455 IAC 3-1-6 - Assisted living Medicaid waiver services
Authority: IC 12-9.1-2-3
Affected: IC 12-15; IC 16-28-13-1
Sec. 6.
(a) The
provider shall provide the following assisted living Medicaid waiver services:
(1) Personal care services.
(2) Homemaker services.
(3) Chore services.
(4) Attendant care services, including
supportive services.
(5) Companion
services.
(6) Medication oversight
services, as permitted by state law. and
(7) Therapeutic, social, and recreational
programming.
(b) Assisted
living Medicaid waiver services shall be provided to a recipient as outlined in
a recipient's plan of care, as developed by the recipient's case manager and
interdisciplinary team, as follows:
(1) The
provider shall provide the intensity and level of services as outlined in the
recipient's plan of care. The intensity and level of services shall range from
level 1 for recipients who are the least impaired and require the least intense
level of services to level 3 for the most severely impaired recipients who
require the most intense level of services.
(2) Should a recipient require more intense
assisted living Medicaid waiver services (a higher level of services) than the
provider is approved to provide, or require services more intense than level 3,
the provider shall assist the recipient in transferring to a more appropriate
setting and shall observe all discharge requirements of
410 IAC 16.2-5.
(c) The initial plan of care must be approved
by the office of Medicaid policy and planning prior to the initiation of
assisted living Medicaid waiver services. It must be updated at least every
ninety (90) days and annually or when the recipient experiences a significant
change per
410 IAC 16.2-1.1-70.
(d) Provider staff shall provide information
to the recipient's interdisciplinary team, as requested by the recipient's
interdisciplinary team. If requested by a recipient and/or recipient's case
manager, appropriate provider staff shall serve on a recipient's
interdisciplinary team.
(e) All
direct care shall be provided by personnel specified in IC
16-28-13-1.
(f) As appropriate,
services shall be provided to recipients in their own living units.
(g) The physical environment and the delivery
of assisted living Medicaid waiver services shall be designed to enhance
autonomy in ways which reflect personal and social values of dignity, privacy,
independence, individuality, choice, and decision making of recipients. The
provider shall provide services in a manner that:
(1) makes the services available in a
homelike environment for recipients with a range of needs and
preferences;
(2) facilitates aging
in place by providing flexible services in an environment that accommodates and
supports the recipient's individuality; and
(3) supports negotiated risk, which includes
the recipient's right to take responsibility for the risks associated with
decision making.
(h) If
requested by a recipient, the provider will assist a recipient and a
recipient's case manager in obtaining, arranging, and coordinating services
outlined in a recipient's plan of care that are not assisted living Medicaid
waiver services.
(i) Should other
entities furnish care directly, or under arrangement with the provider, that
care shall supplement the care provided by the provider but may not supplant
it.
Notes
Transferred from the Division of Disability and
Rehabilitative Services (460 IAC 8-1-6) to the Division of Aging (455 IAC 3-1-6) by P.L.
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