Introduced Version
SENATE BILL No. 88
_____
DIGEST OF INTRODUCED BILL
Citations Affected: IC 5-20-1-2; IC 12-7-2; IC 12-10; IC 12-10.5-2-4;
IC 12-21; IC 12-22; IC 12-23-1-9; IC 12-24-19; IC 12-26-14-4;
IC 12-29-2-13.
Synopsis: Various mental health issues. Changes the allocation of
federal aid used for drug abuse and alcohol abuse used for local
programs. Redefines the services provided by community mental health
centers and specifies that instead of a continuum of care, services are
to be provided. Removes the authority of the division of mental health
and addiction (DMHA) to license respite care. Changes elements of
community based residential programs. Eliminates the duty of DMHA
to submit a biennial report to the governor and the legislative council
on the evaluation of the continuum of care. Makes conforming changes.
Repeals: (1) respite care for persons with mental illness; (2) listing of
elements of community residential programs; (3) children's mental
health bureau; (4) certain placement provisions for community
residential facilities; and (5) definitions made obsolete by the bill. (The
introduced version of this bill was prepared by the Commission on
Mental Health.)
Effective: July 1, 2011.
Lawson C
January 5, 2011, read first time and referred to Committee on Health and Provider
Services.
Introduced
First Regular Session 117th General Assembly (2011)
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
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SENATE BILL No. 88
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:
SOURCE: IC 5-20-1-2; (11)IN0088.1.1. -->
SECTION 1. IC 5-20-1-2, AS AMENDED BY P.L.99-2007,
SECTION 19, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2011]: Sec. 2. As used in this chapter:
"Assisted" means, with respect to a loan:
(1) the payment by the United States or any duly authorized
agency of the United States of assistance payments, interest
payments, or mortgage reduction payments with respect to such
loan; or
(2) the provision of insurance, guaranty, security, collateral,
subsidies, or other forms of assistance or aid acceptable to the
authority for the making, holding, or selling of a loan from the
United States, any duly authorized agency of the United States, or
any entity or corporation acceptable to the authority, other than
the sponsor.
"Authority" means the Indiana housing and community development
authority created by section 3 of this chapter.
"Bonds" or "notes" means the bonds or notes authorized to be issued
by the authority under this chapter.
"Community based residential programs" refers to programs
developed by the division of mental health and addiction under
IC 12-22-2-3.5.
"Development costs" means the costs approved by the authority as
appropriate expenditures and credits which may be incurred by
sponsors, builders, and developers of residential housing prior to
commitment and initial advance of the proceeds of a construction loan
or of a mortgage, including but not limited to:
(1) payments for options to purchase properties on the proposed
residential housing site, deposits on contracts of purchase, or,
with prior approval of the authority, payments for the purchase of
such properties;
(2) legal, organizational, and marketing expenses, including
payments of attorney's fees, project manager, clerical, and other
incidental expenses;
(3) payment of fees for preliminary feasibility studies and
advances for planning, engineering, and architectural work;
(4) expenses for surveys as to need and market analyses;
(5) necessary application and other fees;
(6) credits allowed by the authority to recognize the value of
service provided at no cost by the sponsors, builders, or
developers; and
(7) such other expenses as the authority deems appropriate for the
purposes of this chapter.
"Governmental agency" means any department, division, public
agency, political subdivision, or other public instrumentality of the
state of Indiana, the federal government, any other state or public
agency, or any two (2) or more thereof.
"Construction loan" means a loan to provide interim financing for
the acquisition or construction of single family residential housing,
including land development.
"Mortgage" or "mortgage loan" means a loan to provide permanent
financing for:
(1) the rehabilitation, acquisition, or construction of single family
residential housing, including land development; or
(2) the weatherization of single family residences.
"Mortgage lender" means a bank, trust company, savings bank,
savings association, credit union, national banking association, federal
savings association or federal credit union maintaining an office in this
state, a public utility (as defined in IC 8-1-2-1), a gas utility system
organized under IC 8-1-11.1, an insurance company authorized to do
business in this state, or any mortgage banking firm or mortgagee
authorized to do business in this state and approved by either the
authority or the Department of Housing and Urban Development.
"Land development" means the process of acquiring land primarily
for residential housing construction for persons and families of low and
moderate income and making, installing, or constructing nonresidential
housing improvements, including water, sewer, and other utilities,
roads, streets, curbs, gutters, sidewalks, storm drainage facilities, and
other installations or works, whether on or off the site, which the
authority deems necessary or desirable to prepare such land primarily
for residential housing construction.
"Obligations" means any bonds or notes authorized to be issued by
the authority under this chapter.
"Persons and families of low and moderate income" means persons
and families of insufficient personal or family income to afford
adequate housing as determined by the standards established by the
authority, and in determining such standards the authority shall take
into account the following:
(1) The amount of total income of such persons and families
available for housing needs.
(2) The size of the family.
(3) The cost and condition of housing facilities available in the
different geographic areas of the state.
(4) The ability of such persons and families to compete
successfully in the private housing market and to pay the amounts
at which private enterprise is providing sanitary, decent, and safe
housing.
The standards shall, however, comply with the applicable limitations
of section 4(b) of this chapter.
"Residential facility for children" means a facility:
(1) that provides residential services to individuals who are:
(A) under twenty-one (21) years of age; and
(B) adjudicated to be children in need of services under
IC 31-34 (or IC 31-6-4 before its repeal) or delinquent children
under IC 31-37 (or IC 31-6-4 before its repeal); and
(2) that is:
(A) a child caring institution that is or will be licensed under
IC 31-27;
(B) a residential facility that is or will be licensed under
IC 12-28-5; or
(C) a facility that is or will be certified by the division of
mental health and addiction under IC 12-23.
"Residential facility for persons with a developmental disability"
means a facility that is approved for use in a community residential
program for the developmentally disabled under IC 12-11-1.1.
"Residential facility for persons with a mental illness" means a
facility that is approved by the division of mental health and addiction
for use in a community residential program for the mentally ill under
IC 12-22-2-3(1), IC 12-22-2-3(2), IC 12-22-2-3(3), or IC 12-22-2-3(4).
"Residential housing" means a specific work or improvement
undertaken primarily to provide single or multiple family housing for
rental or sale to persons and families of low and moderate income,
including the acquisition, construction, or rehabilitation of lands,
buildings, and improvements to the housing, and such other
nonhousing facilities as may be incidental or appurtenant to the
housing.
"Sponsors", "builders", or "developers" means corporations,
associations, partnerships, limited liability companies, or other entities
and consumer housing cooperatives organized pursuant to law for the
primary purpose of providing housing to low and moderate income
persons and families.
"State" means the state of Indiana.
"Tenant programs and services" means services and activities for
persons and families living in residential housing, including the
following:
(1) Counseling on household management, housekeeping,
budgeting, and money management.
(2) Child care and similar matters.
(3) Access to available community services related to job training
and placement, education, health, welfare, and other community
services.
(4) Guard and other matters related to the physical security of the
housing residents.
(5) Effective management-tenant relations, including tenant
participation in all aspects of housing administration,
management, and maintenance.
(6) Physical improvements of the housing, including buildings,
recreational and community facilities, safety measures, and
removal of code violations.
(7) Advisory services for tenants in the creation of tenant
organizations which will assume a meaningful and responsible
role in the planning and carrying out of housing affairs.
(8) Procedures whereby tenants, either individually or in a group,
may be given a hearing on questions relating to management
policies and practices either in general or in relation to an
individual or family.
SOURCE: IC 12-7-2-25; (11)IN0088.1.2. -->
SECTION 2. IC 12-7-2-25 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2011]: Sec. 25. "Case
management", means the following:
(1) for purposes of IC 12-10-1 and IC 12-10-10, has the meaning
set forth in IC 12-10-10-1.
(2) For purposes of IC 12-7-2-40.6 and IC 12-24-19, the meaning
set forth in IC 12-24-19-2.
SOURCE: IC 12-7-2-40; (11)IN0088.1.3. -->
SECTION 3. IC 12-7-2-40 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2011]: Sec. 40. "Community based
residential program", for purposes of IC 12-22-2, refers to the programs
described in IC 12-22-2-3. IC 12-22-2-3.5.
SOURCE: IC 12-7-2-40.6; (11)IN0088.1.4. -->
SECTION 4. IC 12-7-2-40.6 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2011]: Sec. 40.6. (a) "Continuum
of care" means a range of services: the provision of which is assured by
a community mental health center or a managed care provider. The
term includes the following:
(1) Individualized treatment planning to increase patient coping
skills and symptom management, which may include any
combination of services listed under this section.
(2) Twenty-four (24) hour a day crisis intervention.
(3) Case management to fulfill individual patient needs, including
assertive case management when indicated.
(4) Outpatient services, including intensive outpatient services,
substance abuse services, counseling, and treatment.
(5) Acute stabilization services, including detoxification services.
(6) Residential services.
(7) Day treatment.
(8) Family support services.
(9) Medication evaluation and monitoring.
(10) Services to prevent unnecessary and inappropriate treatment
and hospitalization and the deprivation of a person's liberty.
(1) defined by the division in rules adopted under IC 4-22-2 to
provide a comprehensive continuum of care by a community
mental health center or other provider; and
(2) based on recovery focused models of care and that are
intended to meet the individual treatment needs of the
behavioral health consumer.
(b) The continuum of care may include the following services:
(1) Wellness programs.
(2) Engagement services.
(3) Outpatient and inpatient services.
(4) Rehabilitative and habilitative services.
(5) Residential care and supported housing.
(6) Acute intensive services.
All services must support prevention and treatment of mental
health and addiction for all populations.
SOURCE: IC 12-7-2-117.6; (11)IN0088.1.5. -->
SECTION 5. IC 12-7-2-117.6, AS ADDED BY P.L.99-2007,
SECTION 45, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2011]: Sec. 117.6. "Individual with a mental illness", for
purposes of IC 12-21-2 IC 12-22-1, and IC 12-24-17, means an
individual who:
(1) has a psychiatric disorder that substantially impairs the
individual's mental health; and
(2) requires care, treatment, training, or detention:
(A) because of the psychiatric disorder; or
(B) for the welfare of the individual or others of the
community in which the individual resides.
SOURCE: IC 12-7-2-127; (11)IN0088.1.6. -->
SECTION 6. IC 12-7-2-127 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2011]: Sec. 127. (a) "Managed care
provider", for purposes of IC 12-14-1 through IC 12-14-9.5 and
IC 12-15 (except IC 12-15-21, IC 12-15-33, and IC 12-15-34) means
either of the following:
(1) A physician licensed under IC 25-22.5 who:
(A) is primarily engaged in general practice, family practice,
internal medicine, pediatric medicine, or obstetrics and
gynecology; and
(B) has entered into a provider agreement for the provision of
physician services under IC 12-15-11-4.
(2) A partnership, corporation, or other entity that:
(A) employs or contracts with physicians licensed under
IC 25-22.5 who are primarily engaged in general practice,
family practice, internal medicine, pediatric medicine, or
obstetrics and gynecology; and
(B) has entered into a provider agreement for the provision of
physician services under IC 12-15-11-4.
(b) "Managed care provider", for purposes of IC 12-21-1 through
IC 12-29-2, means an organization:
(1) that:
(A) for mental health services, is defined under 42 U.S.C.
300x-2(c);
(B) provides addiction services; or
(C) provides children's mental health services;
(2) that has entered into a provider agreement with the division of
mental health and addiction under IC 12-21-2-7 to provide a
continuum of care in the least restrictive, most appropriate
setting; and
(3) that is operated by at least one (1) of the following:
(A) A city, town, county, or other political subdivision of
Indiana.
(B) An agency of Indiana or of the United States.
(C) A political subdivision of another state.
(D) A hospital owned or operated by:
(i) a unit of government; or
(ii) a building authority that is organized for the purpose of
constructing facilities to be leased to units of government.
(E) A corporation incorporated under IC 23-7-1.1 (before its
repeal August 1, 1991) or IC 23-17.
(F) An organization that is exempt from federal income
taxation under Section 501(c)(3) of the Internal Revenue
Code.
(G) A university or college.
SOURCE: IC 12-7-2-149.1; (11)IN0088.1.7. -->
SECTION 7. IC 12-7-2-149.1, AS AMENDED BY P.L.145-2006,
SECTION 57, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2011]: Sec. 149.1. "Provider" means the following:
(1) For purposes of IC 12-10-7, the meaning set forth in
IC 12-10-7-3.
(2) For purposes of the following statutes, an individual, a
partnership, a corporation, or a governmental entity that is
enrolled in the Medicaid program under rules adopted under
IC 4-22-2 by the office of Medicaid policy and planning:
(A) IC 12-14-1 through IC 12-14-9.5.
(B) IC 12-15, except IC 12-15-32, IC 12-15-33, and
IC 12-15-34.
(C) IC 12-17.6.
(3) Except as provided in subdivision (4), for purposes of
IC 12-17.2, a person who operates a child care center or child care
home under IC 12-17.2.
(4) For purposes of IC 12-17.2-3.5, a person that:
(A) provides child care; and
(B) is directly paid for the provision of the child care under the
federal Child Care and Development Fund voucher program
administered under 45 CFR 98 and 45 CFR 99.
The term does not include an individual who provides services to
a person described in clauses (A) and (B), regardless of whether
the individual receives compensation.
(5) For purposes of IC 12-21-1 through IC 12-29-2, an
organization:
(A) that:
(i) provides mental health services, as defined under 42
U.S.C. 300x-2(c);
(ii) provides addiction services; or
(iii) provides children's mental health services;
(B) that has entered into a provider agreement with the
division of mental health and addition under IC 12-21-2-7
to provide services in the least restrictive, most
appropriate setting; and
(C) that is operated by one (1) of the following:
(i) A city, town, county, or other political subdivision of
the state.
(ii) An agency of the state or of the United States.
(iii) A political subdivision of another state.
(iv) A hospital owned or operated by a unit of
government or a building authority that is organized for
the purpose of constructing facilities to be leased to units
of government.
(v) A corporation incorporated under IC 23-7-1.1 (before
its repeal August 1, 1991) or IC 23-17.
(vi) An organization that is exempt from federal income
taxation under Section 501(c)(3) of the Internal Revenue
Code.
(vii) A university or college.
SOURCE: IC 12-7-2-165; (11)IN0088.1.8. -->
SECTION 8. IC 12-7-2-165, AS AMENDED BY P.L.99-2007,
SECTION 49, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2011]: Sec. 165. "Residential facility", for purposes of
IC 12-28-4 and IC 12-28-5, refers to a residential facility for
individuals with a developmental disability. or a residential facility for
individuals with a mental illness.
SOURCE: IC 12-7-2-168; (11)IN0088.1.9. -->
SECTION 9. IC 12-7-2-168 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2011]: Sec. 168. "Respite care"
means,
the following:
(1) for purposes of IC 12-10-4 and IC 12-10-5, temporary care or
supervision of an individual with Alzheimer's disease or a related
senile dementia that is provided because the individual's family
or caretaker is temporarily unable or unavailable to provide
needed care.
(2) For purposes of IC 12-22-1, the meaning set forth in
IC 12-22-1-1.
SOURCE: IC 12-10-6-2.1; (11)IN0088.1.10. -->
SECTION 10. IC 12-10-6-2.1, AS AMENDED BY P.L.121-2008,
SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2011]: Sec. 2.1. (a) An individual who is incapable of residing
in the individual's own home may apply for residential care assistance
under this section. The determination of eligibility for residential care
assistance is the responsibility of the division. Except as provided in
subsections (g) and (i), an individual is eligible for residential care
assistance if the division determines that the individual:
(1) is a recipient of Medicaid or the federal Supplemental Security
Income program;
(2) is incapable of residing in the individual's own home because
of dementia, mental illness, or a physical disability;
(3) requires a degree of care less than that provided by a health
care facility licensed under IC 16-28;
(4) can be adequately cared for in a residential care setting; and
(5) has not made any asset transfer prohibited under the state plan
or in 42 U.S.C. 1396p(c) in order to be eligible for Medicaid.
(b) Individuals with mental retardation may not be admitted to a
home or facility that provides residential care under this section.
(c) A service coordinator employed by the division may:
(1) evaluate a person seeking admission to a home or facility
under subsection (a); or
(2) evaluate a person who has been admitted to a home or facility
under subsection (a), including a review of the existing
evaluations in the person's record at the home or facility.
If the service coordinator determines the person evaluated under this
subsection has mental retardation, the service coordinator may
recommend an alternative placement for the person.
(d) Except as provided in section 5 of this chapter, residential care
consists of only room, board, and laundry, along with minimal
administrative direction. State financial assistance may be provided for
such care in a boarding or residential home of the applicant's choosing
that is licensed under IC 16-28 or a Christian Science facility listed and
certified by the Commission for Accreditation of Christian Science
Nursing Organizations/Facilities, Inc., that meets certain life safety
standards considered necessary by the state fire marshal. Payment for
such care shall be made to the provider of the care according to
division directives and supervision. The amount of nonmedical
assistance to be paid on behalf of a recipient living in a boarding home,
residential home, or Christian Science facility shall be based on the
daily rate established by the division. The rate for facilities that are
referred to in this section and licensed under IC 16-28 may not exceed
an upper rate limit established by a rule adopted by the division. The
recipient may retain from the recipient's income a monthly personal
allowance of fifty-two dollars ($52). This amount is exempt from
income eligibility consideration by the division and may be exclusively
used by the recipient for the recipient's personal needs. However, if the
recipient's income is less than the amount of the personal allowance,
the division shall pay to the recipient the difference between the
amount of the personal allowance and the recipient's income. A reserve
or an accumulated balance from such a source, together with other
sources, may not be allowed to exceed the state's resource allowance
allowed for adults eligible for state supplemental assistance or
Medicaid as established by the rules of the office of Medicaid policy
and planning.
(e) In addition to the amount that may be retained as a personal
allowance under this section, an individual shall be allowed to retain
an amount equal to the individual's state and local income tax liability.
The amount that may be retained during a month may not exceed
one-third (1/3) of the individual's state and local income tax liability for
the calendar quarter in which that month occurs. This amount is
exempt from income eligibility consideration by the division. The
amount retained shall be used by the individual to pay any state or local
income taxes owed.
(f) In addition to the amounts that may be retained under
subsections (d) and (e), an eligible individual may retain a Holocaust
victim's settlement payment. The payment is exempt from income
eligibility consideration by the division.
(g) The rate of payment to the provider shall be determined in
accordance with a prospective prenegotiated payment rate predicated
on a reasonable cost related basis, with a growth of profit factor, as
determined in accordance with generally accepted accounting
principles and methods, and written standards and criteria, as
established by the division. The division shall establish an
administrative appeal procedure to be followed if rate disagreement
occurs if the provider can demonstrate to the division the necessity of
costs in excess of the allowed or authorized fee for the specific
boarding or residential home. The amount may not exceed the
maximum established under subsection (d).
(h) The personal allowance for one (1) month for an individual
described in subsection (a) is the amount that an individual would be
entitled to retain under subsection (d) plus an amount equal to one-half
(1/2) of the remainder of:
(1) gross earned income for that month; minus
(2) the sum of:
(A) sixteen dollars ($16); plus
(B) the amount withheld from the person's paycheck for that
month for payment of state income tax, federal income tax,
and the tax prescribed by the federal Insurance Contribution
Act (26 U.S.C. 3101 et seq.); plus
(C) transportation expenses for that month; plus
(D) any mandatory expenses required by the employer as a
condition of employment.
(i) An individual who, before September 1, 1983, has been admitted
to a home or facility that provides residential care under this section is
eligible for residential care in the home or facility.
(j) The director of the division may contract with the division of
mental health and addiction or the division of disability and
rehabilitative services to purchase services for individuals with a
mental illness or a developmental disability by providing money to
supplement the appropriation for community
based residential care
programs established under IC 12-22-2 or community
based residential
programs established under IC 12-11-1.1-1.
(k) A person with a mental illness may not be placed in a Christian
Science facility listed and certified by the Commission for
Accreditation of Christian Science Nursing Organizations/Facilities,
Inc., unless the facility is licensed under IC 16-28.
SOURCE: IC 12-10-11-8; (11)IN0088.1.11. -->
SECTION 11. IC 12-10-11-8, AS AMENDED BY P.L.99-2007,
SECTION 65, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2011]: Sec. 8. The board shall do the following:
(1) Establish long term goals of the state for the provision of a
continuum of care for the elderly and individuals with a disability
based on the following:
(A) Individual independence, dignity, and privacy.
(B) Long term care services that are:
(i) integrated, accessible, and responsible; and
(ii) available in home and community settings.
(C) Individual choice in planning and managing long term
care.
(D) Access to an array of long term care services:
(i) for an individual to receive care that is appropriate for the
individual's needs; and
(ii) to enable a case manager to have cost effective
alternatives available in the construction of care plans and
the delivery of services.
(E) Long term care services that include home care,
community based services, assisted living, congregate care,
adult foster care, and institutional care.
(F) Maintaining an individual's dignity and self-reliance to
protect the fiscal interests of both taxpayers and the state.
(G) Long term care services that are fiscally sound.
(H) Services that:
(i) promote behavioral health; and
(ii) prevent and treat mental illness and addiction.
(2) Review state policies on community and home care services.
(3) Recommend the adoption of rules under IC 4-22-2.
(4) Recommend legislative changes affecting community and
home care services.
(5) Recommend the coordination of the board's activities with the
activities of other boards and state agencies concerned with
community and home care services.
(6) Evaluate cost effectiveness, quality, scope, and feasibility of
a state administered system of community and home care
services.
(7) Evaluate programs for financing services to those in need of
a continuum of care.
(8) Evaluate state expenditures for community and home care
services, taking into account efficiency, consumer choice,
competition, and equal access to providers.
(9) Develop policies that support the participation of families and
volunteers in meeting the long term care needs of individuals.
(10) Encourage the development of funding for a continuum of
care from private resources, including insurance.
(11) Develop a cost of services basis and a program of cost
reimbursement for those persons who can pay all or a part of the
cost of the services rendered. The division shall use this cost of
services basis and program of cost reimbursement in
administering IC 12-10-10. The cost of services basis and
program of cost reimbursement must include a client cost share
formula that:
(A) imposes no charges for an eligible individual whose
income does not exceed one hundred fifty percent (150%) of
the federal income poverty level; and
(B) does not impose charges for the total cost of services
provided to an individual under the community and home
options to institutional care for the elderly and disabled
program unless the eligible individual's income exceeds three
hundred fifty percent (350%) of the federal income poverty
level.
The calculation of income for an eligible individual must include
the deduction of the individual's medical expenses and the
medical expenses of the individual's spouse and dependent
children who reside in the eligible individual's household.
(12) Establish long term goals for the provision of guardianship
services for adults.
(13) Coordinate activities and programs with the activities of
other boards and state agencies concerning the provision of
guardianship services.
(14) Recommend statutory changes affecting the guardianship of
indigent adults.
(15) Review a proposed rule concerning home and community
based services as required under section 9 of this chapter.
SOURCE: IC 12-10.5-2-4; (11)IN0088.1.12. -->
SECTION 12. IC 12-10.5-2-4 IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2011]: Sec. 4. The continuum of care
provided under this article must include services that support
prevention and treatment of mental illness and addiction.
SOURCE: IC 12-21-2-3; (11)IN0088.1.13. -->
SECTION 13. IC 12-21-2-3, AS AMENDED BY P.L.99-2007,
SECTION 100, IS AMENDED TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2011]: Sec. 3.
(a) In addition to the general
authority granted to the director under IC 12-8-8, the director shall do
the following:
(1) Organize the division, create the appropriate personnel
positions, and employ personnel necessary to discharge the
statutory duties and powers of the division or a bureau of the
division.
(2) Subject to the approval of the state personnel department,
establish personnel qualifications for all deputy directors,
assistant directors, bureau heads, and superintendents.
(3) Subject to the approval of the budget director and the
governor, establish the compensation of all deputy directors,
assistant directors, bureau heads, and superintendents.
(4) Study the entire problem of mental health, mental illness, and
addictions existing in Indiana.
(5) Adopt rules under IC 4-22-2 for the following:
(A) Standards for the operation of private institutions that are
licensed under IC 12-25 for the diagnosis, treatment, and care
of individuals with psychiatric disorders, addictions, or other
abnormal mental conditions.
(B) Licensing supervised group living facilities described in
IC 12-22-2-3 for individuals with a mental illness.
(C) Certifying community residential programs described in
IC 12-22-2-3 for individuals with a mental illness.
(B) Licensing or certifying community residential
programs described in IC 12-22-2-3.5 for individuals with
serious mental illness (SMI), serious emotional disturbance
(SED), or chronic addiction (CA) with the exception of
psychiatric residential treatment facilities.
(D) (C) Certifying community mental health centers to operate
in Indiana.
(E) (D) Establish exclusive geographic primary service areas
for community mental health centers. The rules must include
the following:
(i) Criteria and procedures to justify the change to the
boundaries of a community mental health center's primary
service area.
(ii) Criteria and procedures to justify the change of an
assignment of a community mental health center to a
primary service area.
(iii) A provision specifying that the criteria and procedures
determined in items (i) and (ii) must include an option for
the county and the community mental health center to
initiate a request for a change in primary service area or
provider assignment.
(iv) A provision specifying the criteria and procedures
determined in items (i) and (ii) may not limit an eligible
consumer's right to choose or access the services of any
provider who is certified by the division of mental health
and addiction to provide public supported mental health
services.
(6) Institute programs, in conjunction with an accredited college
or university and with the approval, if required by law, of the
commission for higher education, for the instruction of students
of mental health and other related occupations. The programs may
be designed to meet requirements for undergraduate and
postgraduate degrees and to provide continuing education and
research.
(7) Develop programs to educate the public in regard to the
prevention, diagnosis, treatment, and care of all abnormal mental
conditions.
(8) Make the facilities of the Larue D. Carter Memorial Hospital
available for the instruction of medical students, student nurses,
interns, and resident physicians under the supervision of the
faculty of the Indiana University School of Medicine for use by
the school in connection with research and instruction in
psychiatric disorders.
(9) Institute a stipend program designed to improve the quality
and quantity of staff that state institutions employ.
(10) Establish, supervise, and conduct community programs,
either directly or by contract, for the diagnosis, treatment, and
prevention of psychiatric disorders.
(11) Adopt rules under IC 4-22-2 concerning the records and data
to be kept concerning individuals admitted to state institutions,
community mental health centers, or managed care other
providers.
(12) Establish, maintain, and reallocate before July 1, 1996,
one-third (1/3), and before January 1, 1998, the remaining
two-thirds (2/3) of the following:
(A) long term care service settings; and
(B) state operated long term care inpatient beds;
designed to provide services for patients with long term
psychiatric disorders as determined by the quadrennial actuarial
study under IC 12-21-5-1.5(9). A proportional number of long
term care service settings and inpatient beds must be located in an
area that includes a consolidated city and its adjacent counties.
(13) (12) Compile information and statistics concerning the
ethnicity and gender of a program or service recipient.
(14) (13) Establish standards for each element of the continuum
of care services described in IC 12-7-2-40.6 for community
mental health centers and managed care other providers.
(b) As used in this section, "long term care service setting" means
the following:
(1) The anticipated duration of the patient's mental health setting
is more than twelve (12) months.
(2) Twenty-four (24) hour supervision of the patient is available.
(3) A patient in the long term care service setting receives:
(A) active treatment if appropriate for a patient with a chronic
and persistent mental disorder or chronic addictive disorder;
(B) case management services from a state approved provider;
and
(C) maintenance of care under the direction of a physician.
(4) Crisis care is available.
(c) Funding for services under subsection (a)(12) shall be provided
by the division through the reallocation of existing appropriations. The
need of the patients is a priority for services. The division shall adopt
rules to implement subsection (a)(12) before July 1, 1995.
SOURCE: IC 12-21-2-8; (11)IN0088.1.14. -->
SECTION 14. IC 12-21-2-8, AS AMENDED BY P.L.99-2007,
SECTION 102, IS AMENDED TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2011]: Sec. 8. (a) The director shall develop a
comprehensive system of monitoring, evaluation, and quality assurance
for the continuum of care services required by this chapter.
(b) The director shall determine to whom contracts are awarded,
based on the following factors:
(1) The continuity of services a contractor provides for patients.
(2) The accessibility of a contractor's services to patients.
(3) The acceptability of a contractor's services to patients.
(4) A contractor's ability to focus services on building the
self-sufficiency of the patient.
(c) This subsection applies to the reimbursement of contract
payments to managed care providers. Payments must be determined
prospectively in accordance with generally accepted accounting
principles and actuarial principles recognizing costs incurred by
efficiently and economically operated programs that:
(1) serve individuals with a mental illness or substance abuse
patients; and
(2) are subject to quality and safety standards and laws.
(d) Before entering into a contract under this section, the director
shall submit the contract to the attorney general for approval as to form
and legality.
(e) A contract under this section must do the following:
(1) Specify:
(A) the work to be performed; and
(B) the patient populations to whom services must be
provided.
(2) Provide for a reduction in funding or termination of the
contract for failure to comply with terms of the contract.
(3) Require that the contractor meet the standards set forth in
rules adopted by the division of mental health and addiction under
IC 4-22-2.
(4) Require that the contractor participate in the division's
evaluation process.
(5) For any service for which the division chooses to contract on
a per diem basis, the per diem reimbursement shall be determined
under subsection (c) for the contractor's reasonable cost of
providing services.
(6) In contracts with capitated payment provisions, provide that
the contractor's cost of purchasing stop-loss insurance for the
patient populations to be served in amounts and with limits
customarily purchased by prepaid health care plans must be:
(A) included in the actuarial determination of the capitated
payment amounts; or
(B) separately paid to the contractor by the division.
(7) Provide that a contract for enumerated services granted by the
division under this section to an approved managed care provider
may not create or confer upon the managed care provider liability
or responsibility for care or services beyond those services
supported by the contract.
SOURCE: IC 12-21-5-1.5; (11)IN0088.1.15. -->
SECTION 15. IC 12-21-5-1.5 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2011]: Sec. 1.5. The division shall
do the following:
(1) Adopt rules under IC 4-22-2 to establish and maintain criteria
to determine patient eligibility and priority for publicly supported
mental health and addiction services. The rules must include
criteria for patient eligibility and priority based on the following:
(A) A patient's income.
(B) A patient's level of daily functioning.
(C) A patient's prognosis.
(2) Within the limits of appropriated funds, contract with a
network of
managed care providers to provide
a continuum of
care services in an appropriate setting that is the least restrictive
to individuals who qualify for the services.
(3) Require the providers of services funded directly by the
division to be in good standing with an appropriate accrediting
body as required by rules adopted under IC 4-22-2 by the
division.
(4) Develop a provider profile that must be used to evaluate the
performance of a
managed care provider.
and that may be used to
evaluate other providers of mental health services that access state
administered funds, including Medicaid, and other federal
funding. A provider's profile must include input from consumers,
citizens, and representatives of the mental health ombudsman
program (IC 12-27-9) regarding the provider's:
(A) information provided to the patient on patient rights before
treatment;
(B) accessibility, acceptability, and continuity of services
provided or requested; and
(C) total cost of care per individual, using state administered
funds.
(5) Ensure compliance with all other performance criteria set
forth in a provider contract. In addition to the requirements set
forth in IC 12-21-2-7, a provider contract must include the
following:
(A) A requirement that the standards and criteria used in the
evaluation of care plans be available and accessible to the
patient.
(B) A requirement that the provider involve the patient in the
choice of and preparation of the treatment plan to the greatest
extent feasible.
(C) A provision encouraging the provider to intervene in a
patient's situation as early as possible, balancing the patient's
right to liberty with the need for treatment.
(D) A requirement that the provider set up and implement an
internal appeal process for the patient.
(6) Establish a toll free telephone number that operates during
normal business hours for individuals to make comments to the
division in a confidential manner regarding services or service
providers.
(7) Develop a confidential system to evaluate complaints and
patient appeals received by the division of mental health and
addiction and to take appropriate action regarding the results of
an investigation. A managed care provider is entitled to request
and to have a hearing before information derived from the
investigation is incorporated into the provider's profile.
Information contained within the provider profile is subject to
inspection and copying under IC 5-14-3-3.
(8) Submit a biennial report to the governor and legislative
council that includes an evaluation of the continuum of care. A
report submitted under this subdivision to the legislative council
must be in an electronic format under IC 5-14-6.
(9) Conduct an actuarial analysis every four (4) years beginning
July 1, 2000.
(10) Annually determine sufficient rates to be paid for services
contracted with managed care providers who are awarded a
contract under IC 12-21-2-7.
(11) Take actions necessary to assure the quality of services
required by the continuum of care under this chapter.
(12) Incorporate the results from the actuarial analysis in
subdivision (9) to fulfill the responsibilities of this section.
SOURCE: IC 12-22-2-3.5; (11)IN0088.1.16. -->
SECTION 16. IC 12-22-2-3.5 IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2011]: Sec. 3.5. Community based residential
programs include a broad range of living arrangements designed
to meet the unique needs of individuals with behavioral health
disorders in integrated settings and described in rules adopted by
the division under IC 4-22-2.
SOURCE: IC 12-22-2-5; (11)IN0088.1.17. -->
SECTION 17. IC 12-22-2-5 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2011]: Sec. 5. To the extent that
programs described in section 3 section 3.5 of this chapter are
available and meet an individual's needs, an individual should be
placed in a program that is the least restrictive.
SOURCE: IC 12-22-2-11; (11)IN0088.1.18. -->
SECTION 18. IC 12-22-2-11, AS AMENDED BY P.L.99-2007,
SECTION 114, IS AMENDED TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2011]: Sec. 11. (a) An entity,
other than a
psychiatric residential treatment facility, may not:
(1) operate a program described in IC 12-22-3; or
(2) hold itself out as operating;
(A) a program described in IC 12-22-3; or
(B) a group home for individuals with a mental illness;
operate or hold itself out as operating a group home for individuals
with serious mental illness (SMI), serious emotional disturbance
(SED), or chronic addiction (CA) unless
the entity is licensed or
certified by the division of mental health and addiction. the entity is
licensed or certified by the division.
(b) The division of mental health and addiction shall investigate a
report of:
(1) an unlicensed facility housing a community residential
program described in
section 3(1), 3(2), and 3(3) section 3.5 of
this chapter;
(2) an uncertified operator of a community residential program
described in
section 3(1), 3(2), and 3(3) section 3.5 of this
chapter; or
(3) a licensed or certified entity's noncompliance with this article;
and report the division's findings to the attorney general.
(c) The attorney general may do the following:
(1) Seek the issuance of a search warrant to assist in an
investigation under this section.
(2) File an action for injunctive relief to stop the operation of a
facility described in subsection (b) if there is reasonable cause to
believe that:
(A) the facility or the operator of a community residential
program described in subsection (b) is operating without a
required license or certification; or
(B) a licensed or certified entity's actions or omissions create
an immediate danger of serious bodily injury to an individual
with a mental illness or an imminent danger to the health of an
individual with a mental illness.
(3) Seek in a civil action a civil penalty of not more than one
hundred dollars ($100) a day for each day a facility is operating:
(A) without a license or certification required by law; or
(B) with a license or certification required under this chapter,
but is not in compliance with this article, IC 12-21-2-3, or
rules adopted under this article or IC 12-21-2-3.
(d) The division of mental health and addiction may provide for the
removal of individuals with a mental illness from facilities for
individuals with a mental illness described in subsection (c).
(e) There must be an opportunity for an informal meeting with the
division of mental health and addiction after injunctive relief is ordered
under this section.
(f) The civil penalties collected under this section must be deposited
in the mental health centers fund (IC 6-7-1-32.1).
SOURCE: IC 12-23-1-9; (11)IN0088.1.19. -->
SECTION 19. IC 12-23-1-9 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2011]: Sec. 9. One-third (1/3) (a)
A part of the total amount of the federal money earmarked for Drug
Abuse and Alcohol Abuse/Alcoholics Efforts received for
disbursement by the division shall be used for treatment local programs
that are not under the direction of a community mental health center or
a state institution. provide prevention, intervention, or treatment
services for individuals who:
(1) have a primary diagnosis of chronic substance abuse and
dependence; and
(2) are without significant or immediate treatment needs for
mental illness or serious emotional disturbance.
(b) The amount designated in subsection (a) shall be distributed
to specialty addiction providers that serve the eligible population
to provide consumer choice based on outcomes determined by the
division.
SOURCE: IC 12-24-19-4; (11)IN0088.1.20. -->
SECTION 20. IC 12-24-19-4 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2011]: Sec. 4. Within the limits of
appropriated funds, the division shall provide by written contract a
continuum of care in the community for appropriate patients who are
discharged or transferred under this chapter that does the following:
(1) Integrates services.
(2) Facilitates provision of appropriate services to patients.
(3) Ensures continuity of care including case management, so that
a patient is not discharged or transferred without adequate and
appropriate community services.
(4) Provides services that:
(A) promote behavioral health; and
(B) prevent and treat mental illness and addiction.
SOURCE: IC 12-26-14-4; (11)IN0088.1.21. -->
SECTION 21. IC 12-26-14-4 IS AMENDED TO READ AS
FOLLOWS [EFFECTIVE JULY 1, 2011]: Sec. 4. (a) If a staff member
of a program involved in the treatment, supervision, or care of an
individual ordered to enter an outpatient therapy program under section
1 of this chapter has reason to believe that the individual has failed to
comply with the requirements of section 3 of this chapter, the staff
member shall immediately notify the court of the failure to comply.
(b) Except as provided in subsection (c), the individual may be
transferred from the outpatient therapy program to one (1) of the
following:
(1) The inpatient unit of the facility that has the original
commitment.
(2) A supervised group living program (as defined in
IC 12-22-2-3(2)).
(3) A sub-acute stabilization facility.
(2) A community based residential program under
IC 12-22-2-3.5.
(c) The individual may not be transferred to a supervised group
living program or a sub-acute stabilization facility community based
residential program under IC 12-22-2-3.5 unless in the opinion of
the individual's attending physician:
(1) it is not necessary for the individual to receive acute care
inpatient treatment; and
(2) the individual is in need of either a supervised group living
program or a sub-acute stabilization facility. community based
residential program under IC 12-22-2-3.5.
(d) The individual may not be imprisoned or confined in a jail or
correctional facility unless the individual has been placed under arrest.
(e) A facility to which an individual is transferred under subsection
(b) shall immediately notify the court of the transfer. A transfer to a
facility under subsection (b) is subject to review under section 6 of this
chapter upon petition by the individual who was transferred.
SOURCE: IC 12-29-2-13; (11)IN0088.1.22. -->
SECTION 22. IC 12-29-2-13, AS AMENDED BY P.L.99-2007,
SECTION 151, IS AMENDED TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2011]: Sec. 13. (a) This section applies to Lake
County.
(b) In addition to any other appropriation under this article, the
county annually may fund each center serving the county from the
county's general fund in an amount not exceeding the following:
(1) For 2004, the product of the amount determined under section
2(b)(1) of this chapter multiplied by seven hundred fifty-two
thousandths (0.752).
(2) For 2005 and each year thereafter, the product of the amount
determined under section 2(b)(2) of this chapter for that year
multiplied by seven hundred fifty-two thousandths (0.752).
(c) The receipts from the tax levied under this section shall be used
for the leasing, purchasing, constructing, or operating of
facilities for
community
based residential
facilities programs for individuals with
a mental illness (as defined in
IC 12-7-2-167). IC 12-7-2-40).
(d) Money appropriated under this section must be:
(1) budgeted under IC 6-1.1-17; and
(2) included in the center's budget submitted to the division of
mental health and addiction.
(e) Permission for a levy increase in excess of the levy limitations
may be ordered under IC 6-1.1-18.5-15 only if the levy increase is
approved by the division of mental health and addiction for a
community mental health center.
SECTION 23. THE FOLLOWING ARE REPEALED [EFFECTIVE
JULY 1, 2011]: IC 12-7-2-188.7; IC 12-22-1; IC 12-22-2-3;
IC 12-22-2-4; IC 12-22-2-6; IC 12-22-2-7; IC 12-22-2-8; IC 12-22-2-9;
IC 12-22-2-10; IC 12-22-3; IC 12-24-19-2.