Louisiana Administrative Code › Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE › Part XXI - Home and Community-Based Services Waivers › Subpart 11 - New Opportunities Waiver › Chapter 139 - Covered Services › Section XXI-13907 - Supported Independent Living

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  Supported independent living (SIL) assists the beneficiary to acquire, improve
				  or maintain those social and adaptive skills necessary to enable a beneficiary
				  to reside in the community and to participate as independently as possible. SIL
				  services include assistance and/or training in the performance of tasks such as
				  personal grooming, housekeeping and money management. Payment for this service
				  includes oversight and administration and the development of service plans for
				  the enhancement of socialization with age-appropriate activities that provide
				  enrichment and may promote wellness. The service plan should include initial,
				  introduction, and exploration for positive outcomes for the beneficiary for
				  community integration and development. These services also assist the
				  beneficiary in obtaining financial aid, housing, advocacy and self-advocacy
				  training as appropriate, emergency support, trained staff and assisting the
				  beneficiary in accessing other programs for which he/she qualifies. SIL
				  beneficiaries must be 18 years or older.
B. Place of Service. Services are provided in
				  the beneficiary's residence and/or in the community. The beneficiary's
				  residence includes his/her apartment or house, provided that he/she does not
				  live in the residence of any legally responsible relative. An exception will be
				  considered when the beneficiary lives in the residence of a spouse or disabled
				  parent, or a parent aged 70 years or older. Family members who are not legally
				  responsible relatives can be SIL workers provided they meet the same
				  qualifications as any other SIL worker. A legally responsible relative is
				  defined as a parent of a minor child, foster parent, curator, tutor, legal
				  guardian, or the beneficiary's spouse.
C. Exclusions
1. Legally responsible persons may not be SIL
				  providers for the individual whom they are legally responsible.
2. SIL shall not include the cost of:
a. meals or the supplies needed for
				  preparation;
b. room and
				  board;
c. home maintenance, or
				  upkeep, improvement, modifications, or adaption to a home, or to meet the
				  requirements of the applicable life safety code;
d. routine care and supervision which could
				  be expected to be provided by a family member; or
e. activities or supervision for which a
				  payment is made by a source other than Medicaid, e.g., Office for Citizens with
				  Developmental Disabilities, etc.
3. SIL services cannot be provided in a
				  substitute family care setting.
4.
				  Beneficiaries receiving adult companion care services are not eligible to
				  receive supported independent living services.
5. Monitored in-home-caregiving services
				  cannot be provided at the same time or on the same day as supported independent
				  living.