La. Admin. Code tit. 50 § XXI-8901

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

Section XXI-8901 - Admission Criteria

A. Admission to the Community Choices Waiver program shall be determined in accordance with the following criteria:

1. meets the target population criteria as specified in the approved waiver document;

2. initial and continued Medicaid eligibility;

3. initial and continued eligibility for a nursing facility level of care;

4. justification, as documented in the approved POC, that the Community Choices Waiver services are appropriate, cost effective and represent the least restrictive environment for the individual; and

5. reasonable assurance that the health and welfare of the participant can be maintained in the community with the provision of Community Choices Waiver services.

B. Failure of the individual to cooperate in the eligibility determination, plan of care development process or to meet any of the criteria above shall result in denial of admission to the Community Choices Waiver.

La. Admin. Code tit. 50, § XXI-8901

Promulgated by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 37:3524 (December 2011), amended LR 39:322 (February 2013), Amended by the Department of Health, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 441901 (10/1/2018), Amended LR 50787 (6/1/2024).

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