IN Code § 12-10-11.5-8 (2021)
2021 Indiana Code|Title 12. Human Services|Article 10. Aging Services|Chapter 11.5. Long Term Care Services|12-10-11.5-8. Reimbursement for Assisted Living Services; Home and Community Based Services; Limitations on Office Concerning Assisted Living Services; Rules

Sec. 8. (a) As used in this section, "assisted living services" refers to services covered under a waiver and provided in any of the following entities:(1) A residential care facility licensed under IC 16-28.(2) Any other housing with services establishment.(b) Under a Medicaid waiver that provides services to an individual who is aged or disabled, the office shall reimburse for assisted living services.(c) The office may reimburse for any home and community based services provided to a Medicaid recipient beginning on the date of the individual's Medicaid application.(d) The office may not do any of the following concerning assisted living services provided in a home and community based services program:(1) Require the installation of a sink in the kitchenette within any living unit of an entity that participated in the Medicaid home and community based service program before July 1, 2018.(2) Require all living units within a setting that provides assisted living services to comply with physical plant requirements that are applicable to individual units occupied by a Medicaid recipient.(3) Require a provider to offer only private rooms.(4) Require a housing with services establishment provider to provide housing when:(A) the provider is unable to meet the health needs of a resident without:(i) undue financial or administrative burden; or(ii) fundamentally altering the nature of the provider's operations; and(B) the resident is unable to arrange for services to meet the resident's health needs.(5) Require a housing with services establishment provider to separate an agreement for housing from an agreement for services.(6) Prohibit a housing with services establishment provider from offering studio apartments with only a single sink in the unit.(7) Preclude the use of a shared bathroom between adjoining or shared units if the participants consent to the use of a shared bathroom.(e) The division may adopt rules under IC 4-22-2 that establish the right, and an appeals process, for a resident to appeal a provider's determination that the provider is unable to meet the health needs of the resident as described in subsection (d)(4). The process:(1) must require an objective third party to review the provider's determination in a timely manner; and(2) may not be required if the provider is licensed by the state department of health and the licensure requirements include an appellate procedure for such a determination.(f) Before December 31, 2018, the office shall:(1) implement a process for; and(2) resume enrollment of;a provider with specialized and secure settings for individuals with Alzheimer's disease or other dementia, within a portion of or throughout the setting, to become a provider under a home and community based services program. At least forty-five (45) days before the adoption of an enrollment process under this subsection, the office shall consult with home and community based services providers, case managers, care managers, and persons with expertise in Alzheimer's disease or other dementia. The office's failure to adopt an enrollment process under this subsection shall not prevent the office from processing a provider application.As added by P.L.224-2017, SEC.1. Amended by P.L.173-2018, SEC.3; P.L.10-2019, SEC.56.