of daily living,
811		-	18 self-care, and mobility, including those functions included in
812		-	19 attendant care services;
813		-	20 (4) chooses to self-direct a paid personal services attendant to
814		-	21 perform attendant care services; and
815		-	22 (5) assumes the responsibility to initiate self-directed in-home
816		-	23 care and exercise judgment regarding the manner in which those
817		-	24 services are delivered, including the decision to employ, train, and
818		-	25 dismiss a personal services attendant.
819		-	26 SECTION 17. IC 12-10-17.1-10, AS ADDED BY P.L.141-2006,
820		-	27 SECTION 44, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
821		-	28 JULY 1, 2024]: Sec. 10. (a) An individual may not provide attendant
822		-	29 care services for compensation from Medicaid or the community and
823		-	30 home options to institutional care for the elderly and disabled program
824		-	31 for an individual in need of self-directed in-home care services unless
825		-	32 the individual is registered under section 12 of this chapter.
826		-	33 (b) An individual who is a legally responsible relative of an
827		-	34 individual in need of self-directed in-home care, including a parent of
828		-	35 a minor individual and a spouse, is precluded from providing attendant
829		-	36 care services for compensation under this chapter.
830		-	37 SECTION 18. IC 12-10-17.1-17, AS ADDED BY P.L.141-2006,
831		-	38 SECTION 44, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
832		-	39 JULY 1, 2024]: Sec. 17. The individual in need of self-directed
833		-	40 in-home care and the personal services attendant must each sign a
834		-	41 contract, in a form approved by the division, that includes, at a
835		-	42 minimum, the following provisions:
836		-	HB 1386—LS 7038/DI 147 19
837		-	1 (1) The responsibilities of the personal services attendant.
838		-	2 (2) The frequency the personal services attendant will provide
839		-	3 attendant care services.
840		-	4 (3) The duration of the contract.
841		-	5 (4) The hourly wage of the personal services attendant. The wage
842		-	6 may not be less than the federal minimum wage or more than the
843		-	7 rate that the recipient is eligible to receive under a Medicaid
844		-	8 home and community based services waiver or the community
845		-	9 and home options to institutional care for the elderly and disabled
846		-	10 program for attendant care services.
847		-	11 (5) Reasons and notice agreements for early termination of the
848		-	12 contract.
849		-	13 SECTION 19. IC 12-10-17.1-18, AS ADDED BY P.L.141-2006,
	148	+	13 SECTION 2. IC 12-7-2-18.1, AS ADDED BY P.L.149-2023,
	149	+	14 SECTION 4, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
	150	+	15 JULY 1, 2024]: Sec. 18.1. "Assisted living services", for purposes of
	151	+	16 IC 12-10-11.5, IC 12-8-1.6, has the meaning set forth in
	152	+	17 IC 12-10-11.5-8(a). IC 12-8-1.6-1.
	153	+	18 SECTION 3. IC 12-7-2-107.7 IS ADDED TO THE INDIANA
	154	+	19 CODE AS A NEW SECTION TO READ AS FOLLOWS
	155	+	20 [EFFECTIVE JULY 1, 2024]: Sec. 107.7. "Home and community
	156	+	21 based services waiver", for purposes of IC 12-8-1.6, has the
	157	+	22 meaning set forth in IC 12-8-1.6-2.
	158	+	23 SECTION 4. IC 12-7-2-117.1, AS AMENDED BY P.L.141-2006,
	159	+	24 SECTION 20, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
	160	+	25 JULY 1, 2024]: Sec. 117.1. (a) "Individual in need of self-directed
	161	+	26 in-home care", for purposes of IC 12-8-1.7, has the meaning set
	162	+	27 forth in IC 12-8-1.7-2.
	163	+	28 (b) "Individual in need of self-directed in-home care", for purposes
	164	+	29 of IC 12-10-17.1, has the meaning set forth in IC 12-10-17.1-6.
	165	+	30 SECTION 5. IC 12-7-2-122.6 IS ADDED TO THE INDIANA
	166	+	31 CODE AS A NEW SECTION TO READ AS FOLLOWS
	167	+	32 [EFFECTIVE JULY 1, 2024]: Sec. 122.6. "Level of services", for
	168	+	33 purposes of IC 12-8-1.6, has the meaning set forth in IC 12-8-1.6-3.
	169	+	34 SECTION 6. IC 12-8-1.6 IS ADDED TO THE INDIANA CODE
	170	+	35 AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
	171	+	36 JULY 1, 2024]:
	172	+	37 Chapter 1.6. Medicaid Home and Community Based Services
	173	+	38 Waivers
	174	+	39 Sec. 1. As used in this chapter, "assisted living services" refers
	175	+	40 to services covered under a home and community based services
	176	+	41 waiver and provided in any of the following entities:
	177	+	42 (1) A residential care facility licensed under IC 16-28.
	178	+	2024 IN 1386—LS 7038/DI 147 4
	179	+	1 (2) Any other housing with services establishment.
	180	+	2 Sec. 2. (a) As used in this chapter, "home and community based
	181	+	3 services waiver" refers to a federal Medicaid waiver granted to the
	182	+	4 state under 42 U.S.C. 1396n(c) to provide home and community
	183	+	5 based long term care services and supports to individuals with
	184	+	6 disabilities.
	185	+	7 (b) The term does not include home and community services
	186	+	8 offered as part of the approved Medicaid state plan.
	187	+	9 Sec. 3. As used in this chapter, "level of services" means a
	188	+	10 determination of the type of services an individual may receive
	189	+	11 under a Medicaid waiver based on the individual's impairment and
	190	+	12 dependence and the corresponding reimbursement rate for the
	191	+	13 determined level of care.
	192	+	14 Sec. 4. (a) The office of the secretary has all powers necessary
	193	+	15 and convenient to administer a home and community based
	194	+	16 services waiver.
	195	+	17 (b) The office of the secretary shall do the following:
	196	+	18 (1) Administer money appropriated or allocated to the office
	197	+	19 of the secretary by the state, including money appropriated or
	198	+	20 allocated for a home and community based services waiver.
	199	+	21 (2) Take any action necessary to implement a home and
	200	+	22 community based services waiver, including applying to the
	201	+	23 United States Department of Health and Human Services for
	202	+	24 approval to amend or renew the waiver, implement a new
	203	+	25 Medicaid waiver, or amend the Medicaid state plan.
	204	+	26 (3) Ensure that a home and community based services waiver
	205	+	27 is subject to funding available to the office of the secretary.
	206	+	28 (4) Ensure, in coordination with the budget agency, that the
	207	+	29 cost of a home and community based services waiver does not
	208	+	30 exceed the total amount of funding available by the budget
	209	+	31 agency, including state and federal funds, for the Medicaid
	210	+	32 programs established to provide services under a home and
	211	+	33 community based services waiver.
	212	+	34 (5) Establish and administer a program for a home and
	213	+	35 community based services waiver to provide an eligible
	214	+	36 individual with care that does not cost more than services
	215	+	37 provided to a similarly situated individual residing in an
	216	+	38 institution.
	217	+	39 (6) Within the limits of available resources, provide service
	218	+	40 coordination services to individuals receiving services under
	219	+	41 a home and community based services waiver, including the
	220	+	42 development of an individual service plan that:
	221	+	2024 IN 1386—LS 7038/DI 147 5
	222	+	1 (A) addresses an individual's needs;
	223	+	2 (B) considers the individual's family resources and access
	224	+	3 to community and natural support; and
	225	+	4 (C) is consistent with the person centered care approach
	226	+	5 for receiving services under a waiver.
	227	+	6 (7) Monitor services provided by a provider that:
	228	+	7 (A) provides services to an individual using funds provided
	229	+	8 by the office of the secretary or under the authority of the
	230	+	9 office of the secretary; and
	231	+	10 (B) entered into one (1) or more provider agreements to
	232	+	11 provide services under a home and community based
	233	+	12 services waiver.
	234	+	13 (8) Establish and administer a complaint process for:
	235	+	14 (A) an individual receiving; or
	236	+	15 (B) a provider described in subdivision 7(B) providing;
	237	+	16 services under a home and community based services waiver.
	238	+	17 (c) The office of the secretary may do the following:
	239	+	18 (1) At the office's discretion, delegate any of its authority
	240	+	19 under this chapter to any division or office within the office of
	241	+	20 the secretary of family and social services.
	242	+	21 (2) Issue administrative orders under IC 4-21.5-3-6 regarding
	243	+	22 the provision of a home and community based services
	244	+	23 waiver.
	245	+	24 Sec. 5. (a) The office of the secretary shall establish:
	246	+	25 (1) eligibility criteria for an individual to receive; and
	247	+	26 (2) certification criteria for a provider of;
	248	+	27 services under a home and community based services waiver.
	249	+	28 (b) The eligibility criteria established under subsection (a) may
	250	+	29 vary based on the targeted need of each home and community
	251	+	30 based services waiver.
	252	+	31 (c) An individual who is determined by the office of the
	253	+	32 secretary to be ineligible for services under a home and community
	254	+	33 based services waiver may appeal the determination under
	255	+	34 IC 4-21.5.
	256	+	35 Sec. 6. The office of the secretary shall serve as the placement
	257	+	36 authority for individuals receiving services under a home and
	258	+	37 community based services waiver and an individual service plan.
	259	+	38 Sec. 7. Subject to the availability of applicable waiver slots and
	260	+	39 funding, the office of the secretary shall provide access to home
	261	+	40 and community based services that are appropriate and necessary
	262	+	41 for an individual determined to be eligible by the office of the
	263	+	42 secretary for services under a home and community based services
	264	+	2024 IN 1386—LS 7038/DI 147 6
	265	+	1 waiver.
	266	+	2 Sec. 8. A provider of services under a home and community
	267	+	3 based services waiver shall follow any waiver requirements under
	268	+	4 federal law and developed by the office of the secretary, including
	269	+	5 the planning process, service plan, and home and community based
	270	+	6 setting requirements set forth in 42 CFR 441.301.
	271	+	7 Sec. 9. A home and community based services waiver, including
	272	+	8 the delivery and receipt of services provided under the home and
	273	+	9 community based services waiver, must meet the following
	274	+	10 requirements:
	275	+	11 (1) Be provided under public supervision.
	276	+	12 (2) Be individualized and designed to meet the needs of
	277	+	13 individuals eligible to receive services under the home and
	278	+	14 community based services waiver.
	279	+	15 (3) Meet applicable state and federal standards.
	280	+	16 (4) Be provided by qualified personnel.
	281	+	17 (5) Be provided, to the extent appropriate, with services
	282	+	18 provided under the home and community based services
	283	+	19 waiver that are provided in a home and community based
	284	+	20 setting where nonwaiver individuals receive services.
	285	+	21 (6) Be provided in accordance with an individual's service
	286	+	22 plan.
	287	+	23 Sec. 10. (a) As used in this section, "office" includes the
	288	+	24 following:
	289	+	25 (1) The office of the secretary of family and social services.
	290	+	26 (2) A managed care organization that has contracted with the
	291	+	27 office of Medicaid policy and planning under IC 12-15.
	292	+	28 (3) A person that has contracted with a managed care
	293	+	29 organization described in subdivision (2).
	294	+	30 (b) Under a home and community based services waiver that
	295	+	31 provides services to an individual who is aged or disabled, the
	296	+	32 office shall reimburse for the following services provided to the
	297	+	33 individual by a provider of assisted living services, if determined
	298	+	34 to be medically necessary for the individual:
	299	+	35 (1) Assisted living services.
	300	+	36 (2) Integrated health care coordination.
	301	+	37 (3) Transportation.
	302	+	38 (c) If the office approves an increase in the level of services for
	303	+	39 a recipient of assisted living services, the office shall reimburse the
	304	+	40 provider of assisted living services for the level of services for the
	305	+	41 increase as of the date that the provider has documentation of
	306	+	42 providing the increase in the level of services.
	307	+	2024 IN 1386—LS 7038/DI 147 7
	308	+	1 (d) The office may reimburse for any home and community
	309	+	2 based services provided to a Medicaid recipient beginning on the
	310	+	3 date of the individual's Medicaid application.
	311	+	4 (e) The office may not do any of the following concerning
	312	+	5 assisted living services provided in a home and community based
	313	+	6 services program:
	314	+	7 (1) Require the installation of a sink in the kitchenette within
	315	+	8 any living unit of an entity that participated in the Medicaid
	316	+	9 home and community based services program before July 1,
	317	+	10 2018.
	318	+	11 (2) Require all living units within a setting that provides
	319	+	12 assisted living services to comply with physical plant
	320	+	13 requirements that are applicable to individual units occupied
	321	+	14 by a Medicaid recipient.
	322	+	15 (3) Require a provider to offer only private rooms.
	323	+	16 (4) Require a housing with services establishment provider to
	324	+	17 provide housing when:
	325	+	18 (A) the provider is unable to meet the health needs of a
	326	+	19 resident without:
	327	+	20 (i) undue financial or administrative burden; or
	328	+	21 (ii) fundamentally altering the nature of the provider's
	329	+	22 operations; and
	330	+	23 (B) the resident is unable to arrange for services to meet
	331	+	24 the resident's health needs.
	332	+	25 (5) Require a housing with services establishment provider to
	333	+	26 separate an agreement for housing from an agreement for
	334	+	27 services.
	335	+	28 (6) Prohibit a housing with services establishment provider
	336	+	29 from offering studio apartments with only a single sink in the
	337	+	30 unit.
	338	+	31 (7) Preclude the use of a shared bathroom between adjoining
	339	+	32 or shared units if the participants consent to the use of a
	340	+	33 shared bathroom.
	341	+	34 (8) Reduce the scope of services that may be provided by a
	342	+	35 provider of assisted living services under the aged and
	343	+	36 disabled Medicaid waiver in effect on July 1, 2021.
	344	+	37 (f) The office of the secretary may adopt rules under IC 4-22-2
	345	+	38 that establish the right, and an appeals process, for a resident to
	346	+	39 appeal a provider's determination that the provider is unable to
	347	+	40 meet the health needs of the resident as described in subsection
	348	+	41 (e)(4). The process:
	349	+	42 (1) must require an objective third party to review the
	350	+	2024 IN 1386—LS 7038/DI 147 8
	351	+	1 provider's determination in a timely manner; and
	352	+	2 (2) may not be required if the provider is licensed by the
	353	+	3 Indiana department of health and the licensure requirements
	354	+	4 include an appellate procedure for such a determination.
	355	+	5 Sec. 11. (a) The office of the secretary shall annually determine
	356	+	6 any state savings generated by home and community based services
	357	+	7 under this chapter by reducing the use of institutional care.
	358	+	8 (b) The office of the secretary shall annually report to the
	359	+	9 governor, the budget agency, the budget committee, the interim
	360	+	10 study committee on public health, behavioral health, and human
	361	+	11 services established by IC 2-5-1.3-4, and the executive director of
	362	+	12 the legislative services agency the savings determined under
	363	+	13 subsection (a). A report under this subsection to the executive
	364	+	14 director of the legislative services agency must be in an electronic
	365	+	15 format under IC 5-14-6.
	366	+	16 (c) Savings determined under subsection (a) may be used to fund
	367	+	17 the state's share of additional home and community based
	368	+	18 Medicaid waiver slots.
	369	+	19 Sec. 12. The office of the secretary may adopt rules under
	370	+	20 IC 4-22-2 to implement this chapter.
	371	+	21 SECTION 7. IC 12-8-1.7 IS ADDED TO THE INDIANA CODE
	372	+	22 AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
	373	+	23 JULY 1, 2024]:
	374	+	24 Chapter 1.7. Individuals in Need of Self-Directed In-Home Care
	375	+	25 Sec. 1. As used in this chapter, "attendant care services" means
	376	+	26 the basic and ancillary services that the individual chooses to direct
	377	+	27 and supervise a personal services attendant to perform and that
	378	+	28 enable an individual in need of self-directed in-home care to live in
	379	+	29 the individual's home and community rather than in an institution
	380	+	30 and to carry out functions of daily living, self-care, and mobility.
	381	+	31 Sec. 2. As used in this chapter, "individual in need of
	382	+	32 self-directed in-home care" means an individual with a disability,
	383	+	33 or person responsible for making health related decisions for the
	384	+	34 individual with a disability, who:
	385	+	35 (1) is approved to receive Medicaid waiver services under 42
	386	+	36 U.S.C. 1396n(c);
	387	+	37 (2) is in need of attendant care services because of
	388	+	38 impairment;
	389	+	39 (3) requires assistance to complete functions of daily living,
	390	+	40 self-care, and mobility, including those functions included in
	391	+	41 attendant care services;
	392	+	42 (4) chooses to self-direct a paid personal services attendant to
	393	+	2024 IN 1386—LS 7038/DI 147 9
	394	+	1 perform attendant care services; and
	395	+	2 (5) assumes the responsibility to initiate self-directed in-home
	396	+	3 care and exercise judgment regarding the manner in which
	397	+	4 those services are delivered, including the decision to employ,
	398	+	5 train, and dismiss a personal services attendant.
	399	+	6 Sec. 3. As used in this chapter, "personal services attendant"
	400	+	7 means an individual who is registered to provide attendant care
	401	+	8 services under this chapter and who has entered into a contract
	402	+	9 with an individual and acts under the individual's direction to
	403	+	10 provide attendant care services that could be performed by the
	404	+	11 individual if the individual were physically capable.
	405	+	12 Sec. 4. The office of the secretary shall have self-directed care
	406	+	13 options and services available for an eligible individual who:
	407	+	14 (1) receives services under a home and community based
	408	+	15 services waiver (as defined in IC 12-8-1.6-2); and
	409	+	16 (2) chooses self-directed care services.
	410	+	17 Sec. 5. (a) An individual may not provide attendant care services
	411	+	18 for compensation from Medicaid for an individual in need of
	412	+	19 self-directed in-home care services unless the individual is
	413	+	20 registered under this chapter.
	414	+	21 (b) Except in instances of extraordinary care, an individual who
	415	+	22 is a legally responsible relative of an individual in need of
	416	+	23 self-directed in-home care, including a parent of a minor individual
	417	+	24 and a spouse, is precluded from providing attendant care services
	418	+	25 for compensation under this chapter.
	419	+	26 Sec. 6. (a) The office of the secretary shall register an individual
	420	+	27 to provide services under this chapter who provides the following:
	421	+	28 (1) A personal resume containing information concerning the
	422	+	29 individual's qualifications, work experience, and any
	423	+	30 credentials the individual may hold. The individual must
	424	+	31 certify that the information contained in the resume is true
	425	+	32 and accurate.
	426	+	33 (2) The individual's:
	427	+	34 (A) limited criminal history check from the Indiana central
	428	+	35 repository for criminal history information under
	429	+	36 IC 10-13-3;
	430	+	37 (B) expanded criminal history check (as defined in
	431	+	38 IC 20-26-2-1.5); or
	432	+	39 (C) criminal history check from another source allowed by
	433	+	40 law.
	434	+	41 (3) If applicable, the individual's state nurse aide registry
	435	+	42 report from the Indiana department of health. This
	436	+	2024 IN 1386—LS 7038/DI 147 10
	437	+	1 subdivision does not require an individual to be a nurse aide.
	438	+	2 (4) Three (3) letters of reference.
	439	+	3 (5) A registration fee. The office of the secretary shall
	440	+	4 establish the amount of the registration fee.
	441	+	5 (6) Proof that the individual is at least eighteen (18) years of
	442	+	6 age.
	443	+	7 (7) Any other information required by the office of the
	444	+	8 secretary.
	445	+	9 (b) A registration is valid for two (2) years. A personal services
	446	+	10 attendant may renew the personal services attendant's registration
	447	+	11 by updating any information in the file that has changed and by
	448	+	12 paying the fee required under subsection (a)(5). The limited
	449	+	13 criminal history check and state nurse aid registry report required
	450	+	14 under subsection (a)(2) and (a)(3) must be updated every two (2)
	451	+	15 years.
	452	+	16 (c) The office of the secretary shall maintain a file for each
	453	+	17 personal services attendant that contains:
	454	+	18 (1) comments related to the provision of attendant care
	455	+	19 services submitted by an individual in need of self-directed
	456	+	20 in-home care who has employed the personal services
	457	+	21 attendant; and
	458	+	22 (2) the items described in subsection (a)(1) through (a)(4).
	459	+	23 (d) Upon request, the office of the secretary shall provide to an
	460	+	24 individual in need of self-directed in-home care the following:
	461	+	25 (1) Without charge, a list of personal services attendants who
	462	+	26 are registered with the office of the secretary and available
	463	+	27 within the requested geographic area.
	464	+	28 (2) A copy of the information of a specified personal services
	465	+	29 attendant who is on file with the office of the secretary under
	466	+	30 subsection (c). The office of the secretary may charge a fee for
	467	+	31 shipping, handling, and copying expenses.
	468	+	32 (e) The limited criminal history check requirement described in
	469	+	33 subsection (a)(2) may be satisfied by fulfilling the components of an
	470	+	34 expanded criminal history check under IC 20-26-2-1.5 and is
	471	+	35 subject to the conditions described in IC 16-27-2-4(c).
	472	+	36 Sec. 7. The case manager of an individual in need of
	473	+	37 self-directed in-home care shall maintain an attending physician's
	474	+	38 written opinion in a case file that is maintained for the individual
	475	+	39 by the case manager.
	476	+	40 Sec. 8. (a) A personal services attendant who is hired by the
	477	+	41 individual in need of self-directed in-home care is an employee of
	478	+	42 the individual in need of self-directed in-home care.
	479	+	2024 IN 1386—LS 7038/DI 147 11
	480	+	1 (b) The office of the secretary is not liable for any actions of a
	481	+	2 personal services attendant or an individual in need of self-directed
	482	+	3 in-home care.
	483	+	4 (c) A personal services attendant and an individual in need of
	484	+	5 self-directed in-home care are each liable for any negligent or
	485	+	6 wrongful act or omission in which the person personally
	486	+	7 participates.
	487	+	8 Sec. 9. (a) Except as provided in subsection (b), an individual in
	488	+	9 need of self-directed in-home care is responsible for recruiting,
	489	+	10 hiring, training, paying, certifying any employment related
	490	+	11 documents, dismissing, and supervising in the individual's home
	491	+	12 during service hours a personal services attendant who provides
	492	+	13 attendant care services for the individual.
	493	+	14 (b) If an individual in need of self-directed in-home care is:
	494	+	15 (1) less than twenty-one (21) years of age; or
	495	+	16 (2) unable to direct in-home care because of a brain injury or
	496	+	17 mental deficiency;
	497	+	18 the individual's parent, spouse, legal guardian, or a person
	498	+	19 possessing a valid power of attorney for the individual may make
	499	+	20 employment, care, and training decisions and certify any
	500	+	21 employment related documents on behalf of the individual.
	501	+	22 (c) An individual in need of self-directed in-home care or an
	502	+	23 individual under subsection (b) and the individual's case manager
	503	+	24 shall develop an authorized care plan. The authorized care plan
	504	+	25 must include a list of weekly services or tasks that must be
	505	+	26 performed to comply with the authorized care plan.
	506	+	27 Sec. 10. The individual in need of self-directed in-home care and
	507	+	28 the personal services attendant must each sign a contract, in a form
	508	+	29 approved by the office of the secretary, that includes, at a
	509	+	30 minimum, the following provisions:
	510	+	31 (1) The responsibilities of the personal services attendant.
	511	+	32 (2) The frequency the personal services attendant will provide
	512	+	33 attendant care services.
	513	+	34 (3) The duration of the contract.
	514	+	35 (4) The hourly wage of the personal services attendant. The
	515	+	36 wage may not be less than the federal minimum wage or more
	516	+	37 than the rate that the recipient is eligible to receive under a
	517	+	38 Medicaid home and community based services waiver.
	518	+	39 (5) Reasons and notice agreements for early termination of
	519	+	40 the contract.
	520	+	41 Sec. 11. (a) The office of the secretary shall amend the home and
	521	+	42 community based services waiver program under the Medicaid
	522	+	2024 IN 1386—LS 7038/DI 147 12
	523	+	1 state plan to provide for the payment for attendant care services
	524	+	2 provided by a personal services attendant for an individual in need
	525	+	3 of self-directed in-home care under this chapter, including any
	526	+	4 related record keeping and employment expenses.
	527	+	5 (b) The office of the secretary shall not, to the extent permitted
	528	+	6 by federal law, consider as income money paid under this chapter
	529	+	7 to or on behalf of an individual in need of self-directed in-home
	530	+	8 care to enable the individual to employ registered personal services
	531	+	9 attendants for purposes of determining the individual's income
	532	+	10 eligibility for services under this chapter or IC 12-8-1.6.
	533	+	11 Sec. 12. The office of the secretary shall adopt rules under
	534	+	12 IC 4-22-2 concerning the following:
	535	+	13 (1) The method of payment to a personal services attendant
	536	+	14 who provides authorized services under this chapter.
	537	+	15 (2) Record keeping requirements for personal attendant
	538	+	16 services.
	539	+	17 (3) The receipt, review, and investigation of complaints
	540	+	18 concerning the:
	541	+	19 (A) neglect;
	542	+	20 (B) abuse;
	543	+	21 (C) mistreatment; or
	544	+	22 (D) misappropriation of property;
	545	+	23 of an individual in need of self-directed in-home care by a
	546	+	24 personal services attendant.
	547	+	25 (4) Establishing notice and administrative hearing procedures
	548	+	26 in accordance with IC 4-21.5.
	549	+	27 (5) Appeal procedures, including judicial review of
	550	+	28 administrative hearings.
	551	+	29 (6) Procedures to place a personal services attendant who has
	552	+	30 been determined to have been guilty of:
	553	+	31 (A) neglect;
	554	+	32 (B) abuse;
	555	+	33 (C) mistreatment; or
	556	+	34 (D) misappropriation of property;
	557	+	35 of an individual in need of self-directed in-home care on the
	558	+	36 state nurse aide registry.
	559	+	37 (7) Any rules necessary to implement this chapter.
	560	+	38 SECTION 8. IC 12-9.1-4-1, AS ADDED BY P.L.141-2006,
	561	+	39 SECTION 38, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
	562	+	40 JULY 1, 2024]: Sec. 1. The division shall administer money
	563	+	41 appropriated or allocated to the division by the state, including money
	564	+	42 appropriated or allocated from the following:
	565	+	2024 IN 1386—LS 7038/DI 147 13
	566	+	1 (1) The federal Older Americans Act (42 U.S.C. 3001 et seq.).
	567	+	2 (2) The United States Department of Agriculture (7 U.S.C. 612C
	568	+	3 et seq.).
	569	+	4 (3) Medicaid waiver in-home services for the elderly and disabled
	570	+	5 (42 U.S.C. 1396 et seq.) for treatment of medical conditions.
	571	+	6 (4) (3) Money appropriated or allocated to the division to
	572	+	7 administer a program under this title.
	573	+	8 (5) (4) Other funding sources that are designated by the general
	574	+	9 assembly or available from the federal government under grants
	575	+	10 that are consistent with the duties of the division.
	576	+	11 SECTION 9. IC 12-9.1-4-2, AS ADDED BY P.L.141-2006,
	577	+	12 SECTION 38, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
	578	+	13 JULY 1, 2024]: Sec. 2. The division shall administer the following
	579	+	14 programs:
	580	+	15 (1) Programs established under any of the following statutes:
	581	+	16 (A) This article.
	582	+	17 (B) IC 12-10.
	583	+	18 (2) Programs under IC 12-30, to the extent the division has
	584	+	19 responsibilities for programs under IC 12-30.
	585	+	20 (3) Medicaid waivers for in-home services for treatment of
	586	+	21 medical conditions.
	587	+	22 SECTION 10. IC 12-9.1-4-3 IS REPEALED [EFFECTIVE JULY
	588	+	23 1, 2024]. Sec. 3. Notwithstanding any other law:
	589	+	24 (1) home health agencies licensed under IC 16-27-1 are approved
	590	+	25 to provide home health services; and
	591	+	26 (2) personal services agencies licensed under IC 16-27-4 are
	592	+	27 approved to provide personal services;
	593	+	28 under any federal waiver granted to the state under 42 U.S.C. 1315 or
	594	+	29 42 U.S.C. 1396n that provides services for treatment of medical
	595	+	30 conditions.
	596	+	31 SECTION 11. IC 12-10-11.5-6 IS REPEALED [EFFECTIVE JULY
	597	+	32 1, 2024]. Sec. 6. (a) The office of the secretary of family and social
	598	+	33 services shall annually determine any state savings generated by home
	599	+	34 and community based services under this chapter by reducing the use
	600	+	35 of institutional care.
	601	+	36 (b) The secretary shall annually report to the governor, the budget
	602	+	37 agency, the budget committee, the interim study committee on public
	603	+	38 health, behavioral health, and human services established by
	604	+	39 IC 2-5-1.3-4, and the executive director of the legislative services
	605	+	40 agency the savings determined under subsection (a). A report under
	606	+	41 this subsection to the executive director of the legislative services
	607	+	42 agency must be in an electronic format under IC 5-14-6.
	608	+	2024 IN 1386—LS 7038/DI 147 14
	609	+	1 (c) Savings determined under subsection (a) may be used to fund the
	610	+	2 state's share of additional home and community based Medicaid waiver
	611	+	3 slots.
	612	+	4 SECTION 12. IC 12-10-11.5-8 IS REPEALED [EFFECTIVE JULY
	613	+	5 1, 2024]. Sec. 8. (a) As used in this chapter, "assisted living services"
	614	+	6 refers to services covered under a waiver and provided in any of the
	615	+	7 following entities:
	616	+	8 (1) A residential care facility licensed under IC 16-28.
	617	+	9 (2) Any other housing with services establishment.
	618	+	10 (b) As used in this section, "level of services" means a
	619	+	11 determination of the type of services an individual may receive under
	620	+	12 a Medicaid waiver based on the individual's impairment and
	621	+	13 dependence and the corresponding reimbursement rate for the
	622	+	14 determined level of care.
	623	+	15 (c) As used in this section, "office" includes the following:
	624	+	16 (1) The office of the secretary of family and social services.
	625	+	17 (2) A managed care organization that has contracted with the
	626	+	18 office of Medicaid policy and planning under IC 12-15.
	627	+	19 (3) A person that has contracted with a managed care organization
	628	+	20 described in subdivision (2).
	629	+	21 (d) Under a Medicaid waiver that provides services to an individual
	630	+	22 who is aged or disabled, the office shall reimburse for the following
	631	+	23 services provided to the individual by a provider of assisted living
	632	+	24 services:
	633	+	25 (1) Assisted living services.
	634	+	26 (2) Integrated health care coordination.
	635	+	27 (3) Transportation.
	636	+	28 (e) If the office approves an increase in the level of services for a
	637	+	29 recipient of assisted living services, the office shall reimburse the
	638	+	30 provider of assisted living services for the level of services for the
	639	+	31 increase as of the date that the provider has documentation of providing
	640	+	32 the increase in the level of services.
	641	+	33 (f) The office may reimburse for any home and community based
	642	+	34 services provided to a Medicaid recipient beginning on the date of the
	643	+	35 individual's Medicaid application.
	644	+	36 (g) The office may not do any of the following concerning assisted
	645	+	37 living services provided in a home and community based services
	646	+	38 program:
	647	+	39 (1) Require the installation of a sink in the kitchenette within any
	648	+	40 living unit of an entity that participated in the Medicaid home and
	649	+	41 community based service program before July 1, 2018.
	650	+	42 (2) Require all living units within a setting that provides assisted
	651	+	2024 IN 1386—LS 7038/DI 147 15
	652	+	1 living services to comply with physical plant requirements that
	653	+	2 are applicable to individual units occupied by a Medicaid
	654	+	3 recipient.
	655	+	4 (3) Require a provider to offer only private rooms.
	656	+	5 (4) Require a housing with services establishment provider to
	657	+	6 provide housing when:
	658	+	7 (A) the provider is unable to meet the health needs of a
	659	+	8 resident without:
	660	+	9 (i) undue financial or administrative burden; or
	661	+	10 (ii) fundamentally altering the nature of the provider's
	662	+	11 operations; and
	663	+	12 (B) the resident is unable to arrange for services to meet the
	664	+	13 resident's health needs.
	665	+	14 (5) Require a housing with services establishment provider to
	666	+	15 separate an agreement for housing from an agreement for
	667	+	16 services.
	668	+	17 (6) Prohibit a housing with services establishment provider from
	669	+	18 offering studio apartments with only a single sink in the unit.
	670	+	19 (7) Preclude the use of a shared bathroom between adjoining or
	671	+	20 shared units if the participants consent to the use of a shared
	672	+	21 bathroom.
	673	+	22 (8) Reduce the scope of services that may be provided by a
	674	+	23 provider of assisted living services under the aged and disabled
	675	+	24 Medicaid waiver in effect on July 1, 2021.
	676	+	25 (h) The division may adopt rules under IC 4-22-2 that establish the
	677	+	26 right, and an appeals process, for a resident to appeal a provider's
	678	+	27 determination that the provider is unable to meet the health needs of
	679	+	28 the resident as described in subsection (g)(4). The process:
	680	+	29 (1) must require an objective third party to review the provider's
	681	+	30 determination in a timely manner; and
	682	+	31 (2) may not be required if the provider is licensed by the Indiana
	683	+	32 department of health and the licensure requirements include an
	684	+	33 appellate procedure for such a determination.
	685	+	34 SECTION 13. IC 12-10-17.1-6, AS AMENDED BY P.L.99-2007,
	686	+	35 SECTION 68, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
	687	+	36 JULY 1, 2024]: Sec. 6. As used in this chapter, "individual in need of
	688	+	37 self-directed in-home care" means an individual with a disability, or
	689	+	38 person responsible for making health related decisions for the
	690	+	39 individual with a disability, who:
	691	+	40 (1) is approved to receive Medicaid waiver services under 42
	692	+	41 U.S.C. 1396n(c), or is a participant in the community and home
	693	+	42 options to institutional care for the elderly and disabled program
	694	+	2024 IN 1386—LS 7038/DI 147 16
	695	+	1 under IC 12-10-10;
	696	+	2 (2) is in need of attendant care services because of impairment;
	697	+	3 (3) requires assistance to complete functions of daily living,
	698	+	4 self-care, and mobility, including those functions included in
	699	+	5 attendant care services;
	700	+	6 (4) chooses to self-direct a paid personal services attendant to
	701	+	7 perform attendant care services; and
	702	+	8 (5) assumes the responsibility to initiate self-directed in-home
	703	+	9 care and exercise judgment regarding the manner in which those
	704	+	10 services are delivered, including the decision to employ, train, and
	705	+	11 dismiss a personal services attendant.
	706	+	12 SECTION 14. IC 12-10-17.1-10, AS ADDED BY P.L.141-2006,
	707	+	13 SECTION 44, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
	708	+	14 JULY 1, 2024]: Sec. 10. (a) An individual may not provide attendant
	709	+	15 care services for compensation from Medicaid or the community and
	710	+	16 home options to institutional care for the elderly and disabled program
	711	+	17 for an individual in need of self-directed in-home care services unless
	712	+	18 the individual is registered under section 12 of this chapter.
	713	+	19 (b) An individual who is a legally responsible relative of an
	714	+	20 individual in need of self-directed in-home care, including a parent of
	715	+	21 a minor individual and a spouse, is precluded from providing attendant
	716	+	22 care services for compensation under this chapter.
	717	+	23 SECTION 15. IC 12-10-17.1-17, AS ADDED BY P.L.141-2006,
	718	+	24 SECTION 44, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
	719	+	25 JULY 1, 2024]: Sec. 17. The individual in need of self-directed
	720	+	26 in-home care and the personal services attendant must each sign a
	721	+	27 contract, in a form approved by the division, that includes, at a
	722	+	28 minimum, the following provisions:
	723	+	29 (1) The responsibilities of the personal services attendant.
	724	+	30 (2) The frequency the personal services attendant will provide
	725	+	31 attendant care services.
	726	+	32 (3) The duration of the contract.
	727	+	33 (4) The hourly wage of the personal services attendant. The wage
	728	+	34 may not be less than the federal minimum wage or more than the
	729	+	35 rate that the recipient is eligible to receive under a Medicaid
	730	+	36 home and community based services waiver or the community
	731	+	37 and home options to institutional care for the elderly and disabled
	732	+	38 program for attendant care services.
	733	+	39 (5) Reasons and notice agreements for early termination of the
	734	+	40 contract.
	735	+	41 SECTION 16. IC 12-10-17.1-18, AS ADDED BY P.L.141-2006,
	736	+	42 SECTION 44, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
	737	+	2024 IN 1386—LS 7038/DI 147 17
	738	+	1 JULY 1, 2024]: Sec. 18. (a) The office shall amend the home and
	739	+	2 community based services waiver program under the state Medicaid
	740	+	3 plan to provide for the payment for attendant care services provided by
	741	+	4 a personal services attendant for an individual in need of self-directed
	742	+	5 in-home care under this chapter, including any related record keeping
	743	+	6 and employment expenses.
	744	+	7 (b) The office shall not, to the extent permitted by federal law,
	745	+	8 consider as income money paid under this chapter to or on behalf of an
	746	+	9 individual in need of self-directed in-home care to enable the
	747	+	10 individual to employ registered personal services attendants, for
	748	+	11 purposes of determining the individual's income eligibility for services
	749	+	12 under this chapter.
	750	+	13 SECTION 17. IC 12-10-17.1-20, AS ADDED BY P.L.141-2006,
850	751		14 SECTION 44, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
851		-	15 JULY 1, 2024]: Sec. 18. (a) The office shall amend the home and
852		-	16 community based services waiver program under the state Medicaid
853		-	17 plan to provide for the payment for attendant care services provided by
854		-	18 a personal services attendant for an individual in need of self-directed
855		-	19 in-home care under this chapter, including any related record keeping
856		-	20 and employment expenses.
857		-	21 (b) The office shall not, to the extent permitted by federal law,
858		-	22 consider as income money paid under this chapter to or on behalf of an
859		-	23 individual in need of self-directed in-home care to enable the
860		-	24 individual to employ registered personal services attendants, for
861		-	25 purposes of determining the individual's income eligibility for services
862		-	26 under this chapter.
863		-	27 SECTION 20. IC 12-10-17.1-20, AS ADDED BY P.L.141-2006,
864		-	28 SECTION 44, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
865		-	29 JULY 1, 2024]: Sec. 20. (a) The division and office may adopt rules
866		-	30 under IC 4-22-2 that are necessary to implement this chapter.
867		-	31 (b) The office shall apply for any federal waivers necessary to
868		-	32 implement this chapter.
869		-	33 SECTION 21. IC 12-10-19 IS REPEALED [EFFECTIVE JULY 1,
870		-	34 2024]. (Home and Community Based Services).
871		-	35 SECTION 22. IC 12-11-13-1 IS AMENDED TO READ AS
872		-	36 FOLLOWS [EFFECTIVE JULY 1, 2024]: Sec. 1. (a) Except as
873		-	37 provided in subsection (b), this chapter applies only to an individual
874		-	38 who:
875		-	39 (1) has a developmental disability; and
876		-	40 (2) receives services under a waiver under the federal home and
877		-	41 community based services program. administered by the
878		-	42 bureau.
879		-	HB 1386—LS 7038/DI 147 20
880		-	1 (b) This chapter does not apply to an individual served by the
881		-	2 long term care ombudsman program established under
882		-	3 IC 12-10-13.
883		-	4 SECTION 23. IC 12-11-13-2 IS AMENDED TO READ AS
884		-	5 FOLLOWS [EFFECTIVE JULY 1, 2024]: Sec. 2. As used in this
885		-	6 chapter, "ombudsman" refers to the statewide waiver bureau of
886		-	7 disabilities services ombudsman established by section 3 of this
887		-	8 chapter. The term includes individuals approved to act in the capacity
888		-	9 of ombudsmen by the statewide waiver bureau of disabilities services
889		-	10 ombudsman.
890		-	11 SECTION 24. IC 12-11-13-3 IS AMENDED TO READ AS
891		-	12 FOLLOWS [EFFECTIVE JULY 1, 2024]: Sec. 3. The statewide waiver
892		-	13 bureau of disabilities services ombudsman position is established
893		-	14 within the division.
894		-	15 SECTION 25. IC 12-11-13-7 IS AMENDED TO READ AS
895		-	16 FOLLOWS [EFFECTIVE JULY 1, 2024]: Sec. 7. (a) An ombudsman
896		-	17 must be provided access to the following:
897		-	18 (1) An individual described in section 1 of this chapter.
898		-	19 (2) An entity that provides waiver services to an individual
899		-	20 described in section 1 of this chapter.
900		-	21 (3) Records of an individual described in section 1 of this chapter,
901		-	22 including records held by an entity that provides services to the
902		-	23 individual.
903		-	24 (4) If an individual described in section 1 of this chapter is
904		-	25 incapable of giving consent, as determined by the attending
905		-	26 physician or as otherwise determined under state law, the name,
906		-	27 address, and telephone number of the individual's legal
907		-	28 representative.
908		-	29 Except as provided in subsections (c) and (d), the ombudsman must
909		-	30 obtain consent under subsection (b) before having access to the records
910		-	31 described in subdivision (3).
911		-	32 (b) Consent to have access to an individual's records shall be given
912		-	33 in one (1) of the following forms:
913		-	34 (1) In writing by the individual.
914		-	35 (2) Orally by the individual in the presence of a witness.
915		-	36 (3) In writing by the legal representative of the individual if:
916		-	37 (A) the individual is incapable of giving consent, as
917		-	38 determined by the attending physician or as otherwise
918		-	39 determined under state law; and
919		-	40 (B) the legal representative has the authority to give consent.
920		-	41 (c) If consent to have access to an individual's records cannot be
921		-	42 obtained under subsection (b), an ombudsman may inspect the records
922		-	HB 1386—LS 7038/DI 147 21
923		-	1 of the individual if the individual is incapable of giving consent, as
924		-	2 determined by the attending physician or as otherwise determined
925		-	3 under state law, and:
926		-	4 (1) has no legal representative;
927		-	5 (2) has a legal representative but the legal representative cannot
928		-	6 be contacted within three (3) days; or
929		-	7 (3) has a legal representative but the legal representative does not
930		-	8 have the authority to give consent to have access to the records.
931		-	9 (d) If an ombudsman has:
932		-	10 (1) been denied access to an individual's records by the
933		-	11 individual's legal representative;
934		-	12 (2) reasonable cause to believe that the individual's legal
935		-	13 representative is not acting in the best interests of the individual;
936		-	14 and
937		-	15 (3) received written approval from the state ombudsman;
938		-	16 the ombudsman may inspect the records of the individual.
939		-	17 SECTION 26. IC 12-11-13-8 IS AMENDED TO READ AS
940		-	18 FOLLOWS [EFFECTIVE JULY 1, 2024]: Sec. 8. A provider of waiver
941		-	19 services or an employee of a provider of waiver services is immune
942		-	20 from:
943		-	21 (1) civil or criminal liability; and
944		-	22 (2) actions taken under a professional disciplinary procedure;
945		-	23 for the release or disclosure of records to the ombudsman under this
946		-	24 chapter.
947		-	25 SECTION 27. IC 12-11-13-10, AS AMENDED BY P.L.99-2007,
948		-	26 SECTION 86, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
949		-	27 JULY 1, 2024]: Sec. 10. The ombudsman shall do the following:
950		-	28 (1) Promote effective coordination among the following:
951		-	29 (A) Programs that provide legal services for individuals with
952		-	30 a developmental disability.
953		-	31 (B) The division.
954		-	32 (C) Providers of waiver services to individuals with
955		-	33 developmental disabilities.
956		-	34 (D) Providers of other necessary or appropriate services.
957		-	35 (2) Ensure that the identity of an individual described in section
958		-	36 1 of this chapter will not be disclosed without:
959		-	37 (A) the individual's written consent; or
960		-	38 (B) a court order.
961		-	39 SECTION 28. IC 12-11-13-15 IS AMENDED TO READ AS
962		-	40 FOLLOWS [EFFECTIVE JULY 1, 2024]: Sec. 15. The division shall:
963		-	41 (1) establish a statewide toll free telephone line continuously open
964		-	42 to receive complaints regarding individuals described in section
965		-	HB 1386—LS 7038/DI 147 22
966		-	1 1 of this chapter; and
967		-	2 (2) forward all complaints received from the toll free telephone
968		-	3 line to the statewide waiver ombudsman.
969		-	4 SECTION 29. IC 12-15-1-20.4, AS AMENDED BY P.L.57-2021,
970		-	5 SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
971		-	6 JULY 1, 2024]: Sec. 20.4. (a) If a Medicaid recipient is:
972		-	7 (1) adjudicated to be a delinquent child and placed in:
973		-	8 (A) a community based correctional facility for children;
974		-	9 (B) a juvenile detention facility; or
975		-	10 (C) a secure facility, not including a facility licensed as a child
976		-	11 caring institution under IC 31-27; or
977		-	12 (2) incarcerated in a prison or jail; and
978		-	13 ineligible to participate in the Medicaid program during the placement
979		-	14 described in subdivision (1) or (2) because of federal Medicaid law, the
980		-	15 division of family resources, upon notice that a child has been
981		-	16 adjudicated to be a delinquent child and placed in a facility described
982		-	17 in subdivision (1) or upon notice that a person is incarcerated in a
983		-	18 prison or jail and placed in a facility described in subdivision (2), shall
984		-	19 suspend the person's participation in the Medicaid program.
985		-	20 (b) If the division of family resources receives:
986		-	21 (1) a dispositional decree under IC 31-37-19-28; or
987		-	22 (2) a modified disposition order under IC 31-37-22-9;
988		-	23 and the department of correction gives the division at least forty (40)
989		-	24 days notice that a person will be released from a facility described in
990		-	25 subsection (a)(1)(C) or (a)(2), the division of family resources shall
991		-	26 take action necessary to ensure that a person described in subsection
992		-	27 (a) is eligible to participate in the Medicaid program upon the person's
993		-	28 release, if the person is eligible to participate.
994		-	29 (c) A facility described in subsection (a)(1) shall provide the
995		-	30 division of family resources:
996		-	31 (1) at least forty-five (45) days notice; or
997		-	32 (2) under extenuating circumstances approved by the division,
998		-	33 notice as soon as possible;
999		-	34 that a delinquent child will be released from the facility. The
1000		-	35 division of family services shall take action necessary to ensure that
1001		-	36 the delinquent child, if eligible, participates in the Medicaid
1002		-	37 program upon the child's release and receives services required
1003		-	38 under federal law thirty (30) days before the child's release and
1004		-	39 thirty (30) days after the child's release.
1005		-	40 SECTION 30. IC 12-15-29-4.5, AS AMENDED BY P.L.265-2019,
1006		-	41 SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
1007		-	42 JULY 1, 2024]: Sec. 4.5. (a) An insurer shall accept a Medicaid claim
1008		-	HB 1386—LS 7038/DI 147 23
1009		-	1 for a Medicaid recipient for three (3) years from the date the service
1010		-	2 was provided.
1011		-	3 (b) An insurer may not deny a Medicaid claim submitted by the
1012		-	4 office solely on the basis of:
1013		-	5 (1) the date of submission of the claim;
1014		-	6 (2) the type or format of the claim form;
1015		-	7 (3) the method of submission of the claim; or
1016		-	8 (4) a failure to provide proper documentation at the point of sale
1017		-	9 that is the basis of the claim;
1018		-	10 if the claim is submitted by the office within three (3) years from the
1019		-	11 date the service was provided as required in subsection (a) and the
1020		-	12 office commences action to enforce the office's rights regarding the
1021		-	13 claim within six (6) years of the office's submission of the claim.
1022		-	14 (c) This subsection does not apply to coverage under the
1023		-	15 Medicare program, Medicare Advantage, or Medicare Part D. An
1024		-	16 insurer may not deny a Medicaid claim submitted by the office solely
1025		-	17 due to a lack of prior authorization in accordance with 42 U.S.C.
1026		-	18 1396a(a)(25). An insurer shall:
1027		-	19 (1) after December 31, 2020, meet the requirements set forth in
1028		-	20 IC 27-1-37.5;
1029		-	21 (2) conduct the prior authorization on a retrospective basis for
1030		-	22 claims where prior authorization is necessary; and
1031		-	23 (3) adjudicate any claim authorized in this manner as if the claim
1032		-	24 received prior authorization; and
1033		-	25 (4) respond to a state inquiry regarding a claim under
1034		-	26 subsection (a) not later than sixty (60) days after receiving the
1035		-	27 inquiry.
1036		-	28 SECTION 31. IC 12-15-29-9, AS AMENDED BY P.L.187-2007,
1037		-	29 SECTION 7, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
1038		-	30 JULY 1, 2024]: Sec. 9. (a) IC 27-8-23 applies to this section.
1039		-	31 (b) To the extent that payment for covered medical expenses has
1040		-	32 been made under the state Medicaid program for health care items or
1041		-	33 services furnished to a person, in a case where a third party has a legal
1042		-	34 liability to make payments, the state is considered to have acquired the
1043		-	35 rights of the person to payment by any other party for the accumulated
1044		-	36 and future health care items or services.
1045		-	37 (c) As required under 42 U.S.C. 1396a(a)(25), an insurer shall
1046		-	38 accept the state's right of recovery and the assignment to the state of
1047		-	39 any right of the individual or entity to payment for a health care item
1048		-	40 or service for which payment has been made under the state Medicaid
1049		-	41 plan.
1050		-	42 SECTION 32. IC 16-39-2-6, AS AMENDED BY P.L.137-2021,
1051		-	HB 1386—LS 7038/DI 147 24
1052		-	1 SECTION 27, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
1053		-	2 JULY 1, 2024]: Sec. 6. (a) Without the consent of the patient, the
1054		-	3 patient's mental health record may only be disclosed as follows:
1055		-	4 (1) To individuals who meet the following conditions:
1056		-	5 (A) Are employed by:
1057		-	6 (i) the provider at the same facility or agency;
1058		-	7 (ii) a managed care provider (as defined in IC 12-7-2-127);
1059		-	8 or
1060		-	9 (iii) a health care provider or mental health care provider, if
1061		-	10 the mental health records are needed to provide health care
1062		-	11 or mental health services to the patient.
1063		-	12 (B) Are involved in the planning, provision, and monitoring of
1064		-	13 services.
1065		-	14 (2) To the extent necessary to obtain payment for services
1066		-	15 rendered or other benefits to which the patient may be entitled, as
1067		-	16 provided in IC 16-39-5-3.
1068		-	17 (3) To the patient's court appointed counsel and to the Indiana
1069		-	18 protection and advocacy services commission.
1070		-	19 (4) For research conducted in accordance with IC 16-39-5-3 and
1071		-	20 the rules of the division of mental health and addiction, the rules
1072		-	21 of the division of disability and rehabilitative services, the rules
1073		-	22 of the provider, or the rules of the Indiana archives and records
1074		-	23 administration and the oversight committee on public records.
1075		-	24 (5) To the division of mental health and addiction for the purpose
1076		-	25 of data collection, research, and monitoring managed care
1077		-	26 providers (as defined in IC 12-7-2-127) who are operating under
1078		-	27 a contract with the division of mental health and addiction.
1079		-	28 (6) To the extent necessary to make reports or give testimony
1080		-	29 required by the statutes pertaining to admissions, transfers,
1081		-	30 discharges, and guardianship proceedings.
1082		-	31 (7) To a law enforcement agency if any of the following
1083		-	32 conditions are met:
1084		-	33 (A) A patient escapes from a facility to which the patient is
1085		-	34 committed under IC 12-26.
1086		-	35 (B) The superintendent of the facility determines that failure
1087		-	36 to provide the information may result in bodily harm to the
1088		-	37 patient or another individual.
1089		-	38 (C) A patient commits or threatens to commit a crime on
1090		-	39 facility premises or against facility personnel.
1091		-	40 (D) A patient is in the custody of a law enforcement officer or
1092		-	41 agency for any reason and:
1093		-	42 (i) the information to be released is limited to medications
1094		-	HB 1386—LS 7038/DI 147 25
1095		-	1 currently prescribed for the patient or to the patient's history
1096		-	2 of adverse medication reactions; and
1097		-	3 (ii) the provider determines that the release of the
1098		-	4 medication information will assist in protecting the health,
1099		-	5 safety, or welfare of the patient.
1100		-	6 Mental health records released under this clause must be
1101		-	7 maintained in confidence by the law enforcement agency
1102		-	8 receiving them.
1103		-	9 (8) To a coroner or medical examiner, in the performance of the
1104		-	10 individual's duties.
1105		-	11 (9) To a school in which the patient is enrolled if the
1106		-	12 superintendent of the facility determines that the information will
1107		-	13 assist the school in meeting educational needs of the patient.
1108		-	14 (10) To the extent necessary to satisfy reporting requirements
1109		-	15 under the following statutes:
1110		-	16 (A) IC 12-10-3-10.
1111		-	17 (B) IC 12-24-17-5.
1112		-	18 (C) IC 16-41-2-3.
1113		-	19 (D) IC 16-50-1-8.
1114		-	20 (E) IC 31-25-3-2.
1115		-	21 (F) IC 31-33-5-4.
1116		-	22 (G) IC 34-30-16-2.
1117		-	23 (H) IC 35-46-1-13.
1118		-	24 (11) To the extent necessary to satisfy release of information
1119		-	25 requirements under the following statutes:
1120		-	26 (A) IC 12-24-11-2.
1121		-	27 (B) IC 12-24-12-3, IC 12-24-12-4, and IC 12-24-12-6.
1122		-	28 (C) IC 12-26-11.
1123		-	29 (12) To another health care provider in a health care emergency.
1124		-	30 (13) For legitimate business purposes as described in
1125		-	31 IC 16-39-5-3.
1126		-	32 (14) Under a court order under IC 16-39-3.
1127		-	33 (15) With respect to records from a mental health or
1128		-	34 developmental disability facility, to the United States Secret
1129		-	35 Service if the following conditions are met:
1130		-	36 (A) The request does not apply to alcohol or drug abuse
1131		-	37 records described in 42 U.S.C. 290dd-2 unless authorized by
1132		-	38 a court order under 42 U.S.C. 290dd-2(b)(2)(c).
1133		-	39 (B) The request relates to the United States Secret Service's
1134		-	40 protective responsibility and investigative authority under 18
1135		-	41 U.S.C. 3056, 18 U.S.C. 871, or 18 U.S.C. 879.
1136		-	42 (C) The request specifies an individual patient.
1137		-	HB 1386—LS 7038/DI 147 26
1138		-	1 (D) The director or superintendent of the facility determines
1139		-	2 that disclosure of the mental health record may be necessary
1140		-	3 to protect a person under the protection of the United States
1141		-	4 Secret Service from serious bodily injury or death.
1142		-	5 (E) The United States Secret Service agrees to only use the
1143		-	6 mental health record information for investigative purposes
1144		-	7 and not disclose the information publicly.
1145		-	8 (F) The mental health record information disclosed to the
1146		-	9 United States Secret Service includes only:
1147		-	10 (i) the patient's name, age, and address;
1148		-	11 (ii) the date of the patient's admission to or discharge from
1149		-	12 the facility; and
1150		-	13 (iii) any information that indicates whether or not the patient
1151		-	14 has a history of violence or presents a danger to the person
1152		-	15 under protection.
1153		-	16 (16) To the statewide waiver bureau of disabilities services
1154		-	17 ombudsman established under IC 12-11-13, in the performance
1155		-	18 of the ombudsman's duties.
1156		-	19 (b) If a licensed mental health professional, a licensed paramedic,
1157		-	20 a representative of a mobile integrated healthcare program (as
1158		-	21 described in IC 16-31-12), or a representative of a mental health
1159		-	22 community paramedicine program in the course of rendering a
1160		-	23 treatment intervention, determines that a patient may be a harm to
1161		-	24 himself or herself or others, the licensed mental health professional, the
1162		-	25 licensed paramedic, the representative of the mobile integrated
1163		-	26 healthcare program (as described in IC 16-31-12), or the representative
1164		-	27 of the mental health community paramedicine program may request a
1165		-	28 patient's individualized mental health safety plan from a psychiatric
1166		-	29 crisis center, psychiatric inpatient unit, or psychiatric residential
1167		-	30 treatment provider. Each psychiatric crisis center, psychiatric inpatient
1168		-	31 unit, and psychiatric residential treatment provider shall, upon request
1169		-	32 and without the consent of the patient, share a patient's individualized
1170		-	33 mental health safety plan that is in the standard format established by
1171		-	34 the division of mental health and addiction under IC 12-21-5-6 with the
1172		-	35 following individuals who demonstrate proof of licensure and commit
1173		-	36 to protecting the information in compliance with state and federal
1174		-	37 privacy laws:
1175		-	38 (1) A licensed mental health professional.
1176		-	39 (2) A licensed paramedic.
1177		-	40 (3) A representative of a mobile integrated healthcare program (as
1178		-	41 described in IC 16-31-12).
1179		-	42 (4) A representative of a mental health community paramedicine
1180		-	HB 1386—LS 7038/DI 147 27
1181		-	1 program.
1182		-	2 An individualized mental health safety plan disclosed under this
1183		-	3 subsection may be used only to support a patient's welfare and safety
1184		-	4 and is considered otherwise confidential information under applicable
1185		-	5 state and federal laws.
1186		-	6 (c) After information is disclosed under subsection (a)(15) and if the
1187		-	7 patient is evaluated to be dangerous, the records shall be interpreted in
1188		-	8 consultation with a licensed mental health professional on the staff of
1189		-	9 the United States Secret Service.
1190		-	10 (d) A person who discloses information under subsection (a)(7),
1191		-	11 (a)(15), or (b) in good faith is immune from civil and criminal liability.
1192		-	12 SECTION 33. IC 31-37-19-29 IS ADDED TO THE INDIANA
1193		-	13 CODE AS A NEW SECTION TO READ AS FOLLOWS
1194		-	14 [EFFECTIVE JULY 1, 2024]: Sec. 29. (a) As used in this section,
1195		-	15 "facility" means the following:
1196		-	16 (1) A community based correctional facility for children.
1197		-	17 (2) A juvenile detention facility.
1198		-	18 (3) A secure facility, not including a facility licensed as a child
1199		-	19 caring institution under IC 31-27.
1200		-	20 (b) A facility shall provide the division of family resources:
1201		-	21 (1) at least forty-five (45) days notice; or
1202		-	22 (2) under extenuating circumstances approved by the division,
1203		-	23 notice as soon as possible;
1204		-	24 that a delinquent child will be released from the facility. The
1205		-	25 division of family services shall take action necessary to ensure that
1206		-	26 the delinquent child, if eligible, participates in the Medicaid
1207		-	27 program upon the child's release and receives services required
1208		-	28 under federal law thirty (30) days before the child's release and
1209		-	29 thirty (30) days after the child's release.
1210		-	30 SECTION 34. IC 34-30-2.1-129.4 IS ADDED TO THE INDIANA
1211		-	31 CODE AS A NEW SECTION TO READ AS FOLLOWS
1212		-	32 [EFFECTIVE JULY 1, 2024]: Sec. 129.4. IC 12-8-1.7-8(b)
1213		-	33 (Concerning actions of a personal services attendant).
1214		-	34 SECTION 35. IC 34-30-2.1-137, AS ADDED BY P.L.105-2022,
1215		-	35 SECTION 12, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
1216		-	36 JULY 1, 2024]: Sec. 137. IC 12-11-13-8 (Concerning disclosure of
1217		-	37 records to the statewide waiver bureau of disabilities services
1218		-	38 ombudsman by providers of waiver services and employees of
1219		-	39 providers).
1220		-	40 SECTION 36. IC 34-30-2.1-138, AS ADDED BY P.L.105-2022,
1221		-	41 SECTION 12, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
1222		-	42 JULY 1, 2024]: Sec. 138. IC 12-11-13-12 (Concerning the statewide
1223		-	HB 1386—LS 7038/DI 147 28
1224		-	1 waiver bureau of disabilities services ombudsman).
1225		-	2 SECTION 37. IC 35-52-12-2, AS ADDED BY P.L.169-2014,
1226		-	3 SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
1227		-	4 JULY 1, 2024]: Sec. 2. IC 12-11-13-16 defines a crime concerning
1228		-	5 statewide waiver bureau of disabilities services ombudsman.
1229		-	6 SECTION 38. [EFFECTIVE JULY 1, 2024] (a) An individual
1230		-	7 who:
1231		-	8 (1) is registered under IC 12-10-17.1, as amended by this act,
1232		-	9 before July 1, 2024; and
1233		-	10 (2) provides services under a home and community based
1234		-	11 services waiver;
1235		-	12 is deemed registered under IC 12-8-1.7, as added by this act.
1236		-	13 (b) This SECTION expires July 1, 2026.
1237		-	HB 1386—LS 7038/DI 147 29
1238		-	COMMITTEE REPORT
1239		-	Mr. Speaker: Your Committee on Public Health, to which was
1240		-	referred House Bill 1386, has had the same under consideration and
1241		-	begs leave to report the same back to the House with the
1242		-	recommendation that said bill be amended as follows:
1243		-	Page 3, between lines 12 and 13, begin a new paragraph and insert:
1244		-	"SECTION 2. IC 11-12-5-9, AS ADDED BY P.L.185-2015,
1245		-	SECTION 7, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
1246		-	JULY 1, 2024]: Sec. 9. (a) This section is effective beginning
1247		-	September 1, 2015. July 1, 2024.
1248		-	(b) For an offender who is incarcerated for less than thirty (30) days,
1249		-	a sheriff, in consultation with the county executive or a person
1250		-	designated by the county executive, may:
1251		-	(1) assist an offender in applying for Medicaid; and
1252		-	(2) act as the offender's Medicaid authorized representative as
1253		-	described in IC 11-10-3-7;
1254		-	so that the offender might be eligible for coverage when the offender
1255		-	is subsequently released from the county jail.
1256		-	(c) Before discharge or release from a county jail or juvenile
1257		-	facility described in IC 12-15-1-20.4 of an offender incarcerated for
1258		-	at least thirty (30) days, the sheriff, in consultation with the county
1259		-	executive or a person designated by the county executive in the county
1260		-	in which the incarcerated person is located shall assist the offender in
1261		-	applying for Medicaid, if eligible, as the authorized representative as
1262		-	described in IC 11-10-3-7 or as a health navigator under the
1263		-	requirements of IC 27-19-2-12, so that the offender might be eligible
1264		-	for coverage when the offender is subsequently released from the
1265		-	county jail or juvenile facility.
1266		-	(d) The sheriff shall provide the assistance described in subsection
1267		-	(c) in sufficient time to ensure that the offender will be able to receive
1268		-	coverage at the time the offender is released from the county jail or
1269		-	juvenile facility.
1270		-	(e) A county executive may contract with any entity that complies
1271		-	with IC 27-19-2-12, including a hospital or outreach eligibility worker,
1272		-	to assist with Medicaid applications under this section. A county
1273		-	executive may develop intergovernmental agreements with other
1274		-	counties to provide both authorized representative and health navigator
1275		-	services required under this section. Upon a determination that an
1276		-	incarcerated individual qualifies for Medicaid coverage, the office of
1277		-	the secretary of family and social services, division of family resources,
1278		-	shall authorize and then immediately suspend Medicaid coverage for
1279		-	HB 1386—LS 7038/DI 147 30
1280		-	those inmates not requiring immediate medical attention.".
1281		-	Page 3, between lines 33 and 34, begin a new paragraph and insert:
1282		-	"SECTION 1. IC 12-7-2-135.3 IS AMENDED TO READ AS
1283		-	FOLLOWS [EFFECTIVE JULY 1, 2024]: Sec. 135.3. (a)
1284		-	"Ombudsman", for purposes of IC 12-10-13, has the meaning set forth
1285		-	in IC 12-10-13-4.5.
1286		-	(b) "Ombudsman", for purposes of IC 12-11-13, has the
1287		-	meaning set forth in IC 12-11-13-2.
1288		-	SECTION 1. IC 12-7-2-149.1, AS AMENDED BY P.L.10-2019,
1289		-	SECTION 55, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
1290		-	JULY 1, 2024]: Sec. 149.1. "Provider" means the following:
1291		-	(1) For purposes of IC 12-10-7, the meaning set forth in
1292		-	IC 12-10-7-3.
1293		-	(2) For purposes of the following statutes, an individual, a
1294		-	partnership, a corporation, or a governmental entity that is
1295		-	enrolled in the Medicaid program under rules adopted under
1296		-	IC 4-22-2 by the office of Medicaid policy and planning:
1297		-	(A) IC 12-14-1 through IC 12-14-8.
1298		-	(B) IC 12-15, except IC 12-15-32, IC 12-15-33, and
1299		-	IC 12-15-34.
1300		-	(C) IC 12-17.6.
1301		-	(3) Except as provided in subdivisions (4) and (6), for purposes
1302		-	of IC 12-17.2, a person who operates a child care center or child
1303		-	care home under IC 12-17.2.
1304		-	(4) For purposes of IC 12-17.2-3.5, a person that:
1305		-	(A) provides child care; and
1306		-	(B) is directly paid for the provision of the child care under the
1307		-	federal Child Care and Development Fund voucher program
1308		-	administered under 45 CFR 98 and 45 CFR 99.
1309		-	The term does not include an individual who provides services to
1310		-	a person described in clauses (A) and (B), regardless of whether
1311		-	the individual receives compensation.
1312		-	(5) For purposes of IC 12-21-1 through IC 12-29-2, an
1313		-	organization:
1314		-	(A) that:
1315		-	(i) provides mental health services, as defined under 42
1316		-	U.S.C. 300x-2(c);
1317		-	(ii) provides addiction services; or
1318		-	(iii) provides children's mental health services;
1319		-	(B) that has entered into a provider agreement with the
1320		-	division of mental health and addiction under IC 12-21-2-7 to
1321		-	provide services in the least restrictive, most appropriate
1322		-	HB 1386—LS 7038/DI 147 31
1323		-	setting; and
1324		-	(C) that is operated by one (1) of the following:
1325		-	(i) A city, town, county, or other political subdivision of the
1326		-	state.
1327		-	(ii) An agency of the state or of the United States.
1328		-	(iii) A political subdivision of another state.
1329		-	(iv) A hospital owned or operated by a unit of government
1330		-	or a building authority that is organized for the purpose of
1331		-	constructing facilities to be leased to units of government.
1332		-	(v) A corporation incorporated under IC 23-7-1.1 (before its
1333		-	repeal August 1, 1991) or IC 23-17.
1334		-	(vi) An organization that is exempt from federal income
1335		-	taxation under Section 501(c)(3) of the Internal Revenue
1336		-	Code.
1337		-	(vii) A university or college.
1338		-	(6) For purposes of IC 12-17.2-2-10, the following:
1339		-	(A) A person described in subdivision (4).
1340		-	(B) A child care center licensed under IC 12-17.2-4.
1341		-	(C) A child care home licensed under IC 12-17.2-5.
1342		-	(7) For purposes of IC 12-11-13, an authorized provider entity
1343		-	that delivers services administered by the bureau of
1344		-	disabilities services.".
1345		-	Page 5, line 9, delete "and" and insert "or".
1346		-	Page 5, line 15, delete "subdivision 7(B)" and insert "subdivision
1347		-	(7)".
1348		-	Page 6, line 33, delete "determined" and insert "included in the
1349		-	individual's home and community based service plan:".
1350		-	Page 6, delete line 34.
1351		-	Page 17, between lines 20 and 21, begin a new paragraph and insert:
1352		-	"SECTION 1. IC 12-11-13-1 IS AMENDED TO READ AS
1353		-	FOLLOWS [EFFECTIVE JULY 1, 2024]: Sec. 1. (a) Except as
1354		-	provided in subsection (b), this chapter applies only to an individual
1355		-	who:
1356		-	(1) has a developmental disability; and
1357		-	(2) receives services under a waiver under the federal home and
1358		-	community based services program. administered by the
1359		-	bureau.
1360		-	(b) This chapter does not apply to an individual served by the
1361		-	long term care ombudsman program established under
1362		-	IC 12-10-13.
1363		-	SECTION 2. IC 12-11-13-2 IS AMENDED TO READ AS
1364		-	FOLLOWS [EFFECTIVE JULY 1, 2024]: Sec. 2. As used in this
1365		-	HB 1386—LS 7038/DI 147 32
1366		-	chapter, "ombudsman" refers to the statewide waiver bureau of
1367		-	disabilities services ombudsman established by section 3 of this
1368		-	chapter. The term includes individuals approved to act in the capacity
1369		-	of ombudsmen by the statewide waiver bureau of disabilities services
1370		-	ombudsman.
1371		-	SECTION 3. IC 12-11-13-3 IS AMENDED TO READ AS
1372		-	FOLLOWS [EFFECTIVE JULY 1, 2024]: Sec. 3. The statewide waiver
1373		-	bureau of disabilities services ombudsman position is established
1374		-	within the division.
1375		-	SECTION 4. IC 12-11-13-7 IS AMENDED TO READ AS
1376		-	FOLLOWS [EFFECTIVE JULY 1, 2024]: Sec. 7. (a) An ombudsman
1377		-	must be provided access to the following:
1378		-	(1) An individual described in section 1 of this chapter.
1379		-	(2) An entity that provides waiver services to an individual
1380		-	described in section 1 of this chapter.
1381		-	(3) Records of an individual described in section 1 of this chapter,
1382		-	including records held by an entity that provides services to the
1383		-	individual.
1384		-	(4) If an individual described in section 1 of this chapter is
1385		-	incapable of giving consent, as determined by the attending
1386		-	physician or as otherwise determined under state law, the name,
1387		-	address, and telephone number of the individual's legal
1388		-	representative.
1389		-	Except as provided in subsections (c) and (d), the ombudsman must
1390		-	obtain consent under subsection (b) before having access to the records
1391		-	described in subdivision (3).
1392		-	(b) Consent to have access to an individual's records shall be given
1393		-	in one (1) of the following forms:
1394		-	(1) In writing by the individual.
1395		-	(2) Orally by the individual in the presence of a witness.
1396		-	(3) In writing by the legal representative of the individual if:
1397		-	(A) the individual is incapable of giving consent, as
1398		-	determined by the attending physician or as otherwise
1399		-	determined under state law; and
1400		-	(B) the legal representative has the authority to give consent.
1401		-	(c) If consent to have access to an individual's records cannot be
1402		-	obtained under subsection (b), an ombudsman may inspect the records
1403		-	of the individual if the individual is incapable of giving consent, as
1404		-	determined by the attending physician or as otherwise determined
1405		-	under state law, and:
1406		-	(1) has no legal representative;
1407		-	(2) has a legal representative but the legal representative cannot
1408		-	HB 1386—LS 7038/DI 147 33
1409		-	be contacted within three (3) days; or
1410		-	(3) has a legal representative but the legal representative does not
1411		-	have the authority to give consent to have access to the records.
1412		-	(d) If an ombudsman has:
1413		-	(1) been denied access to an individual's records by the
1414		-	individual's legal representative;
1415		-	(2) reasonable cause to believe that the individual's legal
1416		-	representative is not acting in the best interests of the individual;
1417		-	and
1418		-	(3) received written approval from the state ombudsman;
1419		-	the ombudsman may inspect the records of the individual.
1420		-	SECTION 5. IC 12-11-13-8 IS AMENDED TO READ AS
1421		-	FOLLOWS [EFFECTIVE JULY 1, 2024]: Sec. 8. A provider of waiver
1422		-	services or an employee of a provider of waiver services is immune
1423		-	from:
1424		-	(1) civil or criminal liability; and
1425		-	(2) actions taken under a professional disciplinary procedure;
1426		-	for the release or disclosure of records to the ombudsman under this
1427		-	chapter.
1428		-	SECTION 6. IC 12-11-13-10, AS AMENDED BY P.L.99-2007,
1429		-	SECTION 86, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
1430		-	JULY 1, 2024]: Sec. 10. The ombudsman shall do the following:
1431		-	(1) Promote effective coordination among the following:
1432		-	(A) Programs that provide legal services for individuals with
1433		-	a developmental disability.
1434		-	(B) The division.
1435		-	(C) Providers of waiver services to individuals with
1436		-	developmental disabilities.
1437		-	(D) Providers of other necessary or appropriate services.
1438		-	(2) Ensure that the identity of an individual described in section
1439		-	1 of this chapter will not be disclosed without:
1440		-	(A) the individual's written consent; or
1441		-	(B) a court order.
1442		-	SECTION 7. IC 12-11-13-15 IS AMENDED TO READ AS
1443		-	FOLLOWS [EFFECTIVE JULY 1, 2024]: Sec. 15. The division shall:
1444		-	(1) establish a statewide toll free telephone line continuously open
1445		-	to receive complaints regarding individuals described in section
1446		-	1 of this chapter; and
1447		-	(2) forward all complaints received from the toll free telephone
1448		-	line to the statewide waiver ombudsman.".
1449		-	Page 19, between lines 16 and 17, begin a new paragraph and insert:
1450		-	"SECTION 8. IC 16-39-2-6, AS AMENDED BY P.L.137-2021,
1451		-	HB 1386—LS 7038/DI 147 34
1452		-	SECTION 27, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
1453		-	JULY 1, 2024]: Sec. 6. (a) Without the consent of the patient, the
1454		-	patient's mental health record may only be disclosed as follows:
1455		-	(1) To individuals who meet the following conditions:
1456		-	(A) Are employed by:
1457		-	(i) the provider at the same facility or agency;
1458		-	(ii) a managed care provider (as defined in IC 12-7-2-127);
1459		-	or
1460		-	(iii) a health care provider or mental health care provider, if
1461		-	the mental health records are needed to provide health care
1462		-	or mental health services to the patient.
1463		-	(B) Are involved in the planning, provision, and monitoring of
1464		-	services.
1465		-	(2) To the extent necessary to obtain payment for services
1466		-	rendered or other benefits to which the patient may be entitled, as
1467		-	provided in IC 16-39-5-3.
1468		-	(3) To the patient's court appointed counsel and to the Indiana
1469		-	protection and advocacy services commission.
1470		-	(4) For research conducted in accordance with IC 16-39-5-3 and
1471		-	the rules of the division of mental health and addiction, the rules
1472		-	of the division of disability and rehabilitative services, the rules
1473		-	of the provider, or the rules of the Indiana archives and records
1474		-	administration and the oversight committee on public records.
1475		-	(5) To the division of mental health and addiction for the purpose
1476		-	of data collection, research, and monitoring managed care
1477		-	providers (as defined in IC 12-7-2-127) who are operating under
1478		-	a contract with the division of mental health and addiction.
1479		-	(6) To the extent necessary to make reports or give testimony
1480		-	required by the statutes pertaining to admissions, transfers,
1481		-	discharges, and guardianship proceedings.
1482		-	(7) To a law enforcement agency if any of the following
1483		-	conditions are met:
1484		-	(A) A patient escapes from a facility to which the patient is
1485		-	committed under IC 12-26.
1486		-	(B) The superintendent of the facility determines that failure
1487		-	to provide the information may result in bodily harm to the
1488		-	patient or another individual.
1489		-	(C) A patient commits or threatens to commit a crime on
1490		-	facility premises or against facility personnel.
1491		-	(D) A patient is in the custody of a law enforcement officer or
1492		-	agency for any reason and:
1493		-	(i) the information to be released is limited to medications
1494		-	HB 1386—LS 7038/DI 147 35
1495		-	currently prescribed for the patient or to the patient's history
1496		-	of adverse medication reactions; and
1497		-	(ii) the provider determines that the release of the
1498		-	medication information will assist in protecting the health,
1499		-	safety, or welfare of the patient.
1500		-	Mental health records released under this clause must be
1501		-	maintained in confidence by the law enforcement agency
1502		-	receiving them.
1503		-	(8) To a coroner or medical examiner, in the performance of the
1504		-	individual's duties.
1505		-	(9) To a school in which the patient is enrolled if the
1506		-	superintendent of the facility determines that the information will
1507		-	assist the school in meeting educational needs of the patient.
1508		-	(10) To the extent necessary to satisfy reporting requirements
1509		-	under the following statutes:
1510		-	(A) IC 12-10-3-10.
1511		-	(B) IC 12-24-17-5.
1512		-	(C) IC 16-41-2-3.
1513		-	(D) IC 16-50-1-8.
1514		-	(E) IC 31-25-3-2.
1515		-	(F) IC 31-33-5-4.
1516		-	(G) IC 34-30-16-2.
1517		-	(H) IC 35-46-1-13.
1518		-	(11) To the extent necessary to satisfy release of information
1519		-	requirements under the following statutes:
1520		-	(A) IC 12-24-11-2.
1521		-	(B) IC 12-24-12-3, IC 12-24-12-4, and IC 12-24-12-6.
1522		-	(C) IC 12-26-11.
1523		-	(12) To another health care provider in a health care emergency.
1524		-	(13) For legitimate business purposes as described in
1525		-	IC 16-39-5-3.
1526		-	(14) Under a court order under IC 16-39-3.
1527		-	(15) With respect to records from a mental health or
1528		-	developmental disability facility, to the United States Secret
1529		-	Service if the following conditions are met:
1530		-	(A) The request does not apply to alcohol or drug abuse
1531		-	records described in 42 U.S.C. 290dd-2 unless authorized by
1532		-	a court order under 42 U.S.C. 290dd-2(b)(2)(c).
1533		-	(B) The request relates to the United States Secret Service's
1534		-	protective responsibility and investigative authority under 18
1535		-	U.S.C. 3056, 18 U.S.C. 871, or 18 U.S.C. 879.
1536		-	(C) The request specifies an individual patient.
1537		-	HB 1386—LS 7038/DI 147 36
1538		-	(D) The director or superintendent of the facility determines
1539		-	that disclosure of the mental health record may be necessary
1540		-	to protect a person under the protection of the United States
1541		-	Secret Service from serious bodily injury or death.
1542		-	(E) The United States Secret Service agrees to only use the
1543		-	mental health record information for investigative purposes
1544		-	and not disclose the information publicly.
1545		-	(F) The mental health record information disclosed to the
1546		-	United States Secret Service includes only:
1547		-	(i) the patient's name, age, and address;
1548		-	(ii) the date of the patient's admission to or discharge from
1549		-	the facility; and
1550		-	(iii) any information that indicates whether or not the patient
1551		-	has a history of violence or presents a danger to the person
1552		-	under protection.
1553		-	(16) To the statewide waiver bureau of disabilities services
1554		-	ombudsman established under IC 12-11-13, in the performance
1555		-	of the ombudsman's duties.
1556		-	(b) If a licensed mental health professional, a licensed paramedic,
1557		-	a representative of a mobile integrated healthcare program (as
1558		-	described in IC 16-31-12), or a representative of a mental health
1559		-	community paramedicine program in the course of rendering a
1560		-	treatment intervention, determines that a patient may be a harm to
1561		-	himself or herself or others, the licensed mental health professional, the
1562		-	licensed paramedic, the representative of the mobile integrated
1563		-	healthcare program (as described in IC 16-31-12), or the representative
1564		-	of the mental health community paramedicine program may request a
1565		-	patient's individualized mental health safety plan from a psychiatric
1566		-	crisis center, psychiatric inpatient unit, or psychiatric residential
1567		-	treatment provider. Each psychiatric crisis center, psychiatric inpatient
1568		-	unit, and psychiatric residential treatment provider shall, upon request
1569		-	and without the consent of the patient, share a patient's individualized
1570		-	mental health safety plan that is in the standard format established by
1571		-	the division of mental health and addiction under IC 12-21-5-6 with the
1572		-	following individuals who demonstrate proof of licensure and commit
1573		-	to protecting the information in compliance with state and federal
1574		-	privacy laws:
1575		-	(1) A licensed mental health professional.
1576		-	(2) A licensed paramedic.
1577		-	(3) A representative of a mobile integrated healthcare program (as
1578		-	described in IC 16-31-12).
1579		-	(4) A representative of a mental health community paramedicine
1580		-	HB 1386—LS 7038/DI 147 37
1581		-	program.
1582		-	An individualized mental health safety plan disclosed under this
1583		-	subsection may be used only to support a patient's welfare and safety
1584		-	and is considered otherwise confidential information under applicable
1585		-	state and federal laws.
1586		-	(c) After information is disclosed under subsection (a)(15) and if the
1587		-	patient is evaluated to be dangerous, the records shall be interpreted in
1588		-	consultation with a licensed mental health professional on the staff of
1589		-	the United States Secret Service.
1590		-	(d) A person who discloses information under subsection (a)(7),
1591		-	(a)(15), or (b) in good faith is immune from civil and criminal
1592		-	liability.".
1593		-	Page 19, between lines 38 and 39, begin a new paragraph and insert:
1594		-	"SECTION 9. IC 34-30-2.1-137, AS ADDED BY P.L.105-2022,
1595		-	SECTION 12, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
1596		-	JULY 1, 2024]: Sec. 137. IC 12-11-13-8 (Concerning disclosure of
1597		-	records to the statewide waiver bureau of disabilities services
1598		-	ombudsman by providers of waiver services and employees of
1599		-	providers).
1600		-	SECTION 10. IC 34-30-2.1-138, AS ADDED BY P.L.105-2022,
1601		-	SECTION 12, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
1602		-	JULY 1, 2024]: Sec. 138. IC 12-11-13-12 (Concerning the statewide
1603		-	waiver bureau of disabilities services ombudsman).
1604		-	SECTION 11. IC 35-52-12-2, AS ADDED BY P.L.169-2014,
1605		-	SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
1606		-	JULY 1, 2024]: Sec. 2. IC 12-11-13-16 defines a crime concerning
1607		-	statewide waiver bureau of disabilities services ombudsman.".
1608		-	Renumbers all SECTIONS consecutively.
1609		-	and when so amended that said bill do pass.
1610		-	(Reference is to HB 1386 as introduced.)
1611		-	BARRETT
1612		-	Committee Vote: yeas 10, nays 0.
1613		-	HB 1386—LS 7038/DI 147
	752	+	15 JULY 1, 2024]: Sec. 20. (a) The division and office may adopt rules
	753	+	16 under IC 4-22-2 that are necessary to implement this chapter.
	754	+	17 (b) The office shall apply for any federal waivers necessary to
	755	+	18 implement this chapter.
	756	+	19 SECTION 18. IC 12-10-19 IS REPEALED [EFFECTIVE JULY 1,
	757	+	20 2024]. (Home and Community Based Services).
	758	+	21 SECTION 19. IC 12-15-1-20.4, AS AMENDED BY P.L.57-2021,
	759	+	22 SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
	760	+	23 JULY 1, 2024]: Sec. 20.4. (a) If a Medicaid recipient is:
	761	+	24 (1) adjudicated to be a delinquent child and placed in:
	762	+	25 (A) a community based correctional facility for children;
	763	+	26 (B) a juvenile detention facility; or
	764	+	27 (C) a secure facility, not including a facility licensed as a child
	765	+	28 caring institution under IC 31-27; or
	766	+	29 (2) incarcerated in a prison or jail; and
	767	+	30 ineligible to participate in the Medicaid program during the placement
	768	+	31 described in subdivision (1) or (2) because of federal Medicaid law, the
	769	+	32 division of family resources, upon notice that a child has been
	770	+	33 adjudicated to be a delinquent child and placed in a facility described
	771	+	34 in subdivision (1) or upon notice that a person is incarcerated in a
	772	+	35 prison or jail and placed in a facility described in subdivision (2), shall
	773	+	36 suspend the person's participation in the Medicaid program.
	774	+	37 (b) If the division of family resources receives:
	775	+	38 (1) a dispositional decree under IC 31-37-19-28; or
	776	+	39 (2) a modified disposition order under IC 31-37-22-9;
	777	+	40 and the department of correction gives the division at least forty (40)
	778	+	41 days notice that a person will be released from a facility described in
	779	+	42 subsection (a)(1)(C) or (a)(2), the division of family resources shall
	780	+	2024 IN 1386—LS 7038/DI 147 18
	781	+	1 take action necessary to ensure that a person described in subsection
	782	+	2 (a) is eligible to participate in the Medicaid program upon the person's
	783	+	3 release, if the person is eligible to participate.
	784	+	4 (c) A facility described in subsection (a)(1) shall provide the
	785	+	5 division of family resources:
	786	+	6 (1) at least forty-five (45) days notice; or
	787	+	7 (2) under extenuating circumstances approved by the division,
	788	+	8 notice as soon as possible;
	789	+	9 that a delinquent child will be released from the facility. The
	790	+	10 division of family services shall take action necessary to ensure that
	791	+	11 the delinquent child, if eligible, participates in the Medicaid
	792	+	12 program upon the child's release and receives services required
	793	+	13 under federal law thirty (30) days before the child's release and
	794	+	14 thirty (30) days after the child's release.
	795	+	15 SECTION 20. IC 12-15-29-4.5, AS AMENDED BY P.L.265-2019,
	796	+	16 SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
	797	+	17 JULY 1, 2024]: Sec. 4.5. (a) An insurer shall accept a Medicaid claim
	798	+	18 for a Medicaid recipient for three (3) years from the date the service
	799	+	19 was provided.
	800	+	20 (b) An insurer may not deny a Medicaid claim submitted by the
	801	+	21 office solely on the basis of:
	802	+	22 (1) the date of submission of the claim;
	803	+	23 (2) the type or format of the claim form;
	804	+	24 (3) the method of submission of the claim; or
	805	+	25 (4) a failure to provide proper documentation at the point of sale
	806	+	26 that is the basis of the claim;
	807	+	27 if the claim is submitted by the office within three (3) years from the
	808	+	28 date the service was provided as required in subsection (a) and the
	809	+	29 office commences action to enforce the office's rights regarding the
	810	+	30 claim within six (6) years of the office's submission of the claim.
	811	+	31 (c) This subsection does not apply to coverage under the
	812	+	32 Medicare program, Medicare Advantage, or Medicare Part D. An
	813	+	33 insurer may not deny a Medicaid claim submitted by the office solely
	814	+	34 due to a lack of prior authorization in accordance with 42 U.S.C.
	815	+	35 1396a(a)(25). An insurer shall:
	816	+	36 (1) after December 31, 2020, meet the requirements set forth in
	817	+	37 IC 27-1-37.5;
	818	+	38 (2) conduct the prior authorization on a retrospective basis for
	819	+	39 claims where prior authorization is necessary; and
	820	+	40 (3) adjudicate any claim authorized in this manner as if the claim
	821	+	41 received prior authorization; and
	822	+	42 (4) respond to a state inquiry regarding a claim under
	823	+	2024 IN 1386—LS 7038/DI 147 19
	824	+	1 subsection (a) not later than sixty (60) days after receiving the
	825	+	2 inquiry.
	826	+	3 SECTION 21. IC 12-15-29-9, AS AMENDED BY P.L.187-2007,
	827	+	4 SECTION 7, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
	828	+	5 JULY 1, 2024]: Sec. 9. (a) IC 27-8-23 applies to this section.
	829	+	6 (b) To the extent that payment for covered medical expenses has
	830	+	7 been made under the state Medicaid program for health care items or
	831	+	8 services furnished to a person, in a case where a third party has a legal
	832	+	9 liability to make payments, the state is considered to have acquired the
	833	+	10 rights of the person to payment by any other party for the accumulated
	834	+	11 and future health care items or services.
	835	+	12 (c) As required under 42 U.S.C. 1396a(a)(25), an insurer shall
	836	+	13 accept the state's right of recovery and the assignment to the state of
	837	+	14 any right of the individual or entity to payment for a health care item
	838	+	15 or service for which payment has been made under the state Medicaid
	839	+	16 plan.
	840	+	17 SECTION 22. IC 31-37-19-29 IS ADDED TO THE INDIANA
	841	+	18 CODE AS A NEW SECTION TO READ AS FOLLOWS
	842	+	19 [EFFECTIVE JULY 1, 2024]: Sec. 29. (a) As used in this section,
	843	+	20 "facility" means the following:
	844	+	21 (1) A community based correctional facility for children.
	845	+	22 (2) A juvenile detention facility.
	846	+	23 (3) A secure facility, not including a facility licensed as a child
	847	+	24 caring institution under IC 31-27.
	848	+	25 (b) A facility shall provide the division of family resources:
	849	+	26 (1) at least forty-five (45) days notice; or
	850	+	27 (2) under extenuating circumstances approved by the division,
	851	+	28 notice as soon as possible;
	852	+	29 that a delinquent child will be released from the facility. The
	853	+	30 division of family services shall take action necessary to ensure that
	854	+	31 the delinquent child, if eligible, participates in the Medicaid
	855	+	32 program upon the child's release and receives services required
	856	+	33 under federal law thirty (30) days before the child's release and
	857	+	34 thirty (30) days after the child's release.
	858	+	35 SECTION 23. IC 34-30-2.1-129.4 IS ADDED TO THE INDIANA
	859	+	36 CODE AS A NEW SECTION TO READ AS FOLLOWS
	860	+	37 [EFFECTIVE JULY 1, 2024]: Sec. 129.4. IC 12-8-1.7-8(b)
	861	+	38 (Concerning actions of a personal services attendant).
	862	+	39 SECTION 24. [EFFECTIVE JULY 1, 2024] (a) An individual
	863	+	40 who:
	864	+	41 (1) is registered under IC 12-10-17.1, as amended by this act,
	865	+	42 before July 1, 2024; and
	866	+	2024 IN 1386—LS 7038/DI 147 20
	867	+	1 (2) provides services under a home and community based
	868	+	2 services waiver;
	869	+	3 is deemed registered under IC 12-8-1.7, as added by this act.
	870	+	4 (b) This SECTION expires July 1, 2026.
	871	+	2024 IN 1386—LS 7038/DI 147