Current through Register Vol. 50, No. 9, September 20, 2024
A. Monitored in-home caregiving (MIHC)
services are provided by a principal caregiver to a beneficiary who lives in a
private unlicensed residence.
1. The goal of
this service is to provide a communitybased option that provides continuous
care, supports, and professional oversight.
2. This goal is achieved by promoting a
cooperative relationship between a beneficiary, a principal caregiver, the
professional staff of a monitored in-home caregiver agency provider, and the
beneficiary's support coordinator.
B. The principal caregiver is responsible for
supporting the beneficiary to maximize the highest level of independence
possible by providing necessary care and supports that may include:
1. supervision or assistance in performing
activities of daily living;
2.
supervision or assistance in performing instrumental activities of daily
living;
3. protective supervision
provided solely to assure the health and welfare of a beneficiary;
4. supervision or assistance with health
related tasks, meaning any health related procedures governed under the Nurse
Practice Act, in accordance with applicable laws governing the delegation of
medical tasks/medication administration.
5. supervision or assistance while
escorting/accompanying the individual outside of the home to perform tasks,
including instrumental activities of daily living, health maintenance, or other
needs as identified in the plan of care, and to provide the same supervision or
assistance as would be rendered in the home; and
6. extension of therapy services to maximize
independence when the caregiver has been instructed in the performance of the
activities by a licensed therapist or registered nurse.
C. Service Exclusions and Restrictions
1. Beneficiaries electing monitored in-home
caregiving are not eligible to receive the following New Opportunities Waiver
services during the period of time that the beneficiary is receiving monitored
in-home caregiving services:
a. individual
family support;
b. center-based
respite;
c. supported independent
living;
d. adult companion care;
or
e. skilled nursing
care;
D.
Monitored in-home caregiving providers must be agency providers who employ
professional nursing staff, including a registered nurse and a care manager,
and other professionals to train and support principal caregivers to perform
the direct care activities performed in the home.
1. The agency provider must assess and
approve the home in which services will be provided, and enter into contractual
agreements with caregivers whom that agency has approved and trained.
2. The agency provider will pay per diem
stipends to caregivers. The per diem for monitored in-home caregiving services
does not include payments for room and board.
3. The agency provider must capture daily
notes electronically and use the information collected to monitor beneficiary
health and caregiver performance.
4. The agency provider must take such notes
available to support coordinators and the state, upon request.
E. The MIHC provider must use
secure, web-based information collection from principal caregivers for the
purposes of monitoring beneficiary health and caregiver performance. All
protected health information must be transferred, stored, and otherwise
utilized in compliance with applicable federal and state privacy laws.
Providers must sign, maintain on file, and comply with the LDH HIPAA business
associate addendum.
F. The
department shall reimburse for monitored in home caregiving services based on a
two-tiered model which is designed to address the beneficiary's acuity.
Reimbursement will not be made for room and board of the principal caregiver,
and federal financial participation is not available for room and
board.
G. Provider Qualifications
1. MIHC providers must be licensed according
to the home and community based service provider licensing requirements
contained in the
R.S.
40:2120.2-2121.9 and their implementing
regulations.
2. MIHC providers must
enroll as a Medicaid monitored in-home caregiving provider.
3. MIHC providers must comply with LDH rules
and regulations.
4. The principal
caregiver must:
a. be at least 18 years of
age;
b. live in the home with the
beneficiary; and
c. be available 24
hours a day, 7 days a week.
H. The assessment performed by the monitored
in-home caregiving provider shall be reimbursed when the service has been
approved by the plan of care.
AUTHORITY
NOTE: Promulgated in accordance with
R.S.
36:254 and Title XIX of the Social Security
Act.
