Current through Register Vol. 50, No. 12, December 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:
3. cognitive and communication skills;
and
4. development of appropriate,
positive behaviors.
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.
1. Services are not allowed
to be provided in the direct service worker's place of
residence.
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; and
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:
5. Community living supports may not be
billed at the same time on the same day as:
b. prevocational services;
c. respite care services-out of
home;
d. transportation-community
access;
e. monitored in-home
caregiving (MIHC); or
f. adult day
health care.
6. Community living supports may
not be provided in a licensed respite care facility.
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/per staff member, 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.
