Section 405IAC5-21.6-8. Adult day services

   (a) The services reimbursable as adult day services consist of community-based group programs designed to meet the needs of adults with significant behavioral health impairments as identified in a member's IICP. These comprehensive, nonresidential programs provide health, wellness, social, and therapeutic activities. The day services are delivered in a structured, supportive environment and provide the member with supervision, support services, and personal care as required by the member's IICP.

  (b) Adult day services may include any of the following services as they relate to the member's IICP:

(1) Care planning.

(2) Treatment.

(3) Monitoring of weight, blood glucose level, and blood pressure.

(4) Medication administration.

(5) Nutritional assessment and planning provided by a certified dietitian.

(6) Individual or group exercise training.

(7) Reinforcement of established skills and may include activities of daily living.

(8) Other social activities.

  (c) Provider staff of adult day services must meet any of the following qualifications:

(1) Be a licensed professional, except for a licensed clinical addiction counselor as defined under IC 25-23.6-10.5.

(2) Be a QBHP.

(3) Be an OBHP.

  (d) The agency staff member providing adult day services must receive supervision by a licensed professional.

  (e) Medication administration provided as an adult day service must be delivered within the individual's 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 licensed physician.

(2) An authorized health care professional (AHCP).

(3) A registered nurse.

(4) A licensed practical nurse (LPN).

(5) A medical assistant who has graduated from a two-year clinical program.

  (f) A certified dietitian providing nutritional assessment and planning as a part of the adult day service must meet the qualifications in IC 25-14.5.

  (g) Adult day service standards include all of the following requirements:

(1) The service requires face-to-face contact with the member.

(2) The member must be the focus of the service delivered.

(3) Clinical oversight must be provided by a licensed physician, who is:

(A) on-site at least once a week; and

(B) available to program staff when not physically present on-site.

(4) Each service must be documented in the member's clinical record.

(5) At least weekly, a designated clinical staff member must:

(A) review the member's progress toward meeting habilitative goals; and

(B) document the member's progress in the clinical record.

  (h) Services provided in a residential setting are not reimbursable as adult day services under this rule. (Office of the Secretary of Family and Social Services; 405 IAC 5-21.6-8; filed Dec 16, 2013, 9:11 a.m.: 20140115-IR-405130183FRA; filed Aug 1, 2016, 3:44 p.m.: 20160831-IR-405150418FRA)