*HB1391.1*
February 11, 2025
HOUSE BILL No. 1391
_____
DIGEST OF HB 1391 (Updated February 11, 2025 12:52 pm - DI 147)
Citations Affected: IC 12-10; IC 12-15; noncode.
Synopsis: Services for the aged and disabled. Amends the definition
of "community and home care services" for purposes of community and
home options to institutional care for the elderly and disabled program
(CHOICE). Prohibits the division of aging from requiring a CHOICE
provider to be certified under a Medicaid waiver program. Requires a
local area agency on aging (area agency) to prioritize CHOICE funding
to identify specified individuals and provide community and home care
services to these individuals. Requires the office of the secretary of
family and social services (office of the secretary), in negotiating
reimbursement rates for CHOICE services, to consider the location and
availability of service providers. Establishes the Medicaid diversion
pilot program to evaluate the effectiveness of home modification and
telehealth enhanced chronic care services provided by specified area
agencies in reducing Medicaid expenditures. Allows the office of the
secretary, a managed care organization that has contracted with the
office of Medicaid policy and planning, and a person who has
contracted with a certain managed care organization or the office of the
secretary to contract with an area agency to provide and receive
reimbursement for a level of care assessment for the: (1) health and
wellness Medicaid waiver; (2) traumatic brain injury Medicaid waiver;
and (3) risk based managed care program for the covered population.
Allows the office of the secretary to study and prepare a report
containing recommendations for realigning and consolidating the area
agency planning and service areas.
Effective: Upon passage; July 1, 2025.
Clere, Ledbetter, Goss-Reaves,
Shackleford
January 13, 2025, read first time and referred to Committee on Public Health.
February 11, 2025, amended, reported — Do Pass. Referred to Committee on Ways and
Means pursuant to Rule 126.3.
HB 1391—LS 7677/DI 147 February 11, 2025
First Regular Session of the 124th General Assembly (2025)
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
Constitution) is being amended, the text of the existing provision will appear in this style type,
additions will appear in this style type, and deletions will appear in this style type.
Additions: Whenever a new statutory provision is being enacted (or a new constitutional
provision adopted), the text of the new provision will appear in this style type. Also, the
word NEW will appear in that style type in the introductory clause of each SECTION that adds
a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
between statutes enacted by the 2024 Regular Session of the General Assembly.
HOUSE BILL No. 1391
A BILL FOR AN ACT to amend the Indiana Code concerning
human services.
Be it enacted by the General Assembly of the State of Indiana:
1 SECTION 1. IC 12-10-10-2, AS AMENDED BY P.L.209-2018,
2 SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
3 JULY 1, 2025]: Sec. 2. As used in this chapter, "community and home
4 care services" means services provided within the limits of available
5 funding to an eligible individual. The term includes the following:
6 (1) Homemaker services and attendant care, including personal
7 care services.
8 (2) Respite care services and other support services for primary
9 or family caregivers.
10 (3) Adult day care services.
11 (4) Home health services and supplies.
12 (5) Home delivered meals.
13 (6) Transportation.
14 (7) Attendant care services provided by a registered personal
15 services attendant under IC 12-10-17.1 to persons described in
16 IC 12-10-17.1-6.
17 (8) Other services necessary to prevent and reduce:
HB 1391—LS 7677/DI 147 2
1 (A) hospitalization and institutionalization; and
2 (B) the need for Medicaid home and community based
3 services;
4 of eligible individuals when feasible.
5 (9) Other services, not covered by Medicaid, including equipment
6 and building modifications, necessary to:
7 (A) prevent individuals with intellectual or developmental
8 disabilities from being institutionalized; and
9 (B) help an individual described in clause (A) to transition out
10 of a health facility licensed under IC 16-28 or a group home
11 (as defined by IC 31-9-2-48.5).
12 (10) Support services that provide education, resources, and
13 strategies to help caregivers and family members of
14 individuals with dementia.
15 SECTION 2. IC 12-10-10-6, AS AMENDED BY P.L.47-2009,
16 SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
17 JULY 1, 2025]: Sec. 6. (a) The community and home options to
18 institutional care for the elderly and disabled program is established.
19 The division shall administer the program and shall do the following:
20 (1) Adopt rules under IC 4-22-2 for the coordination of the
21 program.
22 (2) Administer state and federal money for the program.
23 (3) Develop and implement a process for the management and
24 operation of the program locally through the area agencies on
25 aging based upon criteria developed by the division.
26 (4) Approve the selection of community and home care services
27 providers based upon criteria developed by the division.
28 (5) Review and approve community and home care services plans
29 developed by services providers.
30 (6) Provide training and technical assistance for the staff
31 providers.
32 (7) Select or contract with agencies throughout Indiana to provide
33 community and home care services.
34 (8) Assist the office in applying for Medicaid waivers from the
35 United States Department of Health and Human Services to fund
36 community and home care services needed by eligible individuals
37 under this chapter.
38 (9) Have self-directed care options and services available for an
39 eligible individual who chooses self-directed care services.
40 (b) The division may not require a provider seeking to provide
41 services under the program to be certified under a Medicaid
42 waiver program.
HB 1391—LS 7677/DI 147 3
1 SECTION 3. IC 12-10-10-7.5 IS ADDED TO THE INDIANA
2 CODE AS A NEW SECTION TO READ AS FOLLOWS
3 [EFFECTIVE JULY 1, 2025]: Sec. 7.5. An area agency on aging shall
4 prioritize program funding to do the following:
5 (1) Identify individuals who are:
6 (A) at risk of impairment with respect to activities of daily
7 living;
8 (B) eligible for the program; and
9 (C) not eligible to receive Medicaid.
10 (2) Provide community and home care services to individuals
11 described in subdivision (1) for the purpose of:
12 (A) preventing and reducing:
13 (i) hospitalizations; and
14 (ii) institutionalizations; and
15 (B) reducing the need for Medicaid home and community
16 based services.
17 SECTION 4. IC 12-10-10-12, AS ADDED BY P.L.246-2005,
18 SECTION 100, IS AMENDED TO READ AS FOLLOWS
19 [EFFECTIVE JULY 1, 2025]: Sec. 12. (a) The office of the secretary,
20 in consultation with the local area agencies on aging, shall negotiate
21 reimbursement rates for services provided under this chapter.
22 (b) Payments for services under this chapter may not be counted in
23 a Medicaid recipient's spend down requirement in IC 12-15.
24 (c) In negotiating the reimbursement rates described in
25 subsection (a), the office of the secretary shall consider the:
26 (1) location; and
27 (2) availability;
28 of providers who provide services under this chapter.
29 SECTION 5. IC 12-10-10-14 IS ADDED TO THE INDIANA
30 CODE AS A NEW SECTION TO READ AS FOLLOWS
31 [EFFECTIVE UPON PASSAGE]: Sec. 14. (a) As used in this section,
32 "telehealth enhanced chronic care services" means the delivery of
33 comprehensive care, including behavioral health care, through
34 telehealth to an eligible individual with a chronic disease to manage
35 the eligible individual's chronic disease.
36 (b) The Medicaid diversion pilot program is established for the
37 purpose of evaluating the effectiveness of home modification and
38 telehealth enhanced chronic care services provided by:
39 (1) Area 7; and
40 (2) Area 9;
41 of the area agencies on aging to eligible individuals in reducing
42 Medicaid expenditures.
HB 1391—LS 7677/DI 147 4
1 (c) Subject to approval by the office of the secretary, the Indiana
2 Association of Area Agencies on Aging, in collaboration with the
3 University of Notre Dame Wilson Sheehan Lab for Economic
4 Opportunities, shall administer the pilot program.
5 (d) As part of the pilot program, Area 7 and Area 9 of the area
6 agencies on aging shall provide home modification and telehealth
7 enhanced chronic care services to not more than a total of one
8 thousand (1,000) eligible individuals.
9 (e) Not later than November 1, 2026, the University of Notre
10 Dame Wilson Sheehan Lab for Economic Opportunities shall
11 prepare and submit a report on the results of the pilot program to
12 the legislative council in an electronic format under IC 5-14-6.
13 (f) This section expires December 31, 2026.
14 SECTION 6. IC 12-15-1.3-18.5 IS ADDED TO THE INDIANA
15 CODE AS A NEW SECTION TO READ AS FOLLOWS
16 [EFFECTIVE JULY 1, 2025]: Sec. 18.5. (a) As used in this section,
17 "office" includes the following:
18 (1) The office of the secretary of family and social services.
19 (2) A managed care organization that has contracted with the
20 office of Medicaid policy and planning under this article.
21 (3) A person that has contracted with:
22 (A) the office of the secretary of family and social services;
23 or
24 (B) a managed care organization described in subdivision
25 (2).
26 (b) The office may contract with an area agency on aging to
27 provide and receive reimbursement for a level of care assessment
28 for the following:
29 (1) The health and wellness Medicaid waiver.
30 (2) The traumatic brain injury Medicaid waiver.
31 SECTION 7. IC 12-15-12.5 IS ADDED TO THE INDIANA CODE
32 AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
33 JULY 1, 2025]:
34 Chapter 12.5. Managed Care for the Aging
35 Sec. 1. As used in this chapter, "area agency" means an area
36 agency on aging designated by the bureau of aging and in-home
37 services under IC 12-10-1-4.
38 Sec. 2. As used in this chapter, "covered population" means all
39 Medicaid recipients who meet the criteria set forth in section 4 of
40 this chapter.
41 Sec. 3. As used in this chapter, "office" includes the following:
42 (1) The office of the secretary of family and social services.
HB 1391—LS 7677/DI 147 5
1 (2) A managed care organization that has contracted with the
2 office of Medicaid policy and planning under this article.
3 (3) A person that has contracted with:
4 (A) the office of the secretary of family and social services;
5 or
6 (B) a managed care organization described in subdivision
7 (2).
8 Sec. 4. An individual is a member of the covered population if
9 the individual:
10 (1) is eligible to participate in the federal Medicare program
11 (42 U.S.C. 1395 et seq.) and receives nursing facility services;
12 or
13 (2) is:
14 (A) at least sixty (60) years of age;
15 (B) blind, aged, or disabled; and
16 (C) receiving services through one (1) of the following:
17 (i) The aged and disabled Medicaid waiver.
18 (ii) A risk based managed care program for aged, blind,
19 or disabled individuals who are not eligible to participate
20 in the federal Medicare program.
21 (iii) The state Medicaid plan.
22 Sec. 5. The office may contract with an area agency to:
23 (1) provide; and
24 (2) receive reimbursement for;
25 a level of care assessment for the risk based managed care
26 program for the covered population through an area agency's
27 aging and disability resource center.
28 SECTION 8. [EFFECTIVE UPON PASSAGE] (a) As used in this
29 SECTION, "advisory council" refers to the division of disability
30 and rehabilitative services advisory council established under
31 IC 12-9-4.
32 (b) As used in this SECTION, "board" refers to the community
33 and home options to institutional care for the elderly and disabled
34 board established by IC 12-10-11-1.
35 (c) As used in this SECTION, "commission" refers to the
36 Indiana state commission on aging established by IC 12-10-2-2.
37 (d) As used in this SECTION, "office" refers to the office of
38 family and social services established by IC 12-8-1.5-1.
39 (e) The office may, in collaboration with the Indiana Association
40 of Area Agencies on Aging, study and prepare a report containing
41 recommendations for realigning and consolidating the area agency
42 on aging planning and service areas.
HB 1391—LS 7677/DI 147 6
1 (f) If the office elects to study and prepare the report described
2 in subsection (e), the office shall do the following:
3 (1) In studying and preparing the report, consult with the:
4 (A) advisory council;
5 (B) board; and
6 (C) commission;
7 at the regularly scheduled public meetings of the advisory
8 council, board, and commission to receive input and feedback
9 concerning the recommendations described in subsection (e).
10 (2) Not later than November 1, 2025, submit the report to the
11 legislative council in an electronic format under IC 5-14-6.
12 (g) This SECTION expires December 31, 2025.
13 SECTION 9. An emergency is declared for this act.
HB 1391—LS 7677/DI 147 7
COMMITTEE REPORT
Mr. Speaker: Your Committee on Public Health, to which was
referred House Bill 1391, has had the same under consideration and
begs leave to report the same back to the House with the
recommendation that said bill be amended as follows:
Page 1, delete lines 1 through 17, begin a new paragraph and insert:
"SECTION 1. IC 12-10-10-2, AS AMENDED BY P.L.209-2018,
SECTION 3, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2025]: Sec. 2. As used in this chapter, "community and home
care services" means services provided within the limits of available
funding to an eligible individual. The term includes the following:
(1) Homemaker services and attendant care, including personal
care services.
(2) Respite care services and other support services for primary
or family caregivers.
(3) Adult day care services.
(4) Home health services and supplies.
(5) Home delivered meals.
(6) Transportation.
(7) Attendant care services provided by a registered personal
services attendant under IC 12-10-17.1 to persons described in
IC 12-10-17.1-6.
(8) Other services necessary to prevent and reduce:
(A) hospitalization and institutionalization; and
(B) the need for Medicaid home and community based
services;
of eligible individuals when feasible.
(9) Other services, not covered by Medicaid, including equipment
and building modifications, necessary to:
(A) prevent individuals with intellectual or developmental
disabilities from being institutionalized; and
(B) help an individual described in clause (A) to transition out
of a health facility licensed under IC 16-28 or a group home
(as defined by IC 31-9-2-48.5).
(10) Support services that provide education, resources, and
strategies to help caregivers and family members of
individuals with dementia.".
Page 2, delete lines 1 through 11.
Page 2, delete lines 37 through 41.
Page 3, line 5, delete "may" and insert "shall prioritize program
funding to do the following:".
HB 1391—LS 7677/DI 147 8
Page 3, delete lines 6 through 13, begin a new line block indented
and insert:
"(1) Identify individuals who are:
(A) at risk of impairment with respect to activities of daily
living;
(B) eligible for the program; and
(C) not eligible to receive Medicaid.
(2) Provide community and home care services to individuals
described in subdivision (1) for the purpose of:
(A) preventing and reducing:
(i) hospitalizations; and
(ii) institutionalizations; and
(B) reducing the need for Medicaid home and community
based services.".
Page 3, between lines 25 and 26, begin a new paragraph and insert:
"SECTION 5. IC 12-10-10-14 IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE UPON PASSAGE]: Sec. 14. (a) As used in this section,
"telehealth enhanced chronic care services" means the delivery of
comprehensive care, including behavioral health care, through
telehealth to an eligible individual with a chronic disease to manage
the eligible individual's chronic disease.
(b) The Medicaid diversion pilot program is established for the
purpose of evaluating the effectiveness of home modification and
telehealth enhanced chronic care services provided by:
(1) Area 7; and
(2) Area 9;
of the area agencies on aging to eligible individuals in reducing
Medicaid expenditures.
(c) Subject to approval by the office of the secretary, the Indiana
Association of Area Agencies on Aging, in collaboration with the
University of Notre Dame Wilson Sheehan Lab for Economic
Opportunities, shall administer the pilot program.
(d) As part of the pilot program, Area 7 and Area 9 of the area
agencies on aging shall provide home modification and telehealth
enhanced chronic care services to not more than a total of one
thousand (1,000) eligible individuals.
(e) Not later than November 1, 2026, the University of Notre
Dame Wilson Sheehan Lab for Economic Opportunities shall
prepare and submit a report on the results of the pilot program to
the legislative council in an electronic format under IC 5-14-6.
(f) This section expires December 31, 2026.".
HB 1391—LS 7677/DI 147 9
Page 4, after line 39, begin a new paragraph and insert:
"SECTION 8. [EFFECTIVE UPON PASSAGE] (a) As used in this
SECTION, "advisory council" refers to the division of disability
and rehabilitative services advisory council established under
IC 12-9-4.
(b) As used in this SECTION, "board" refers to the community
and home options to institutional care for the elderly and disabled
board established by IC 12-10-11-1.
(c) As used in this SECTION, "commission" refers to the
Indiana state commission on aging established by IC 12-10-2-2.
(d) As used in this SECTION, "office" refers to the office of
family and social services established by IC 12-8-1.5-1.
(e) The office may, in collaboration with the Indiana Association
of Area Agencies on Aging, study and prepare a report containing
recommendations for realigning and consolidating the area agency
on aging planning and service areas.
(f) If the office elects to study and prepare the report described
in subsection (e), the office shall do the following:
(1) In studying and preparing the report, consult with the:
(A) advisory council;
(B) board; and
(C) commission;
at the regularly scheduled public meetings of the advisory
council, board, and commission to receive input and feedback
concerning the recommendations described in subsection (e).
(2) Not later than November 1, 2025, submit the report to the
legislative council in an electronic format under IC 5-14-6.
(g) This SECTION expires December 31, 2025.
SECTION 9. An emergency is declared for this act.".
Renumber all SECTIONS consecutively.
and when so amended that said bill do pass.
(Reference is to HB 1391 as introduced.)
BARRETT
Committee Vote: yeas 11, nays 0.
HB 1391—LS 7677/DI 147