La. Admin. Code tit. 50 § XV-12903

Current through Register Vol. 50, No. 11, November 20, 2024

Section XV-12903 - Covered Services

A.LT-PCS are defined as those services that provide assistance with the distinct tasks associated with the performance of the activities of daily living (ADLs) and the instrumental activities of daily living (IADLs). Assistance may be either the actual performance of the personal care task for the individual or supervision and prompting so the individual performs the task by themselves.

1. ADLs are those personal, functional activities required by the participant. ADLs include tasks such as:

a. eating;

b. bathing;

c. dressing;

d. grooming/personal hygiene;

e. transferring;

f. ambulation;

g. toileting; and

h. bed mobility.

2. IADLs are those activities that are considered essential but may not require performance on a daily basis. IADLs include tasks such as:

a. light housekeeping;

b. food preparation and storage;

c. shopping;

d. laundry;

e. assistance with scheduling medical appointments when necessary;

f. accompanying to medical appointments when necessary;

g. assistance with accessing transportation;

h. medication reminders; and

i. medically non-complex tasks where the direct service worker has received the proper training pursuant to R.S. 37:1031-1034.

3. Emergency and non-emergency medical transportation is a covered Medicaid service and is available to all participants. Non-medical transportation is not a required component of LT-PCS. However, providers may choose to furnish transportation for participants during the course of providing LT-PCS. If transportation is furnished, the provider agency must accept any liability for their employee transporting a participant. It is the responsibility of the provider agency to ensure that the employee has a current, valid driver's license and automobile liability insurance.

4. Constant or intermittent supervision and/or sitter services are not a component of LT-PCS.

5. For participants receiving LT-PCS with the Adult Day Health Care (ADHC) Waiver, LT-PCS may be provided by one worker for up to three LT-PCS participants who live together, and who have a common direct service provider.

A.6. - E. Repealed.

La. Admin. Code tit. 50, § XV-12903

Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Services Financing, LR 29:912 (June 2003), amended LR 30:2831 (December 2004), amended by the Department of Health and Hospitals, Office of Aging and Adult Services, LR 34:2578 (December 2008), amended by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 39:2507 (September 2013), Amended by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 42902 (6/1/2016), Amended by the Department of Health, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 421931 (11/1/2016), Amended LR 47593 (5/1/2021), Amended LR 49879 (5/1/2023).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.