Louisiana Administrative Code
Title 48 - PUBLIC HEALTH-GENERAL
Part IX - Developmental Disabilities Services
Chapter 1 - Adult Day Services
Section IX-101 - General Provisions

Universal Citation: LA Admin Code IX-101

Current through Register Vol. 50, No. 9, September 20, 2024

A. Definitions. For the purposes of this Chapter:

Contracted Vocational and Habilitative Services-those services which are purchased by the Office for Citizens with Developmental Disabilities through contractual arrangements with private providers. The services include, but are not limited to, supported employment and other vocational services provided in conjunction with Louisiana Rehabilitation Services (LRS), group models of community-based work, facility-based work and habilitative services as they relate to the acquisition of vocationally-related skills, community-based skills, daily life skills and behavior management.

Corrective Action Plan-a set of plans developed by a provider of vocational and habilitative services in response to findings of noncompliance with minimum standards. The plans indicate how the provider will come into compliance with minimum standards, the staff responsible for implementing such plans and the time by which the corrective actions will be in place.

Minimum Standards-those standards contained in this Chapter which are identified by the acronym "MS" and which define minimally acceptable standards of care for private providers of contracted vocational and habilitative services.

Monitor/Monitoring Team-staff employed by the Office for Citizens with Developmental Disabilities who are assigned to evaluate the practices of providers of contracted vocational and habilitative services.

Quality Indicators-those standards contained in this Chapter which are identified by the acronym "QI" and which reflect best practices in the area of vocational and habilitative services. When a contracted provider adopts the practices demanded by these standards, the Office for Citizens with Developmental Disabilities recognizes such a provider for excellence in programming.

B. Introduction

1. The present standards were developed by a committee composed of a parent representative, provider agencies, and employees of the Office for Citizens with Developmental Disabilities (OCDD). Prior to publication they were distributed for statewide input from provider agencies, OCDD employees, and legally-established OCDD State and Regional Advisory Committees.

2. The purpose of these standards is to establish and maintain high quality, individualized, vocational and habilitative services for persons with developmental disabilities and to offer these individuals choice in the types of services and supports to be rendered.
a. In order to insure the development of an instrument that addressed quality, the committee developed a set of principles on which the standards were to be based and measured against.

b. In addition, the structure of the standards and the procedures for monitoring them have been designed to recognize excellence in program practices, to provide direction for growth and a basis for the provision of technical assistance and training. Both minimum standards and quality indicators are included in the standards document. Agencies pursuing excellence will seek to achieve success on some or all of the quality indicators. The OCDD in turn will recognize such achievement by awarding a higher class certification.

C. Monitoring Procedures

1. Application. The standards and monitoring procedures will be applied to all entities contracting with the Office for Citizens with Developmental Disabilities to provide Vocational and Habilitative Services.

2. Minimum Standards and Quality Indicators. Each standard or in some cases portions of standards are preceded by the letters "MS" for Minimum Standard or "QI" for Quality Indicator. Contractors are expected to comply with all Minimum Standards (MS) and compliance with them will be measured at every formal monitoring visit. Agencies that wish to demonstrate excellence will identify the Quality Indicators (QI) they are pursuing and be prepared to provide evidence of compliance.

3. Frequency of Monitoring
a. In general, each contractor will be formally monitored by OCDD Regional staff for compliance with these standards on an annual basis. When a contractor has demonstrated a high degree of excellence during a monitoring visit (see "Rating System,"§101. C.5.b i), the annual monitoring requirement will be waived for a one-year period.

b. Regional staff may make aperiodic, informal visits to the program site where the need for technical assistance may be assessed. Such informal visits will not be considered part of a formal monitoring procedure and consequently, will not result in a request for a corrective action plan. However, observations which are made on such visits may be documented as evidence to be cited at the time of the formal, annual monitoring visit. If in the course of an informal visit, a serious condition which endangers the health and/or safety of a consumer is detected, proper authorities, including the Department of Social Services, Bureau of Licensing and Certification, will be notified and action taken to remove the threat.

4. Procedures
a. The OCDD monitor(s) will evaluate compliance with Minimum Standards based on their reviews of agency policies and procedures, observation of the overall program, staff and consumer interviews, review of a predetermined sample of records based on the number of people served and other review techniques identified by the OCDD.

b. Quality Indicators will be monitored only upon the request of the contracted agency. The agency must identify specific indicators to be measured and provide documentation of success. The monitor will consider such evidence and make independent observations of program practices to verify compliance.

c. Immediately following completion of a monitoring survey the monitor/monitoring team will conduct an exit interview with the provider agency. At the exit interview an exit report will be issued which identifies deficiencies noted. Should the provider agency and the monitor disagree about particular findings, every attempt should be made to resolve the issues prior to the issuance of a confirmation report. The confirmation report will describe overall impressions of the program, particularly positive aspects, and will have the exit report attached. It will be issued within five working days of the exit interview. The agency monitored is responsible for submitting a Corrective Action Plan to the OCDD Regional Office within 10 working days after the postmarked date of the confirmation report.

5. Criteria for Certification. Upon publication of the final rule establishing these standards (July 20, 1995), provider agencies will be given one full year to modify current practices or implement the new practices the minimum standards demand. One monitoring visit will occur during this period, the purpose of which will be to identify areas in need of change. Beginning on July 20, 1996, provider agencies will be expected to comply with all minimum standards.
a. In order to achieve full certification there must be evidence of compliance with all minimum standards. Where a standard demands review of individual consumer records, 85 per cent compliance must be demonstrated within each standard.

b. Contractors who achieve full certification and who adopt practices consonant with the Quality Indicators will be awarded full certification with "Stars of Excellence." The greater the number of Quality Indicators which have been adopted, the greater the rating of the program:
i. Rating System

Number of Quality

Indicators Adopted

Description

Rating

15 +

Three Star Program

Superior

14 - 6

Two Star Program

Outstanding

5 - 1

One Star Program

Exceeds Expectations

ii. When an agency receives one of the above ratings, a certificate will be issued noting such and monitoring against program standards will be waived for a one-year period.

c. Provisional Certification. Provisional certification will be awarded to programs achieving 72 - 84 percent compliance. Such programs will be expected to correct deficiencies within a specified time period (no longer than three months) and achieve full certification.

d. Termination Notice
i. Programs that do not meet the criteria for provisional certification or that have failed to achieve full certification three months after receiving a provisional certificate will be issued a notice of intent to terminate the contractual agreement between the provider agency and the OCDD.

ii. The OCDD may withdraw a termination notice, if within the 30 calendar days following receipt of the notice the provider agency complies with or has taken significant steps towards complying with the requirements.

iii. Payment for services provided will continue during the 30 day period, except that they may be prorated depending on the number of individuals receiving services.

iv. In the event that a violation poses an immediate and serious threat to the health or safety of the consumers, the OCDD will notify the Department of Social Services, Bureau of Licensing and Certification and notify the Contractor of the intent to temporarily terminate service provision and payments. The provider agency receiving such notice shall not accept additional consumers for services during such a period.

e. Other conditions under which certification may be denied, are as follows:
i. failure of an agency or an authorized agent of the agency to comply with requests for information regarding these standards;

ii. a knowing provision of false or misleading information to the OCDD;

iii. refusal by on-premise personnel to admit any duly authorized employee of the DHH for the purpose of inspection of the program or its records; or,

iv. any reported abuse or neglect of consumers involving program personnel which has been substantiated by appropriate authorities, the circumstances of which have not been corrected as determined by DHH.

6. Administrative Hearings
a. Findings may be grieved under two circumstances:
i. when a provisional certification has been issued and the monitor/monitoring team and provider agency disagree as to whether the corrective actions taken are sufficient or complete, and

ii. when a notice of intent to terminate a contract has been issued and the provider disagrees with the findings leading to such action.

b. All grievances must be submitted by the provider agency in writing to the Community Services Regional Administrator (CSRM) in the contracting region within 30 calendar days of receipt of the written certification report.

c. When a corrective action plan or its implementation is found to be inadequate, the provider agency may grieve specific findings on specific standards to the CSRM, who is ultimately responsible for resolving such issues. Such a grievance must demonstrate that specific findings were made in error or provide positive evidence that the deficiency was, in fact, corrected. The CSRM will issue her/his decision within 20 working days of receipt of the written request for an administrative hearing.

d. When a provider agency receives a notice of intent to terminate a contract, and wishes to grieve such, three levels within the grievance process are available.
i. The first level grievance must be made to the CSRM. The CSRM will issue her/his decision within 20 working days of receipt of the written request for an administrative hearing.

ii. Should the CSRM uphold the findings of the monitoring team, a second level request for an administrative hearing may be made to the Assistant Secretary of the OCDD. A hearing will be held within 20 working days of receipt of the request and a written ruling issued within 15 working days of the hearing. The contractor is responsible for providing evidence to the Assistant Secretary that demonstrates the decision to terminate was made in error.

iii. A final request for an administrative hearing may be made to the Secretary of the DHH. The same process used at the Assistant Secretary level applies in this case, however, the Secretary's ruling is not due until 20 working days have elapsed, and it is final.

AUTHORITY NOTE: Promulgated in accordance with R.S. 28.380 through 444.

Disclaimer: These regulations may not be the most recent version. Louisiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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