La. Admin. Code tit. 50 § XXI-16313

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

Section XXI-16313 - Host Home

A. Host home services are personal care and supportive services provided to a beneficiary who lives in a private home with a family who is not the beneficiary's parent, legal representative, or spouse. Host home families are a standalone family living arrangement in which the principle caregiver in the host home assumes the direct responsibility for the beneficiary's physical, social, and emotional wellbeing and growth in a family environment. Host home services are to take into account compatibility with the host home family members, including age, support needs, and privacy needs.

B. Host home services include assistance with:

1. personal care, assistance with the activities of daily living and adaptive living needs;

2. leisure activities, assistance to develop leisure interests and daily activities in the home setting;

3. social development/family inclusion, assistance to develop relationships with other members of the household; and

4. community inclusion supports in accessing community services and activities and pursuing and developing recreational and social interests outside the home.

NOTE: Natural supports are also encouraged and supported when possible. Supports are to be consistent with the beneficiary's skill level, goals, and interests.

C. Host home provider agencies oversee and monitor the host home contractor to ensure the availability, quality, and continuity of host home services. Host home provider agencies are responsible for the following functions:

1. arranging, training, and overseeing host home services (host home family);

2. making an initial inspection and periodic inspections of the host home and upon any significant changes in the host family unit or significant events which may impact the beneficiary;

3. having 24-hour responsibility over host home services to the beneficiary, which includes back-up staffing for scheduled and unscheduled absences of the host home family for up to 360 hours (15 days) as authorized by the beneficiary's plan of care; and

4. providing relief staffing in the beneficiary's home or in another host home family's home.

D. Host home contractors are responsible for:

1. attending the beneficiary's plan of care meeting and participating, including providing information needed in the development of the plan;

2. following all aspects of the beneficiary's plan of care and any support plans;

3. maintaining the beneficiary's documentation;

4. assisting the beneficiary in attending appointments (i.e., medical, therapy, etc.) and undergoing any specialized training deemed necessary by the provider agency, or required by the department, to provide supports in the host home setting;

5. following all requirements for staff as in any other waiver service including immediately reporting to the department and applicable authorities any major issues or concerns related to the beneficiary's safety and well-being; and

6. providing transportation as would a natural family member.

E. Host home contractors who serve children are required to provide daily supports and supervision on a 24-hour basis.

1. If the beneficiary is a child, the host home family is to provide the supports required to meet the needs of a child as any family would for a minor child.

2. Support needs are based on the child's age, capabilities, health, and special needs.

3. A host home family can provide compensated supports for up to two beneficiaries, regardless of the funding source

F.Host home contractors serving adults are required to be available for daily supervision, support needs or emergencies as outlined in the adult beneficiary's POC based on medical, health and behavioral needs, age, capabilities and any special needs.

1. Host home contractors that serve adults who have been interdicted must ensure that services are furnished in accordance with the legal requirements of the interdiction.

G. Host home contractors who are engaged in employment outside the home must adjust these duties to allow the flexibility needed to meet their responsibilities to the beneficiary.

H. Host Home Capacity. Regardless of the funding source, a host home contractor may not provide services for more than two beneficiaries in the home.

I. Service Exclusions

1. Separate payment will not be made for community living supports since these services are integral to, and inherent in, the provision of host home services.

2. Payment will not be made for the following:

a. respite care services-out of home;

b. shared living/shared living conversion;

c. community living supports;

d. companion care;

e. monitored in-home caregiving (MIHC);

f. transportation-community access; or

g. one-time transition services.

3. The host home contractor may not be the same individual as the owner or administrator of the designated provider agency.

4. Payment will not be made for services provided by a relative who is a:

a. parent(s) of a minor child;

b. legal guardian of an adult or child with developmental disabilities;

c. parent(s) for an adult child, regardless of whether or not the adult child has been interdicted; or

d. spouse of the beneficiary.

5. Children eligible for Title IV-E services are not eligible for host home services.

6. Payment does not include room and board or maintenance, upkeep, or improvement of the host home family's residence.

7. Environmental adaptations are not available to beneficiaries receiving host home services since the beneficiary's place of residence is owned or leased by the host home family.

J. Provider Qualifications

1. Home host service provider agencies must meet the following qualifications:

a. have experience in delivering therapeutic services to persons with developmental disabilities;

b. have staff who have experience working with persons with developmental disabilities;

c. screen, train, oversee and provide technical assistance to the host home family in accordance with OCDD requirements, including the coordination of an array of medical, behavioral and other professional services geared to persons with developmental disabilities (DD); and

d. provide on-going assistance to the host home family so that all HCBS waiver health and safety assurances, monitoring, and critical incident reporting requirements are met.

2. Agencies serving children must be licensed by the Department of Children and Family Services as a Class "A" Child Placing Agency under the Specialized Provider Licensing Act (R.S. 46:1401-46:1430), LAC 67:V.Chapter 73.

3. Agencies serving adults must be licensed by the Department of Health as a home and community-based services provider and meet the module requirements for substitute family care in LAC 48:I.Chapter 50.

La. Admin. Code tit. 50, § XXI-16313

Promulgated by the Department of Health and Hospitals, Office for Citizens with Developmental Disabilities, LR 33:2447 (November 2007), Amended by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office for Citizens with Developmental Disabilities, LR 422160 (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 471514 (10/1/2021), Amended LR 481564 (6/1/2022).

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