CHAPTER 13. LONG TERM CARE OMBUDSMAN PROGRAM
IC 12-10-13
Chapter 13. Long Term Care Ombudsman Program
IC 12-10-13-1
Repealed
(Repealed by P.L.139-1993, SEC.24.)
IC 12-10-13-2
Repealed
(Repealed by P.L.139-1993, SEC.24.)
IC 12-10-13-3
Home care services
Sec. 3. As used in this chapter, "home care services" means
in-home services funded through any of the following:
(1) The office of Medicaid policy and planning.
(2) A county office.
(3) The division.
As added by P.L.2-1992, SEC.4. Amended by P.L.139-1993, SEC.5;
P.L.4-1993, SEC.39; P.L.5-1993, SEC.52.
IC 12-10-13-3.3
Legal representative
Sec. 3.3. As used in this chapter, "legal representative" means:
(1) a guardian;
(2) a health care representative acting under IC 16-36-1;
(3) an attorney-in-fact for health care appointed under
IC 30-5-5-16;
(4) an attorney-in-fact appointed under IC 30-5-5 who does not
hold health care powers; or
(5) the personal representative of the estate;
of a resident of a long term facility or client of home care services.
As added by P.L.139-1993, SEC.6. Amended by P.L.1-1994, SEC.54.
IC 12-10-13-3.6
Long term care facility
Sec. 3.6. As used in this chapter, "long term care facility" means
either of the following:
(1) A facility licensed under or subject to IC 16-28-2.
(2) An adult care home.
As added by P.L.139-1993, SEC.7. Amended by P.L.2-1995, SEC.47.
IC 12-10-13-4
Office
Sec. 4. As used in this chapter, "office" refers to the long term
care ombudsman office established by this chapter. The term
includes individuals approved to act in the capacity of ombudsmen
by the long term care ombudsmen office.
As added by P.L.2-1992, SEC.4. Amended by P.L.139-1993, SEC.8.
IC 12-10-13-4.5
Ombudsman
Sec. 4.5. As used in this chapter, "ombudsman" means an
employee of the office or an individual approved by the office to
investigate and resolve complaints and concerns regarding the health,
safety, welfare, or rights of residents or clients under 42 U.S.C. 3027
and this chapter.
As added by P.L.139-1993, SEC.9.
IC 12-10-13-5
Repealed
(Repealed by P.L.139-1993, SEC.24.)
IC 12-10-13-6
State ombudsman
Sec. 6. As used in this chapter, "state ombudsman" refers to the
individual who directs the long term care ombudsman office.
As added by P.L.2-1992, SEC.4. Amended by P.L.139-1993, SEC.10.
IC 12-10-13-7
Establishment of office
Sec. 7. The division shall establish the long term care ombudsman
office in compliance with 42 U.S.C. 3027.
As added by P.L.2-1992, SEC.4.
IC 12-10-13-8
State ombudsman; appointment
Sec. 8. Subject to sections 10 through 12 of this chapter, the
director of the division shall appoint the state long term care
ombudsman to direct the office on a full-time basis.
As added by P.L.2-1992, SEC.4. Amended by P.L.139-1993, SEC.11.
IC 12-10-13-9
Vacancy
Sec. 9. The director shall appoint an acting state ombudsman
within thirty (30) days of a vacancy in the position of state
ombudsman. The acting state ombudsman has the powers and duties
of the state ombudsman.
As added by P.L.2-1992, SEC.4.
IC 12-10-13-10
Qualifications
Sec. 10. The state ombudsman must have familiarity with the
following:
(1) Gerontology or long term care.
(2) The legal system.
(3) Dispute or problem resolution techniques, including
investigation, mediation, and negotiation.
As added by P.L.2-1992, SEC.4.
IC 12-10-13-11
State ombudsman; eligibility; employment by health facility or
home care service organization
Sec. 11. The director may not appoint as state ombudsman an
individual who has been employed by a long term care facility or a
home care service organization within one (1) year preceding the
director's proposed appointment.
As added by P.L.2-1992, SEC.4. Amended by P.L.139-1993, SEC.12.
IC 12-10-13-12
State ombudsman; eligibility; pecuniary interest in health facility
or home care service organization
Sec. 12. The state ombudsman and a member of the state
ombudsman's immediate family may not have had a pecuniary
interest in a long term care facility or a home care service
organization within three (3) years preceding the director's proposed
appointment.
As added by P.L.2-1992, SEC.4. Amended by P.L.139-1993, SEC.13.
IC 12-10-13-13
Technical experts; staff
Sec. 13. The state ombudsman may employ technical experts and
other employees to carry out the purposes of the office.
As added by P.L.2-1992, SEC.4.
IC 12-10-13-14
Investigation and resolution of complaints and concerns
Sec. 14. (a) The office shall receive, investigate, and attempt to
resolve complaints and concerns that:
(1) are made by or on behalf of a patient, resident, or client of
a long term care facility or a home care service, except for an
individual with a developmental disability who is receiving
waiver services; and
(2) involve the health, safety, welfare, or rights of a resident or
client.
(b) At the conclusion of an investigation of a complaint, the office
shall report the office's findings to the complainant.
As added by P.L.2-1992, SEC.4. Amended by P.L.139-1993, SEC.14;
P.L.272-1999, SEC.32.
IC 12-10-13-15
Report of findings
Sec. 15. At the conclusion of an investigation of a complaint, the
office shall report the office's findings to the complainant.
As added by P.L.2-1992, SEC.4.
IC 12-10-13-16
Decision not to investigate; notice
Sec. 16. If the office does not investigate a complaint, the office
shall notify the complainant of the decision not to investigate and the
reasons for the decision.
As added by P.L.2-1992, SEC.4. Amended by P.L.139-1993, SEC.15.
IC 12-10-13-16.2
Ombudsman; access to persons, places, records, and other
information
Sec. 16.2. In accordance with this chapter, an ombudsman must
be provided access to the following:
(1) Long term care facilities, entities that provide home care
services, and the residents or clients of the long term care
facilities or entities that provide home care services.
(2) As provided in section 16.4 of this chapter, a resident's or
client's medical, financial, and social records.
(3) If the resident or client is incapable of giving consent, as
determined by the attending physician or as otherwise
determined under state law, the name, address, and telephone
number of the resident's or client's legal representative.
As added by P.L.139-1993, SEC.16.
IC 12-10-13-16.4
Ombudsman; access to medical, financial, and social records of
resident or client; consent
Sec. 16.4. (a) An ombudsman must be provided access to a
resident's or client's medical, financial, and social records. Except as
provided in subsections (c) and (d), the ombudsman must obtain
consent under subsection (b) before having access to the records.
(b) Consent to have access to a resident's or client's medical,
financial, and social records shall be given in one (1) of the
following forms:
(1) In writing by the resident or client.
(2) Orally by the resident or client in the presence of a witness.
(3) In writing by the legal representative of the resident or client
if:
(A) the resident or client is incapable of giving consent, as
determined by the attending physician or as otherwise
determined under state law; and
(B) the legal representative has the authority to give consent.
(c) If consent to have access to a resident's or client's medical,
financial, and social records cannot be obtained under subsection (b),
an ombudsman may inspect the records of a resident or client if the
resident or client is incapable of giving consent, as determined by the
attending physician or as otherwise determined under state law, and:
(1) has no legal representative;
(2) has a legal representative but the legal representative cannot
be contacted within three (3) days; or
(3) has a legal representative but the legal representative does
not have the authority to give consent to have access to the
records.
(d) If an ombudsman has:
(1) been denied access to a resident's or client's medical,
financial, and social records by the resident's or client's legal
representative;
(2) reasonable cause to believe that the resident's or client's
legal representative is not acting in the best interests of the
resident or client; and
(3) received written approval from the state ombudsman;
the ombudsman may inspect the records of the resident or client.
As added by P.L.139-1993, SEC.17.
IC 12-10-13-16.5
Ombudsman; access to records of long term care facility or home
care service
Sec. 16.5. An ombudsman shall be given appropriate access to the
records of a long term care facility or home care service.
As added by P.L.139-1993, SEC.18.
IC 12-10-13-16.6
Ombudsman; access to records of state or local government agency
or entity
Sec. 16.6. A state or local government agency or entity that has
records that are relevant to a complaint or an investigation conducted
by an ombudsman shall provide the ombudsman with access to the
records.
As added by P.L.139-1993, SEC.19.
IC 12-10-13-16.7
Long term care facility, home care service, or employee; disclosure
of records; immunity from liability
Sec. 16.7. A long term care facility or home care service or an
employee of a long term care facility or home care service is immune
from:
(1) civil or criminal liability; and
(2) actions taken under a professional disciplinary procedure;
for the release or disclosure of records to an ombudsman under this
chapter.
As added by P.L.139-1993, SEC.20.
IC 12-10-13-16.8
Coordination among government agencies; toll free telephone
number for reporting problems; nondisclosure of identity of
complainant, resident, or client
Sec. 16.8. The office shall do the following:
(1) Promote effective coordination between the office and the
following:
(A) Programs that provide legal services for the elderly.
(B) The adult protective services program.
(C) The attorney general's division of Medicaid fraud.
(D) The state department of health.
(E) Indiana protection and advocacy services.
(2) Establish a statewide toll free telephone line to receive
reports of problems about long term care facilities or home care
services.
(3) Ensure that the identity of a complainant, resident, or client
will not be disclosed without:
(A) the complainant's, resident's, or client's written consent;
or
(B) a court order.
As added by P.L.139-1993, SEC.21.
IC 12-10-13-17
Rules
Sec. 17. The director of the division shall adopt rules under
IC 4-22-2 necessary to carry out this chapter.
As added by P.L.2-1992, SEC.4. Amended by P.L.2-1993, SEC.86;
P.L.139-1993, SEC.22.
IC 12-10-13-18
Civil immunity
Sec. 18. A representative of the office is not civilly liable for the
good faith performance of official duties.
As added by P.L.2-1992, SEC.4.
IC 12-10-13-19
Annual report; distribution
Sec. 19. (a) The office shall prepare a report each year on the
operations of the office.
(b) A copy of the report shall be provided to the following:
(1) The governor.
(2) The general assembly. The report must be in an electronic
format under IC 5-14-6.
(3) The division.
(4) The federal Commissioner on Aging.
(5) Each area agency on aging.
(6) The state department of health.
As added by P.L.2-1992, SEC.4. Amended by P.L.28-2004, SEC.93.
IC 12-10-13-20
Violations
Sec. 20. A person who:
(1) intentionally prevents the work of the office;
(2) knowingly offers compensation to the office in an effort to
affect the outcome of an investigation or a potential
investigation; or
(3) retaliates against a resident, a client, an employee, or
another person who files a complaint or provides information to
the office;
commits a Class B misdemeanor.
As added by P.L.2-1992, SEC.4. Amended by P.L.139-1993, SEC.23.