Current through Register Vol. 50, No. 9, September 20, 2024
A.
Definition/Description
1. Home health care is
that component of comprehensive health care in which health services are
provided to individuals and families in their places of residence for purpose
of restoring health or maximizing the level of independence, while minimizing
the effects of disability and illness, including terminal illness. Services
appropriate to the needs of the individual patient and family are planned,
coordinated, and made available by public or private providers organized for
the delivery of home health care through the use of employed staff, contractual
arrangements, or a combination of the two patterns.
2. Health services provided include, but are
not limited to, the following:
a. skilled
nursing respiratory therapy
b. home
health aide occupational therapy
c.
speech therapy and audiology medical social work
d. physical therapy medical
supplies
e. nutrition durable
medical equipment
3. The
home health agency providing medical services maintains a plan for home health
services for each patient in conformance with the patient's plan of treatment
as prescribed by his/her physician. Such agencies provide care to patients with
a wide range of diagnoses and at all levels of dependence, including those
completely bed-ridden and those needing to be fed. Persons or groups in need of
home health services include elderly persons whose activities are limited by
physical and/or mental deterioration; persons who recuperating from a wide
range of acute medical problems such as injuries, infections, diseases, and
complications of pregnancy.
B. Advantages
1. Home health care provides an increased
range of options for the provider, the community and the individual. Services
are focused on the individual in need of care, rather than on groups, allowing
for economy in the use of professional and other staff. The largest expenditure
in home health care is for personal care and supportive services.
2. Studies have shown that patients generally
respond more rapidly and fully to care in the home. At a lower cost than a
hospitalization, the home health patient generally has an improved outcome in
terms of early discharge from care; is less often institutionalized; and has
increased contentment, improved mental functioning and increased social
activity.
C.
Alternatives to Institutionalization
1. A
health care system should provide an array of services which provide care
without institutionalization, and which match an individual's needs to the
appropriate service available. Some of the possible alternatives to
institutionalization are adult day care centers, subsidized housing complexes
with health services, homemakers, and home health services. There is convincing
evidence that such services may not only postpone but often prevent more costly
institutionalization.
2. Care at
home, through a home health agency, is the most desirable alternative and
should be considered first. It should be noted, however, that home care is not
a viable alternative to institutionalization for all patients. The environment
at home may be inappropriate, the family may be unable to handle the
responsibility, or the patient may not have a family. Some patients require the
sheltered support of an institution. In the natural order of things, however,
institutionalization should be an alternative to home health care.
D. Act 347 of the 1984 Regular
Session of the Legislature. Act 347 amends and reenacts
R.S.
40:2009.34 relative to home health care
agencies, to require the Secretary of the Department of Health and Human
Resources to promulgate rules to require approval by the agency responsible for
the implementation of Section 1122 of the Social Security Act as a condition
for licensure. Such approval will be required for the first licensing of all
home health agencies not in existence as of April 20, 1985.
E. Utilization.
1. The benefits of home health care over
institutional care have been documented in preceding paragraphs; however,
underutilization of home health agencies can lead to lower quality of care and
a proliferation of underutilized agencies is undersirable as an alternative to
institutionalization. Optimal utilization of each home health agency should
take into account the following factors:
a.
the number of direct service staff available to provide home health
services;
b. the number of home
health visits/services which can be delivered by each direct service staff
member per day;
c. the number of
days available for the provision of such services;
d. the average length of time used for each
visit.
F.
Area of Analysis. The area of analysis for home health agencies is defined as
the health planning district in which the agency or proposed agency is
located.
G. Resource Goals
1. Applicant shall project a caseload of 30
patients or more, and shall provide a list of practicing physicians with
referral agreements with the proposed agency.
2. Home health services shall be available at
least 8 hours a day 5 days a week and shall be available on an emergency basis
24 hours a day 7 days a week. Home health services shall be available to an
individual in need within 1-3 days, contingent upon the patient's condition and
the physician's recommendation.
3.
A proposal to provide home health services shall indicate that the proposed
agency will meet licensing requirements and Medicare certification criteria.
Applicants seeking private payor only funds are exempt from meeting Medicare
certification criteria.
H. The Department of Health and Human
Resources, Division of Licensing and Certification, shall deny licensure to any
home health agency which does not receive a favorable recommendation from the
department's Division of Policy, Planning and Evaluation as a result of the
applicant's failing to meet the criteria stated in the Resource Goals and the
General Criteria for Need Certification Reviews.
I. Should the party seeking licensure desired
to appeal, he must respond in writing to the Division of Licensing and
Certification not more than 30 days after the date for notification of
non-licensure in order to request a fair hearing or he forfeits his right of
appeal. The hearing shall conform to rules set forth in the Louisiana
Administrative Procedure Act.
AUTHORITY NOTE:
Promulgated in accordance with P.L. 93-641 as amended by P.L. 96-79, and
R.S.
36:256(b).
