La. Admin. Code tit. 50 § XXI-8101

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

Section XXI-8101 - Introduction

A. The target population for the Community Choices Waiver (CCW) includes individuals who:

1. are 65 years of age or older; or

2. are 21-64 years of age with a physical disability; and

3. meet nursing facility level of care requirements.

4. Repealed.

B. Services are provided under the provisions of the approved waiver agreement between the Centers for Medicare and Medicaid Services (CMS) and the Louisiana Medicaid Program.

C. Requests for Community Choices Waiver services shall be accepted from the following:

1. an individual requestor/applicant;

2. an individual who is legally responsible for a requestor/applicant; or

3. a responsible representative designated by the requestor/applicant to act on his/her behalf.

D. Each individual who requests Community Choices Waiver services has the option to designate a responsible representative. For purposes of these provisions, a responsible representative shall be defined as the person designated by the individual to act on his/her behalf in the process of accessing and/or maintaining Community Choices Waiver services.

1. The appropriate form authorized by the Office of Aging and Adult Services (OAAS) shall be used to designate a responsible representative.

a. The written designation of a responsible representative does not take away the right of the individual to continue to transact business on his/her own behalf nor does it give the representative any legal authority other than as specified in the designation form.

b. The written designation is valid until it is revoked by the individual granting the designation. To revoke the written designation, the revocation must be submitted in writing to OAAS or its designee.

2. The functions of a responsible representative are to:

a. assist and represent the individual in the assessment, care plan development and service delivery processes; and

b. to aid the participant in obtaining all of the necessary documentation for these processes.

3. No individual, unless granted an exception by OAAS, may concurrently serve as a responsible representative for more than two participants in OAAS-operated Medicaid home and community-based service programs. This includes but is not limited to:

a. the Program of All-Inclusive Care for the Elderly (PACE);

b. long term-personal care services (LT-PCS);

c. the Community Choices Waiver; and

d. the Adult Day Health Care (ADHC) Waiver.

La. Admin. Code tit. 50, § XXI-8101

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 37:3517 (December 2011), amended LR 40: 791 (April 2014), Amended by the Department of Health, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 441896 (10/1/2018), Repromulgated LR 442005 (11/1/2018), Amended LR 50784 (6/1/2024).

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