1. A. Day habilitation services assist the beneficiary to gain desired community living experience, including the acquisition, retention, or improvement in self-help, socialization, and adaptive skills, and/or to provide the beneficiary an opportunity to contribute to his or her community. These services shall be coordinated with any physical, occupational, or speech therapies identified in the individualized plan of care (POC). Day habilitation services may include assistance with personal care or with activities of daily living, but such assistance should not be the primary activity. Day habilitation services may serve to reinforce skills or lessons taught in other settings. Volunteer activities may be a part of this service and should follow the state guidelines for volunteering.

2. B.

   1. 1. Day habilitation is the overarching service and may be delivered in a combination with these two service types:

      1. a. onsite day habilitation; and
      2. b. community life engagement.
   2. 2. Day habilitation services may be delivered virtually and be included in the plan of care.

3. C. Day habilitation services are provided on a regularly scheduled basis for one or more days per week in a variety of community settings that are separate from the beneficiary’s private residence, with the exception of virtual day habilitation. Day habilitation services should not be limited to a fixed site facility. Activities and environments are designed to foster personal choice in developing the beneficiary’s meaningful day including community activities alongside people who do not receive home and community-based services.

   1. 1. Transportation is a separate billable service and may be billed on the day that an in-person day habilitation service is provided.
   2. 2. Transportation is not a part of the service for virtual day habilitation.
4. D. Beneficiaries receiving day habilitation provider services may receive other services on the same day, but these services cannot be provided during the same time period, with the exception of community life engagement development and MIHC.

5. E. Service Exclusions

   1. 1. Time spent in transportation between the beneficiary’s residence/location and the day habilitation site is not to be included in the total number of day habilitation service hours per day, except when the transportation is for the purpose of travel training.

      1. a. Travel training for the purpose of teaching the beneficiary to use transportation services may be included in determining the total number of service hours provided per day. Travel training must be included in the beneficiary’s POC.
   2. 2. Transportation-community access will not be used to transport ROW beneficiaries to any day habilitation services.

   3. 3. Day habilitation services cannot be billed for at the same time on the same day as:

      1. a. community-living supports;
      2. b. professional services, except when there are direct contacts needed in the development of a support plan;
      3. c. respite—out of home;
      4. d. adult day health care;
      5. e. monitored in-home caregiving (MIHC);
      6. f. prevocational services; or
      7. g. supported employment.

   4. 4. Day habilitation services shall be furnished on a regularly scheduled basis for up to eight hours per day, one or more days per week.

      1. a. Services are based on a 15 minute unit of service on time spent at the service site by the beneficiary. Any time less than 15 minutes of service is not billable or payable. No rounding up of units is allowed.
      2. b. Services are based on the person-centered plan and the beneficiary’s ROW budget.
   5. 5. All virtual day habilitation services must be approved on the plan of care.
   6. 6. Day habilitation may not provide for the payment of services that are vocational in nature. For example, the primary purpose of producing goods or performing services.
6. F. Provider Qualifications. Providers must be licensed by the Department of Health as a home and community-based services provider and meet the module requirements for adult day care in LAC 48:I.Chapter 50.

Authority Note

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:254 and Title XIX of the Social Security Act.

Historical Note

HISTORICAL NOTE: Promulgated by the Department of Health and Hospitals, Office for Citizens with Developmental Disabilities, LR 33:2445 (November 2007), amended by the Department of Health and Hospitals, Bureau of Health Services Financing and the Office for Citizens with Developmental Disabilities, LR 41:2158 (October 2015), amended by the Department of Health, Bureau of Health Services Financing and the Office for Citizens with Developmental Disabilities, LR 45:1765 (December 2019), LR 47:1512 (October 2021), LR 48:1562 (June 2022), LR 50:1831 (December 2024).