Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 5 - Health Planning › Chapter 111 - Area Level Planning › Section I-11107 - Long Term Care

Current through Register Vol. 50, No. 6, June 20, 2024
A. Introduction.
				  For the purpose of this planning analysis, long term care services are those
				  direct services needed by persons functionally impaired by advancing age,
				  physical or developmental disability, chronic disease, or recuperating from
				  acute illness. Services are both institutional and non-institutional.
				  Non-institutional long term care services are those which are primarily
				  directed toward preventing or postponing institutionalization. Not included in
				  this analysis are long term care services needed by persons impaired because of
				  mental illness or substance abuse. These are covered in the subsequent area
				  level planning section.
B. New
				  Orleans/Bayou-River Health System Area
1. The
				  percentage of persons 65 + in the New Orleans/Bayou-River health system area is
				  8.8 percent. The current nursing home bed (SNF, ICF I and II) to population
				  ratio is 36.3 beds per 1,000 population age 65 + . This is significantly fewer
				  beds than are available in the other parts of the state. In 1980, 90.1 percent
				  of patient days were by persons age 65 + ; 3.9 percent were by persons with
				  developmental disability; and 6.0 percent were utilized by other persons. The
				  average occupancy in 1981 was 96 percent in the New Orleans district. The
				  average 1981 occupancy in the Bayou district was 99 percent.
2. There is one intermediate care facility
				  for the mentally retarded (ICF-MR) in the New Orleans/Bayou-River area, Belle
				  Chasse State School, operating 604 beds at 88 percent occupancy. A state school
				  in Thibodaux is under construction and will have a bed capacity of
				  75.
3. Planning Objectives for Long
				  Term Care for HSA I
a. Through 1985, the
				  proportion of skilled (SNF) beds should be maintained between 15 and 20 percent
				  of the total number of nursing home beds located in the HSA.
b. Through 1987, the ratio of total nursing
				  home beds to the population age 65 and over within the HSA should not exceed 65
				  beds per 1000 population age 65 and over.
c. Through 1985, the overall annual occupancy
				  rate for nursing homes in HSA I should be maintained at least 95
				  percent.
d. By 1985, all nursing
				  homes should provide the full range of rehabilitation and supportive services
				  established by the federal guidelines for nursing home care and should be
				  encouraged to seek Joint Commission on Accreditation of Hospitals (JCAH)
				  accreditation.
e. By 1988, the
				  development of small, community-based ICF/MR services should be initiated, in
				  accordance with the goals and standards established in the State Health Plan
				  1982-87.
f. By 1985, valid and
				  reliable data describing the scope, utilization, and cost of all home health
				  and other community-based services provided to the functionally impaired
				  population residing in the health service area should be accessible to those
				  involved in the development and/or expansion of community-based
				  services.
g. By 1985, accurate and
				  complete information describing the availability of institutional and
				  community-based long term care services should be accessible to the aged
				  residents in the health service area.
h. By 1985, the development and expansion of
				  the array of community-based long term care services including home health
				  services, adult day care, day-hospital, respite care services, and alternative
				  residential settings for the developmentally disabled, should be
				  initiated.
i. 1987, Comprehensive
				  Physical Rehabilitation Facility services should be available and accessible to
				  the population, meeting goals and standards for CPRF services established in
				  the State Health Plan 198287.
j. By
				  1987, Home Health services should be available and accessible to the
				  population, meeting goals and standards for such services established in the
				  State Health Plan 1982-87.
4. Recommended Actions
a. Existing providers of nursing home care
				  should assess the feasibility of altering their services to include outpatient,
				  mobile, or home-based services.
b.
				  Existing and potential providers of ICF I and II nursing home care should
				  assess the feasibility of conversion to or construction of skilled (SNF) care
				  or day care.
c. General hospital
				  facilities with underutilized medical/surgical beds should assess the
				  feasibility of converting space to medical day care services or skilled nursing
				  beds.
d. The Department of Health
				  and Human Resources should assess the feasibility of securing an appropriation
				  of funds to be used for low interest loans to persons willing to develop
				  currently unavailable community-based services to the functionally impaired to
				  prevent institutionalization.
e.
				  The Department of Health and Human Resources should assess the feasibility of
				  securing a recurring appropriation of funds through 1987 to be used for low
				  interest loans to persons willing to develop small community-based residential
				  services for the developmentally disabled.
f. The Department of Health and Human
				  Resources, the Office of Elderly Affairs and the Legislative Health and Welfare
				  Oversight Committee should assess the feasibility of making at-home services
				  economically accessible to persons not eligible for Medicaid reimbursed at-home
				  services, but having potential eligibility for institutional long term care
				  services. Alternatives to prevent costly institutionalization might be "co-pay"
				  programs through which eligibles pay 25 percent of the cost of services.
				  (Sliding scale payments are not recommended because of the cost of
				  administration.)