Section 405IAC5-21.6-10. Respite care services

   (a) The services reimbursable as respite care services are provided to a member who is:

(1) unable to care for himself or herself; and

(2) living with a nonprofessional caregiver.

  (b) The service provided under this section shall be furnished on a short-term basis because of a nonprofessional caregiver's absence or need for relief.

  (c) The service may be provided in any of the following locations:

(1) A member's home or place of residence.

(2) A caregiver's home.

(3) A nonprivate residential setting such as a group home or adult foster care.

  (d) Provider staff delivering service under this section must meet one (1) of the following qualifications:

(1) A licensed professional.

(2) A QBHP.

(3) An OBHP.

  (e) Medication administration provided within the respite care service must be provided within the scope of practice, as defined by federal and state law, by an agency staff member who meets one (1) of the following qualifications:

(1) A physician.

(2) An advanced practice nurse (APN).

(3) A physician assistant (PA).

(4) A registered nurse (RN).

(5) A licensed practical nurse (LPN).

  (f) Respite care service standards include the following:

(1) The member must be living with a nonprofessional caregiver.

(2) The location of services and the level of professional care are based on the needs of the member of the service, including the regular monitoring of medications or behavioral symptoms as identified in the member's IICP.

(3) Services must be provided in the least restrictive environment available and ensure the health and welfare of the member.

(4) Services shall not be used as a substitute for regular care in order to allow the member's caregiver to:

(A) attend school;

(B) hold a job; or

(C) engage in employment or employment search related activities.

(5) Respite care must not duplicate any other service being provided under the member's IICP.

  (g) The following services are not reimbursable under this section:

(1) Services provided to a member living in an office-licensed residential facility.

(2) Services provided to a member who receives in-home support from a professional caregiver, rather than a nonpaid caregiver.

(3) Respite care services provided by either of the following:

(A) Any relative who is the primary caregiver of the member.

(B) Anyone living in the member's home or residence.

(Office of the Secretary of Family and Social Services; 405 IAC 5-21.6-10; filed Dec 16, 2013, 9:11 a.m.: 20140115-IR-405130183FRA; filed Aug 1, 2016, 3:44 p.m.: 20160831-IR-405150418FRA)