Section 405 IAC 5-21.5-10 - Adult intensive rehabilitative servicesAuthority: IC 12-15
Affected: IC 12-13-7-3
Sec. 10.
(a) The services reimbursable as adult intensive rehabilitative services (AIRS) are time-limited, nonresidential services provided in a clinically supervised setting to a member who requires structured rehabilitative services in order to maintain the member on an outpatient basis.(b) Services are curriculum based and designed to alleviate emotional or behavioral problems with the goals of: (1) reintegrating the member into the community;(2) increasing social connectedness beyond a clinical setting; or(c) The requirements for AIRS shall be as follows:(1) Services may be provided for members who:(A) are at least eighteen (18) years of age with serious mental illness who need structured therapeutic and rehabilitative services;(B) have significant impairment in day-to-day personal, social, or vocational functioning;(C) do not require acute stabilization, including inpatient or detoxification services; and(D) are not at imminent risk of harm to self or others.(2) Services may be provided to members less than eighteen (18) years of age, but not less than sixteen (16) years of age with prior authorization.(d) Providers must meet any of the following qualifications:(1) A licensed professional.(e) Programming standards shall be as follows: (1) Services must be authorized by a physician or an HSPP.(2) Direct services must be supervised by a licensed professional.(3) Clinical oversight must be provided by a licensed physician, who is on-site weekly and is available to program staff when not physically present.(4) Member goals must be designed to facilitate community integration, employment, and use of natural supports.(5) Therapeutic services include clinical therapies, psycho-educational groups, and rehabilitative activities.(6) A weekly review and update of progress takes place and is documented in the member's clinical record.(7) Services must be provided in an age appropriate setting for members less than eighteen (18) years of age receiving services.(8) The member is the focus of the service.(9) Documentation must support how the service benefits the member, including when provided in a group setting.(10) Services must demonstrate movement toward or achievement of member treatment goals identified in the individualized integrated care plan.(11) Service goals must be rehabilitative in nature.(f) Exclusions from reimbursement shall be as follows:(1) Services that are purely recreational or diversionary in nature or that do not have therapeutic or programmatic content.(2) Formal educational or vocational services.(3) AIRS will not be reimbursed for a member who receives both AIRS and individual or group skills training and development on the same day.(4) AIRS will not be reimbursed for a member who receives both AIRS and CAIRS on the same day.Office ofthe Secretary of Family and Social Services; 405 IAC 5-21.5-10; filed May 27, 2010, 9:15 a.m.: 20100623-IR-405100045FRA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR-405130241RFAFiled 8/1/2016, 3:44 p.m.: 20160831-IR-405150418FRAReadopted filed 7/28/2022, 2:21 p.m.: 20220824-IR-405220205RFAReadopted filed 5/30/2023, 11:54 a.m.: 20230628-IR-405230292RFA