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Indiana Administrative Code (Last Updated: December 20, 2016) |
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Title 455. DIVISION OF AGING |
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Article 455IAC3. ASSISTED LIVING MEDICAID WAIVER SERVICES |
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Rule 455IAC3-1. Assisted Living Medicaid Waiver Services |
Section 455IAC3-1-9. Negotiated risk plan appropriate to level of service
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(a) If deemed appropriate and determined to be necessary by a recipient's interdisciplinary team, the provider shall establish a negotiated risk plan with a recipient.
(b) The negotiated risk plan shall address unusual situations in which a recipient's assertion of a right, preference, or behavior exposes the recipient or someone else to a real and substantial risk of injury.
(c) The negotiated risk plan shall identify and accommodate a recipient's need in a way that is acceptable to both the provider and the recipient.
(d) A negotiated risk plan shall include:
(1) an explanation of the cause(s) of concern;
(2) the possible negative consequences to the recipient and/or others;
(3) a description of the recipient's preferences;
(4) possible alternatives or interventions to minimize the potential risks associated with the recipient's preference/action;
(5) a description of the assisted living Medicaid waiver services the provider will provide to accommodate the recipient's choice or minimize the potential risk and services others [sic., other] entities will provide to accommodate the recipient's choice or minimize the potential risk; and
(6) the final agreement, if any, reached by all involved parties.
(e) The provider shall involve the recipient and the recipient's interdisciplinary team in developing, implementing, and reviewing a negotiated risk plan.
(f) The provider shall review a negotiated risk plan with a recipient and a recipient's team at least quarterly. (Division of Aging; 455 IAC 3-1-9; filed Apr 8, 2004, 3:15 p.m.: 27 IR 2493; readopted filed May 27, 2010, 10:11 a.m.: 20100609-IR-460100196RFA; readopted filed May 10, 2016, 11:21 a.m.: 20160608-IR-455160133RFA) NOTE: Transferred from the Division of Disability and Rehabilitative Services (460 IAC 8-1-9) to the Division of Aging (455 IAC 3-1-9) by P.L.153-2011, SECTION 21, effective July 1, 2011.