reglab/statecodes huggingface dataset:
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter A - General Provisions › Section XXI-501 - Introduction

Current through Register Vol. 50, No. 6, June 20, 2024
A. The Department
					 of Health (LDH) establishes these minimum standards for participation which
					 provides the core requirements for support coordination services provided under
					 home and community-based services waiver programs administered by the Office of
					 Aging and Adult Services (OAAS). OAAS must determine the adequacy of quality
					 and protection of waiver participants in accordance with the provisions of
					 these standards.
B. OAAS, or its
					 designee, is responsible for setting the standards for support coordination,
					 monitoring the provisions of this Rule, and applying administrative sanctions
					 for failures by support coordinators to meet the minimum standards for
					 participation in serving participants of OAAS-administered waiver
					 programs.
C. Support coordination
					 are services that will 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.
D. If, in the judgement
					 of OAAS, application of the requirements stated in these standards would be
					 impractical in a specified case; such requirements may be modified by the OAAS
					 assistant secretary to allow alternative arrangements that will secure as
					 nearly equivalent provision of services as is practical. In no case will the
					 modification afford less quality or protection, in the judgement of OAAS, than
					 that which would be provided with compliance of the provisions contained in
					 these standards.
1. Requirement modifications
					 may be reviewed by the OAAS assistant secretary and either continued or
					 canceled.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter A - General Provisions › Section XXI-503 - Certification Requirements

Current through Register Vol. 50, No. 6, June 20, 2024
A. All
					 agencies that provide support coordination to OAAS-administered home- and
					 community-based waivers must be certified by the Department of Health and
					 Hospitals. It shall be unlawful to operate as a support coordination agency for
					 OAAS-administered waivers without being certified by the department.
B. In order to provide support coordination
					 services for OAAS-administered home- and community-based waiver programs, the
					 agency must:
1. be certified and meet the
					 standards for participation requirements as set forth in this Rule;
2. sign a performance agreement with
					 OAAS;
3. assure staff attends all
					 training mandated by OAAS;
4.
					 enroll as a Medicaid support coordination agency in all regions in which it
					 intends to provide services for OAAS-administered home- and community-based
					 services; and
5. comply with all
					 DHH and OAAS policies and procedures.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter A - General Provisions › Section XXI-505 - Certification Issuance

Current through Register Vol. 50, No. 6, June 20, 2024
A. A
					 certification shall:
1. be issued only to the
					 entity named in the certification application;
2. be valid only for the support coordination
					 agency to which it is issued after all applicable requirements are
					 met;
3. enable the support
					 coordination agency to provide support coordination for OAAS-administered home-
					 and community-based waivers within the specified DHH region; and
4. be valid for the time specified on the
					 certification, unless revoked, suspended, modified or terminated prior to that
					 date.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter A - General Provisions › Section XXI-507 - Certification Refusal or Revocation and Fair Hearing

Current through Register Vol. 50, No. 6, June 20, 2024
A. A certification may be revoked or refused
					 if applicable certification requirements, as determined by OAAS or its
					 designee, have not been met. Certification decisions are subject to appeal and
					 fair hearing, in accordance with
					 R.S.
					 46:107(A)(3).
AUTHORITY NOTE:
						Promulgated in accordance with
						R.S.
						36:254.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter A - General Provisions › Section XXI-509 - Certification Review

Current through Register Vol. 50, No. 6, June 20, 2024
A. Compliance
					 with certification requirements is determined by OAAS through its agency review
					 and support coordination monitoring processes. This review is usually annual
					 but may be conducted at any time and may be conducted without advance notice.
					 Monitors must be given access to all areas of the agency and all relevant files
					 and records.
AUTHORITY NOTE:
						Promulgated in accordance with
						R.S.
						36:254.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter B - Administration and Organization › Section XXI-513 - Governing Body

Current through Register Vol. 50, No. 6, June 20, 2024
A. A support
					 coordination agency shall have an identifiable governing body with
					 responsibility for and authority over the policies and activities of the
					 agency.
1. An agency shall have documents
					 identifying all members of the governing body, their addresses, their terms of
					 membership, and officers of the governing body.
2. The governing body shall hold formal
					 meetings at least twice a year.
3.
					 There shall be written minutes of all formal meetings of the governing
					 body.
4. There shall be governing
					 body by-laws which specify the frequency of meetings and quorum
					 requirements.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter B - Administration and Organization › Section XXI-515 - Business Location and Operations

Current through Register Vol. 50, No. 6, June 20, 2024
A. Each support coordination agency shall
					 have a business location which shall not be in an occupied personal residence.
					 The business location shall be in the DHH region for which the certification is
					 issued and shall be where the agency:
1.
					 maintains staff to perform administrative functions;
2. maintains the agency's personnel records;
					 and
3. maintains the agency's
					 participant service records.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter B - Administration and Organization › Section XXI-517 - Financial Management

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 agency must establish a system of financial management and staffing to assure
					 maintenance of complete and accurate accounts, books and records in keeping
					 with generally accepted accounting principles.
B. The agency must not permit public funds to
					 be paid or committed to be paid, to any person who is a member of the governing
					 board or administrative personnel who may have any direct or indirect financial
					 interest, or in which any of these persons serve as an officer or employee,
					 unless the services or goods involved are provided at a competitive cost or
					 under terms favorable to the agency. The agency shall have a written disclosure
					 of any financial transaction with the agency in which a member of the governing
					 board, administrative personnel, or his/her immediate family is
					 involved.
C. For the protection of
					 its participants, staff, facilities, and the general public, the agency must
					 have at least $150,000 in general liability and at least $150,000 in
					 professional liability insurance coverage.
AUTHORITY NOTE:
						Promulgated in accordance with
						R.S.
						36:254.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter B - Administration and Organization › Section XXI-519 - Policy and Procedures

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 support coordination agency shall have written policies and procedures approved
					 by the owner or governing body which must be implemented and followed that
					 address at a minimum the following:
1.
					 confidentiality and confidentiality agreements;
2. security of files;
3. publicity and marketing, including the
					 prohibition of illegal or coercive inducement, solicitation and
					 kickbacks;
4. personnel;
5. participant rights;
6. grievance procedures;
7. emergency preparedness;
8. abuse and neglect reporting;
9. critical incident reporting;
10. worker safety;
11. documentation; and
12. admission and discharge
					 procedures.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter B - Administration and Organization › Section XXI-521 - Organizational Communication

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 agency must establish procedures to assure adequate communication among staff
					 to provide continuity of services to the participant and to facilitate feedback
					 from staff, participants, families, and when appropriate, the
					 community.
B. The agency must have
					 brochures and make them available to OAAS or its designee. The brochures must
					 include the following information:
1. that
					 each participant has the freedom to choose their providers and that their
					 choice of provider does not affect their eligibility for waiver, state plan, or
					 support coordination services;
2.
					 that a participant receiving support coordination through OAAS may contact the
					 OAAS help line for information, assistance with, or questions about OAAS
					 programs;
3. the OAAS help line
					 number along with the appropriate OAAS regional office telephone
					 numbers;
4. information, including
					 the Health Standards Section complaint line, on where to make complaints
					 against support coordinators, support coordination agencies, and providers;
					 and
5. a description of the agency,
					 services provided, current address, and the agency's local and nationwide
					 toll-free number.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter C - Provider Responsibilities › Section XXI-525 - General Provisions

Current through Register Vol. 50, No. 6, June 20, 2024
A. Any
					 entity wishing to provide support coordination services for any
					 OAAS-administered home- and community-based waiver program shall meet all of
					 the standards for participation contained in this Rule, unless otherwise
					 specifically noted within these provisions.
B. The support coordination agency shall also
					 abide by and adhere to any federal, state law, Rule, policy, procedure,
					 performance agreement, manual or memorandum pertaining to the provision of
					 support coordination services for OAAS-administered home- and community-based
					 waiver programs.
C. Failure to
					 comply with the requirements of these standards for participation may result in
					 sanctions including, but not limited to:
1.
					 recoupment of funds;
2. cessation
					 of linkages;
3. citation of
					 deficient practice and plan of correction submission;
4. removal from the freedom of choice list;
					 or
5. decertification as a support
					 coordination agency for OAAS-administered home- and community-based waiver
					 services.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter C - Provider Responsibilities › Section XXI-527 - Support Coordination Services

Current through Register Vol. 50, No. 6, June 20, 2024
A. Support coordination is services that will
					 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;
3. plan of care development and
					 revision;
4. linkage to direct
					 services and other resources;
5.
					 coordination of multiple services among multiple providers;
6. monitoring/follow-up;
7. reassessment;
8. evaluation and re-evaluation of level of
					 care and need for waiver services;
9. ongoing assessment and mitigation of
					 health, behavioral and personal safety risk;
10. responding to participant
					 crisis;
11. critical incident
					 management; and
12.
					 transition/discharge and closure.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter C - Provider Responsibilities › Section XXI-529 - Transfers and Discharges

Current through Register Vol. 50, No. 6, June 20, 2024
A. All
					 participants of OAAS-administered waiver programs must receive support
					 coordination services. However, a participant has the right to choose a support
					 coordination agency. This right includes the right to be discharged from
					 his/her current support coordination agency and be transferred to another
					 support coordination agency.
B.
					 Upon notice by the participant or his/her authorized representative that the
					 participant has selected another support coordination agency or the participant
					 has decided to discontinue participation in the waiver program, the agency
					 shall have the responsibility of planning for the participant's transfer or
					 discharge.
C. The support
					 coordination agency shall also have the responsibility of planning for a
					 participant's transfer when the support coordination agency ceases to operate
					 or when the participant moves from the geographical region serviced by the
					 support coordination agency.
D. The
					 transfer or discharge responsibilities of the support coordinator shall
					 include:
1. holding a transfer or discharge
					 planning conference with the participant, his/her family, providers, legal
					 representative and advocate, if such are known, in order to facilitate a smooth
					 transfer or discharge, unless the participant declines such a
					 meeting;
2. providing a current
					 plan of care to the receiving support coordination agency (if applicable);
					 and
3. preparing a written
					 discharge summary. The discharge summary shall include, at a minimum, a summary
					 on the health, behavioral, and social issues of the participant and shall be
					 provided to the receiving support coordination agency (if
					 applicable).
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter C - Provider Responsibilities › Section XXI-531 - Staffing Requirements

Current through Register Vol. 50, No. 6, June 20, 2024
A. Agencies
					 must maintain sufficient staff to comply with OAAS staffing, timeline,
					 workload, and performance requirements. This includes, but is not limited to,
					 including sufficient support coordinators and support coordinator supervisors
					 that have passed all of the OAAS training and certification requirements. At
					 all times, an agency must have at least one certified support coordination
					 supervisor and at least one certified support coordinator, both employed full
					 time. Agencies may employ staff who are not certified to perform services or
					 requirements other than assessment and care planning.
B. Agencies must maintain sufficient
					 supervisory staff to comply with OAAS supervision and CQI requirements. Support
					 coordination supervisors must be continuously available to support coordinators
					 by telephone.
1. Each support coordination
					 agency must have and implement a written plan for supervision of all support
					 coordination staff.
2. Each
					 supervisor must maintain a file on each support coordinator supervised and hold
					 documented supervisory sessions and evaluate each support coordinator at least
					 annually.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter C - Provider Responsibilities › Section XXI-533 - Personnel Standards

Current through Register Vol. 50, No. 6, June 20, 2024
A. Support
					 coordinators must meet one of the following requirements:
1. a bachelor's or master's degree in social
					 work from a program accredited by the Council on Social Work
					 Education;
2. a diploma,
					 associate's bachelor's or master's degree in nursing (RN) currently licensed in
					 Louisiana;
3. a bachelor's or
					 master's degree in a human service related field which includes:
a. psychology;
b. education;
c. counseling;
d. social services;
e. sociology;
f. philosophy;
g. family and participant sciences;
h. criminal justice;
i. rehabilitation services;
j. substance abuse treatment;
k. gerontology;
l. vocational rehabilitation; or
4. a bachelor's degree in liberal
					 arts or general studies with a concentration of at least 16 hours in one of the
					 fields in §533.
					 A.3 a-l of this Section.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter C - Provider Responsibilities › Section XXI-535 - Employment and Recruitment Practices

Current through Register Vol. 50, No. 6, June 20, 2024
A. A support coordination agency shall have
					 written personnel policies, which must be implemented and followed, that
					 include:
1. a plan for recruitment, screening,
					 orientation, ongoing training, development, supervision and performance
					 evaluation of staff members;
2. a
					 policy to prevent discrimination and comply with all state and federal
					 employment practices and laws;
3. a
					 policy to recruit, wherever possible, qualified persons of both sexes
					 representative of cultural and racial groups served by the agency, including
					 the hiring of qualified persons with disabilities;
4. written job descriptions for each staff
					 position, including volunteers;
5.
					 an employee grievance procedure that allows employees to make complaints
					 without fear of retaliation; and
6.
					 abuse reporting procedures that require all employees to report any incidents
					 of abuse or mistreatment, whether that abuse or mistreatment is done by another
					 staff member, a family member, a participant or any other person.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter C - Provider Responsibilities › Section XXI-537 - Orientation and Training

Current through Register Vol. 50, No. 6, June 20, 2024
A. Support
					 coordinators must receive necessary orientation and periodic training on the
					 provision of support coordination services arranged or provided through their
					 agency at the agency's expense.
B.
					 Orientation shall be provided by the agency to all staff, volunteers and
					 students within five working days of begin/employment date.
C. Orientation and training of at least 32
					 hours shall be provided by the agency to all newly hired support coordinators
					 within five working days of employment. The topics shall be agency/OAAS
					 specific and shall include, at a minimum:
1.
					 core OAAS support coordination requirements;
2. agency policies and procedures;
3. confidentiality;
4. case record documentation;
5. participant rights protection and
					 reporting of violations;
6.
					 professional ethics;
7. emergency
					 and safety procedures;
8. infection
					 control, including universal precautions;
9. overview of all OAAS waivers and
					 services;
10. fundamentals of
					 support coordination (e.g. person centered planning, emergency planning,
					 back-up staff planning, critical incident reporting, risk assessment and
					 mitigation, etc.);
11. interviewing
					 techniques;
12. data
					 management;
13. communication
					 skills;
14. community
					 resources;
15. continuous quality
					 improvement; and
16. abuse and
					 neglect policies and procedures.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter C - Provider Responsibilities › Section XXI-539 - Participant Rights

Current through Register Vol. 50, No. 6, June 20, 2024
A. Unless
					 adjudicated by a court of competent jurisdiction, participants served by a
					 support coordination agency shall have the same rights, benefits, and
					 privileges guaranteed by the constitution and the laws of the United States and
					 Louisiana.
B. There shall be
					 written policies and procedures that protect the participant's welfare,
					 including the means by which the protections will be implemented and
					 enforced.
C. Each support
					 coordination agency's written policies and procedures, at a minimum, shall
					 ensure the participant's right to:
1.
					 confidentiality;
2.
					 privacy;
3. impartial access to
					 treatment regardless of race, religion, sex, ethnicity, age or
					 disability;
4. access to the
					 interpretive services, translated material and similar accommodations as
					 appropriate;
5. access to his/her
					 records upon the participant's written consent for release of
					 information;
6. an explanation of
					 the nature of services to be received;
7. actively participate in
					 services;
8. refuse services or
					 participate in any activity against their will;
9. obtain copies of the support coordination
					 agency's complaint or grievance procedures;
10. file a complaint or grievance without
					 retribution, retaliation or discharge;
11. be informed of the financial aspect of
					 services;
12. give informed written
					 consent prior to being involved in research projects;
13. refuse to participate in any research
					 project without compromising access to services;
14. be free from mental, emotional and
					 physical abuse and neglect;
15. be
					 free from chemical or physical restraints;
16. receive services that are delivered in a
					 professional manner and are respectful of the participant's wishes concerning
					 their home environment;
17. receive
					 services in the least intrusive manner appropriate to their needs;
18. contact any advocacy resources as needed,
					 especially during grievance procedures; and
19. discontinue services with one provider
					 and choose the services of another provider.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter C - Provider Responsibilities › Section XXI-541 - Grievances

Current through Register Vol. 50, No. 6, June 20, 2024
A. The support
					 coordination agency shall establish and follow a written grievance procedure to
					 be used to process complaints by participants, their family member(s), or a
					 legal representative that is designed to allow participants to make complaints
					 without fear of retaliation. The written grievance procedure shall be provided
					 to the participant.
AUTHORITY NOTE:
						Promulgated in accordance with
						R.S.
						36:254.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter C - Provider Responsibilities › Section XXI-543 - Critical Incident Reporting

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 Support coordination agencies shall report critical incidents according to
					 established OAAS policy including timely entries into the designated DHH
					 critical incident database.
AUTHORITY NOTE:
						Promulgated in accordance with
						R.S.
						36:254.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter C - Provider Responsibilities › Section XXI-545 - Participant Records

Current through Register Vol. 50, No. 6, June 20, 2024
A. Participant
					 records shall be maintained in the support coordinator's office. The support
					 coordinator shall have a current written record for each participant.
B. Support coordination agencies shall
					 maintain participant records in readily accessible form for a period of six
					 years.
AUTHORITY NOTE:
						Promulgated in accordance with
						R.S.
						36:254.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter C - Provider Responsibilities › Section XXI-547 - Emergency Preparedness

Current through Register Vol. 50, No. 6, June 20, 2024
A. Support
					 coordination agencies shall ensure that each participant has an individual plan
					 for dealing with emergencies and disasters and shall assist participants in
					 identifying the specific resources available through family, friends, the
					 neighborhood, and the community. The support coordinator shall assess monthly
					 whether the emergency plan information is current and effective and shall make
					 changes accordingly.
B. Continuity
					 of Operations. The support coordination agency shall have an emergency
					 preparedness plan to maintain continuity of the agency's operations in
					 preparation for, during, and after an emergency or disaster. The plan shall be
					 designed to manage the consequences of all hazards, declared disasters or other
					 emergencies that disrupt the agency's ability to render services.
C. The support coordination agency shall
					 follow and execute its emergency preparedness plan in the event of the
					 occurrence of a declared disaster or other emergency.
D. The support coordinator shall cooperate
					 with the department and with the local or parish Office of Homeland Security
					 and Emergency Preparedness in the event of an emergency or disaster and shall
					 provide information as requested.
E. The support coordinator shall monitor
					 weather warnings and watches as well as evacuation orders from local and state
					 emergency preparedness officials.
F. All agency employees shall be trained in
					 emergency or disaster preparedness. Training shall include orientation, ongoing
					 training, and participation in planned drills for all personnel.
G. Upon request by the department, the
					 support coordination agency shall submit a copy of its emergency preparedness
					 plan and a written summary attesting to how the plan was followed and
					 executed.
AUTHORITY NOTE:
						Promulgated in accordance with
						R.S.
						36:254.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter C - Provider Responsibilities › Section XXI-549 - Continuous Quality Improvement Plan

Current through Register Vol. 50, No. 6, June 20, 2024
A. Support coordination agencies shall have a
					 continuous quality improvement (CQI) plan which governs the agency's internal
					 quality management activities.
B.
					 The CQI plan shall demonstrate a process of continuous cyclical improvement and
					 include the following:
1.
design
-continuous quality improvement approach detailing how
					 the agency monitors its operations and makes improvements when problems are
					 detected;
2.
discovery
-the methods used to uncover problems and deviations
					 from plan design and programmatic processes in a timely fashion;
3.
remediation
-the process
					 of addressing and resolving problems uncovered in the course of discovery;
					 and
4.
improvement
-the actions taken to make adjustments to the
					 system's processes or procedures to prevent or minimize future
					 problems.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter C - Provider Responsibilities › Section XXI-551 - Support Coordination Monitoring

Current through Register Vol. 50, No. 6, June 20, 2024
A. Support coordination agencies shall be
					 monitored annually as outlined in the OAAS policies and procedures.
B. Support coordination agencies shall offer
					 full cooperation with the OAAS during the monitoring process. Responsibilities
					 of the support coordination agency in the monitoring process include, but are
					 not limited to:
1. providing policy and
					 procedure manuals, personnel records, case records, and other
					 documentation;
2. providing space
					 for documentation review and support coordinator interviews; and
3. coordinating agency support coordinator
					 interviews.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 5 - Support Coordination Standards for Participation for Office of Aging and Adult Services Waiver Programs › Subchapter C - Provider Responsibilities › Section XXI-553 - Workforce Retention Bonus Payments

Current through Register Vol. 50, No. 6, June 20, 2024
A. Establishment of Support Coordination
					 Workforce Bonus Payments
1. Support
					 coordination agencies (SCAs) who provided services from April 1, 2021 to
					 October 31, 2022 shall receive bonus payments of $300 per month for each SCA
					 staff member that worked directly with participants for those months.
2. The SCA staff member who worked directly
					 with participants from April 1, 2021 to October 31, 2022 must receive at least
					 $250 of this $300 bonus payment paid to the agency. This bonus payment is
					 effective for all affected SCA staff members of any working status, whether
					 full-time or part-time.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 7 - Reimbursement Methodology › Subchapter A - Personal Care Services Providers › Section XXI-701 - General Provisions

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 Department of Health (LDH) establishes reimbursement methodologies and cost
					 reporting requirements for providers of home and community-based services
					 waiver programs who provide personal care services (including personal care
					 services, personal care attendant services, community living supports services,
					 attendant care services, personal assistance services, in home respite, and
					 individual and family support services).
B. - C. Repealed.
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 1 - General Provisions › Chapter 7 - Reimbursement Methodology › Subchapter A - Personal Care Services Providers › Section XXI-703 - Cost Reporting Requirements

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 Effective July 1, 2012, the department implemented mandatory cost reporting
					 requirements for providers of home and community-based waiver services listed
					 above in §701.A The cost reports
					 will be used to verify expenditures and to support rate setting for the
					 services rendered to waiver participants.
1.
					 - 7. Repealed.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 7 - Reimbursement Methodology › Subchapter A - Personal Care Services Providers › Section XXI-705 - Rate Methodology

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 Reimbursement for the following services shall be a prospective flat rate for
					 each approved unit of service that is provided to the participant:
1. personal care services;
2. personal care attendant
					 services;
3. community living
					 supports services;
4. attendant
					 care services;
5. personal
					 assistance services;
6. in-home
					 respite; and
7. individual and
					 family support services, collectively referred to as reimbursable assistance
					 services.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 7 - Reimbursement Methodology › Subchapter B - Adult Day Health Care Providers › Section XXI-707 - General Provisions

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 Department of Health (LDH) establishes reimbursement methodologies and cost
					 reporting requirements for Adult Day Health Care (ADHC) providers of home and
					 community-based waiver programs.
B.
					 ADHC providers in the following waiver programs shall be required to submit
					 cost reports:
1. Adult Day Health Care (ADHC)
					 Waiver;
2. Community Choices
					 Waiver; and
3. Residential Options
					 Waiver (ROW).
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 7 - Reimbursement Methodology › Subchapter B - Adult Day Health Care Providers › Section XXI-709 - Rate Methodology

Current through Register Vol. 50, No. 6, June 20, 2024
A. Adult
					 day health care providers shall be reimbursed a per quarter hour rate for
					 services provided under a prospective payment system (PPS). The system shall be
					 designed in a manner that recognizes and reflects the cost of direct care
					 services provided. The reimbursement methodology is designed to improve the
					 quality of care for all waiver participants by ensuring that direct care
					 services are provided at an acceptable level while fairly reimbursing the
					 providers.
B. Reimbursement shall
					 not be made for ADHC waiver services provided under the waivers prior to the
					 department's approval of the POC.
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 1 - General Provisions › Chapter 7 - Reimbursement Methodology › Subchapter B - Adult Day Health Care Providers › Section XXI-711 - Cost Reporting

Current through Register Vol. 50, No. 6, June 20, 2024
A. Cost Centers
					 Components
1. Direct Care Costs. This
					 component reimburses for in-house and contractual direct care staffing, social
					 services, and activities (excluding the activities director) and fringe
					 benefits and direct care supplies.
2. Care Related Costs. This component
					 reimburses for in-house and contractual salaries and fringe benefits for
					 supervisory and dietary staff, raw food costs, and care related
					 supplies.
3. Administrative and
					 Operating Costs. This component reimburses for in-house or contractual salaries
					 and related benefits for administrative, housekeeping, laundry, and maintenance
					 staff. Also included are:
a.
					 utilities;
b. accounting;
c. dietary supplies;
d. housekeeping and maintenance supplies;
					 and
e. all other administrative and
					 operating type expenditures.
4. Property. This component reimburses for
					 depreciation, interest on capital assets, lease expenses, property taxes, and
					 other expenses related to capital assets, excluding property costs related to
					 participant transportation.
5.
					 Transportation. This component reimburses for inhouse and contractual driver
					 salaries and related benefits, non-emergency medical transportation, vehicle
					 maintenance, and supply expense, motor vehicle depreciation, interest expense
					 related to vehicles, vehicle insurance, and auto leases.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 7 - Reimbursement Methodology › Subchapter B - Adult Day Health Care Providers › Section XXI-715 - Allowable Costs

Current through Register Vol. 50, No. 6, June 20, 2024
A. Allowable
					 costs include those costs incurred by providers to conform to state licensure
					 and federal certification standards. General cost principles are applied during
					 the desk review and audit process to determine allowable costs.
1. These general cost principles include
					 determining whether the cost is:
a. ordinary,
					 necessary, and related to the delivery of care;
b. what a prudent and cost conscious business
					 person would pay for the specific goods or services in the open market or in an
					 arm's length transaction; and
c.
					 for goods or services actually provided to the center.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 7 - Reimbursement Methodology › Subchapter B - Adult Day Health Care Providers › Section XXI-717 - Non-allowable Costs

Current through Register Vol. 50, No. 6, June 20, 2024
A. Costs that
					 are not based on the reasonable cost of services covered under Medicare and are
					 not related to the care of participants are considered non-allowable
					 costs.
B. Reasonable cost does not
					 include the following:
1. costs not related to
					 participant care;
2. costs
					 specifically not reimbursed under the program;
3. costs that flow from the provision of
					 luxury items or services (items or services substantially in excess or more
					 expensive than those generally considered necessary for the provision of the
					 care);
4. costs that are found to
					 be substantially out of line with other centers that are similar in size, scope
					 of services, and other relevant factors;
5. costs exceeding what a prudent and
					 cost-conscious buyer would incur to purchase the goods or services.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 7 - Reimbursement Methodology › Subchapter B - Adult Day Health Care Providers › Section XXI-719 - Audits

Current through Register Vol. 50, No. 6, June 20, 2024
A. Each provider
					 shall file an annual center cost report and, if applicable, a central office
					 cost report.
B. The provider shall
					 be subject to financial and compliance audits.
C. All providers who elect to participate in
					 the Medicaid program shall be subject to audit by state or federal regulators
					 or their designees. Audit selection shall be at the discretion of the
					 department.
1. The department conducts desk
					 reviews of all of the cost reports received and also conducts on-site audits of
					 provider cost reports.
2. The
					 records necessary to verify information submitted to the department on Medicaid
					 cost reports, including related-party transactions, and other business
					 activities engaged in by the provider, must be accessible to the department's
					 audit staff.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 7 - Reimbursement Methodology › Subchapter B - Adult Day Health Care Providers › Section XXI-721 - Exclusions from the Database

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
					 following providers shall be excluded from the database used to calculate the
					 rates:
1. providers with disclaimed audits;
					 and
2. providers with cost reports
					 for periods other than a 12-month period.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 7 - Reimbursement Methodology › Subchapter B - Adult Day Health Care Providers › Section XXI-723 - Provider Reimbursement

Current through Register Vol. 50, No. 6, June 20, 2024
A. Cost
					 Determination Definitions
Base Rate
-calculated in accordance with
						§723.B 5, plus any base
						rate adjustments granted in accordance with
						§723.B.7 which are in
						effect at the time of calculation of new rates or adjustments.
Index Factor
-computed by dividing the
						value of the index for December of the year preceding the rate year by the
						value of the index one year earlier (December of the second preceding
						year).
Indices-
a.
CPI, All Items
-the
					 Consumer Price Index for All Urban Consumers-South Region (all items line) as
					 published by the United States Department of Labor.
b.
CPI, Medical Services
-the
					 Consumer Price Index for All Urban Consumers-South Region (medical services
					 line) as published by the United States Department of Labor.
Rate Component
-the rate is the summation
						of the following:
a. direct
					 care;
b. care related
					 costs;
c. administrative and
					 operating costs;
d. property costs;
					 and
e. transportation
					 costs.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 9 - Provider Requirements › Subchapter A - General Provisions › Section XXI-901 - Settings Requirements for Service Delivery

Current through Register Vol. 50, No. 6, June 20, 2024
A. All home and community-based services
					 (HCBS) delivered through a 1915(c) waiver must be provided in settings with the
					 following qualities:
1. the setting is
					 integrated in and supports full access of waiver participants to the greater
					 community, including opportunities to:
a. seek
					 employment and work in competitive integrated settings;
b. control personal resources;
c. engage in community life; and
d. receive services in the community to the
					 same degree of access as individuals not receiving Medicaid home and
					 community-based services;
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 9 - Provider Requirements › Subchapter A - General Provisions › Section XXI-903 - Electronic Visit Verification

Current through Register Vol. 50, No. 6, June 20, 2024
A. An
					 electronic visit verification (EVV) system must be used for time and attendance
					 tracking and post-authorization for home and community-based services.
1. Home and community-based waiver providers
					 identified by the department shall use:
a.
					 the EVV system designated by the department, or
b. an alternate system that:
i. has successfully passed the data
					 integration process to connect to the designated EVV system, and
ii. is approved by the department.
Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 1 - General Provisions › Chapter 9 - Provider Requirements › Subchapter A - General Provisions › Section XXI-904 - Social Security Verification

Current through Register Vol. 50, No. 6, June 20, 2024
A. Home and
					 community-based waiver providers shall verify all currently employed and all
					 new employees Social Security numbers either by obtaining a copy of the
					 employees Social Security card or through a Social Security number verification
					 service.
B. A copy of the employees
					 Social Security card or proof of verification shall be kept in the employees
					 record.
1. The department or its designee
					 reserves the right to request verification of an employees Social Security
					 number at any time.
2. Should the
					 provider be unable to provide proof of verification, payments associated with
					 that employees previously billed time may be recouped and/or future
					 reimbursement withheld until proper verification is submitted.