Current through Register Vol. 50, No. 9, September 20, 2024
A. Individual family support (IFS) services
are direct support and assistance services, provided in the beneficiary's home
or in the community, that allow the beneficiary to achieve and/or maintain
increased independence, productivity, enhanced family functioning and inclusion
in the community to the same degree as individuals without disabilities. IFS
services are also used to provide relief to the primary caregiver.
Transportation is included in the reimbursement for these services.
Reimbursement for these services includes the development of a service plan for
the provision of these services, based on the approved COPC.
1. Individual and family support day (IFS-D)
services will be authorized during waking hours for up to 16 hours when natural
supports are unavailable in order to provide continuity of services to the
beneficiary. Waking hours are the period of time when the beneficiary is awake
and not limited to traditional daytime hours as outlined in the CPOC.
a. Additional hours of IFS-D services beyond
the 16 hours can be approved based on documented need, which can include
medical or behavioral need, and specified in the approved
CPOC.
2. Individual
family support-night (IFS-N) service is direct support and assistance provided
during the beneficiary's sleeping "night" hours. Night hours are considered to
be the period of time when the beneficiary is asleep and there is a reduced
frequency and intensity of required assistance. IFS-N services are not limited
to traditional nighttime hours and are outlined in the CPOC. The IFS-N worker
must be immediately available and in the same residence as the beneficiary to
be able to respond to the beneficiary's immediate needs. Documentation of the
level of support needed, based on the frequency and intensity of needs, shall
be included in the CPOC with supporting documentation in the provider's
services plan. Supporting documentation shall outline the beneficiary's safety,
communication, and response methodology planned for and agreed to by the
beneficiary and/or his/her authorized representative identified in his/her
circle of support. The IFS-N worker is expected to remain awake and alert
unless otherwise authorized under the procedures noted below.
a. Beneficiaries who are able during sleeping
hours to notify direct support workers of his/her need for assistance may
choose the option of IFS-N services where staff is not required to remain
awake.
b. The beneficiary's support
team shall assess the beneficiary's ability to awaken staff. If it is
determined that the beneficiary is able to awaken staff and requests that the
IFS-N worker be allowed to sleep, the CPOC shall reflect the beneficiary's
request.
c. Support teams should
consider the use of technological devices that would enable the beneficiary to
notify/awaken IFS-N staff. (Examples of devices include wireless pagers,
alerting devices such as a buzzer, a bell or a monitoring system.) If the
method of awakening the IFS-N worker utilizes technological device(s), the
service provider will document competency in use of devices by both the
beneficiary and IFS-N staff prior to implementation. The support coordinator
will require a demonstration of effectiveness of this service no less than
quarterly.
d. A review shall
include review of log notes indicating instances when IFS-N staff was awakened
to attend to the beneficiary. Also included in the review is acknowledgement by
the beneficiary that IFS-N staff responded to his/her need for assistance
timely and appropriately. Instances when staff did not respond appropriately
will immediately be brought to the support team for discontinuation of
allowance of the staff to sleep. The service will continue to be provided by
awake and alert staff.
e. Any
allegation of abuse/neglect during sleeping hours will result in the
discontinuation of allowance of the staff to sleep until investigation is
complete. Valid findings of abuse/neglect during night hours will require
immediate revision to the CPOC.
B. IFS services may be shared by up to three
waiver beneficiaries who may or may not live together and who have a common
direct service provider agency. Waiver beneficiaries may share IFS services
staff when agreed to by the beneficiaries and health and welfare can be assured
for each beneficiary. The decision to share staff must be reflected on the CPOC
and based on an individual-by individual determination and choice.
Reimbursement rates are adjusted accordingly. Shared IFS services, hereafter
referred to as shared support services, may be either day or night services. In
addition, IFS direct support may be shared across the Children's Choice Waiver
or the Residential Options Waiver at the same time.
C. IFS (day or night) services include:
1. assisting and prompting with the following
activities of daily living (ADL):
a. personal
hygiene;
b. dressing;
c. bathing;
d. grooming;
e. eating;
f. toileting;
g. ambulation or transfers;
h. other personal care and behavioral support
needs; and
i. any medical task
which can be delegated;
2. assisting and/or training in the
performance of tasks related to maintaining a safe, healthy and stable home,
such as:
a. housekeeping;
b. laundry;
c. cooking;
d. evacuating the home in emergency
situations;
e. shopping;
and
f. money management;
3. personal support and assistance
in participating in community, employment, health and leisure
activities;
4. support and
assistance in developing relationships with neighbors and others in the
community and in strengthening existing informal social networks and natural
supports;
5. enabling and promoting
individualized community supports targeted toward inclusion into meaningful
integrated experiences; and
6.
accompanying the beneficiary to the hospital and remaining until admission or a
responsible representative arrives, whichever occurs first. IFS services may
resume at the time of discharge.
D. Exclusions. The following exclusions apply
to IFS services.
1. IFS-D services and IFS-N
services will not be authorized or provided to the beneficiary while the
beneficiary is in a center-based respite facility.
2. IFS-D and IFS-N services will not be
authorized or provided to the beneficiary while the beneficiary is receiving
monitored in-home caregiving services.
3. Beneficiaries receiving adult companion
care services are not eligible to receive individual family support
services.
E. Staffing
Criteria and Limitations
1. Family members
who provide IFS services must meet the same standards as providers or direct
care staff who are unrelated to the beneficiary. Service hours shall be capped
at 40 hours per week, Sunday to Saturday, for services delivered by family
members living in the home.
2.
Legally responsible individuals (such as a parent or spouse) and legal
guardians may provide individual and family support services for a beneficiary
provided that the care is extraordinary in comparison to that of a beneficiary
of the same age without a disability and the care is in the best interest of
the beneficiary.
F.
Place of Service
1. IFS services shall be
provided in the state of Louisiana. IFS services may be performed outside the
state for a time-limited period or for emergencies. The provision of services
outside of the state must be prior-approved by the department.
2. Provision of IFS services shall not be
authorized outside of the United States or the Territories of the United
States.
3. The provision of IFS
services in licensed congregated settings shall be excluded from
coverage.
G. Provider
Requirements. Providers must be licensed by the Department of Health as a home
and community-based services provider and must meet the module-specific
requirements for the service being provided.
AUTHORITY
NOTE: Promulgated in accordance with
R.S.
36:254 and Title XIX of the Social Security
Act.
