Current through Register Vol. 50, No. 9, September 20, 2024
A. Monitored in-home caregiving (MIHC)
services are provided to a beneficiary living in a private home with a
principal caregiver. The principal caregiver shall be contracted by the
licensed HCBS provider having a MIHC service module. The principal caregiver
shall reside with the beneficiary. Professional staff employed by the HCBS
provider shall provide oversight, support and monitoring of the principal
caregiver, service delivery, and beneficiary outcomes through on-site visits,
training, and daily webbased electronic information exchange.
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 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 (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 or 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 Residential Options Waiver services during the period of time
that the beneficiaries are receiving monitored in-home caregiving services:
a. community living supports (CLS);
b. companion care supports;
c. host home;
d. shared living supports; and
e. adult day health care services.
2. - 5. Repealed.
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 the agency has approved and
trained.
2. The agency provider
will pay per diem stipends to caregivers.
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 make such notes
available to support coordinators and the state, upon request.
5. Repealed.
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.
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.
2. MIHC providers must enroll as a Medicaid
monitored in-home caregiving provider.
3. MIHC providers must comply with LDH rules
and regulations.
AUTHORITY
NOTE: Promulgated in accordance with
R.S.
36:254 and Title XIX of the Social Security
Act.
