Introduced Version
HOUSE BILL No. 1689
_____
DIGEST OF INTRODUCED BILL
Citations Affected: IC 12-7-2; IC 12-11-13; IC 12-15; IC 16-39-2-6;
IC 34-30-2.1; IC 35-52-12-2.
Synopsis: Human services matters. Provides that provisions of law
concerning the statewide waiver ombudsman apply to an individual
who has a developmental disability and receives services administered
by the bureau of disabilities services. (Current law specifies that these
provisions apply to an individual who has a developmental disability
and receives services under the federal home and community based
services program.) Specifies that these provisions do not apply to an
individual served by the long term care ombudsman program. Changes
references from "statewide waiver ombudsman" to "statewide bureau
of disabilities services ombudsman". Requires the office of the
secretary of family and social services (office of the secretary) to
prepare an annual report on the provision of Medicaid home and
community based waiver services. Specifies the information that must
be included in the report. Requires the office of the secretary to apply
for an amendment to a home and community based services Medicaid
waiver to: (1) establish a new and proportional reimbursement level for
a structured family caregiving service arrangement; and (2) subject to
specified conditions, allow a legally responsible individual to provide
home and community based waiver services to a Medicaid recipient.
Effective: July 1, 2025.
Clere, Porter, Behning, Pryor
January 21, 2025, read first time and referred to Committee on Public Health.
2025 IN 1689—LS 7675/DI 147 Introduced
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. 1689
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 12-7-2-135.3 IS AMENDED TO READ AS
2 FOLLOWS [EFFECTIVE JULY 1, 2025]: Sec. 135.3. (a)
3 "Ombudsman", for purposes of IC 12-10-13, has the meaning set forth
4 in IC 12-10-13-4.5.
5 (b) "Ombudsman", for purposes of IC 12-11-13, has the
6 meaning set forth in IC 12-11-13-2.
7 SECTION 2. IC 12-7-2-149.1, AS AMENDED BY P.L.10-2019,
8 SECTION 55, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
9 JULY 1, 2025]: Sec. 149.1. "Provider" means the following:
10 (1) For purposes of IC 12-10-7, the meaning set forth in
11 IC 12-10-7-3.
12 (2) For purposes of the following statutes, an individual, a
13 partnership, a corporation, or a governmental entity that is
14 enrolled in the Medicaid program under rules adopted under
15 IC 4-22-2 by the office of Medicaid policy and planning:
16 (A) IC 12-14-1 through IC 12-14-8.
17 (B) IC 12-15, except IC 12-15-32, IC 12-15-33, and
2025 IN 1689—LS 7675/DI 147 2
1 IC 12-15-34.
2 (C) IC 12-17.6.
3 (3) Except as provided in subdivisions (4) and (6), for purposes
4 of IC 12-17.2, a person who operates a child care center or child
5 care home under IC 12-17.2.
6 (4) For purposes of IC 12-17.2-3.5, a person that:
7 (A) provides child care; and
8 (B) is directly paid for the provision of the child care under the
9 federal Child Care and Development Fund voucher program
10 administered under 45 CFR 98 and 45 CFR 99.
11 The term does not include an individual who provides services to
12 a person described in clauses (A) and (B), regardless of whether
13 the individual receives compensation.
14 (5) For purposes of IC 12-21-1 through IC 12-29-2, an
15 organization:
16 (A) that:
17 (i) provides mental health services, as defined under 42
18 U.S.C. 300x-2(c);
19 (ii) provides addiction services; or
20 (iii) provides children's mental health services;
21 (B) that has entered into a provider agreement with the
22 division of mental health and addiction under IC 12-21-2-7 to
23 provide services in the least restrictive, most appropriate
24 setting; and
25 (C) that is operated by one (1) of the following:
26 (i) A city, town, county, or other political subdivision of the
27 state.
28 (ii) An agency of the state or of the United States.
29 (iii) A political subdivision of another state.
30 (iv) A hospital owned or operated by a unit of government
31 or a building authority that is organized for the purpose of
32 constructing facilities to be leased to units of government.
33 (v) A corporation incorporated under IC 23-7-1.1 (before its
34 repeal August 1, 1991) or IC 23-17.
35 (vi) An organization that is exempt from federal income
36 taxation under Section 501(c)(3) of the Internal Revenue
37 Code.
38 (vii) A university or college.
39 (6) For purposes of IC 12-17.2-2-10, the following:
40 (A) A person described in subdivision (4).
41 (B) A child care center licensed under IC 12-17.2-4.
42 (C) A child care home licensed under IC 12-17.2-5.
2025 IN 1689—LS 7675/DI 147 3
1 (7) For purposes of IC 12-11-13, an authorized provider entity
2 that delivers services administered by the bureau of
3 disabilities services.
4 SECTION 3. IC 12-11-13-1 IS AMENDED TO READ AS
5 FOLLOWS [EFFECTIVE JULY 1, 2025]: Sec. 1. (a) Except as
6 provided in subsection (b), this chapter applies only to an individual
7 who:
8 (1) has a developmental disability; and
9 (2) receives services under a waiver under the federal home and
10 community based services program. administered by the
11 bureau.
12 (b) This chapter does not apply to an individual served by the
13 long term care ombudsman program established under
14 IC 12-10-13.
15 SECTION 4. IC 12-11-13-2 IS AMENDED TO READ AS
16 FOLLOWS [EFFECTIVE JULY 1, 2025]: Sec. 2. As used in this
17 chapter, "ombudsman" refers to the statewide waiver bureau of
18 disabilities services ombudsman established by section 3 of this
19 chapter. The term includes individuals approved to act in the capacity
20 of ombudsmen by the statewide waiver bureau of disabilities services
21 ombudsman.
22 SECTION 5. IC 12-11-13-3 IS AMENDED TO READ AS
23 FOLLOWS [EFFECTIVE JULY 1, 2025]: Sec. 3. The statewide waiver
24 bureau of disabilities services ombudsman position is established
25 within the division.
26 SECTION 6. IC 12-11-13-7 IS AMENDED TO READ AS
27 FOLLOWS [EFFECTIVE JULY 1, 2025]: Sec. 7. (a) An ombudsman
28 must be provided access to the following:
29 (1) An individual described in section 1 of this chapter.
30 (2) An entity that provides waiver services to an individual
31 described in section 1 of this chapter.
32 (3) Records of an individual described in section 1 of this chapter,
33 including records held by an entity that provides services to the
34 individual.
35 (4) If an individual described in section 1 of this chapter is
36 incapable of giving consent, as determined by the attending
37 physician or as otherwise determined under state law, the name,
38 address, and telephone number of the individual's legal
39 representative.
40 Except as provided in subsections (c) and (d), the ombudsman must
41 obtain consent under subsection (b) before having access to the records
42 described in subdivision (3).
2025 IN 1689—LS 7675/DI 147 4
1 (b) Consent to have access to an individual's records shall be given
2 in one (1) of the following forms:
3 (1) In writing by the individual.
4 (2) Orally by the individual in the presence of a witness.
5 (3) In writing by the legal representative of the individual if:
6 (A) the individual is incapable of giving consent, as
7 determined by the attending physician or as otherwise
8 determined under state law; and
9 (B) the legal representative has the authority to give consent.
10 (c) If consent to have access to an individual's records cannot be
11 obtained under subsection (b), an ombudsman may inspect the records
12 of the individual if the individual is incapable of giving consent, as
13 determined by the attending physician or as otherwise determined
14 under state law, and:
15 (1) has no legal representative;
16 (2) has a legal representative but the legal representative cannot
17 be contacted within three (3) days; or
18 (3) has a legal representative but the legal representative does not
19 have the authority to give consent to have access to the records.
20 (d) If an ombudsman has:
21 (1) been denied access to an individual's records by the
22 individual's legal representative;
23 (2) reasonable cause to believe that the individual's legal
24 representative is not acting in the best interests of the individual;
25 and
26 (3) received written approval from the state ombudsman;
27 the ombudsman may inspect the records of the individual.
28 SECTION 7. IC 12-11-13-8 IS AMENDED TO READ AS
29 FOLLOWS [EFFECTIVE JULY 1, 2025]: Sec. 8. A provider of waiver
30 services or an employee of a provider of waiver services is immune
31 from:
32 (1) civil or criminal liability; and
33 (2) actions taken under a professional disciplinary procedure;
34 for the release or disclosure of records to the ombudsman under this
35 chapter.
36 SECTION 8. IC 12-11-13-10, AS AMENDED BY P.L.99-2007,
37 SECTION 86, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
38 JULY 1, 2025]: Sec. 10. The ombudsman shall do the following:
39 (1) Promote effective coordination among the following:
40 (A) Programs that provide legal services for individuals with
41 a developmental disability.
42 (B) The division.
2025 IN 1689—LS 7675/DI 147 5
1 (C) Providers of waiver services to individuals with
2 developmental disabilities.
3 (D) Providers of other necessary or appropriate services.
4 (2) Ensure that the identity of an individual described in section
5 1 of this chapter will not be disclosed without:
6 (A) the individual's written consent; or
7 (B) a court order.
8 SECTION 9. IC 12-11-13-15 IS AMENDED TO READ AS
9 FOLLOWS [EFFECTIVE JULY 1, 2025]: Sec. 15. The division shall:
10 (1) establish a statewide toll free telephone line continuously open
11 to receive complaints regarding individuals described in section
12 1 of this chapter; and
13 (2) forward all complaints received from the toll free telephone
14 line to the statewide waiver ombudsman.
15 SECTION 10. IC 12-15-1-14.5 IS ADDED TO THE INDIANA
16 CODE AS A NEW SECTION TO READ AS FOLLOWS
17 [EFFECTIVE JULY 1, 2025]: Sec. 14.5. (a) The office of the
18 secretary shall prepare a report on the provision of Medicaid home
19 and community based waiver services to recipients who have
20 medically complex conditions, including the following:
21 (1) The number of recipients who received services
22 categorized by recipients:
23 (A) less than; and
24 (B) at least;
25 eighteen (18) years of age.
26 (2) The county of residence of each recipient who received
27 services.
28 (3) The specific Medicaid state plan or Medicaid home and
29 community based waiver services used.
30 (4) A list of approved services that are not fully utilized by the
31 recipients.
32 (5) Any reason the services described in subdivision (4) are
33 not fully utilized.
34 (6) The cost of providing services categorized by:
35 (A) the type of service; and
36 (B) a recipient's medical diagnosis or condition, if known.
37 (7) Outcomes and performance metrics, including quality of
38 care.
39 (8) Recommendations to ensure the delivery of appropriate
40 high quality services to recipients, including the following:
41 (A) An evaluation of models of care for complex care
42 assistants utilized in other states, including the cost
2025 IN 1689—LS 7675/DI 147 6
1 effectiveness and outcomes.
2 (B) The feasibility of establishing a complex care assistant
3 program in Indiana.
4 (C) An analysis of the complex care assistant program
5 described in clause (B), including:
6 (i) potential benefits and risks to recipients and family
7 caregivers;
8 (ii) anticipated fiscal impact;
9 (iii) training and certification requirements; and
10 (iv) implementation challenges and strategies to address
11 the challenges.
12 (b) In developing the recommendations described in subsection
13 (a)(8), the office of the secretary shall consult with the office of
14 Medicaid policy and planning.
15 (c) Not later than September 1, 2025, and each September 1
16 thereafter, the office of the secretary shall submit the report
17 described in subsection (a) to the following:
18 (1) The Medicaid advisory commission, established by
19 IC 12-15-33-2.
20 (2) The Medicaid oversight committee, in an electronic format
21 under IC 5-14-6.
22 (3) The state budget committee.
23 (4) The legislative council, in an electronic format under
24 IC 5-14-6.
25 SECTION 11. IC 12-15-1.3-25.3 IS ADDED TO THE INDIANA
26 CODE AS A NEW SECTION TO READ AS FOLLOWS
27 [EFFECTIVE JULY 1, 2025]: Sec. 25.3. (a) As used in this section,
28 "extraordinary care" means the provision of:
29 (1) hands on assistance with activities of daily living and
30 incidental activities of daily living; and
31 (2) supervisory monitoring care;
32 that exceeds the assistance or care that a parent of a child would
33 ordinarily perform in the household on behalf of a child who does
34 not have a disability or chronic illness or a spouse who does not
35 have a disability or chronic illness.
36 (b) Before October 1, 2025, the office of the secretary shall apply
37 to the United States Department of Health and Human Services for
38 an amendment to a home and community based services Medicaid
39 waiver to do the following:
40 (1) Establish a new and proportional reimbursement level for
41 a structured family caregiving service arrangement that:
42 (A) except as provided in clause (B), is provided to a
2025 IN 1689—LS 7675/DI 147 7
1 Medicaid recipient who is a minor and requires
2 extraordinary care; and
3 (B) allows a Medicaid recipient who receives services
4 under the reimbursement level established under this
5 subdivision to remain eligible for services, regardless of the
6 recipient's age, for as long as the recipient requires
7 extraordinary care and elects to receive services.
8 (2) Subject to the following conditions, allow a legally
9 responsible individual to provide home and community based
10 waiver services, including attendant care services and home
11 and community assistance, to a Medicaid recipient:
12 (A) The office of the secretary determines that a recipient
13 lacks a reasonable choice of other providers or direct care
14 workers who are:
15 (i) able, willing, and available to provide home and
16 community based waiver services to the recipient; and
17 (ii) compatible with the recipient and the recipient's
18 family.
19 In determining whether a provider or direct care worker
20 is compatible under this clause, the office of the secretary
21 shall consider any determination by the recipient and the
22 recipient's family as to whether a provider or direct care
23 worker is compatible with the recipient and the recipient's
24 family.
25 (B) The legally responsible individual elects to provide the
26 home and community based waiver services to the
27 recipient.
28 (C) The legally responsible individual must be employed by
29 a Medicaid provider.
30 (D) The recipient's treating physician completes the form
31 developed by the office of the secretary under subsection
32 (c).
33 (E) The legally responsible individual provides the office of
34 the secretary with the following:
35 (i) The form completed by the recipient's treating
36 physician under clause (D).
37 (ii) A list of the home and community based waiver
38 services the legally responsible individual intends to
39 provide to the recipient.
40 (F) The office of the secretary determines the following:
41 (i) The legally responsible individual is capable of
42 providing home and community based waiver services to
2025 IN 1689—LS 7675/DI 147 8
1 the recipient in a manner that meets the recipient's
2 health and safety needs.
3 (ii) Based on the information received under clause (E),
4 the recipient requires extraordinary care and the
5 services the legally responsible individual intends to
6 provide to the recipient constitute extraordinary care.
7 (G) Except as provided in clause (H), reimbursement for
8 the provision of attendant care services must be limited to
9 not more than sixteen (16) hours per day per household,
10 regardless of the number of:
11 (i) recipients receiving; and
12 (ii) legally responsible individuals providing;
13 home and community based waiver services.
14 (H) The office of the secretary may waive the conditions
15 described in clause (G) if the office of the secretary
16 determines that extraordinary medical or behavioral
17 circumstances exist.
18 (I) A legally responsible individual shall maintain
19 documentation concerning the number of hours and
20 activities spent providing home and community based
21 waiver services. A legally responsible individual who:
22 (i) provides home and community based waiver services;
23 and
24 (ii) acts in good faith and without the intent to commit
25 fraud;
26 may not be held personally liable for billing or
27 documenting services described in this clause.
28 (c) This subsection applies if the office of the secretary obtains
29 approval under subsection (b). The office of the secretary shall
30 develop a form to be used by a physician to:
31 (1) evaluate whether a recipient requires extraordinary care;
32 and
33 (2) confirm that the legally responsible individual is capable
34 of delivering the services.
35 The form must be approved by the division of disability and
36 rehabilitative services advisory council established under
37 IC 12-9-4.
38 SECTION 12. IC 16-39-2-6, AS AMENDED BY P.L.137-2021,
39 SECTION 27, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
40 JULY 1, 2025]: Sec. 6. (a) Without the consent of the patient, the
41 patient's mental health record may only be disclosed as follows:
42 (1) To individuals who meet the following conditions:
2025 IN 1689—LS 7675/DI 147 9
1 (A) Are employed by:
2 (i) the provider at the same facility or agency;
3 (ii) a managed care provider (as defined in IC 12-7-2-127);
4 or
5 (iii) a health care provider or mental health care provider, if
6 the mental health records are needed to provide health care
7 or mental health services to the patient.
8 (B) Are involved in the planning, provision, and monitoring of
9 services.
10 (2) To the extent necessary to obtain payment for services
11 rendered or other benefits to which the patient may be entitled, as
12 provided in IC 16-39-5-3.
13 (3) To the patient's court appointed counsel and to the Indiana
14 protection and advocacy services commission.
15 (4) For research conducted in accordance with IC 16-39-5-3 and
16 the rules of the division of mental health and addiction, the rules
17 of the division of disability and rehabilitative services, the rules
18 of the provider, or the rules of the Indiana archives and records
19 administration and the oversight committee on public records.
20 (5) To the division of mental health and addiction for the purpose
21 of data collection, research, and monitoring managed care
22 providers (as defined in IC 12-7-2-127) who are operating under
23 a contract with the division of mental health and addiction.
24 (6) To the extent necessary to make reports or give testimony
25 required by the statutes pertaining to admissions, transfers,
26 discharges, and guardianship proceedings.
27 (7) To a law enforcement agency if any of the following
28 conditions are met:
29 (A) A patient escapes from a facility to which the patient is
30 committed under IC 12-26.
31 (B) The superintendent of the facility determines that failure
32 to provide the information may result in bodily harm to the
33 patient or another individual.
34 (C) A patient commits or threatens to commit a crime on
35 facility premises or against facility personnel.
36 (D) A patient is in the custody of a law enforcement officer or
37 agency for any reason and:
38 (i) the information to be released is limited to medications
39 currently prescribed for the patient or to the patient's history
40 of adverse medication reactions; and
41 (ii) the provider determines that the release of the
42 medication information will assist in protecting the health,
2025 IN 1689—LS 7675/DI 147 10
1 safety, or welfare of the patient.
2 Mental health records released under this clause must be
3 maintained in confidence by the law enforcement agency
4 receiving them.
5 (8) To a coroner or medical examiner, in the performance of the
6 individual's duties.
7 (9) To a school in which the patient is enrolled if the
8 superintendent of the facility determines that the information will
9 assist the school in meeting educational needs of the patient.
10 (10) To the extent necessary to satisfy reporting requirements
11 under the following statutes:
12 (A) IC 12-10-3-10.
13 (B) IC 12-24-17-5.
14 (C) IC 16-41-2-3.
15 (D) IC 16-50-1-8.
16 (E) IC 31-25-3-2.
17 (F) IC 31-33-5-4.
18 (G) IC 34-30-16-2.
19 (H) IC 35-46-1-13.
20 (11) To the extent necessary to satisfy release of information
21 requirements under the following statutes:
22 (A) IC 12-24-11-2.
23 (B) IC 12-24-12-3, IC 12-24-12-4, and IC 12-24-12-6.
24 (C) IC 12-26-11.
25 (12) To another health care provider in a health care emergency.
26 (13) For legitimate business purposes as described in
27 IC 16-39-5-3.
28 (14) Under a court order under IC 16-39-3.
29 (15) With respect to records from a mental health or
30 developmental disability facility, to the United States Secret
31 Service if the following conditions are met:
32 (A) The request does not apply to alcohol or drug abuse
33 records described in 42 U.S.C. 290dd-2 unless authorized by
34 a court order under 42 U.S.C. 290dd-2(b)(2)(c).
35 (B) The request relates to the United States Secret Service's
36 protective responsibility and investigative authority under 18
37 U.S.C. 3056, 18 U.S.C. 871, or 18 U.S.C. 879.
38 (C) The request specifies an individual patient.
39 (D) The director or superintendent of the facility determines
40 that disclosure of the mental health record may be necessary
41 to protect a person under the protection of the United States
42 Secret Service from serious bodily injury or death.
2025 IN 1689—LS 7675/DI 147 11
1 (E) The United States Secret Service agrees to only use the
2 mental health record information for investigative purposes
3 and not disclose the information publicly.
4 (F) The mental health record information disclosed to the
5 United States Secret Service includes only:
6 (i) the patient's name, age, and address;
7 (ii) the date of the patient's admission to or discharge from
8 the facility; and
9 (iii) any information that indicates whether or not the patient
10 has a history of violence or presents a danger to the person
11 under protection.
12 (16) To the statewide waiver bureau of disabilities services
13 ombudsman established under IC 12-11-13, in the performance
14 of the ombudsman's duties.
15 (b) If a licensed mental health professional, a licensed paramedic,
16 a representative of a mobile integrated healthcare program (as
17 described in IC 16-31-12), or a representative of a mental health
18 community paramedicine program in the course of rendering a
19 treatment intervention, determines that a patient may be a harm to
20 himself or herself or others, the licensed mental health professional, the
21 licensed paramedic, the representative of the mobile integrated
22 healthcare program (as described in IC 16-31-12), or the representative
23 of the mental health community paramedicine program may request a
24 patient's individualized mental health safety plan from a psychiatric
25 crisis center, psychiatric inpatient unit, or psychiatric residential
26 treatment provider. Each psychiatric crisis center, psychiatric inpatient
27 unit, and psychiatric residential treatment provider shall, upon request
28 and without the consent of the patient, share a patient's individualized
29 mental health safety plan that is in the standard format established by
30 the division of mental health and addiction under IC 12-21-5-6 with the
31 following individuals who demonstrate proof of licensure and commit
32 to protecting the information in compliance with state and federal
33 privacy laws:
34 (1) A licensed mental health professional.
35 (2) A licensed paramedic.
36 (3) A representative of a mobile integrated healthcare program (as
37 described in IC 16-31-12).
38 (4) A representative of a mental health community paramedicine
39 program.
40 An individualized mental health safety plan disclosed under this
41 subsection may be used only to support a patient's welfare and safety
42 and is considered otherwise confidential information under applicable
2025 IN 1689—LS 7675/DI 147 12
1 state and federal laws.
2 (c) After information is disclosed under subsection (a)(15) and if the
3 patient is evaluated to be dangerous, the records shall be interpreted in
4 consultation with a licensed mental health professional on the staff of
5 the United States Secret Service.
6 (d) A person who discloses information under subsection (a)(7),
7 (a)(15), or (b) in good faith is immune from civil and criminal liability.
8 SECTION 13. IC 34-30-2.1-137, AS ADDED BY P.L.105-2022,
9 SECTION 12, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
10 JULY 1, 2025]: Sec. 137. IC 12-11-13-8 (Concerning disclosure of
11 records to the statewide waiver bureau of disabilities services
12 ombudsman by providers of waiver services and employees of
13 providers).
14 SECTION 14. IC 34-30-2.1-138, AS ADDED BY P.L.105-2022,
15 SECTION 12, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
16 JULY 1, 2025]: Sec. 138. IC 12-11-13-12 (Concerning the statewide
17 waiver bureau of disabilities services ombudsman).
18 SECTION 15. IC 35-52-12-2, AS ADDED BY P.L.169-2014,
19 SECTION 2, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
20 JULY 1, 2025]: Sec. 2. IC 12-11-13-16 defines a crime concerning
21 statewide waiver bureau of disabilities services ombudsman.
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