Indiana § 12-10-23-4 - Included services

§ 12-10-23-4. Included services

Sec. 4. The continuum of care provided under this article must include services that support prevention and treatment of mental illness and addiction.

[Pre-2026 Revision Citation: 12-10.5-2-4.]

As added by P.L.122-2026, SEC.50.

IC 12-10.5ARTICLE 10.5. REPEALEDRepealed by P.L.122-2026, SEC.51.

IC 12-11ARTICLE 11. SERVICES FOR INDIVIDUALS WITH DISABILITIES

Ch. 1.Repealed Ch. 1.1.Bureau of Disabilities Services; Community Based Services Ch. 2.Repealed Ch. 2.1.Service Coordination Services for Developmentally Disabled Individuals Ch. 3.Repealed Ch. 4.Repealed Ch. 5.Repealed Ch. 6.Other Services for Individuals With Developmental Disabilities Ch. 7.Repealed Ch. 8.Institute for Autism Ch. 10.Repealed Ch. 11.1.Repealed Ch. 12.Repealed Ch. 13.Statewide Waiver Ombudsman Ch. 14.Achieving a Better Life Experience (ABLE) Program Ch. 15.Expired Ch. 15.5.Expired Ch. 16.Direct Support Professional Registry and Training

IC 12-11-1Chapter 1. Repealed[Pre-1992 Revision Citations:

12-11-1-1formerly 4-28-20-112-11-1-2formerly 4-28-20-212-11-1-3formerly 4-28-20-312-11-1-4formerly 4-28-20-412-11-1-5formerly 4-28-20-512-11-1-6formerly 4-28-20-612-11-1-7formerly 4-28-20-712-11-1-8formerly 4-28-20-8; 16-13-22-8.]Repealed by P.L.272-1999, SEC.66.

IC 12-11-1.1Chapter 1.1. Bureau of Disabilities Services; Community Based Services

12-11-1.1-1Establishment; services; approving entities and providers; supported living service arrangements; community based services; administration 12-11-1.1-2Medicaid funding; payment for services 12-11-1.1-3Contracts to provide services 12-11-1.1-4Continuing eligibility for Medicaid 12-11-1.1-5Continuing approved placement of individuals in certain facilities 12-11-1.1-6Individuals with autism not excluded 12-11-1.1-7Community residential facilities operated by division 12-11-1.1-8Repealed 12-11-1.1-9Rules 12-11-1.1-10Provider assessment 12-11-1.1-11Issuance of citation for violations; requirements; remedies; considerations in determining remedy

IC 12-11-1.1-1Establishment; services; approving entities and providers; supported living service arrangements; community based services; administration Sec. 1. (a) The bureau of disabilities services is established within the division.

(b) The bureau shall plan, coordinate, and administer the provision of individualized, integrated community based services for individuals with a developmental disability and their families, within the limits of available resources. The planning and delivery of services must be based on future plans of the individual with a developmental disability rather than on traditional determinations of eligibility for discrete services, with an emphasis on the preferences of the individual with a developmental disability and that individual's family.

(c) Services for individuals with a developmental disability must be services that meet the following conditions:

(1) Are provided under public supervision.

(2) Are designed to meet the developmental needs of individuals with a developmental disability.

(3) Meet all required state and federal standards.

(4) Are provided by qualified personnel.

(5) To the extent appropriate, are provided in home and community based settings in which individuals without disabilities participate.

(6) Are provided in conformity with a service plan developed under IC 12-11-2.1-2.

(d) The bureau shall approve entities to provide community based services and supports as follows:

(1) The bureau shall ensure that an entity approved to provide day services, identified day habilitation, including facility based or community based habilitation, prevocational services, or employment services under home and community based services waivers (as defined in IC 12-8-1.6-2) is accredited by an approved national accrediting body described in subsection (j).

(2) The bureau shall ensure that an entity approved to provide residential habilitation and support services under home and community based services waivers (as defined in IC 12-8-1.6-2) is accredited by an approved national accrediting body.

(e) Subject to subsection (k), the bureau shall initially approve, reapprove, and monitor community based residential, habilitation, and employment service providers that provide alternatives to placement of individuals with a developmental disability in state institutions and health facilities licensed under IC 16-28 for individuals with a developmental disability. The services must simulate, to the extent feasible, patterns and conditions of everyday life that are as close as possible to the conditions in which individuals without disabilities participate. The community based service categories include the following:

(1) Supervised group living programs, which serve at least four (4) individuals and not more than eight (8) individuals, are funded by Medicaid, and are licensed by the division.

(2) Supported living service arrangements to meet the unique needs of individuals in integrated settings. Supported living service arrangements providing residential services may not serve more than four (4) unrelated individuals in any one (1) setting. However, a program that:

(A) is in existence on January 1, 2013, as a supervised group living program described in subdivision (1); and

(B) has more than four (4) individuals residing as part of the program;

may convert to a supported living service arrangement under this subdivision and continue to provide services to up to the same number of individuals in the supported living setting.

(f) To the extent that services described in subsection (e) are available and meet the individual's needs, an individual is entitled to receive services in the least restrictive environment possible.

(g) Community based services under subsection (e)(1) or (e)(2) must consider the needs of and provide choices and options for:

(1) individuals with a developmental disability; and

(2) families of individuals with a developmental disability.

(h) The bureau shall administer a system of service coordination to carry out this chapter.

(i) The bureau may issue orders under IC 4-21.5-3-6 against a provider that violates rules issued by the bureau for programs in which the provider is providing services in accordance with section 11 of this chapter.

(j) For purposes of subsections (d) and (k), "approved national accrediting body" means any of the following:

(1) The Commission on Accreditation of Rehabilitation Facilities (CARF), or its successor.

(2) The Council on Quality and Leadership In Supports for People with Disabilities, or its successor.

(3) The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), or its successor.

(4) The ISO-9001 human services QA system.

(5) The Council on Accreditation, or its successor.

(6) An independent national accreditation organization approved by the secretary.

(k) An entity that is accredited by an approved national accrediting body is not subject to reapproval surveys or routine monitoring surveys by the division or bureau, including any reapproval survey under a home and community based services waiver (as defined in IC 12-8-1.6-2). However, the bureau may perform validation surveys and complaint investigations of an entity accredited by an approved national accrediting body.

(l) The bureau shall monitor services provided by the following:

(1) An entity that provides services to an individual with funds provided by the bureau or under the authority of the bureau.

(2) An entity that has entered into a provider agreement under IC 12-15-11 to provide Medicaid in-home waiver services.

(m) The bureau shall establish and administer a complaint process for the following:

(1) An individual who receives services from an entity with funds provided through the bureau or under the authority of the bureau.

(2) An entity that has entered into a provider agreement under IC 12-15-11 to provide Medicaid in-home waiver services.

As added by P.L.272-1999, SEC.33. Amended by P.L.243-2003, SEC.11; P.L.99-2007, SEC.70; P.L.22-2010, SEC.1; P.L.153-2011, SEC.11; P.L.154-2012, SEC.1; P.L.130-2013, SEC.1; P.L.210-2015, SEC.21; P.L.74-2022, SEC.6; P.L.241-2023, SEC.6; P.L.174-2025, SEC.30.

IC 12-11-1.1-2Medicaid funding; payment for services Sec. 2. (a) Except as specified by the terms of the Medicaid program:

(1) an individual who receives services under this chapter; and

(2) the parents of the individual, if the individual is less than eighteen (18) years of age;

are liable for the cost of services and supports.

(b) The bureau shall make every effort to assure that individualized service plans developed for individuals with a developmental disability maximize the amount of Medicaid funding available to meet the needs of the individual.

(c) The bureau may provide reimbursement for services identified in an individual's individual service plan that are not eligible for Medicaid reimbursement and for which the individual does not have the resources to pay.

As added by P.L.272-1999, SEC.33. Amended by P.L.99-2007, SEC.71.

IC 12-11-1.1-3Contracts to provide services Sec. 3. The division may contract with:

(1) community intellectual disability and other developmental disabilities centers;

(2) corporations; or

(3) individuals;

that are approved by the division to provide the services described in this chapter.

As added by P.L.272-1999, SEC.33. Amended by P.L.117-2015, SEC.19.

IC 12-11-1.1-4Continuing eligibility for Medicaid Sec. 4. An individual with a developmental disability who is eligible for Medicaid remains eligible for Medicaid if transferred to community based services described in section 1(e) of this chapter.

As added by P.L.272-1999, SEC.33. Amended by P.L.99-2007, SEC.72.

IC 12-11-1.1-5Continuing approved placement of individuals in certain facilities Sec. 5. The bureau may continue the approved placement of an individual with a developmental disability in a child caring institution licensed under IC 31-27, a county home regulated by IC 12-30-3, or a health facility licensed under IC 16-28 if:

(1) the individual was placed in the institution, home, or facility before July 1, 1985; and

(2) the placement continues to be appropriate for the individual, as determined by the bureau.

As added by P.L.272-1999, SEC.33. Amended by P.L.145-2006, SEC.70; P.L.99-2007, SEC.73.

IC 12-11-1.1-6Individuals with autism not excluded Sec. 6. An individual who has been diagnosed to have autism may not be excluded from services for individuals with a developmental disability because the individual has autism.

As added by P.L.272-1999, SEC.33. Amended by P.L.99-2007, SEC.74.

IC 12-11-1.1-7Community residential facilities operated by division Sec. 7. Subject to the availability of money, the division may operate community residential facilities for individuals with a developmental disability who are hard to place, if private providers cannot be found to operate facilities for those individuals. Placement of individuals in these facilities is governed by IC 12-11-2.1.

As added by P.L.272-1999, SEC.33. Amended by P.L.99-2007, SEC.75.

IC 12-11-1.1-8RepealedAs added by P.L.272-1999, SEC.33. Repealed by P.L.188-2013, SEC.7.

IC 12-11-1.1-9Rules Sec. 9. The secretary may adopt rules under IC 4-22-2 to carry out this chapter.

As added by P.L.272-1999, SEC.33. Amended by P.L.35-2016, SEC.21.

IC 12-11-1.1-10Provider assessment Sec. 10. (a) The office may assess providers of community based services to individuals with a developmental disability who otherwise qualify to receive ICF/IID (as defined in IC 16-29-4-2) based services in an amount not to exceed six percent (6%) of all service revenue included on the annual plan of care excluding resident living allowances.

(b) The assessments shall be paid to the office not later than the tenth day of the month for each month that the individual is in service. The office or the office's designee may withhold Medicaid payments to a provider described in subsection (a) that fails to pay an assessment within thirty (30) days after the due date. The amount withheld may not exceed the amount of the assessments due.

(c) The community services quality assurance fund is created. The fund shall be administered by the office.

(d) Revenue from the assessments under this section shall be deposited into the fund. Money in the fund must be used for community services for persons with developmental disabilities.

(e) Money in the fund at the end of a state fiscal year does not revert to the state general fund.

(f) If federal financial participation to match the assessments in subsection (a) becomes unavailable under federal law, the authority to impose the assessments terminates on the date that the federal statutory, regulatory, or interpretive change takes effect.

As added by P.L.259-2003, SEC.1. Amended by P.L.246-2005, SEC.101; P.L.35-2016, SEC.22.

IC 12-11-1.1-11Issuance of citation for violations; requirements; remedies; considerations in determining remedy Sec. 11. (a) Upon a determination by the bureau that a provider has violated this article or a rule adopted under this article, the director shall issue a citation under IC 4-21.5-3-6 to the provider. The citation must state the following:

(1) The nature of the violation.

(2) The classification of the violation.

(3) The corrective actions required of the provider to remedy the breach and to protect clients of the provider.

(4) Any penalty imposed on the provider.

(b) A person aggrieved by a citation issued under this section may request a review under IC 4-21.5-3-7. If a request for a hearing is not filed within the fifteen (15) day period, the determination contained in the citation is final.

(c) The bureau may impose the following remedies for a violation of this article or a rule adopted under this article:

(1) Issuance of an order for immediate correction of the violation.

(2) Imposition of a fine not to exceed ten thousand dollars ($10,000).

(3) Suspension of new clients by the provider for a period not to exceed ninety (90) days.

(4) Revocation of the provider's license or issuance of a probationary license.

(5) A requirement that the provider comply with any plan of correction approved or directed by the division.

(d) In determining appropriate remedies under this section for a violation, the bureau shall consider the following:

(1) Whether the violation occurred for reasons beyond the provider's control.

(2) Whether the provider has demonstrated that the provider has taken the appropriate steps to reasonably ensure that the violation will not recur.

(3) The history of violations by the provider.

(4) The effect of the violation on the client.

(5) The degree of the violation.

As added by P.L.153-2011, SEC.12.

IC 12-11-2Chapter 2. Repealed[Pre-1992 Revision Citations:

12-11-2-1formerly 4-28-22-112-11-2-2formerly 4-28-22-312-11-2-3formerly 4-28-22-412-11-2-4formerly 4-28-22-512-11-2-5formerly 4-28-22-612-11-2-6formerly 4-28-22-712-11-2-7formerly 4-28-22-812-11-2-8formerly 4-28-22-912-11-2-9formerly 4-28-22-1012-11-2-10formerly 4-28-22-1112-11-2-11formerly 4-28-22-1212-11-2-12formerly 4-28-22-13.]Repealed by P.L.272-1999, SEC.66.

IC 12-11-2.1Chapter 2.1. Service Coordination Services for Developmentally Disabled Individuals

12-11-2.1-1Diagnostic assessment 12-11-2.1-2Service coordination services 12-11-2.1-3Services provided through individual service plan; review of request to increase service units 12-11-2.1-4Placement authority 12-11-2.1-5Authorizing services for individual in community based setting 12-11-2.1-6Approval of placement in intermediate care facility 12-11-2.1-7Service plan for individual discharged or on outpatient status from state institution 12-11-2.1-8Repealed 12-11-2.1-9Memorandum of understanding concerning referrals 12-11-2.1-10Personal and vocational counselors required 12-11-2.1-11Decertified individuals receiving services; resources 12-11-2.1-12Rules

IC 12-11-2.1-1Diagnostic assessment Sec. 1. (a) The bureau shall determine whether or not an individual has a developmental disability. For individuals for whom there is not enough current information available to make a determination of eligibility, the bureau shall use the results of a diagnostic assessment in determining whether an individual has a developmental disability. A diagnostic assessment must include the following:

(1) Diagnostic information concerning the individual's functioning level and medical and habilitation needs.

(2) All information necessary for the use of the office of Medicaid policy and planning, the Indiana department of health, and the division.

(3) The use of all appropriate assessments conducted under rules adopted under IC 16-28.

(b) An individual who is found not to have a developmental disability may appeal the bureau's finding under IC 4-21.5.

(c) If an individual is determined to have a developmental disability, the office shall determine whether the individual meets the appropriate federal level of care requirements.

As added by P.L.272-1999, SEC.34. Amended by P.L.99-2007, SEC.76; P.L.197-2011, SEC.41; P.L.85-2017, SEC.55; P.L.56-2023, SEC.94.

IC 12-11-2.1-2Service coordination services Sec. 2. The bureau shall, within the limits of available resources, provide service coordination services to individuals with a developmental disability. Service coordination services must include the development of an individual service plan.

As added by P.L.272-1999, SEC.34. Amended by P.L.99-2007, SEC.77.

IC 12-11-2.1-3Services provided through individual service plan; review of request to increase service units Sec. 3. (a) All services provided to an individual must be provided under the individual service plan of the individual with a disability. To the extent that services described in IC 12-11-1.1-1(e) are available and meet the individual's needs, services provided to an individual shall be provided in the least restrictive environment possible.

(b) Pursuant to the applicable home and community based services waiver, a request to increase service units on an individual's approved service plan must be submitted to the bureau for review and approval or denial not later than forty-five (45) calendar days from the first day of the qualifying event, as prescribed by the bureau.

As added by P.L.272-1999, SEC.34. Amended by P.L.14-2000, SEC.29; P.L.99-2007, SEC.78; P.L.160-2026, SEC.6.

IC 12-11-2.1-4Placement authority Sec. 4. The bureau shall serve as the placement authority for individuals with a developmental disability under service plans developed under this chapter, including all placements in an intermediate care facility.

As added by P.L.272-1999, SEC.34. Amended by P.L.99-2007, SEC.79; P.L.188-2013, SEC.8.

IC 12-11-2.1-5Authorizing services for individual in community based setting Sec. 5. When authorizing services for an individual with a developmental disability in a community based setting, the bureau shall give equal consideration based on need between:

(1) individuals who resided with a family member, relative, or guardian immediately before the community based residential placement; and

(2) individuals being placed from:

(A) an intermediate care facility; or

(B) a nursing facility.

As added by P.L.272-1999, SEC.34. Amended by P.L.99-2007, SEC.80; P.L.188-2013, SEC.9.

IC 12-11-2.1-6Approval of placement in intermediate care facility Sec. 6. The bureau may not approve the initial placement of a developmentally disabled individual in an intermediate care facility for individuals with intellectual disabilities serving more than eight (8) individuals or a nursing facility unless:

(1) the individual has medical needs; and

(2) the placement is appropriate to the individual's needs.

As added by P.L.272-1999, SEC.34. Amended by P.L.35-2016, SEC.23; P.L.32-2021, SEC.29.

IC 12-11-2.1-7Service plan for individual discharged or on outpatient status from state institution Sec. 7. Before an individual with a developmental disability is:

(1) discharged from a state institution; or

(2) placed on outpatient status under IC 12-26-14 by a state institution;

the bureau shall develop a service plan for the individual under section 2 of this chapter.

As added by P.L.272-1999, SEC.34. Amended by P.L.99-2007, SEC.81.

IC 12-11-2.1-8RepealedAs added by P.L.272-1999, SEC.34. Amended by P.L.99-2007, SEC.82. Repealed by P.L.188-2013, SEC.10.

IC 12-11-2.1-9Memorandum of understanding concerning referrals Sec. 9. The division of mental health and addiction and the division shall enter into a memorandum of understanding concerning referrals to the bureau of developmentally disabled individuals discharged from or on an outpatient status from a state institution operated by the division of mental health and addiction.

As added by P.L.272-1999, SEC.34. Amended by P.L.215-2001, SEC.39.

IC 12-11-2.1-10Personal and vocational counselors required Sec. 10. The division shall require service coordination personnel and vocational counselors to coordinate their services.

As added by P.L.272-1999, SEC.34.

IC 12-11-2.1-11Decertified individuals receiving services; resources Sec. 11. (a) An individual who:

(1) is receiving services for individuals with a developmental disability that are funded by Medicaid; and

(2) has been decertified by the office because the individual fails to meet appropriate federal level of care requirements;

must continue to receive the same services, unless an appropriate individual service plan has been developed outlining the services needed by the individual to live in the least restrictive environment.

(b) After available federal, local, and individual resources have been used, unencumbered state appropriations that are available, as determined by the budget director, must be used to implement plans developed under subsection (a).

As added by P.L.272-1999, SEC.34. Amended by P.L.99-2007, SEC.83.

IC 12-11-2.1-12Rules Sec. 12. The secretary may adopt rules under IC 4-22-2 to carry out this chapter.

As added by P.L.272-1999, SEC.34. Amended by P.L.35-2016, SEC.24.

IC 12-11-3Chapter 3. Repealed[Pre-1992 Revision Citations:

12-11-3-1formerly 4-28-26-1 part12-11-3-2formerly 4-28-26-1 part12-11-3-3formerly 4-28-26-212-11-3-4formerly 4-28-26-312-11-3-5formerly 4-28-26-412-11-3-6formerly 4-28-26-5.]Repealed by P.L.272-1999, SEC.66.

IC 12-11-4Chapter 4. Repealed[Pre-1992 Revision Citations:

12-11-4-1formerly 12-1-23-112-11-4-2formerly 12-1-23-212-11-4-3formerly 12-1-23-4(a)12-11-4-4formerly 12-1-23-4(b)12-11-4-5formerly 12-1-23-4(c)12-11-4-6formerly 12-1-23-4(d)12-11-4-7formerly 12-1-23-5(a)12-11-4-8formerly 12-1-23-5(b)12-11-4-9formerly 12-1-23-5(c)12-11-4-10formerly 12-1-23-5(d)12-11-4-11formerly 12-1-23-6.]Repealed by P.L.272-1999, SEC.66.

IC 12-11-5Chapter 5. Repealed[Pre-1992 Revision Citations:

12-11-5-1formerly 16-7-15-2(a)12-11-5-2formerly 16-7-15-2(b)12-11-5-3formerly 16-7-15-312-11-5-4formerly 16-7-15-412-11-5-5formerly 16-7-15-5.]Repealed by P.L.272-1999, SEC.66.

IC 12-11-6Chapter 6. Other Services for Individuals With Developmental Disabilities

12-11-6-1Planning, research, and development of other services; coordination of programs and services; crisis assistance program 12-11-6-2Rules 12-11-6-3Repealed