Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 3 - Licensing and Certification › Chapter 50 - Home and Community-Based Services Providers Licensing Standards › Subchapter A - General Provisions › Section I-5007 - Initial Licensure Application Process

Current through Register Vol. 50, No. 6, June 20, 2024
A. An initial application for licensing as an
					 HCBS provider shall be obtained from the department. A completed initial
					 license application packet for an HCBS provider shall be submitted to and
					 approved by the department prior to an applicant providing HCBS
					 services.
B. The initial licensing
					 application packet shall include:
1. a
					 completed HCBS licensure application and the non-refundable licensing fee as
					 established by statute;
2. a copy
					 of the approval letter of the architectural facility plans for the adult day
					 care module and the center-based respite module from the Office of the State
					 Fire Marshal and any other office/entity designated by the department to review
					 and approve the facility's architectural plans;
3. a copy of the on-site inspection report
					 for the adult day care module and the center-based respite module with approval
					 for occupancy by the Office of the State Fire Marshal;
4. a copy of the health inspection report
					 with approval of occupancy from the Office of Public Health for the adult day
					 care module and the center-based respite module;
5. a copy of a statewide criminal background
					 check, conducted by the Louisiana State Police, or its authorized agent,
					 including sex offender registry status, on all owners and administrators;
a. each owner shall be at least aged 18
					 years;
6. proof of
					 financial viability, comprised of the following:
a. a line of credit issued from a federally
					 insured, licensed lending institution in the amount of at least $50,000 that
					 is:
i. current at the time of submission of
					 the application for licensure; and
ii. issued to/in the name of the applicant at
					 the geographic location shown on the application for licensure;
b. general and professional
					 liability insurance in the amount of at least $300,000 that is current and in
					 effect at the time of license application; and
c. worker's compensation insurance that is
					 current and in effect at the time of license application;
NOTE: The LDH Health Standards Section shall specifically
						be identified as the certificate holder on these policies pursuant to
						§5007. B.6 a-c and any certificates of insurance issued as proof of
						insurance by the insurer or producer (agent). The policy shall have a
						cancellation/change statement requiring notification of the certificate holder
						30 days prior to any cancellation or change of coverage.
7. a completed disclosure of
					 ownership form which includes any controlling interest or ownership in any
					 other licensed agencies;
8. the
					 days and hours of operation;
9. an
					 organizational chart and names, including position titles, of key
					 administrative personnel and governing body; and
10. any other documentation or information
					 required by the department for licensure including, but not limited to, a copy
					 of the facility need review approval letter.