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

Affected: IC 12-7-2-40.6; IC 12-13-7-3; IC 12-15-2-3.5; IC 12-29-2; IC 25-23-1-1; IC 25-23.6-10.5; IC 25-27.5-5

Sec. 5. (a) A member approved to receive BPHC services under this rule shall be eligible for such services for up to a six (6) month period commencing from the date of service approval and authorization, as long as eligibility and needs-based eligibility criteria and other eligibility continue to be met.

(b) A reevaluation will be conducted at least every six (6) months and shall include the following:

1. (1) Conducting a face-to-face holistic clinical and biopsychosocial evaluation completed by an office-approved BPHC service provider.
2. (2) Administering the office-approved behavioral assessment tool to determine whether the member still meets the level of need for intensive community-based services, as demonstrated by a rating level of three (3) or higher.
3. (3) Assessing the member's progress toward meeting treatment goals set forth in the IICP.
4. (4) Documenting that the member continues to meet BPHC target group eligibility and needs-based eligibility criteria.
5. (5) Completing an updated application.
6. (6) Completing an updated IICP documenting the member's choice of BPHC service providers.

(c) The state evaluation team will review and assess the application and reevaluation results to determine whether the member continues to meet needs-based and target group eligibility criteria.

(d) Any approval or denial of eligibility and services under this rule will be communicated to the following:

1. (1) The applicant or the applicant's authorized representative.
2. (2) The referring provider agency.

(Office of the Secretary of Family and Social Services; 405 IAC 5-21.8-5; filed Apr 8, 2014, 12:41 p.m.: 20140507-IR-405130530FRA; 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)