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Indiana Administrative Code (Last Updated: December 20, 2016) |
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Title 405. OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES |
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Article 405IAC5. MEDICAID SERVICES |
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Rule 405IAC5-21.7. Child Mental Health Wraparound Services |
Section 405IAC5-21.7-18. Respite care services
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(a) Respite care services are:
(1) provided to a member unable to care for himself or herself; and
(2) furnished on a short-term basis because of the absence, or need for relief, of a person or persons who normally provide care for the member.
(b) Respite care services may be provided in the following manner for planned or routine time frames when a caregiver is aware of needing relief or assistance through respite care:
(1) On an hourly basis, but billed for less than seven (7) hours in the same day.
(2) On a daily basis and billed for a service provided from seven (7) to twenty-four (24) hours in the same day.
(3) As a daily service not to exceed a period of fourteen (14) consecutive days at one (1) time.
(c) Crisis respite care services may be provided on an unplanned basis when the caregiver requires assistance in caring for a member as follows:
(1) In a crisis situation in which a child's health and welfare would be seriously impacted or harmed in the absence of crisis respite care.
(2) On a daily basis, and billed from eight (8) to twenty-four (24) hours in the same day.
(3) Not to exceed fourteen (14) consecutive days at one (1) time.
(d) Respite care services must be provided in the least restrictive environment available to ensure the health and welfare of the member.
(e) Respite care service may be provided in the following locations:
(1) The member's home or private place of residence in the community.
(2) Any office-certified state licensed facility.
(f) A member who needs consistent twenty-four (24) hour supervision, with regular monitoring of medications or behavioral symptoms, must be placed in a facility under the supervision of any of the following:
(1) A psychologist.
(2) A psychiatrist, physician, or nurse who meets licensing or certification requirements of his or her profession in the state of Indiana.
(g) Allowed respite care service activities include the following:
(1) Assistance with daily living skills, including assistance with accessing community activities and transporting the member to or from community activities.
(2) Assistance with grooming and personal hygiene.
(3) Meal preparation, serving, and cleanup.
(4) The administration of medications.
(5) Supervision.
(h) Respite care service exclusions are the following:
(1) Respite care provided by the following:
(A) A parent or parents for a member who is a minor child.
(B) Any relative who is the primary caregiver of a member.
(C) Any individual living in a member's residence.
(2) Respite care services provided as a substitute for regular child care to allow the parent to attend school or to engage in employment or employment search-related activities.
(3) Respite care provided in the residence of a CMHW respite care service provider, unless the service is provided by an office-authorized relative of the member.
(4) Respite care used to provide services to the member while the member is attending school.
(5) Crisis respite care service scheduled to relieve the family when a member is in crisis.
(Office of the Secretary of Family and Social Services; 405 IAC 5-21.7-18; filed Dec 18, 2013, 11:13 a.m.: 20140115-IR-405130211FRA; filed Aug 1, 2016, 3:44 p.m.: 20160831-IR-405150418FRA)