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Library: Policy

317:35-23-4. Re-enrollment

Revised 6-25-12

(a) Members in the Living Choice Program.

  • (1) The member remains eligible during periods of institutionalization as long as the stay does not exceed 30 days.

  • (2) A member with an institutional stay longer than 30 days may re-enroll in the program without re-establishing the 90 day institutional residency requirement if:

    • (A) the necessity for the institutionalization is documented in the revised individual transition plan; and

    • (B) the member can safely return to the community as determined by the transition coordinator, the member and the transition planning team. 

  • (3) The re-enrolled member is eligible to receive services for any remaining days up to the 365 day limit.

(b) Members no longer in the Living Choice Program.

  • (1) Members who have completed 365 days in the Living Choice Program and have been re-institutionalized for a minimum of 90 consecutive days may be eligible for re-enrollment in the Living Choice Program.  Before re-enrollment of a former member, a re-evaluation of the former member's plan of care must be completed and a determination made if the plan of care could not be carried out as a result of:

    • (A) medical and/or behavioral changes resulting in the necessity of readmission into the inpatient facility;

    • (B) the lack of community services to support the member that were identified in the original plan of care; or

    • (C) the plan of care was not supported by the delivery of quality services.

  • (2) After determining the basis for re-institutionalization and creation of a new plan of care that ensures the health and safety of the former member, he/she may be re-enrolled for an additional 365 days.

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