Section 460IAC6-19-6. Monitoring of services

   (a) A provider of case management shall monitor and document the quality, timeliness, and appropriateness of the care, services, and products delivered to an individual.

  (b) The documentation required under this section shall include an assessment of the following:

(1) The appropriateness of the outcomes in the individual's ISP.

(2) An individual's progress toward the outcomes in the individual's ISP.

  (c) The documentation required by this section shall include the following:

(1) Any medication administration system for the individual.

(2) An individual's behavioral support plan.

(3) Any health-related incident management system for the individual.

(4) Any side effect monitoring system for the individual.

(5) Any seizure management system for the individual.

(6) Any other system for the individual implemented by more than one (1) provider.

  (d) A provider of case management services shall continuously monitor the services and outcomes established for the individual in the individual's ISP, including the following:

(1) A provider of case management services shall timely follow-up on identified problems.

(2) A provider of case management services shall act immediately to resolve critical issues and crises in accordance with this article.

(3) If concerns with services or outcomes are identified, a provider of case management services shall:

(A) address the concerns in a timely manner; and

(B) involve all necessary providers and the individual's support team if necessary.

  (e) A provider of case management services who is attempting to resolve a dispute shall follow the dispute resolution procedure described in 460 IAC 6-10-8.

  (f) No later than thirty (30) days after the implementation of an individual's ISP, unless otherwise specified in the ISP, a provider of case management shall make the first monitoring contact with the individual.

  (g) A provider of case management services shall have regular in-person contact with the individual as required by the ISP and this section. The provider of case management services shall make at least:

(1) one (1) in-person contact with the individual every ninety (90) days to review and complete with the individual or the individual's representative the case management ninety (90) day check list available to providers of case management on the division's providers' computer automation system;

(2) two (2) in-person contacts each year in the individual's residence; and

(3) one (1) in-person contact each year unannounced.

  (h) If an individual's ISP requires more contact than required by subsection (g), the individual's ISP shall control the amount of contact a provider of case management services must make with an individual receiving case management services.

  (i) A provider of case management services shall coordinate the provision of family and caregiver training services. (Division of Disability and Rehabilitative Services; 460 IAC 6-19-6; filed Nov 4, 2002, 12:04 p.m.: 26 IR 777; filed Aug 29, 2003, 10:30 a.m.: 27 IR 113; filed Apr 16, 2004, 10:00 a.m.: 27 IR 2725; readopted filed Sep 26, 2008, 11:11 a.m.: 20081015-IR-460080618RFA; readopted filed Aug 11, 2014, 11:20 a.m.: 20140910-IR-460140241RFA)