Current through Register Vol. 50, No. 9, September 20, 2024
A. All
services provided under this program are to be performed in the home for HIV
infected clients at a physician's order. Visits are limited to a maximum of
once a day unless otherwise indicated.
B. Home Based Care
1. Skilled nursing including but not limited
to:
a. medication preparation,
administration, and monitoring;
b.
care of peripheral and central access devices;
c. insertion, irrigation and maintenance of
foley catheters;
d. complex wound
care and dressing changes;
e.
oxygen therapy and monitoring and other respiratory therapy;
f. venipuncture for laboratory
studies;
g. client/significant
other education:
i. medications and adverse
effects;
ii. diet;
iii. self care;
iv. disease process;
v. treatments;
vi. custodial care;
vii. infection control procedures.
h. aerosolized pentamidine
treatments (IM pentamidine is not covered by this program);
i. palliative care focusing on pain relief
and symptom control.
2.
Home health aides (maximum of five visits per week) to assist with activities
of daily living.
3. Supplies,
durable medical equipment rental.
4. Medications at a maximum of 30 percent
above cost. IV therapy needed more than once a day up to three times a day can
be covered for up to eight weeks. Daily IV therapy can continue for the
duration of the home based care. Medications covered are those provided under
the Level 1, 2, or 3 state formularies or a formulary approved by the
department through the LHCA HIV Ambulatory Care Sites.
5. Physical therapy.
6. Social worker services (maximum of two
visits a week).
7. Routine
diagnostic tests.
8. Nutritional
therapy following the Louisiana Medicaid Guidelines including supplements at a
maximum of 30 percent above cost. (Physician order need not specify enteral via
tube for this program). Total parenteral nutrition is not covered by this
program.
C. Hospice Care
1. Skilled nursing services. Palliative care
including but not limited to:
a. medication
preparation, administration, and monitoring;
b. care of peripheral and central access
devices;
c. insertion, irrigation
and maintenance of foley catheters;
d. complex wound care and dressing
changes;
e. oxygen therapy and
monitoring and other respiratory therapy;
f. venipuncture for laboratory studies
related to palliative care;
g.
client/significant other education:
i.
medications;
ii. comfort
measures;
iii. self-care;
iv. disease process;
v. treatments;
vi. custodial care;
vii. infection control procedures;
viii. end stage care planning (anticipated
signs and symptoms of approaching death);
h. palliative care focusing on pain relief
and symptom control;
i. support for
client, family, and significant others.
2. Home health aides (maximum of five visits
per week) to assist with activities of daily living.
3. Supplies, durable medical equipment
rental.
4. Medications at a maximum
of 30 percent above cost. IV therapy needed more than once a day up to three
times a day can be covered for up to eight weeks. Daily IV therapy can continue
for the duration of the hospice care.
Medications covered are those provided under Level 1, 2,
or 3 State Formularies or a formulary approved by the department through the
LHCA HIV Ambulatory Care Sites.
5. Social worker services (maximum of two
visits per week).
6. Pastoral
care.
7. Bereavement follow-up for
significant others and family members.
8. Trained volunteers to provide support to
the client and family through tasks such as shopping, sitting, running errands,
preparing meals, and listening.
NOTE: 6, 7, and 8 are not reimbursable services.
D. Personal Care
Attendant Services. Personal care attendants to provide services including
light housework, grocery shopping, and cooking (maximum of five visits per week
and 160 hours per client per twelve month period). Clients may be eligible for
an additional 320 hours if they meet one of the following criteria:
1. patients currently receiving care from a
licensed hospice agency;
2.
prognosis of less than one month as determined by the primary care
physician;
3. nursing home or
residential care facility placement is not feasible within 30 days.
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
36:256 et seq.
NOTE: Each agency would be strictly controlled in the
use of the extension. The referral must come from the client's primary care
physician and must meet one of the guidelines above. Approvals would be granted
on a case-by-case basis for up to four weeks at a time. Authority for approvals
would rest with the HIV Program Office.
