INDIANA
Two Indiana commissions examined issues in 2002 relating to expansion of home and community-based services (HCBS) for people with disabilities and the supply and training of the long-term care work force. The legislature also enacted a measure that would help facilitate the use of certain unlicensed workers in HCBS programs.
Planning and Reports
In July 2002, Governor Frank O'Bannon appointed a 21-member Governor's Commission on Home and Community-Based Services, the purpose of which is to develop short- and long-term strategies to create or expand home and community-based services for people with disabilities. The commission convened five special task forces, each devoted to specific policy areas of concern, and a Consumer Advisory Committee to assist with its work.
The commission issued an interim report on December 23, 2002, with 16 recommendations under five categories: eligibility, streamlining and maximizing funding, provider incentives to increase capacity, consumer education, and consumer choice. Under eligibility, for example, the commission recommended that the state apply spousal impoverishment provisions to the Medicaid Aged and Disabled Waiver Program as is done for Medicaid-funded nursing home care, and raise the monthly income eligibility standard for the waiver program to 300 percent of Supplemental Security Income as is the case for nursing home care. A final report is to be issued in June 2003.
The Indiana legislature established the Governor's Commission on Long Term Caregivers in 2001. The commission convened in 2002 to review information and data related to long-term caregivers, evaluate the adequacy of the state's training programs, and make recommendations to increase the supply. The legislation defined "long-term caregivers" as certified nurse aides, licensed practical nurses, and registered nurses " ... employed in health facilities, home health care, and community-based settings."
Work Force
In 2002, the legislature also enacted a bill permitting certain individuals who are not licensed health care professionals to provide health-related services to individuals who need in-home care services under the state-funded CHOICE program and Medicaid waiver programs. The unlicensed caregiver under this legislation is known as a "Personal Services Attendant." The Indiana Division of Disability, Aging and Rehabilitative Services is developing a registry for personal services attendants. The legislation also provides that hospice and home health agency employees who have received training (which has been approved by the attending physician) from a registered nurse may perform medical activities that have been delegated.
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