Section 455 IAC 3-1-2 - DefinitionsAuthority: IC 12-9.1-2-3
Affected: IC 12-9-1-1; IC 12-10-13-4.5; IC 12-15; IC 16-28; IC 16-36-1-5
Sec. 2.
The following definitions apply throughout this rule:
(1) "Activities of daily living" means those personal functional activities required by a recipient for continued well-being including:(2) "Aging in place" means being in a care environment that will provide the recipient with a range of care options as the needs of the recipient change. Aging in place does not preclude assisting a recipient in relocating to a new care environment if necessary.(3) "Applicant" means a natural person or entity that applies to provide assisted living Medicaid waiver services.(4) "Area agency on aging" means the agency designated by the BAIHS services in each planning and service area under IC 12-10-1-4(18).(5) "Assessed impairment level" means the level of service needed by a recipient as determined using the level of service assessment form.(6) "Assisted living Medicaid waiver services" means the array of services provided to a recipient residing in a facility, including any or all of the following: (A) Personal care services.(D) Attendant care services.(F) Medication oversight (to the extent permitted under state law). and(G) Therapeutic social and recreational programming.(7) "Assisted living Medicaid waiver services provider" means an entity approved to provided [sic., provide] assisted living Medicaid waiver services.(8) "Attendant care" means hands-on care, of both a supportive and health-related nature, specific to the needs of a medically stable, physically disabled individual.(9) "BAIHS" means the bureau of aging and in-home services as created under IC 12-10-1-1.(10) "Case manager" means the individual or agency enrolled by the office of Medicaid policy and planning chosen by the recipient to provide case management services.(11) "Choice" means a recipient has viable options that enable him or her to exercise greater control over his or her life. Choice is supported by the provision of sufficient private and common space within the facility to provide opportunities for recipients to select where and how to spend time and receive personal assistance.(12) "Chore services" means services needed to maintain the recipient's residential unit in a clean, sanitary, and safe environment.(13) "Companion services" means nonmedical care, supervision, and socialization services. It does not include assisting or supervising the recipient with meal preparation, laundry, or shopping.(14) "Complaint" means an allegation that an assisted living Medicaid waiver services provider has violated this article or a dissatisfaction relating to the condition of the facility or the recipient(s).(15) "Dignity" means providing support in such a way as to validate the self-worth of the recipient. Dignity is supported by designing a structure that allows personal assistance to be provided in privacy and delivering services in a manner that shows courtesy and respect.(16) "Division" means the division of disability, aging, and rehabilitative services created under IC 12-9-1-1.(17) "Facility" a means facility licensed under IC 16-28 and 410 IAC 16.2-5.(18) "Homelike" means an environment that has the qualities of a home, including privacy, comfortable surroundings, and the opportunity to modify one's living area to suit one's individual preferences, which promotes the dignity, security, and comfort of recipients through the provision of personalized care and services to encourage independence, choice, and decision making by the recipients. A homelike environment also provides recipients with an opportunity for self-expression and encourages interaction with the community, family, and friends.(19) "Homemaker services" means services consisting of general household activities, including meal preparation and routine household care.(20) "Independence" means being free from the control of others and being able to assert one's own will, personality, and preferences within the parameters of the house rules or residency agreement.(21) "Interdisciplinary team" means a group of individuals, which must include the recipient, and which may be composed of, but is not limited to:(A) the recipient's family and/or legal representative;(B) the recipient's case manager;(C) a licensed nurse; and(D) the provider(s) of service; who work together to develop the recipient's individual plan of care.(22) "Legal representative" means a person who is:(B) a health care representative;(C) an attorney in fact; or(D) a person authorized by IC 16-36-1-5 to give health care consent.(23) "Level of service" means the specific level of service that an assisted living Medicaid waiver services provider is authorized to provide to a recipient in accordance with the recipient's plan of care and that is based on the assessed impairment level of the recipient.(24) "Medication oversight services" means personnel operating within the scope of applicable licenses and/or certifications providing reminders or cues to recipients to take medication, open preset medication containers, and handle and/or dispense medication.(25) "Office of Medicaid policy and planning" means the office of Medicaid policy and planning created by IC 12-8-6-1 [IC 12-8-6 expired under IC 12-8-6-10. See IC 12-8-6.5.].(26) "Ombudsman" means a representative of the office of the state long term care ombudsman as provided in IC 12-10-13 4.5.(27) "Personal care services" means assistance with: (D) personal hygiene; and(E) activities of daily living.(28) "Plan of care" means the written plan developed by the interdisciplinary team, on which the recipient's case manager documents the proposed Medicaid waiver services, the Medicaid state plan services, as well as other medical services and social services and informal community supports that are needed by the recipient to ensure the health and welfare of the recipient.(29) "Provider" means an entity approved under this article to provider [sic., provide] assisted living Medicaid waiver services.(30) "Recipient" means an individual who is receiving assisted living Medicaid waiver services.(31) "Room and board" means the provision of:(32) "Service plan" means a written plan for services to be provided by the provider, developed by the provider, the recipient, and others, if appropriate, on behalf of the recipient, consistent with the services needed to ensure the health and welfare of the recipient. It is a detailed description of the capabilities, needs, choices, measurable goals, and if applicable the measurable goals and managed risk issues, and documents the specific duties to be performed for the recipient, including who will perform the task, when, and the frequency of each task based on the individual's assessed needs and preferences.(33) "Services" means activities which help a recipient develop skills to increase or maintain level of functioning or which assist the recipient in performing personal care or activities of daily living or individual social activities.(34) "Supportive services" means services which substitute for the:(D) impairment; of a physical or cognitive function.Division of Aging; 455 IAC 3-1-2; filed Apr 8, 2004, 3:15 p.m.: 27 IR 2489; readopted filed May 27, 2010, 10:11 a.m.: 20100609-IR-460100196RFAReadopted filed 5/10/2016, 11:21 a.m.: 20160608-IR-455160133RFAReadopted filed 11/4/2022, 4:00 p.m.: 20221130-IR-455220277RFATransferred from the Division of Disability and Rehabilitative Services (460 IAC 8-1-2) to the Division of Aging (455 IAC 3-1-2) by P.L. 153-2011, SECTION 21, effective July 1, 2011.