reglab/statecodes huggingface dataset:
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 5 - Supports Waiver › Chapter 55 - Target Population › Section XXI-5503 - Denial of Admission or Discharge Criteria

Current through Register Vol. 50, No. 6, June 20, 2024
A. Beneficiaries shall be denied admission
				  to, or discharged from, the supports waiver if one of the following criteria is
				  met:
1. the beneficiary does not meet the
				  financial eligibility requirements for the Medicaid Program;
2. the beneficiary does not meet the
				  requirement for an ICF/IID level of care;
3. the beneficiary is incarcerated or placed
				  under the jurisdiction of penal authorities, courts or state juvenile
				  authorities;
4. the beneficiary
				  resides in another state or has a change of residence to another
				  state;
5. the beneficiary is
				  admitted to an ICF/IID or nursing facility with the intent to stay and not to
				  return to waiver services:
a. the waiver
				  beneficiary may return to waiver services when documentation is received from
				  the treating physician that the admission is temporary and shall not exceed 90
				  days;
b. the beneficiary will be
				  discharged from the waiver on the ninety-first day if the participant is still
				  in the ICF/IID or nursing facility;
6. the health and welfare of the beneficiary
				  cannot be assured through the provision of supports waiver services within the
				  beneficiary's approved plan of care;
7. the beneficiary fails to cooperate in the
				  eligibility determination/re-determination process and in the development or
				  implementation of the approved plan of care; and/or
8. continuity of services is interrupted as a
				  result of the beneficiary not receiving a supports waiver service during a
				  period of 30 or more consecutive days. This does not include interruptions in
				  supports waiver services because of hospitalization, institutionalization (such
				  as ICFs/DD or nursing facilities), or non-routine lapses in services where the
				  family agrees to provide all needed or paid natural supports. There must be
				  documentation from the treating physician that this interruption will not
				  exceed 90 days. During this 90-day period, the OCDD will not authorize payment
				  for supports waiver services.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 5 - Supports Waiver › Chapter 55 - Target Population › Section XXI-5505 - Needs-Based Assessment

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
				  Office for Citizens with Developmental Disabilities (OCDD) has developed a
				  framework for all activities related to planning for individualized supports
				  and services. Discovery activities include:
1.
				  a review of the beneficiary's records relevant to service planning (i.e.
				  school, vocational, medical, and psychological records);
2. completing person-centered tools and
				  worksheets, which may include a personal outcomes assessment, which assists the
				  planning team in determining what is important to the beneficiary and his/her
				  satisfaction or dissatisfaction with different life domain areas;
3. completion and review of the needs-based
				  assessment within 30 days of a person being linked to a waiver opportunity and
				  support coordination agency; and
4.
				  review and/or completion of any additional interviews, observations, or other
				  needed professional assessments (i.e. occupational therapist, physical
				  therapist, or speech therapist assessments).
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 5 - Supports Waiver › Chapter 57 - Covered Services › Section XXI-5701 - Supported Employment Services

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  Supported employment services consists of intensive, ongoing supports and
				  services necessary for a beneficiary to achieve the desired outcome of
				  employment in a community setting where a majority of the persons employed are
				  without disabilities. Beneficiaries utilizing these services may need ongoing
				  supports for the life of their employment due to the nature of their
				  disability, and natural supports may not meet this need.
B. Supported employment services provide
				  supports in the following areas:
1.
				  individual job, group employment, or self-employment;
2. job assessment, discovery and development,
				  placement; and
3. initial job
				  support and job retention, which may include assistance in personal care with
				  activities of daily living in the supported employment setting and
				  follow-along.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 5 - Supports Waiver › Chapter 57 - Covered Services › Section XXI-5703 - Day Habilitation

Current through Register Vol. 50, No. 6, June 20, 2024
A. Day
				  habilitation is services that assist the beneficiary to gain desired community
				  living experience, including the acquisition, retention or improvement in
				  self-help, socialization and adaptive skills, and/or to provide the beneficiary
				  an opportunity to contribute to his or her community. These services may be
				  coordinated with any physical, occupational, or speech therapies identified in
				  the individualized plan of care. Volunteer activities may be a part of this
				  service and should follow the state guidelines for volunteering.
B. Day habilitation is the overarching
				  service and may be delivered in a combination of these two service types:
1. onsite day habilitation; and
2. community life engagement.
NOTE: Day habilitation services may be delivered virtually
					 and be included in the approved plan of care.
3. Repealed.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 5 - Supports Waiver › Chapter 57 - Covered Services › Section XXI-5705 - Prevocational Services

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  Prevocational services are individualized, person centered services that assist
				  the beneficiaries in establishing their path to obtain individualized community
				  employment. This service is time limited and targeted for people who have an
				  interest in becoming employed in individual jobs in the community, but who may
				  need additional skills, information, and experiences to determine their
				  employment goal and become successfully employed. Beneficiaries receiving
				  prevocational services may choose to leave this service at any time or pursue
				  employment opportunities at any time. Career planning must be a major component
				  of prevocational services and should include activities focused on
				  beneficiaries becoming employed to their highest ability.
B. Prevocational services is the overarching
				  service and may be delivered in a combination of these two service types:
1. onsite prevocational; and
2. community career planning.
NOTE: Prevocational services may be delivered
					 virtually.
3.
				  Repealed.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 5 - Supports Waiver › Chapter 57 - Covered Services › Section XXI-5707 - Respite

Current through Register Vol. 50, No. 6, June 20, 2024
A. Respite care is
				  a service provided on a short-term basis to a beneficiary who is unable to care
				  for himself/herself due to the absence or need for relief of those unpaid
				  persons normally providing care for the beneficiary.
B. Respite may be provided in a licensed
				  respite care facility that is determined to be appropriate by the beneficiary
				  or other responsible party, or may be provided in the beneficiary's home or
				  private place of residence.
C.
				  Service Limitations. Services shall not exceed 428 units of service in a plan
				  of care year.
D. Choice and need
				  for this service must be documented on the plan of care.
AUTHORITY
					 NOTE: Promulgated in accordance with
					 R.S.
					 36:254 and Title XIX of the Social Security
					 Act.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 5 - Supports Waiver › Chapter 57 - Covered Services › Section XXI-5709 - Habilitation

Current through Register Vol. 50, No. 6, June 20, 2024
A. Habilitation
				  offers services designed to assist the beneficiary in acquiring, retaining, and
				  improving the self-help, socialization, and adaptive skills necessary to reside
				  successfully in home and community settings.
B. Habilitation is provided in the home or
				  community, includes necessary transportation, and is included on the plan of
				  care as determined to be appropriate.
C. Habilitation services may include, but are
				  not limited to:
1. acquisition of skills
				  needed to do household tasks which include, but are not limited to laundry,
				  dishwashing, housekeeping, grocery shopping in the community, and other tasks
				  to promote independence in the home and community; and
2. travel training activities in the
				  community that promote community independence, to include but not limited to,
				  place of individual employment, church, or other community activity. This does
				  not include group supported employment, day habilitation, or prevocational
				  sites.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 5 - Supports Waiver › Chapter 57 - Covered Services › Section XXI-5711 - Individual Goods and Services (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 36:254 and Title XIX of the Social Security
					 Act.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 5 - Supports Waiver › Chapter 57 - Covered Services › Section XXI-5713 - Personal Emergency Response System

Current through Register Vol. 50, No. 6, June 20, 2024
A. A personal emergency response system
				  (PERS) is an electronic device connected to the beneficiary's phone which
				  enables a beneficiary to secure help in the community. The system is programmed
				  to signal a response center staffed by trained professionals when a "help"
				  button is activated.
B. This
				  service must be prior authorized and be in accordance with the plan of
				  care.
AUTHORITY
					 NOTE: Promulgated in accordance with
					 R.S.
					 36:254 and Title XIX of the Social Security
					 Act.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 5 - Supports Waiver › Chapter 57 - Covered Services › Section XXI-5715 - Support Coordination

Current through Register Vol. 50, No. 6, June 20, 2024
A. Support
				  coordination is a service that will assist beneficiaries in gaining access to
				  all of their necessary services, as well as medical, social, educational, and
				  other services, regardless of the funding source for the services. Support
				  coordinators shall be responsible for on-going monitoring of the provision of
				  services included in the beneficiary's approved plan of care.
AUTHORITY
					 NOTE: Promulgated in accordance with
					 R.S.
					 36:254 and Title XIX of the Social Security
					 Act.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 5 - Supports Waiver › Chapter 57 - Covered Services › Section XXI-5717 - Housing Stabilization Transition Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Housing stabilization transition services
				  enable beneficiaries who are transitioning into a permanent supportive housing
				  unit, including those transitioning from institutions, to secure their own
				  housing. The service is provided while the beneficiary is in an institution and
				  preparing to exit the institution using the waiver. The service includes the
				  following components:
1. conducting a housing
				  assessment to identify the beneficiary's preferences related to housing (i.e.,
				  type, location, living alone or with someone else, need for accommodations, and
				  other important preferences), and his/her needs for support to maintain
				  housing, including:
a. access to
				  housing;
b. meeting the terms of a
				  lease;
c. eviction
				  prevention;
d. budgeting for
				  housing/living expenses;
e.
				  obtaining/accessing sources of income necessary for rent;
f. home management;
g. establishing credit; and
h. understanding and meeting the obligations
				  of tenancy as defined in the lease terms;
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 5 - Supports Waiver › Chapter 57 - Covered Services › Section XXI-5719 - Housing Stabilization Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Housing stabilization services enable
				  waiver beneficiaries to maintain their own housing as set forth in a
				  beneficiary's approved plan of care. Services must be provided in the home or a
				  community setting. This service includes the following components:
1. conducting a housing assessment to
				  identify the beneficiary's preferences related to housing (i.e., type,
				  location, living alone or with someone else, accommodations needed, and other
				  important preferences), and his/her needs for support to maintain housing,
				  including:
a. access to housing;
b. meeting the terms of a lease;
c. eviction prevention;
d. budgeting for housing/living
				  expenses;
e. obtaining/accessing
				  sources of income necessary for rent;
f. home management;
g. establishing credit; and
h. understanding and meeting the obligations
				  of tenancy as defined in the lease terms;
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 5 - Supports Waiver › Chapter 57 - Covered Services › Section XXI-5721 - Dental Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Dental
				  services are available to adult beneficiaries over the age of 21. Covered
				  dental services include:
1. adult diagnostic
				  services;
2. preventative
				  services;
3. restorative
				  services;
4. endodontics;
5. periodontics;
6. prosthodontics;
7. oral and maxillofacial surgery;
8. orthodontics;
9. emergency care; and
10. adjunctive general services.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 5 - Supports Waiver › Chapter 57 - Covered Services › Section XXI-5723 - Community Life Engagement Development

Current through Register Vol. 50, No. 6, June 20, 2024
A. Community life engagement development
				  (CLED) facilitates the development of opportunities to assist beneficiaries in
				  becoming involved in the community. The purpose of CLED is to find the
				  opportunities that encourage and foster the development of meaningful
				  relationships in the community reflecting the beneficiary's choices and values.
				  Objectives outlined in the comprehensive plan of care will afford opportunities
				  to increase community inclusion, participation in leisure/recreational
				  activities, and encourage participation in volunteer and civic activities. To
				  utilize this service, the beneficiary may or may not be present. CLED services
				  may be performed by a staff person for up to three waiver beneficiaries who
				  have a common provider agency for day services and supports. Rates shall be
				  adjusted accordingly.
B.
				  Transportation costs are included in the reimbursement for CLED
				  services.
C. Service Limitations.
				  Services shall not exceed the number of units as defined in the beneficiary's
				  plan of care and must have a prior authorization.
D. Provider Qualifications. Providers must be
				  licensed by the Department of Health as a home and community-based services
				  provider and must meet the module specific requirements for the service being
				  provided.
AUTHORITY
					 NOTE: Promulgated in accordance with
					 R.S.
					 36:254 and Title XIX of the Social Security
					 Act.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 5 - Supports Waiver › Chapter 57 - Covered Services › Section XXI-5725 - Specialized Medical Equipment and Supplies

Current through Register Vol. 50, No. 6, June 20, 2024
A. Incontinence briefs and supplies are
				  available for a beneficiary, 21 years or older, who has a physician's order and
				  requires the use of incontinence briefs and supplies.
B. Service Restrictions
1. This service is for those who are 21 years
				  of age or older.
2. This service
				  requires a physician's order.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 5 - Supports Waiver › Chapter 59 - Provider Participation › Section XXI-5901 - General Provisions

Current through Register Vol. 50, No. 6, June 20, 2024
A. In order
				  to participate in the Medicaid Program as a provider of Supports Waiver
				  services, a p rovider must meet all qualifications outlined in LAC 50.XXI,
				  Subpart 1, Chapter 1 and all applicable amendments.
B. If the transportation component for
				  supported employment, day habilitation, and/or prevocational services is
				  provided by the provider, the provider must have insurance coverage that meets
				  current home and community-based services providers licensing standards on any
				  vehicles used in transporting a beneficiary.
C. In addition to meeting the requirements
				  cited in this
				  §5901.A and B,
				  providers must meet the following requirements for the provision of designated
				  services.
1. Day Habilitation and
				  Prevocational Services. The provider must possess a current, valid license as
				  an adult day care center in order to provide these services.
2. Supported Employment Services. The
				  provider must possess a valid certificate of compliance as a community
				  rehabilitation provider (CRP) from an approved program or the certification and
				  training as required per OCDD.
3.
				  Respite Services. The provider must possess a current, valid license as a
				  personal care attendant agency or a respite care center in order to provide
				  these services.
4. Habilitation
				  Services. The provider must possess a valid license as a personal care
				  attendant agency in order to provide this service.
5. Personal Emergency Response System. The
				  provider must be enrolled to participate in the Medicaid Program as a provider
				  of personal emergency response systems.
6. Support Coordination. Providers must be
				  licensed as support coordination agencies and enrolled in the Medicaid Program
				  to deliver these services.
7.
				  Dental Services. Providers of this service are managed through the LA Dental
				  Benefit Program and must have a current, valid license from the State Board of
				  Dentistry.
8. Specialized Medical
				  Equipment and Supplies. Providers of this service must be enrolled to
				  participate in the Medicaid Program as a provider of assistive technology,
				  specialized medical equipment, and supplies.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 5 - Supports Waiver › Chapter 59 - Provider Participation › Section XXI-5903 - Electronic Visit Verification

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  Effective for dates of service on or after August 1, 2015, Supports Waiver
				  providers shall use the electronic visit verification (EVV) system designated
				  by the department for automated scheduling, time and attendance tracking, and
				  billing for certain home and community-based services.
B. Reimbursement shall only be made to
				  providers with use of the EVV system. The services that require use of the EVV
				  system include the following: in home respite, center-based respite,
				  habilitation, day habilitation, prevocational services, and supported
				  employment services.
AUTHORITY
					 NOTE: Promulgated in accordance with
					 R.S.
					 36:254 and Title XIX of the Social Security
					 Act.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 81 - General Provisions › Section XXI-8101 - Introduction

Current through Register Vol. 50, No. 6, June 20, 2024
A. The target
				  population for the Community Choices Waiver (CCW) includes individuals who:
1. are 65 years of age or older; or
2. are 21-64 years of age with a physical
				  disability; and
3. meet nursing
				  facility level of care requirements.
4. Repealed.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 81 - General Provisions › Section XXI-8103 - Request for Services Registry

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  The Department of Health (LDH) is responsible for the request for services
				  registry, hereafter referred to as "the registry," for the Community Choices
				  Waiver. An individual who wishes to have his or her name placed on the registry
				  must contact a toll-free telephone number which shall be maintained by the
				  department.
B. Individuals who
				  desire their name to be placed on the community choices waiver registry shall
				  be screened to determine whether they meet:
1.
				  nursing facility level of care; and
2. are members of the target population as
				  identified in the federally-approved waiver document.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 81 - General Provisions › Section XXI-8105 - Programmatic Allocation of Waiver Opportunities

Current through Register Vol. 50, No. 6, June 20, 2024
A. When funding is available for a new
				  Community Choices Waiver opportunity or an existing opportunity is vacated, the
				  department shall send a written notice to an individual on the registry
				  indicating that a waiver opportunity is available. If the individual accepts
				  the opportunity, that individual shall be evaluated for a possible Community
				  Choices Waiver opportunity assignment.
B. Community Choices Waiver opportunities
				  shall be offered to individuals on the registry according to priority groups.
				  The following groups shall have priority for Community Choices Waiver
				  opportunities, in the order listed:
1.
				  individuals with substantiated cases of abuse or neglect referred by protective
				  services who, without Community Choices Waiver services, would require
				  institutional placement to prevent further abuse or neglect;
2. individuals diagnosed with Amyotrophic
				  Lateral Sclerosis (ALS), also known as Lou Gehrig's disease;
3. individuals who are residing in a state of
				  Louisiana permanent supportive housing unit or who are linked for the state of
				  Louisiana permanent supportive housing process;
4. individuals admitted to or residing in a
				  nursing facility who have Medicaid as the sole payer source for the nursing
				  facility stay;
5. individuals who
				  are not presently receiving home and community-based services (HCBS) under
				  another Medicaid program, including, but not limited to:
a. Program of All-Inclusive Care for the
				  Elderly (PACE);
b. long
				  term-personal care services (LT-PCS); and/or
c. any other 1915(c) waiver;.
6. all other eligible individuals
				  on the CCW registry, by date of first request for services.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 83 - Covered Services › Section XXI-8301 - Support Coordination

Current through Register Vol. 50, No. 6, June 20, 2024
A. Support
				  coordination services assist participants in gaining access to needed waiver
				  and other state plan services, as well as needed medical, social, educational,
				  housing, and other services, regardless of the funding source for these
				  services. Support coordination agencies shall be required to perform the
				  following core elements of support coordination services:
1. intake;
2. assessment and re-assessment;
3. plan of care development and
				  revision;
4.
				  follow-up/monitoring;
5. critical
				  incident management; and
6.
				  transition/discharge and closure.
7. -12. Repealed.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 83 - Covered Services › Section XXI-8302 - Long Term-Personal Care Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Community Choices Waiver participants
				  cannot also receive long term-personal care services.
AUTHORITY
					 NOTE: Promulgated in accordance with
					 R.S.
					 36:254 and Title XIX of the Social Security
					 Act.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 83 - Covered Services › Section XXI-8303 - Transition Intensive Support Coordination

Current through Register Vol. 50, No. 6, June 20, 2024
A. Transition intensive support coordination
				  services assist participants who are currently residing in nursing facilities
				  in gaining access to needed waiver and other state plan services, as well as
				  needed medical, social, housing, educational and other services, regardless of
				  the funding source for these services. Support coordinators shall initiate and
				  oversee the process for assessment and reassessment, as well as be responsible
				  for ongoing monitoring of the provision of services included in the
				  participants approved POC.
1. This service is
				  paid for up to six months prior to transition from the nursing facility when
				  adequate pre-transition supports and activities are provided and
				  documented.
2. The scope of
				  transition intensive support coordination shall not overlap with the scope of
				  support coordination.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 83 - Covered Services › Section XXI-8305 - Environmental Accessibility Adaptations

Current through Register Vol. 50, No. 6, June 20, 2024
A. Environmental accessibility adaptations
				  are necessary physical adaptations that will be made to the home to reasonably
				  assure the health and welfare of the participant, or enable the participant to
				  function with greater independence in the home.
1. There must be an identified need for
				  environmental accessibility adaptations as indicated by:
a. the interRAI assessment; or
b. supporting documentation of the
				  need.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 83 - Covered Services › Section XXI-8307 - Personal Assistance Services

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  Personal assistance services (PAS) provide assistance and/or supervision
				  necessary for the participant with functional impairments to remain safely in
				  the community. PAS include the following services and supports based on the
				  approved POC:
1. supervision or assistance in
				  performing activities of daily living (ADL);
2. supervision or assistance in performing
				  instrumental activities of daily living (IADL);
3. protective supervision provided solely to
				  assure the health and welfare of a participant;
4. supervision or assistance with health
				  related tasks (any health related procedures governed under the Nurse Practice
				  Act) where the direct service worker has received proper training pursuant to
				  R.S.
				  37:1031-1034;
5. supervision or assistance while
				  escorting/accompanying the participant outside of the home to perform tasks,
				  including instrumental activities of daily living, health maintenance or other
				  needs as identified in the POC and to provide the same supervision or
				  assistance as would be rendered in the home; and
6. extension of therapy services, defined as
				  follows:
a. Licensed therapists may choose to
				  instruct the attendants on the proper way to assist the participant in
				  follow-up therapy sessions. This assistance and support provides reinforcement
				  of instruction and aids in the rehabilitative process.
b. In addition, a registered nurse may
				  instruct an attendant to perform basic interventions with a participant that
				  would increase and optimize functional abilities for maximum independence in
				  performing activities of daily living such as range of motion
				  exercises.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 83 - Covered Services › Section XXI-8309 - Transition Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Transition
				  Services are time limited, non-recurring set-up expenses available for
				  individuals who have been offered and approved for a Community Choices Waiver
				  opportunity and are transitioning from a nursing facility to a living
				  arrangement in a private residence where the individual is directly responsible
				  for his/her own living expenses.
B.
				  Allowable expenses are those necessary to enable the individual to establish a
				  basic household (excluding expenses for room and board) including, but not
				  limited to:
1. security deposits that are
				  required to obtain a lease on an apartment or house;
2. specific set up fees or
				  deposits;
3. activities to assess
				  need, arrange for and procure needed resources;
4. essential furnishings to establish basic
				  living arrangements; and
5. health
				  and welfare assurances.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 83 - Covered Services › Section XXI-8311 - Adult Day Health Care Services

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  Adult day health care (ADHC) services are furnished as specified in the POC at
				  an ADHC center, in a non-institutional, community-based setting encompassing
				  both health/medical and social services needed to ensure the optimal
				  functioning of the participant.
B.
				  ADHC services include those core service requirements identified in the ADHC
				  licensing standards (LAC 48.I.4243), in addition to:
1. medical care management; and
2. transportation to and from medical and
				  social activities (if the participant is accompanied by the ADHC center
				  staff).
3. - 8.
				  Repealed.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 83 - Covered Services › Section XXI-8313 - Caregiver Temporary Support Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Caregiver temporary support services are
				  furnished on a short-term basis because of the absence or need for relief of
				  caregivers during the time they are normally providing unpaid care for the
				  participant.
B. Federal financial
				  participation is not claimed for the cost of room and board except when
				  provided as part of caregiver temporary support services furnished in a
				  facility approved by the state that is not a private residence.
C. The intent of caregiver temporary support
				  services is to provide relief to unpaid caregivers to maintain the informal
				  support system.
D. Caregiver
				  temporary support services are provided in the following locations:
1. the participant's home or place of
				  residence;
2. nursing
				  facilities;
3. assisted living
				  facilities;
4. respite centers;
				  or
5. adult day health care
				  centers.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 83 - Covered Services › Section XXI-8315 - Assistive Devices and Medical Supplies

Current through Register Vol. 50, No. 6, June 20, 2024
A. Assistive devices and medical supplies are
				  specialized medical equipment and supplies which include:
1. devices, controls, appliances or
				  nutritional supplements that enable participants to increase their ability to
				  perform activities of daily living; or
2. devices, controls, appliances or
				  nutritional supplements that enable participants to perceive, control, or
				  communicate with the environment in which they live or provide emergency
				  response;
3. items, supplies and
				  services necessary for life support, ancillary supplies and equipment necessary
				  to the proper functioning of such items;
4. supplies and services necessary to assure
				  health and welfare;
5. other
				  durable and non-durable medical equipment and medical supplies that are
				  necessary, but not available under the state plan;
6. personal emergency response systems
				  (PERS);
7. other in-home monitoring
				  and medication management devices and technology;
8. routine maintenance or repair of
				  specialized equipment; and
9.
				  batteries, extended warranties, and service contracts that are cost effective
				  and assure health and welfare.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 83 - Covered Services › Section XXI-8317 - Home Delivered Meals

Current through Register Vol. 50, No. 6, June 20, 2024
A. The purpose of
				  home delivered meals is to assist in meeting the nutritional needs of an
				  individual in support of the maintenance of self-sufficiency and enhancing the
				  quality of life.
B. Up to two
				  nutritionally balanced meals per day may be delivered to the home of an
				  eligible participant who is unable to leave his/her home without assistance,
				  unable to prepare his/her own meals, and/or has no responsible caregiver in the
				  home.
C. Each meal shall provide a
				  minimum of one-third of the current recommended dietary allowance (RDA) for the
				  participant as adopted by the United States Department of Agriculture. The
				  provision of home delivered meals does not provide a full nutritional
				  regimen.
D. Medically tailored meals
				  (MTMs) may be delivered to participants with chronic conditions when
				  discharging from the hospital and/or nursing facility. In addition,
				  participants will receive nutritional guidance to support healthy food choices
				  for their third meal and snacks.
AUTHORITY
					 NOTE: Promulgated in accordance with
					 R.S.
					 36:254 and Title XIX of the Social Security
					 Act.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 83 - Covered Services › Section XXI-8319 - Non-Medical Transportation (Repealed)

Current through Register Vol. 50, No. 6, June 20, 2024
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 36:254 and Title XIX of the Social Security
					 Act.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 83 - Covered Services › Section XXI-8321 - Nursing Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Nursing
				  services are services that are medically necessary and may only be provided
				  efficiently and effectively by a registered nurse or a licensed practical nurse
				  working under the supervision of a registered nurse. These nursing services
				  provided must be within the scope of the Louisiana statutes governing the
				  practice of nursing.
B. Nursing
				  services may include periodic assessment of the participant's medical condition
				  when the condition requires a skilled nurse to identify and evaluate the need
				  for medical intervention or to monitor and/or modify the medical treatment
				  services provided by non-professional care providers.
C. Services may also include regular, ongoing
				  monitoring of a participant's fragile or complex medical condition as well as
				  the monitoring of a participant with a history of noncompliance with medication
				  or other medical treatment needs.
D. Nursing may also be used to assess a
				  participant's need for assistive devices or home modifications, training the
				  participant and family members in the use of the purchased devices, and
				  training of direct service workers in tasks necessary to carry out the
				  POC.
E. Where applicable, a
				  participant must use Medicare, Medicaid State Plan services, or other available
				  payers first. The participant's preference for a certain staff or agencies is
				  not grounds for declining another payer in order to access waiver
				  services.
F. All services must be
				  based on a verified need of the participant. The service must have a direct or
				  remedial benefit to the participant with specific goals and outcomes.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 36:254 and Title XIX of the Social Security
					 Act.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 83 - Covered Services › Section XXI-8323 - Skilled Maintenance Therapy

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  Skilled maintenance therapy is therapy services that may be received by
				  participants in the home or rehabilitation center.
B. Skilled maintenance therapy services
				  include physical therapy, occupational therapy, and speech and language
				  therapy.
C. Therapy services
				  provided to participants are not necessarily tied to an episode of illness or
				  injury and instead focus primarily on the participant's functional need for
				  maintenance of, or reducing the decline in, the participant's ability to carry
				  out activities of daily living.
D.
				  Skilled maintenance therapies may also be used to assess a participant's need
				  for assistive devices or home modifications, training the participant and
				  family members in the use of the purchased devices, performance of in-home fall
				  prevention assessments, and participation on the POC planning team.
E. Services may be provided in a variety of
				  locations including the participant's home or as approved by the POC planning
				  team.
F. Skilled maintenance
				  therapy services specifically include:
1.
				  physical therapy services which promote the maintenance of, or the reduction
				  in, the loss of gross/fine motor skills, and facilitate independent functioning
				  and/or prevent progressive disabilities including:
a. professional assessment(s), evaluation(s)
				  and monitoring for therapeutic purposes;
b. physical therapy treatments and
				  interventions;
c. training
				  regarding physical therapy activities, use of equipment and
				  technologies;
d. designing,
				  modifying or monitoring the use of related environmental
				  modifications;
e. designing,
				  modifying, and monitoring the use of related activities supportive to the POC
				  goals and objectives; or
f.
				  consulting or collaborating with other service providers or family members, as
				  specified in the POC;
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 83 - Covered Services › Section XXI-8325 - Housing Transition or Crisis Intervention Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Housing transition or crisis intervention
				  services enable participants who are transitioning into a permanent supportive
				  housing (PSH) unit, including those transitioning from institutions, to secure
				  their own housing or provide assistance at any time the participants housing is
				  placed at risk (e.g., eviction, loss of roommate or income). The service
				  includes the following components:
1.
				  conducting a housing assessment identifying the participants preferences
				  related to housing (type, location, living alone or with someone else,
				  accommodations needed, and other important preferences), and identifying
				  his/her needs for support to maintain housing, including:
a. access to housing;
b. becoming familiar with neighborhood,
				  resources, and neighbors;
c.
				  meeting the terms of a lease;
d.
				  eviction prevention;
e. budgeting
				  for housing/living expenses;
f.
				  obtaining/accessing sources of income necessary for rent;
g. home management; and
h. understanding and meeting the obligations
				  of tenancy as defined in the lease terms;
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 83 - Covered Services › Section XXI-8327 - Housing Stabilization Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Housing stabilization services enable
				  waiver participants to, once housed, successfully maintain tenancy and
				  residence in their own housing as set forth in the participants approved plan
				  of care. Services must be provided in the home or a community setting. This
				  service includes the following components:
1.
				  participation in the plan of care renewal and updates as needed, incorporating
				  elements of the housing support plan;
2. providing supports and interventions
				  designed to maintain ongoing successful and stable tenancy and
				  residence;
3. serving as point of
				  contact for the landlord or property manager regarding any accommodations
				  needed by the participant, any components of emergency procedures involving the
				  landlord or property manager and to assist with issues that may place the
				  participants housing at risk; and
4. updating the housing support plan annually
				  or as needed due to changes in the participant's situation or status.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 83 - Covered Services › Section XXI-8329 - Monitored In-Home Caregiving Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Monitored in-home caregiving (MIHC)
				  services are provided by a principal caregiver to a participant who lives in a
				  private unlicensed residence. The principal caregiver shall be contracted by
				  the licensed HCBS provider having a MIHC service module. The principal
				  caregiver shall reside with the participant. Professional staff employed by the
				  HCBS provider shall provide oversight, support and monitoring of the principal
				  caregiver, service delivery, and participant outcomes through on-site visits,
				  training, and daily, web-based electronic information exchange.
B. The principal caregiver is responsible for
				  supporting the participant to maximize the highest level of independence
				  possible by providing necessary care and supports that may include:
1. supervision or assistance in performing
				  activities of daily living;
2.
				  supervision or assistance in performing instrumental activities of daily
				  living;
3. protective supervision
				  provided solely to assure the health and welfare of a participant;
4. supervision or assistance with health
				  related tasks (any health related procedures governed under the Nurse Practice
				  Act) in accordance with applicable laws governing the delegation of medical
				  tasks/medication administration;
5.
				  supervision or assistance while escorting/ accompanying the participant outside
				  of the home to perform services indicated in the plan of care and to provide
				  the same level of supervision or assistance as would be rendered in the home;
				  and
6. extension of therapy
				  services to maximize independence when the caregiver has been instructed in the
				  performance of the activities by a licensed therapist or registered
				  nurse.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 83 - Covered Services › Section XXI-8331 - Assistive Technology

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  Assistive technology services include the following:
1. an item, piece of equipment or product
				  system, acquired commercially, that is used to increase, maintain or improve
				  functional capabilities of participants; and
2. the assistance provided to the participant
				  in the acquisition, set up and use of an assistive technology device:
a. evaluating to determine if an assistive
				  technology device is appropriate for the participant;
b. purchasing the most appropriate assistive
				  technology device for the participant; and
c. costs associated with the delivery, set
				  up, and training.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 7 - Community Choices Waiver › Chapter 83 - Covered Services › Section XXI-8335 - Financial Management Services

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  Financial management services (FMS) assist the participant to live
				  independently in the community while controlling their services by choosing the
				  staff who work with them.
B. FMS
				  are provided to participants who have chosen and are capable of self-directing
				  their Community Choices Waiver services.
C. FMS are provided by a Medicaid enrolled
				  fiscal employer agent (F/EA) and the F/EA's responsibilities and standards for
				  participation are identified in LAC 50:XXI.Chapter 11, Subchapters
				  A-C.
AUTHORITY
					 NOTE: Promulgated in accordance with
					 R.S.
					 36:254 and Title XIX of the Social Security
					 Act.