in-20260805-IR-460260116SNA: LEVEL OF CARE ASSESSMENTS

TITLE 460 DIVISION OF DISABILITY, AGING, AND REHABILITATIVE SERVICES Notice of Second Public Comment Period LSA Document #26-116 LEVEL OF CARE ASSESSMENTS PURPOSE OF NOTICE The Family and Social Services Administration (FSSA) Division of Disability, Aging, and Rehabilitative Services (DDARS) is soliciting public comment on adding rules at 460 IAC 15 concerning level of care assessments. HISTORY Notice of First Public Comment Period: 20260513-IR-460260116FNA Regulatory Analysis submitted with Notice of First Public Comment Period: 20260513-IR-460260116RAA Date of First Hearing: June 15, 2026 ADDITIONAL DOCUMENTS Regulatory Analysis: No changes were made to the Regulatory Analysis published with the Notice of First Public Comment Period. Notice of Public Hearing: 20260805-IR-460260116PHA CITATIONS AFFECTED: 460 IAC 15 AUTHORITY: IC 12-11-2.1-1; IC 12-11-2.1-4; IC 12-11-2.1-12 OVERVIEW Basic Purpose and Background The proposed rule adds rules at 460 IAC 15 to establish standards and requirements for the intermediate care facility for individuals with intellectual disabilities (ICF/IID) level of care. IC 12-11-2.1-1 requires DDARS - bureau of disabilities services (DDARS-BDS) to determine if an individual has a developmental disability and meets level of care criteria for services, and requires the use of a diagnostic assessment to make that determination. The assessment must include comprehensive information concerning an individual's functional capacity, medical and habilitation needs, and any additional data necessary for coordination of services. Eligibility determinations all rely on these assessments to authorize home and community based services waivers and to determine the appropriateness of community-based supports. This rule will apply to all individuals with intellectual disabilities, developmental disabilities, or related conditions who are applying for and eligible for services requiring an ICF/IID level of care administered or overseen by DDARS-BDS. The implementation costs of the proposed rule are not expected to exceed the threshold set in IC 4-22-2-22.7(c)(6). For purposes of IC 4-22-2-28.1, small businesses affected by this rulemaking may contact the Small Business Regulatory Coordinator: For purposes of IC 4-22-2-28.1, the Small Business Ombudsman designated by IC 5-28-17-6 is: Resources available to regulated entities through the small business ombudsman include the ombudsman's duties stated in IC 5-28-17-6, specifically IC 5-28-17-6(9), investigating and attempting to resolve any matter regarding compliance by a small business with a law, rule, or policy administered by a state agency, either as a party to a proceeding or as a mediator. SUMMARY/RESPONSE TO COMMENTS DDARS requested public comment from May 13, 2026, through June 15, 2026, and during the public hearing on June 15, 2026. The comment received and DDARS's response to the comment is summarized as follows: Leah Steere, New Hope of Indiana Comment: Leah Steere asked questions about timing of level of care assessments for group homes and asked for clarification on the process if they would be required on an annual basis. Response: The DDARS appreciates the feedback from Leah Steere. The Annual Level of Care of Assessments are not currently required of group home residents. The confirmation of diagnosis is required at the initial application and not currently required on an annual basis. REQUEST FOR PUBLIC COMMENT DDARS is soliciting public comment on the proposed rule. Comments may be submitted in one of the following ways: COMMENT PERIOD DEADLINE All comments must be postmarked or time-stamped not later than September 4, 2026. The rule, Regulatory Analysis, appendices referenced in the Regulatory Analysis, and materials incorporated by reference (if applicable) are on file at the Family and Social Services Administration, 402 West Washington Street, Room W451, Indianapolis, Indiana and are available for public inspection. Copies of the rule, Regulatory Analysis, and appendices referenced in the Regulatory Analysis are available at the Family and Social Services Administration office. This notice is for the second of two (2) thirty (30) day periods in which the public may comment on the proposed rule. Following this second public comment period, DDARS may adopt a version of the proposed rule that is the same as or does not substantially differ from the text of the proposed rule published in this notice. EXPLANATION OF DIFFERENCES IN PROPOSED RULE There are no differences between the proposed rule in this document and the proposed rule published in the Notice of First Public Comment Period. PROPOSED RULE Sec. 1. The definitions in this rule apply throughout this article. Sec 2. “BDS” means the bureau of disabilities services established by IC 12-11-1.1-1. Sec. 3. “ICF/IID” means an intermediate care facility for individuals with intellectual disabilities. Sec. 1. The purpose of this article is to establish standards and requirements for the ICF/IID level of care. Sec. 2. This article applies to all individuals with intellectual disabilities, developmental disabilities, or related conditions who are applying for and eligible for services requiring an ICF/IID level of care administered or overseen by BDS. Sec. 3. To be eligible for services requiring an ICF/IID level of care administered or overseen by BDS, an individual must meet the: Sec. 4. To meet the ICF/IID level of care eligibility criteria, an individual must have a severe, chronic disability that meets all the following conditions: Sec. 5. An individual shall apply for services requiring an ICF/IID level of care administered or overseen by BDS by completing and submitting an online, including email, or a physical version of State Form 55068 (R/6-23). The physical application must be legible to BDS staff and returned to a local BDS office by fax, mail, or in-person delivery. Sec. 6. An individual shall meet the ICF/IID level of care eligibility criteria at the following times: Sec. 7. An individual's level of care assessment must be made by a BDS staff member, or its designee, who is a qualified intellectual disability professional under 42 CFR 483.430(a). The assessment includes an in-person interview, to the extent practicable. Sec. 8. (a) An individual shall submit, and permit BDS to obtain, documentation relevant to their disability with their application. An individual may submit additional assessments from licensed psychologists, physicians, nurses, and social workers. (b) The following documentation is required: Sec. 9. The level of care assessment tool is used for reviewing the application, required documentation, and interview to determine whether eligibility is met, as required in this rule. Sec. 10. (a) An individual's ICF/IID level of care eligibility may only be denied by qualified BDS staff under this rule. (b) An individual shall receive written notice of the denial of their level of care eligibility by BDS, with appeal rights and instructions. Notice will be mailed to the address provided on the application. If an individual's address changes after the submission of their application, it is the individual's responsibility to notify BDS to update their address. (c) An individual's level of care eligibility may be denied due to a failure to meet ICF/IID criteria, or fraudulent, inaccurate, incomplete, or conflicting information in the application, documentation, or interview. Sec. 11. An individual shall receive written notice of the approval of their level of care eligibility by BDS. Notice will be mailed to the address provided on the application. If an individual's address changes after the submission of their application, it is the individual's responsibility to notify BDS to update their address. Sec. 12. An individual seeking to appeal their ICF/IID level of care eligibility determination shall: LSA Document #26-116 Notice of First Public Comment Period: May 13, 2026 Documents Incorporated by Reference: None Received by Publisher Small Business Regulatory Coordinator: Jessica Harlan-York, Chief Operating Officer, Division of Disability and Rehabilitative Services, Indiana Government Center South, 402 West Washington Street, Room W453, Indianapolis, IN 46204, (317) 234-1147, Jessica.harlan-york@fssa.in.gov