Current through Register Vol. 50, No. 9, September 20, 2024
A.
Community living supports (CLS) are provided to a beneficiary in his/her own
home and in the community to achieve and/or to maintain the outcomes of
increased independence, productivity, and enhanced family functioning, to
provide relief of the caregiver, and to provide for inclusion in the community.
Community living supports may be a self-directed service.
B. Community living supports focus on the
achievement of one or more goals as indicated in the beneficiary's approved
plan of care by incorporating teaching and support strategies. Supports
provided are related to the acquisition, improvement, and maintenance of
independence, autonomy and adaptive skills. These skills include:
1. self-help skills;
2. socialization skills;
3. cognitive and communication skills;
and
4. development of appropriate,
positive behaviors.
a. - b.
Repealed.
C.
Place of Service. CLS services are furnished to adults and children who live in
a home that is leased or owned by the beneficiary or his/her family. Services
may be provided in the home or community, with the place of residence as the
primary setting.
D. Community
living supports may be shared by up to three beneficiaries who may or may not
live together, and who have a common direct service provider agency. In order
for CLS services to be shared, the following conditions must be met.
1. An agreement must be reached among all of
the involved beneficiaries, or their legal guardians, regarding the provisions
of shared CLS services. If the person has a legal guardian, their approval must
also be obtained. In addition, CLS direct support staff may be shared across
the Children's Choice or New Opportunities Waiver at the same time.
2. The health and welfare must be assured for
each beneficiary.
3. Each
beneficiary's plan of care must reflect shared services and include the shared
rate for the service indicated.
4.
A shared rate must be billed.
5.
The cost of transportation is built in to the community living services rate
and must be provided when integral to community living services.
E. Service Exclusions
1. Community living supports staff are not
allowed to sleep during billable hours of community living supports.
2. Payment does not include room and board or
the maintenance, upkeep, and improvement of the provider's or family's
residence.
3. Community living
supports may not be provided in a licensed respite care facility.
4. Community living supports services are not
available to beneficiaries receiving any of the following services:
a. shared living;
b. host home; or
c. companion care.
5. Community living supports may not be
billed at the same time on the same day as:
a.
day habitation;
b. prevocational
services;
c. supported
employment;
d. respite care
services-out of home;
e.
transportation-community access;
f.
monitored in-home caregiving (MIHC); or
g. adult day health care.
6. Community living supports may
not be provided in a licensed respite care facility.
7. Community living supports services are not
available to participants receiving any of the following services:
a. shared living;
b. host home;
c. companion care; or
d. monitored in-home caregiving
(MIHC).
8. Community
living supports may not be billed at the same time on the same day as:
a. day habilitation;
b. prevocational services;
c. supported employment;
d. respite care services-out of
home;
e. transportation-community
access;
f. monitored in-home
caregiving (MIHC); or
g. adult day
health care.
9. Payment
will not be made for services provided by a relative who is:
a. parent(s) of a minor child;
b. legal guardian of an adult or child with
developmental disabilities;
c.
spouse of or legally responsible adult for the participant; or
d. power of attorney, curator, or authorized
responsible representative for the waiver participant.
F. Provider Qualifications. CLS
providers must be licensed by the Department of Health as a home and
community-based services provider and meet the module requirements for personal
care attendant in LAC 48:I. Chapter 50.
1.
Family members who provide CLS services must meet the same standards as
providers 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 community living supports 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.
AUTHORITY
NOTE: Promulgated in accordance with
R.S.
36:254 and Title XIX of the Social Security
Act.
