Section 455 IAC 3-1-6 - Assisted living Medicaid waiver servicesAuthority: 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.(4) Attendant care services, including supportive 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.Division of Aging; 455 IAC 3-1-6; filed Apr 8, 2004, 3:15 p.m.: 27 IR 2492; readopted filed May 27, 2010, 10:11 a.m.: 20100609-IR-460100196RFAReadopted filed 5/10/2016, 11:21 a.m.: 20160608-IR-455160133RFAReadopted filed 11/4/2022, 4:00 p.m.: 20221130-IR-455220277RFATransferred 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. 153-2011, SECTION 21, effective July 1, 2011.