reglab/statecodes huggingface dataset:
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 113 - State Health Policy Analysis › Subchapter A - Statutory Sources for Louisiana Health Policy › Section I-11305 - Conclusion

Current through Register Vol. 50, No. 6, June 20, 2024
A. Louisiana has a
					 large body of Law devoted to providing health care, promoting health within its
					 general population, and protecting the health of its citizens. This phase of
					 analysis has attempted only to determine the broad objectives of each health
					 related statute or group of statutes and to provide an inventory of those
					 statutes organized within a framework from which additional analysis can be
					 performed.
B. It appears from the
					 analysis thus far performed, that health policy in Louisiana has been concerned
					 primarily with the development of resources and with ensuring rights
					 distribution. No statutes were found to be primarily related to status
					 allocation as defined in the "Methodology" Section of this Chapter. This is not
					 necessarily an indication that status allocation issues are not addressed in
					 the statutes which have been categorized as relating primarily to the key
					 process areas of resource development and rights distribution. In fact, an
					 effective policy should address issues related to each of the three key
					 societal processes. Consequently, a next phase of analysis might be to
					 determine the extent to which statutes which are primarily concerned with
					 resource development, also address rights distribution and status allocation
					 issues; likewise, the extent to which rights distribution related statutes
					 address resource development and status allocation.
C. Other types of analyses which the
					 framework used herein may facilitate are:
1.
					 an analysis of resources devoted to various state objectives within and among
					 target areas of concern; and
2.
					 inconsistencies among objectives within target areas.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 115 - Health Resource requirements › Subchapter A - Introduction › Section I-11501 - Introduction

Current through Register Vol. 50, No. 6, June 20, 2024
A. The State Health
					 Planning and Development Agency is required to develop standards, criteria, and
					 plans against which proposed capital expenditures are to be reviewed. Goals are
					 established for institutional health care resources requiring 1122 review and
					 for other important areas in the health care system.
AUTHORITY NOTE:
						Promulgated in accordance with P.L. 93-641 as amended by P.L. 96-79, and
						R.S.
						36:256(b).
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 115 - Health Resource requirements › Subchapter B - Facility or Service-Specific Criteria and Standards › Section I-11505 - General Acute Care Hospital Beds

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 General Information, Criteria and Standards
1.
					 Description
a. General acute care hospital
					 beds are those short-term acute care beds available for the overnight care of
					 patients hospitalized for any of a variety of medical reasons.
b. In Louisiana, general acute care hospital
					 beds include but are not limited to: medical/surgical, obstetrics, pediatrics,
					 intensive care/ coronary care, neonatal intensive care, pediatric intensive
					 care, chemical dependency, hospital-based, Medicare certified skilled nursing
					 beds and "swing" beds. All such types of hospital beds are included in the
					 total bed complement of a hospital.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 115 - Health Resource requirements › Subchapter B - Facility or Service-Specific Criteria and Standards › Section I-11509 - Chemical Dependency Services

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 Description
1. Chemical dependency services
					 are provided in general acute care hospitals, in psychiatric hospitals, or in
					 licensed free-standing substance abuse facilities. The only free standing
					 facilities subject to section 1122 review are those licensed as hospitals or
					 for which the expenditure is by or on behalf of a health care facility. The
					 incidence of alcohol and drug abuse in the population has increased
					 significantly in the past twenty years, particularly among adolescents and
					 youth, and has stimulated public concern about substance abuse and its
					 treatment.
2. A 28-day inpatient
					 period is the average established treatment course, followed by outpatient or
					 community-based after care. Treatments offered in chemical dependency units
					 (CDU's) include detoxification, education, and individual, group, and family
					 therapy.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 115 - Health Resource requirements › Subchapter B - Facility or Service-Specific Criteria and Standards › Section I-11511 - Open Heart Surgery

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 Definition/Description
1. Open heart surgery
					 is the generic term for various surgical operations performed on the heart or
					 major arteries of the heart. Open heart surgery procedures are defined as those
					 which use a heart-lung bypass machine to perform the function of circulation
					 during surgery.
2. The
					 Inter-Society Commission on Heart Diseases Resources reports that there are
					 over 1,000,000 deaths in the United States each year due to diseases of the
					 heart and coronary arteries. A wide range of congenital and acquired disease
					 and defects of the heart (and allied vessels) can be rectified with open heart
					 surgery. This sophisticated procedure is used to preserve life and to improve
					 the quality of life by repairing or replacing damaged portions of the heart and
					 blood vessels to prevent the development of more serious problems, and to
					 reduce disability.
3. Open heart
					 surgery procedures, adult and pediatric, require costly, highly specialized
					 personnel and facility resources, and supportive intensive care and cardiac
					 care units. The total bill for open heart surgery can exceed $150,000. Thus,
					 efforts should be made to limit unnecessary duplication of related
					 resources.
4. Adult open heart
					 surgical programs should have the capability of performing a full range of
					 procedures, including but not limited to, the following: repair/replacement of
					 heart valves: repair of congenital defects; cardiac revascularization;
					 repair/reconstruction of intra-thoracic vessels; and treatment of cardiac
					 trauma.
5. Open heart surgical
					 programs should have the ability to implement and apply circulatory assist
					 devices such as intra-aortic balloon, prolonged cardiopulmonary partial bypass,
					 and a full range of diagnostic and support system services. Some of the
					 services provided are cardiology, hematology, nephrology, general medicine,
					 pathology, anesthesiology, radiology, neurology, cardiac catheterization, and
					 social services.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 115 - Health Resource requirements › Subchapter B - Facility or Service-Specific Criteria and Standards › Section I-11513 - Cardiac Catheterization Units

Current through Register Vol. 50, No. 6, June 20, 2024
A. Definition/Description of Service
1. Cardiac catheterization is a
					 hospital-based diagnostic medical procedure, for examination of the heart and
					 surrounding blood vessels. The "invasive" procedure involves the insertion of a
					 catheter into the patient's arm or leg and into the chambers of the
					 heart.
2. The term
cardiac
					 catheterization
is used to describe a broad range of invasive cardiac
					 diagnostic procedures, the most common of which are angiocardiography and
					 coronary arteriography. These and other studies provide otherwise unavailable
					 information in many types of heart diseases, and permit a definitive diagnosis
					 of a number of heart and circulatory conditions affecting an age range from
					 newborn to geriatric.
3. Patients
					 are generally referred for catheterization after other noninvasive (and less
					 serious) diagnostic tests have indicated or confirmed abnormal
					 heart/circulatory function, but have not provided a precise diagnosis. Because
					 it is sophisticated and expensive, and because of its invasive nature, it is
					 not lightly chosen as a diagnostic technique.
4. In the United States, cardiovascular
					 illness claims nearly one million lives each year. Heart disease is the
					 nation's number one killer, accounting for half of all deaths recorded
					 annually. In 1977, cardiovascular diseases alone cost the American people more
					 than $27 billion, including physicians' fees, hospital costs, drugs, and lost
					 wages.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 115 - Health Resource requirements › Subchapter B - Facility or Service-Specific Criteria and Standards › Section I-11517 - Computed Tomography

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 Description of Service
1. Computed tomography
					 (CT) is a diagnostic service utilizing an X-Ray source, detector and computer
					 to reconstruct from multiple projections a pictorial representation of the
					 internal structure of an object. CT scanning is based upon the principle of
					 conventional radiology: tissues may be distinguished by their respective
					 densities, which are determined by the amount of radiation transmitted through
					 the objects. CT scanning differs from conventional X-Ray in that numerous
					 images are recorded as the X-Ray equipment traverses the body or head area.
					 These images are reconstructed onto a screen or film in a representation of a
					 selected slice of the body.
2. CT
					 scanning is much more sensitive than conventional X-Ray to differenced in
					 tissue density and thus more readily permits the identification of tumors and
					 other soft tissue abnormalities. In addition to its superior diagnostic
					 capability, CT scanning may reduce patient risk by replacing painful invasive
					 diagnostic procedures, such as cerebral angiography and pneuoencephalography,
					 and by reducing the need for exploratory surgery.
3. The evolution of CT has been
					 extraordinarily rapid. The first brain scanner was introduced by EMI in 1972
					 following five years of development. Progress was quickly made toward the
					 development of body scanners which showed organs such as the pancreas, kidneys
					 and lungs. The speed and accuracy of scanning is now much advanced from the
					 early stages of development.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 115 - Health Resource requirements › Subchapter B - Facility or Service-Specific Criteria and Standards › Section I-11519 - End Stage Renal Disease Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Definition
1. End Stage Renal Disease services are
					 diagnostic, therapeutic, maintenance, and rehabilitative services required for
					 the care of patients with End State Renal Disease. End Stage Renal Disease
					 (ESRD) is defined as renal impairment which is permanent and
					 irreversible.
2. It is estimated
					 that eight million persons in the United States have some form of kidney
					 disease, and about 60,000 persons die each year from End State Renal Disease.
					 The two major types of ESRD services are transplantation and
					 dialysis.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 115 - Health Resource requirements › Subchapter B - Facility or Service-Specific Criteria and Standards › Section I-11523 - Long Term Care Beds

Current through Register Vol. 50, No. 6, June 20, 2024
A. Skilled Nursing
					 and Intermediate Care Facilities
1.
					 Definition/Description
a. In the broadest
					 sense, long term care includes the complete spectrum of institutional and
					 non-institutional services which provide health care to persons with chronic
					 disease or disability requiring care over an extended period of time, or to
					 persons recovering from the an acute phase of illness requiring continuing
					 care. Services range from those provided in the home to inpatient or
					 residential services provided in public or private institutions. The goal of
					 long term care is to provide persons of all ages with preventive, diagnostic,
					 medical, rehabilitative, maintenance, or social services, to achieve optimal
					 physical, social, and psychological functioning.
b. Long Term Care beds may be located in
					 general acute care hospitals or in nursing homes. A licensed nursing home is a
					 long term care facility which provides, in addition to food and shelter,
					 professional attendant and nursing care, 24 hours a day, to the chronically
					 ill, convalescent, disabled, and the elderly, with a full range of
					 complementary services (therapeutic, dietary, social, etc.)
c. Nursing homes differ from hospitals in
					 that they have no facilities for diagnostic services or for acute or emergency
					 medical care (x-ray, laboratory, or surgical units); however, nursing homes
					 provide the most complete care possible outside of a hospital, because services
					 and manpower are located and delivered within the institution in which the
					 patients reside.
d. Nursing homes
					 are classified according to the type of care provided. A nursing home may be
					 certified in one or more of the following levels of care:
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 115 - Health Resource requirements › Subchapter B - Facility or Service-Specific Criteria and Standards › Section I-11525 - Ambulatory Surgery

Current through Register Vol. 50, No. 6, June 20, 2024
A. Description
1. Ambulatory surgery is elective minor
					 surgery for pre-examined and diagnosed low-risk patients. Ambulatory surgery is
					 limited to excisional, incisional, or repair procedures which require local,
					 regional, or general anesthesia followed by at least an hour of professional
					 post operative observation, but do not require overnight inpatient care. It
					 does not include procedures which can be safely and efficiently performed in a
					 doctor's office or a clinic, or cases normally handled in the emergency room.
					 It has been estimated that over 40 percent of all hospital operations could be
					 performed on a same-day basis, saving the national health care delivery system
					 between ten and fifteen billion dollars annually.
2. Some of the advantages of ambulatory
					 surgery are reduced costs, more effective use of physicians' time, greater bed
					 availability, and earlier return to work. Additionally, studies have shown that
					 ambulatory surgery creates less psychological stress and less physical
					 isolation for patients than inpatient hospital surgery. Because of the short
					 stay, there is less exposure of the patient to hospital-acquired infections,
					 and less need for pre-operative and post-operative medication.
3. For Section 1122 purposes, an ambulatory
					 surgery facility is a facility, not a part of a hospital, which provides
					 surgical treatment to patients not requiring hospitalization. The term does not
					 include offices of private physicians or dentists, whether for individual or
					 group practice. Ambulatory surgery facilities can be either hospital-based or
					 free-standing. Hospital-based ambulatory surgery facilities are distinguished
					 from same day surgery services provided in hospitals in that hospital-based
					 ambulatory surgery facilities are used solely for ambulatory surgery and are
					 licensed as hospital-based ambulatory surgery facilities.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 115 - Health Resource requirements › Subchapter B - Facility or Service-Specific Criteria and Standards › Section I-11527 - Preventive Health

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 Definition/Description
1. Traditional
					 definitions of health prevention are divided into three levels of activity:
					 those which prevent the occurrence of disease or illness, those which intervene
					 after disease is detected but before it is symptomatic, and those which prevent
					 the progression of symptomatic disease or illness. Because there is lack of
					 agreement among professionals about a clear definition of health prevention, an
					 accurate and complete inventory of preventive health programs cannot be
					 compiled. Another reason for the difficulty in assessing the scope of health
					 prevention activities is that health-related and prevention-related activities
					 are frequently subsumed under other functions (e.g. defense, security, natural
					 resources, environment). Programs and activities in areas traditionally
					 regarded as preventive include, but are not limited to, the following:
a. health education/information/research
					 (human sexualtiy, contraceptive use, excercise, stress, behavioral
					 problems);
b. direct preventive
					 health services (family planning, immunization);
c. nutrition;
d. environmental protection;
e. occupational health and safety;
f. transportation safety;
g. home safety codes and standards;
h. recreational safety;
i. consumer product quality and safety (food,
					 drugs, cosmetics, appliances, alcohol, tobacco, firearms, motor
					 vehicles);
j. fire
					 prevention.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 115 - Health Resource requirements › Subchapter B - Facility or Service-Specific Criteria and Standards › Section I-11529 - Comprehensive Physical Rehabilitation Facilities (Inpatient)

Current through Register Vol. 50, No. 6, June 20, 2024
A. Definition. In
					 general, rehabilitation is the process of restoring disabled persons to the
					 fullest degree of physical, mental, social, vocational, and economic usefulness
					 of which they are capable. Within this context, Comprehensive Physical
					 Rehabilitation Facilities, (CPRF's) are medical facilities which emphasize
					 physical restoration activities for patients with physiologically based disease
					 and disabilities. These facilities are either freestanding or a component of a
					 general hospital. They provide a comprehensive, integrated rehabilitation
					 program of medical, psychological, social, and vocational services, using a
					 multi-disciplinary approach, centered on the patient.
B. Scope of Services
1. Services provided by CPRF's vary in nature
					 and intensity according to the degree of disability and the general condition
					 of the patient. The combination of services provided is designed to meet the
					 individual patient's needs. CPRF's provide or arrange for such services as
					 medical services, rehabilitation, nursing services, occupational therapy,
					 physical therapy, speech therapy, audiology, social services, psychological
					 services, vocational services, prosthetic and orthotic services. The services
					 may be provided directly by staff members or through consultation or
					 affiliation agreements.
2.
					 Comprehensive physical rehabilitation facilities may be highly specialized, and
					 treat only selected conditions or age groups, or treat all or various types of
					 disabilities. Many CPRF's also provide outpatient and/ or follow up care for
					 patients they have rehabilitated. Some of the conditions treated within CPRF's
					 are hemiplegia, paraplegia, quadriplegia, cerebral palsy, multiple sclerosis,
					 amputations, arthritis, cervical/lower back pain syndrom, emphysema, stroke,
					 and hip fracture. The conditions vary greatly, in that some primarily affect
					 certain age groups, some result from accidents, some result from acute
					 diseases, and some are chronic.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 115 - Health Resource requirements › Subchapter B - Facility or Service-Specific Criteria and Standards › Section I-11531 - Home Health Services

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 Definition/Description
1. Home health care is
					 that component of comprehensive health care in which health services are
					 provided to individuals and families in their places of residence for purpose
					 of restoring health or maximizing the level of independence, while minimizing
					 the effects of disability and illness, including terminal illness. Services
					 appropriate to the needs of the individual patient and family are planned,
					 coordinated, and made available by public or private providers organized for
					 the delivery of home health care through the use of employed staff, contractual
					 arrangements, or a combination of the two patterns.
2. Health services provided include, but are
					 not limited to, the following:
a. skilled
					 nursing respiratory therapy
b. home
					 health aide occupational therapy
c.
					 speech therapy and audiology medical social work
d. physical therapy medical
					 supplies
e. nutrition durable
					 medical equipment
3. The
					 home health agency providing medical services maintains a plan for home health
					 services for each patient in conformance with the patient's plan of treatment
					 as prescribed by his/her physician. Such agencies provide care to patients with
					 a wide range of diagnoses and at all levels of dependence, including those
					 completely bed-ridden and those needing to be fed. Persons or groups in need of
					 home health services include elderly persons whose activities are limited by
					 physical and/or mental deterioration; persons who recuperating from a wide
					 range of acute medical problems such as injuries, infections, diseases, and
					 complications of pregnancy.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 115 - Health Resource requirements › Subchapter B - Facility or Service-Specific Criteria and Standards › Section I-11533 - Magnetic Resonance Imaging

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 Definition/Description
1. Magnetic resonance
					 imaging (MRI), also referred to as Nuclear magnetic resonance, is a diagnostic
					 technique that employs magnetic and radio frequency fields to image body tissue
					 and monitor body chemistry noninvasively. The basic principle of this modality
					 involves the magnetizing of the hydrogen nuclei of the body which then become
					 aligned, while spinning, in the direction of the magnetic field. A variable
					 wobble is produced in the nuclei spin by a pulsating radio frequency current
					 directed at a 90 degree angle to the magnetic field. The small voltage of a
					 resulting electrical current is detected by a surface coil receiver and relayed
					 to a computer for analysis.
2.
					 Although different in principle there is some similarity between magnetic
					 resonance imaging and computer assisted tomography (CT). These similarities are
					 associated with the purposes, uses, and output of the two modalities. Both are
					 diagnostic modalities. Both are imaging devices capable of soft tissue
					 scanning, although each demonstrates advantages specific to certain tissues,
					 organs, and lesions. Finally, both produce cross-sectional images. Because of
					 these similarities there is some overlap in capabilities of the two and the
					 extent of this overlap appears to be increasing as magnetic resonance imaging
					 becomes more refined. This has led to some speculation that MRI may supplant CT
					 in the future.
3. However, there
					 also exist some fundamental differences between the modalities. Among these
					 differences are the facts that 1) MRI is not a radiation-based technology, 2)
					 MRI has no moving parts, 3) parameters measured by MRI relate to tissue
					 chemistry and 4) MRI is superior in lesion detection while CT provides greater
					 anatomical information.
4. In
					 applying planning strategies in the area of magnetic resonance imaging, there
					 are several critical definitions which must be established. These are:
a.
MRI Procedure or Scan
is
					 one discrete MRI study of one patient in one visit regardless of the number of
					 tissues, organs or lesions examined in that one study.
b.
MRI Unit
is considered to
					 be all of the essential equipment and facilities necessary to operate one MRI
					 suite.
c.
Service
					 Area
is defined as the health planning district in which the MRI is or
					 will be located.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 115 - Health Resource requirements › Subchapter B - Facility or Service-Specific Criteria and Standards › Section I-11535 - Acquired Immunodeficiency Syndrome

Current through Register Vol. 50, No. 6, June 20, 2024
A. Health Care for Persons with Acquired
					 Immunodeficiency Syndrome
1. It is recognized
					 that certain factors may limit accessibility of health care facility beds to
					 persons who have been diagnosed as having Acquired Immunodeficiency Syndrome
					 (AIDS) or even persons who have tested positive for evidence of the virus (HIV)
					 in the body. Many times persons must remain in a hospital for a significant
					 number of days at $450-$800 per day because of the inaccessibility of nursing
					 home care. Sixty percent of the cases documented to date are from Orleans
					 Parish. For these reasons, a need exists for 100 beds which may be approved to
					 care for these patients, not necessarily in the same facility. The Section 1122
					 approval process will consider the following priorities:
a. using existing beds in several health care
					 facilities (acute or long term care) which can be converted to meet the
					 standards for this care;
b.
					 converting an entire existing facility to provide care for these patients;
					 or
c. developing a new facility for
					 this use.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 117 - Louisiana Medical Facilities Inventory › Section I-11701 - Explanation

Current through Register Vol. 50, No. 6, June 20, 2024
A. The Louisiana
				  Medical Facilities Inventory is not included as part of the 1985-1990 State
				  Health Plan. The Louisiana health system is constantly changing. Including a
				  static picture of this dynamic system as part of the State Health Plan is not
				  helpful since most inventories are out of date within months of the publication
				  of the plan.
B. Current facility
				  inventories are available from the Division of Policy, Planning and Evaluation,
				  200 Lafayette Street, Suite 406, Baton Rouge, La. 70801 upon written
				  request.
AUTHORITY NOTE:
					 Promulgated in accordance with P.L. 93-641 as amended by P.L. 96-79, and
					 R.S.
					 36:256(b).
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 119 - Health Care Manpower › Section I-11901 - Introduction

Current through Register Vol. 50, No. 6, June 20, 2024
A. key component of
				  any health care system is its manpower. Manpower planning is important because
				  the status of health as well as the effectiveness of that system is heavily
				  dependent upon both the quantity and quality of health professionals who
				  provide health services. A shortage or maldistribution of health care
				  professionals can lead to inaccessibility or inadequate health care for some of
				  the system's consumers. A surplus of manpower supply in any one area can
				  influence overutilization of health care services and result in a need for
				  providers to increase their charges for services to compensate for shrinking
				  patient caseloads. If the supply is adequate but it is not being used properly,
				  then a problem of need is presented which is not reflective of actual need.
				  Finally, an accurate picture of an area's health manpower status is essential
				  for projecting future needs and identifying those areas where surpluses or
				  shortages of health manpower will adversely affect an area's health status if
				  left unchecked.
B. A discussion of
				  health manpower includes four key dimensions:
1. Supply-This dimension deals with numbers.
				  In short, "Is there enough manpower to serve the needs of the
				  population?"
2. Distribution-This
				  dimension deals with the location of the manpower supply. It attempts to answer
				  the question, "Is the manpower located where it is most needed?"
3. Utilization-This dimension deals with the
				  types of tasks that the manpower professionals perform and are trained to
				  perform. It attempts to answer the question, "Are providers and consumers
				  making the best use of the available manpower supply?"
4. Resource Renewal-This dimension deals with
				  future need and supply. It attempts to answer the question, "How does the
				  pattern of manpower supply meet the needs of the future population and health
				  system configurations?"
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 119 - Health Care Manpower › Section I-11903 - Physicians

Current through Register Vol. 50, No. 6, June 20, 2024
A. Introduction
1. In the late 1960's, a study was published
				  by the Carnegie Institute which identified and forecast a large manpower
				  shortage in the United States in the area of supply of physicians. Throughout
				  the 1970's, a disproportionately large number of students entered medical
				  training schools. It is now thought by many experts that most of the forecast
				  shortages have been prevented. The preliminary indications are that many
				  previously identified shortages of physicians are being met in Louisiana and
				  other forecast shortages allayed by a significant influx of physicians into the
				  health care manpower supply. There are only a few exceptions to this generally
				  healthy status of physician manpower in Louisiana.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 119 - Health Care Manpower › Section I-11905 - Dentists

Current through Register Vol. 50, No. 6, June 20, 2024
A. Introduction
1. Dentists are an important primary health
				  care provider. Like primary care physicians, it is essential that dentists be
				  available and reasonably accessible to a population if regular preventive care
				  is to be obtained and acute health problems minimized.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 119 - Health Care Manpower › Section I-11907 - Registered Nurses

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  Introduction. In the mid 1970s both the federal Department of Health, Education
				  and Welfare and the Louisiana Board of Regents reported that the state and the
				  nation were well on their way to solving previously noted shortages in the area
				  of nursing manpower. In light of this perception, federal funds were curtailed
				  for nursing education and other initiatives were aborted. However, enrollment
				  in nursing programs began to level off and as more job opportunities opened for
				  women in other fields, many nurses left the profession for jobs that were
				  either less strenuous or more rewarding, financially and otherwise. Due in
				  great part to these trends, there is no longer an abundant supply of nurses and
				  most areas and health care facilities in the state have difficulty filling all
				  their nursing staff needs. This is true for both Registered Nurses (R.N.'s) and
				  Licensed Practical Nurses (L.P.N.'s); however, the data reported in this
				  analysis relates only to R.N.'s. The number of L.P.N.'s in the workforce is
				  unknown at present since a nurse registry is maintained only for
				  R.N.'s.
B. Supply
1. Louisiana lags behind the national average
				  in the ratio of nurses to general population. The most recent data published by
				  the U.S. House of Representatives and its Subcommittee on Health and the
				  Environment indicate a national average of 520 nurses per 100,000 population.
				  Similar figures for Louisiana indicate a rate of 367 nurses per 100,000.
				  Relative to other states in the region, Louisiana's nursing supply is also
				  below several comparable averages, as is reflected in the following table.
Active Registered Nurses
Geographic Area
per 100,000 general population
United States
520.8
Louisiana
367.6
Alabama
350.2
Kentucky
402.6
Mississippi
394.8
Tennessee
363.0
Arkansas
325.7
Oklahoma
390.7
Texas
374.3
2.
				  It can be seen that Louisiana is not unique in the southern region in having
				  fewer nurses than is the average nationally. The Louisiana Board of Regents has
				  reported that this disparity decreased greatly in Louisiana with the aid of
				  federal funds for nursing education. In the years before funds were available
				  (1958-1966), nursing enrollments in Louisiana grew not at all: 306 graduates in
				  1955 and 306 in 1965. After the enactment and implementation of the nurse
				  training act of 1964, the number of graduates had risen to 435 in 1970. This
				  number nearly tripled by 1978, as 1148 new graduates entered the nursing
				  profession in Louisiana. Since then, there has been a significant decline. In
				  1981, there were 21,317 licensed R.N.'s in Louisiana.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 119 - Health Care Manpower › Section I-11909 - Allied Health Professionals

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
				  Health Manpower Training Act of 1972 defined allied health professions in the
				  following manner: "Allied health professions are those with training and
				  responsibilities for supporting and complementing or supplementing the
				  professional functions of physicians, dentists and other health professionals
				  in the delivery of health care to patients; or, assisting environmental
				  engineers and other personnel in environmental health control and preventive
				  medicine activities."
B. 1978 Board
				  of Regents Study
1. A study released by the
				  Louisiana Board of Regents in 1978 included the areas of Dental Hygiene,
				  Occupational Therapy, Medical Records Administration, Health and Hospital
				  Administration, Physical Therapy, Medical Technology, Cytotechnology,
				  Dietetics, Radiologic Technology and Respiratory Care Technology within the
				  allied health field. The Louisiana Office of Licensing and Regulation has also
				  included Pharmacy and Social Work within this field for classification
				  purposes.
2. In the Louisiana Board
				  of Regents' 1978 study, Louisiana was reported to have no serious shortages in
				  the area of allied health professionals. The study indicated that although some
				  small rural hospitals and state hospitals did have problems in recruiting
				  personnel, these were mainly due to conditions within the institutions (e.g.
				  low pay, location, etc.) rather than a shortage of manpower supply. A spokesman
				  for the Board of Regents provided a verbal update to this report in March,
				  1982, and suggested that the satisfactory rating in terms of allied health
				  manpower supply in Louisiana may be reversing itself. Particularly in the areas
				  of medical technology and physical therapy, the state appears now to be
				  experiencing serious manpower shortages.
3. There is very little hard data available
				  on which to base an analysis of allied health manpower resources. In 1978 the
				  Louisiana Board of Regents recommended that the state maintain a registry of
				  allied health personnel in order to build an adequate data base for manpower
				  planning purposes. A spokesman for the Board of Regents reports that this has
				  not yet been done. Any accurate assessment of allied health manpower in the
				  state will be impossible until this data base is developed.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 125 - Facility Need Review › Subchapter A - General Provisions › Section I-12503 - General Information

Current through Register Vol. 50, No. 6, June 20, 2024
A. No
					 healthcare provider designated in
					 R.S.
					 40:2116 or
					 R.S.
					 40.2116.1 shall be licensed by LDH and/or
					 certified to participate in the Title XIX program without first obtaining FNR
					 approval and complying with any and all licensing regulations promulgated by
					 LDH. Any person establishing, managing, or operating a facility, provider,
					 service, or bed without the approval required by this Chapter shall immediately
					 cease providing services and shall be prohibited from obtaining a license from
					 LDH and/or participating in the Title XIX program, until FNR approval has been
					 granted by the department.
B. The
					 FNR committee shall consist of the following members:
1. the secretary of LDH, or his
					 designee;
2. the assistant
					 secretary of the Office of Behavioral Health (OBH) of LDH, or his
					 designee;
3. the assistant
					 secretary of the Office for Citizens with Developmental Disabilities (OCDD) of
					 LDH, or his designee;
4. the
					 assistant secretary of the Office of Aging and Adult Services (OAAS) of LDH, or
					 his designee;
5. the assistant
					 secretary of the Office of Public Health (OPH) of LDH, or his
					 designee;
6. the Medicaid director
					 of LDH, or his designee;
7. the
					 Medicaid medical director of LDH, or his designee; and
8. any additional FNR committee members
					 appointed by LDH secretary when necessary in reviewing applications of OTPs,
					 including but not limited to the following individuals:
a. the LDH OBH medical director or physician
					 who has expertise in substance use disorder treatment and, in particular,
					 opioid treatment;
b. an addiction
					 counselor licensed in the state of Louisiana by Addictive Disorder Regulatory
					 Authority; and
c. the Louisiana
					 State Opioid Treatment Authority.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 125 - Facility Need Review › Subchapter A - General Provisions › Section I-12505 - Initial Application and Review Process

Current through Register Vol. 50, No. 6, June 20, 2024
A. Facility need review (FNR) applications as
					 defined in the Chapter except for FNR applications that are submitted pursuant
					 to a Request for Proposal (RFP) or Request for Application (RFA) issued by the
					 department will follow the initial application and review process, the
					 supplemental application review process, and the appeal provisions set forth in
					 this licensing Rule. Facility need review applications that are submitted
					 pursuant to a RFP or RFA will follow the application process, the review
					 process, the supplemental review process, the notice provisions, and the appeal
					 provisions that are contained in the individual RFP or RFA.
B. Facility need review applications shall be
					 submitted on 8.5 inch by 11 inch paper that shall not include Health Insurance
					 Portability and Accountability Act (HIPPA) protected information, to the HSS,
					 FNR program manager by one of the following means:
1. via postal service to the designated FNR
					 program mailing address; or
2.
					 electronically via the HSS designated system or software.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 125 - Facility Need Review › Subchapter A - General Provisions › Section I-12507 - Supplemental Application Review Process

Current through Register Vol. 50, No. 6, June 20, 2024
A. If the applicant decides to request a
					 supplemental review of the denied initial application, a written request for
					 supplemental application review must be received by the department within 30
					 days of receipt of notice of the denial letter.
B. Upon receipt of the applicant's timely
					 written request to supplement its FNR application, a written confirmation
					 notice will be sent to the applicant informing the applicant that he or she has
					 30 days to send in any additional documentation and evidence in support of the
					 FNR application, pursuant to the provisions of this Rule.
1. If the applicant fails to timely submit
					 the supplemental materials, the supplemental application is automatically
					 denied. Written notice of the denial shall be forwarded to the applicant, with
					 information regarding the applicant's right to file an administrative appeal
					 with the DAL.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 125 - Facility Need Review › Subchapter A - General Provisions › Section I-12508 - Pediatric Day Health Care Providers

Current through Register Vol. 50, No. 6, June 20, 2024
A. No PDHC provider shall be licensed to
					 operate unless the FNR Program has granted an approval for the issuance of a
					 PDHC provider license. Once the FNR Program approval is granted, a PDHC
					 provider is eligible to be licensed by the department, subject to meeting all
					 of the requirements for licensure.
B. For purposes of facility need review, the
					 service area for a proposed PDHC shall be within a 30 mile radius of the
					 proposed physical address where the provider will be licensed.
C. Determination of Need/Approval
1. The department will review the application
					 to determine if there is a need for an additional PDHC provider in the
					 geographic location and service area for which the application is
					 submitted.
2. The department shall
					 grant FNR approval only if the FNR application, the data contained in the
					 application, and other evidence effectively establishes the probability of
					 serious, adverse consequences to recipients ability to access health care if
					 the provider is not allowed to be licensed.
3. In reviewing the application, the
					 department may consider, but is not limited to, evidence showing:
a. the number of other PDHC providers in the
					 same geographic location, region, and service area servicing the same
					 population; and
b. allegations
					 involving issues of access to health care and services.
4. The burden is on the applicant to provide
					 data and evidence to effectively establish the probability of serious, adverse
					 consequences to recipients ability to access health care if the provider is not
					 allowed to be licensed. The department shall not grant any FNR approvals if the
					 application fails to provide such data and evidence.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 125 - Facility Need Review › Subchapter A - General Provisions › Section I-12509 - Administrative Appeal Procedures

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 An applicant who receives a denial of an initial FNR application or denial of a
					 supplemental FNR application may request an administrative hearing within 30
					 calendar days after receipt of the department's notice of denial of FNR
					 application.
1. The request for an
					 administrative hearing shall be made in writing to the DAL with a copy of the
					 request also sent to the department's FNR program.
2. The request shall contain a statement
					 setting forth the specific reason with which the applicant disagrees and the
					 reasons for the disagreement.
3.
					 The request shall be considered timely if it is postmarked by the 30th calendar
					 day after receipt of the department's notice of denial.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 125 - Facility Need Review › Subchapter B - Determination of Bed, Unit, Facility, or Agency Need › Section I-12511 - Nursing Facilities

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 service area for proposed or existing nursing facilities or beds is the parish
					 in which the site is located.
1. Exception.
					 Any parish that has any portion of the parish below Interstate 10 and which is
					 intersected by the Mississippi river will be composed of two separate service
					 areas as divided by the Mississippi River.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 125 - Facility Need Review › Subchapter B - Determination of Bed, Unit, Facility, or Agency Need › Section I-12513 - Intermediate Care Facilities for the Developmentally Disabled

Current through Register Vol. 50, No. 6, June 20, 2024
A. Except as
					 otherwise provided in this Chapter, no ICF-DD shall be certified or enrolled to
					 participate in the Title XIX program unless the FNR program has granted an
					 approval for an additional ICF-DD facility or additional ICF-DD beds to be
					 enrolled in the Title XIX program.
B. The geographic service area for a proposed
					 or existing ICF-DD facility is designated as the LDH administrative region in
					 which the facility or proposed facility is or will be located. The
					 administrative regions and the parishes that comprise these regions are as
					 follows:
1. Region I: Jefferson, Orleans,
					 Plaquemines, and St. Bernard;
2.
					 Region II: Ascension, East Baton Rouge, East Feliciana, Iberville, Pointe
					 Coupee, West Baton Rouge, and West Feliciana;
3. Region III: Assumption, Lafourche, St.
					 Charles, St. James, St. John, St. Mary, and Terrebonne;
4. Region IV: Acadia, Evangeline, Iberia,
					 Lafayette, St. Landry, St. Martin, and Vermilion;
5. Region V: Allen, Beauregard, Calcasieu,
					 Cameron, and Jefferson Davis;
6.
					 Region VI: Avoyelles, Catahoula, Concordia, Grant, LaSalle, Rapides, Vernon,
					 and Winn;
7. Region VII: Bienville,
					 Bossier, Caddo, Claiborne, DeSoto, Natchitoches, Red River, Sabine, and
					 Webster;
8. Region VIII: Caldwell,
					 East Carroll, Franklin, Jackson, Lincoln, Madison, Morehouse, Ouachita,
					 Richland, Tensas, Union, and West Carroll; and
9. Region IX: Livingston, St. Helena, St.
					 Tammany, Tangipahoa, and Washington.