La. Admin. Code tit. 50 § XXI-16305

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

Section XXI-16305 - Companion Care

A. Companion care services provide supports to assist the beneficiary in achieving and/or maintaining increased independence, productivity and community inclusion as identified in the beneficiary's plan of care. These services are designed for individuals who live independently and can manage their own household with limited supports. The companion provides personal care and supportive services to a beneficiary who resides as a roommate with his/her caregiver. This service includes:

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

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

B. Companion care services can be arranged by licensed providers who hire companions. The beneficiary must be able to self-direct services to companion. The companion is a principal care provider who is at least 18 years of age, who lives with the beneficiary as a roommate, and provides services in the beneficiary's home. The companion is a contracted employee of the provider agency and is paid as such by the provider.

C. Provider Responsibilities

1.The provider organization shall develop a written agreement that defines all of the shared responsibilities between the companion and the beneficiary. This agreement becomes a part of the beneficiary's plan of care. 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. Revisions to this agreement must be facilitated by the provider and approved as part of the plan of care following the same process as would any revision to a plan of care. Revisions can be initiated by the beneficiary, the companion, the provider, or a member of the beneficiary's support team.

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

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

b. conducting an initial inspection of the beneficiary's home with on-going periodic inspections of a frequency determined by the provider;

c. making contact with the companion at a minimum of once per week, or more often as specified in the beneficiary's plan of care; and

d. providing 24-hour oversight, back-up staff, and companion supervision.

4. The provider shall facilitate a signed written agreement between the companion and the beneficiary.

D. Responsibilities of the companion include:

1. providing assistance with activities of daily living (ADLs);

a. - c. Repealed.

2. community integration;

3. providing transportation;

4. coordinating and assisting as needed with transportation to medical/therapy appointments;

5. participating in and following the beneficiary's plan of care and any support plans;

6. maintaining documentation/records in accordance with state and provider requirements;

7. being available in accordance with a pre-arranged time schedule as outlined in the beneficiary's plan of care;

8. purchasing own personal items and food; and

9. being available 24 hours a day (by phone contact) to the beneficiary to provide supports on short notice as a need arises.

E. Service Limits

1. The provider must provide relief staff for scheduled and unscheduled absences, available for up to 360 hours (15 days) per plan of care year. The companion care provider's rate includes funding for relief staff for scheduled and unscheduled absences.

F. Service Exclusions

1. Companion care is not available to individuals receiving the following services:

a. respite care service out of home;

b. shared living;

c. community living supports;

d. host home; or

e. monitored in-home caregiving (MIHC).

2. Companion care services are not available to participants under the age of 18.

3. Legally responsible individuals and legal guardians may provide companion care services for a relative who beneficiary provided that the care is extraordinary in comparison to that of a beneficiary of the same age without a disability and the care is in the best interest of the beneficiary.

4. Payment does not include room and board or maintenance, upkeep, and improvement of the beneficiaries or provider's property.

5. transportation is billed by the vocational provider.

G. Provider Qualifications. Providers must be licensed by the Department of Health as a home and community based services provider and meet the module requirements for personal care attendant in LAC 48:I.Chapter 50.

La. Admin. Code tit. 50, § XXI-16305

Promulgated by the Department of Health and Hospitals, Office for Citizens with Developmental Disabilities, LR 33:2444 (November 2007), Amended by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office for Citizens with Developmental Disabilities, LR 422158 (10/1/2015), Amended by the Department of Health, Bureau of Health Services Financing and the Office for Citizens with Developmental Disabilities, LR 451765 (12/1/2019), Amended LR 471511 (10/1/2021), Amended LR 481561 (6/1/2022).

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