1. A. Admission shall be denied or the participant shall be discharged from the Community Choices Waiver program if any of the following conditions are determined.

   1. 1. The individual does not meet the target population criteria as specified in the federally approved waiver document.
   2. 2. The individual does not meet the criteria for Medicaid financial eligibility.
   3. 3. The individual does not meet the criteria for nursing facility level of care.
   4. 4. The participant resides in another state or has a change of residence to another state.

   5. 5. Continuity of services is interrupted as a result of the participant not receiving and/or refusing Community Choices Waiver services (exclusive of support coordination services) for a period of 30 consecutive days.

      EXCEPTION: An exception may be granted by OAAS to delay discharge if interruption is due to an acute care hospital, rehabilitation hospital, or nursing facility admission.

   6. 6. The health and welfare of the individual cannot be reasonably assured through the provision of Community Choices Waiver services.
   7. 7. The individual fails to cooperate in the eligibility determination or plan of care development processes or in the performance of the POC.
   8. 8. Failure on behalf of the individual to maintain a safe and legal environment.
   9. 9. It is not cost effective or appropriate to serve the individual in the Community Choices Waiver.

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, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 37:3524 (December 2011), amended LR 39:322 (February 2013), amended by the Department of Health, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 44:1901 (October 2018), LR 50:788 (June 2024).