Louisiana Administrative Code
Title 50 - PUBLIC HEALTH-MEDICAL ASSISTANCE
Part XXI - Home and Community-Based Services Waivers
Subpart 11 - New Opportunities Waiver
Chapter 139 - Covered Services
Section XXI-13909 - Substitute Family Care

Universal Citation: LA Admin Code XXI-13909

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

A. Substitute family care (SFC) provides for day programming, transportation, independent living training, community integration, homemaker, chore, attendant care and companion services, and medication oversight (to the extent permitted under state law) to beneficiaries residing in a substitute family care home that meets all licensing requirements for the substitute family care module. The service is a stand-alone family living arrangement for beneficiaries aged 18 years and older. The SFC house parents assume the direct responsibility for the beneficiary's physical, social, and emotional well-being and growth, including family ties. Only two SFC beneficiaries may reside in a single SFC setting at the same time. There shall be no more than three persons living in a substitute family care setting who are unrelated to the SFC provider. Immediate family members (mother, father, brother and/or sister) cannot be substitute family care parents. Reimbursement for this service includes the development of a service plan based on the approved CPOC. Beneficiaries living in an SFC home may receive IFS services.

B. Service Limits. SFC services are limited to one service per day.

C. Exclusions

1. Beneficiaries receiving adult companion care services are not eligible to receive substitute family care services.

2. Payments may not be made for room and board, items of comfort or convenience, or the cost of facility maintenance, upkeep, or improvement.

3. Payments may not be made directly or indirectly to members of the beneficiary's immediate family.

D. Provider Qualifications. 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.

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