Ind. Admin. Code tit. 410, r. 16.2-5-11.1 – Mental health screening for individuals who are recipients of Medicaid or federal Supplemental Security Income

Sec. 11.1. (a) As used in this section, "mental health service provider" means the community mental health center local to the residential care facility.

(b) If the individual is a recipient of Medicaid or federal Supplemental Security Income (SSI), the individual needs evaluation provided in section 2(a) of this rule shall include, but not be limited to, the following:

(1) Screening of the individual for major mental illness, such as a diagnosed major mental illness, is limited to the following disorders:
1. (A) Schizophrenia.
2. (B) Schizoaffective disorder.
3. (C) Mood (bipolar and major depressive type) disorder.
4. (D) Paranoid or delusional disorder.
5. (E) Panic or other severe anxiety disorder.
6. (F) Somatoform or paranoid disorder.
7. (G) Personality disorder.
8. (H) Atypical psychosis or other psychotic disorder (not otherwise specified).
(2) Obtaining a history of treatment received by the individual for a major mental illness within the last two (2) years.
(3) Obtaining a history of individual behavior within the last two (2) years that would be considered dangerous to facility residents, the staff, or the individual.

(c) If a person is a recipient of Medicaid or federal SSI and has a major mental illness as defined by the individual needs assessment, the person will be referred to the mental health service provider for a consultation on needed treatment services. All residents who participate in Medicaid or SSI admitted after April 1, 1997, shall have a completed individual needs assessment in their clinical record. All persons admitted after April 1, 1997, shall have the assessment completed prior to the admission, and, if a mental health center consultation is needed, the consultation shall be completed prior to the admission and a copy maintained in the clinical record.

(d) When a state hospital refers a person with a major mental illness, the residential care facility shall request that a copy of the psychosocial and treatment recommendations collaboratively developed between the state hospital and the mental health center be forwarded to the residential care facility so that the residential care facility can determine the degree to which it can provide or arrange for the provision of such service.

(e) The residential care facility shall not admit residents with a major mental illness if:

(1) the mental health service provider determines that the resident's needs cannot be met; and
(2) the residential care facility does not have a means to access needed services to carry out the comprehensive care plan.

(f) Each resident with a major mental illness must have a comprehensive care plan that is developed within thirty (30) days after admission to the residential care facility.

(g) The residential care facility, in cooperation with the mental health service providers, shall develop the comprehensive care plan for the resident that includes the following:

(1) Psychosocial rehabilitation services that are to be provided within the community.
(2) A comprehensive range of activities to meet multiple levels of need, including the following:
1. (A) Recreational and socialization activities.
2. (B) Social skills.
3. (C) Training, occupational, and work programs.
4. (D) Opportunities for progression into less restrictive and more independent living arrangements.

(h) The residential care facility shall provide or arrange for services to carry out the resident's comprehensive care plan.

(i) The residential care facility shall seek appropriate alternate placement in accordance with 410 IAC 16.2-2-3 if the resident's needs or comprehensive care plan, or both, cannot be met by the residential care facility.

(j) The facility must comply with IC 12-10-6 for those residents eligible for residential care assistance.

(k) For purposes of IC 16-28-5-1, a breach of:

(1) subsection (e) is an offense;
(2) subsection (b), (c), (g), (h), or (i) is a deficiency; and
(3) subsection (d), (f), or (j) is a noncompliance.

(Indiana Department of Health; 410 IAC 16.2-5-11.1; filed Jan 21, 2003, 8:34 a.m.: 26 IR 1935, eff Mar 1, 2003; readopted filed May 22, 2007, 1:44 p.m.: 20070613-IR-410070141RFA; readopted filed Sep 11, 2013, 3:19 p.m.: 20131009-IR-410130346RFA; readopted filed Nov 13, 2019, 3:14 p.m.: 20191211-IR-410190391RFA; readopted filed Nov 14, 2025, 11:18 a.m.: 20251210-IR-410240588RFA)