La. Admin. Code tit. 50 § XXI-13931

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

Section XXI-13931 - Adult Companion Care

A. Adult companion care services assist the beneficiary to achieve and/or maintain the outcomes of increased independence, productivity and inclusion in the community. These services are designed for an individual who lives independently and can manage his/her own household with limited supports. The companion is a principal care provider chosen by the beneficiary, who provides services in the beneficiary's home. The companion must be at least 18 years of age and lives with the beneficiary as a roommate. Adult companion care services are furnished through a licensed provider organization as outlined in the beneficiary's CPOC. This service includes:

1. providing assistance with all of the activities of daily living as indicated in the beneficiary's CPOC;

2. providing community integration and coordination of transportation services, including medical appointments; and

3. providing medical and physical health care that can be delivered by unlicensed persons in accordance with Louisiana's Nurse Practice Act.

B. Adult companion care services are arranged by provider organizations that are subject to licensure. The setting is the beneficiary's home which should have been freely chosen by the beneficiary from among non-disability specific settings and not owned or controlled by the provider. The companion is an employee or contractor of the provider organization and is responsible for providing limited, daily direct services to the beneficiary.

1. The companion shall be available in accordance with a pre-arranged time schedule and available by telephone for crisis support on short notice.

2. Services may not be provided by a family member who is a legally responsible individual, such as the beneficiary's spouse, or a legal guardian.

C. Provider Responsibilities

1. The provider organization shall develop a written agreement as part of the beneficiary CPOC which defines all of the shared responsibilities between the companion and the beneficiary. The written agreement shall include, but is not limited to:

a. types of support provided by the companion;

b. activities provided by the companion; and

c. a typical weekly schedule.

2. Repealed.

3. The provider organization is responsible for performing the following functions which are included in the daily rate:

a. arranging the delivery of services and providing emergency services;

b. making an initial home visit to the beneficiary home, as well as periodic home visits as required by the department;

c. contacting the companion a minimum of once per week or as specified in the beneficiary's comprehensive plan of care; and

d. providing 24-hour oversight and supervision of the adult companion care services, including back-up for the scheduled and unscheduled absences of the companion.

4. The provider shall facilitate a signed written agreement between the companion and the beneficiary which assures that:

a. the companion's portion of expenses must be at least $200 per month, but shall not exceed 50 percent of the combined monthly costs which includes rent, utilities and primary telephone expenses; and

b. inclusion of any other expenses must be negotiated between the beneficiary and the companion. These negotiations must be facilitated by the provider and the resulting agreement must be included in the written agreement and in the beneficiary's CPOC.

D. Companion Responsibilities

1. The companion is responsible for:

a. participating in, and abiding by, the CPOC;

b. maintaining records in accordance with state and provider requirements; and

c. purchasing his/her own food and personal care items.

2. The companion is an employee of the provider agency and is paid a flat daily rate to provide adult companion care services as included in the approved CPOC.

3. The companion is responsible for meeting all financial obligations as agreed upon in the agreement between the provider agency, the beneficiary, and the companion.

E. Service Limits

1. Adult companion care services may be authorized for up to 365 days per year as documented in the beneficiary's CPOC.

F. Service Exclusions

1. Adult companion care services cannot be provided or billed for at the same time as center-based respite care services.

2. Beneficiaries receiving adult companion care services are not eligible for receiving the following services:

a. supported independent living;

b. individual and family support;

c. substitute family care;

d. skilled nursing; or

e. monitored in-home caregiving (MIHC).

G. 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.

La. Admin. Code tit. 50, § XXI-13931

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office for Citizens with Developmental Disabilities, LR 40:77 (January 2014), Amended by the Department of Health, Bureau of Health Services Financing and the Office for Citizens with Developmental Disabilities, LR 4457 (1/1/2018), Repromulgated LR 44282 (2/1/2018), Amended LR 481554 (6/1/2022).

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