Authority: IC 12-8-6.5-5; IC 12-15

Affected: IC 12-13-7-3; IC 12-29; IC 25-23-1-1; IC 25-23.6-10.5; IC 25-27.5-5

Sec. 11. (a) The services reimbursable as therapy and behavioral support services include the following:

1. (1) Services provided in an individual or a group setting.
2. (2) Services provided to family members or other nonprofessional caregivers in an individual or group setting, with or without the member present.

(b) Services provided to a member must be:

1. (1) time-limited;
2. (2) structured; and
3. (3) provided in a face-to-face session.

(c) Services provided must meet the following requirements:

1. (1) Be provided either at home or at locations outside the clinic setting.
2. (2) Be provided in an individual setting or a group setting.
3. (3) Be a face-to-face interaction with the member, family members, or nonprofessional caregivers supporting a member.
4. (4) The member must be the focus of the service.

(d) Provider staff delivering services under this subsection must meet one (1) of the following qualifications:

1. (1) Be a licensed professional, as defined in this rule, except not a licensed clinical addiction counselor as defined under IC 25-23.6-10.5.
2. (2) Be a QBHP.

(e) Therapy and behavioral support service standards include the following:

1. (1) Observation of the member and environment for purposes of the development of the IICP.
2. (2) Development of a person-centered behavioral support plan and subsequent revisions that may be a part of the IICP.

3. (3) Therapy and support activities include, but are not limited to, the following:

   1. (A) Assertiveness training.
   2. (B) Stress reduction techniques.
   3. (C) Development of socially accepted behaviors.
   4. (D) Implementation of a behavior support plan for staff, family members, roommates, and other appropriate individuals.

(f) The services are not reimbursable under this section if provided in a clinic setting.

(Office of the Secretary of Family and Social Services; 405 IAC 5-21.6-11; filed Dec 16, 2013, 9:11 a.m.: 20140115-IR-405130183FRA; filed Aug 1, 2016, 3:44 p.m.: 20160831-IR-405150418FRA; readopted filed Jul 28, 2022, 2:21 p.m.: 20220824-IR-405220205RFA; readopted filed May 30, 2023, 11:54 a.m.: 20230628-IR-405230292RFA)