1. A. Reimbursement for the following services shall be a prospective flat rate for each approved unit of service provided to the participant. One quarter hour (15 minutes) is the standard unit of service, which covers both the service provision and administrative costs for the following services, and reimbursement shall not be made for less than one quarter hour (15 minutes) of service:

   1. 1. personal assistance services (except for the “a.m. and p.m.” service delivery model);

      1. a. up to three participants may share personal assistance services if they live together and share a common provider of these services; and
      2. b. there is a separate reimbursement rate for shared personal assistance services;
   2. 2. in-home caregiver temporary support services when provided by a personal care services or home health agency;
   3. 3. caregiver temporary support services when provided by an adult day health care center;
   4. 4. adult day health care services;
   5. 5. housing transition or crisis intervention services; and
   6. 6. housing stabilization services.

2. B. The following services shall be reimbursed at the authorized rate or approved amount of the assessment, inspection, installation/fitting, maintenance, repairs, adaptation, device, equipment, or supply item and when the service has been prior authorized by the plan of care:

   1. 1. environmental accessibility adaptations;
   2. 2. environmental accessibility adaption assessment and inspections;
   3. 3. assistive devices and medical supplies;
   4. 4. home delivered meals (not to exceed the maximum limit set by OAAS);
   5. 5. transition services (not to exceed the maximum lifetime limit set by OAAS);
   6. 6. monitored in-home caregiving (MIHC) assessment;
   7. 7. certain nursing, and skilled maintenance therapy procedures; and
   8. 8. assistive technology.

3. C. The following services shall be reimbursed at a per diem rate:

   1. 1. caregiver temporary support services when rendered by the following providers:

      1. a. assisted living providers;
      2. b. nursing facility; or
      3. c. respite center; and

   2. 2. monitored in-home caregiving services.

      1. a. The per diem rate for monitored in-home caregiving services does not include payment for room and board, and federal financial participation is not claimed for room and board.

4. D. The following services shall be reimbursed at an established monthly rate:

   1. 1. support coordination;
   2. 2. transition intensive support coordination;
   3. 3. monthly monitoring/maintenance for certain assistive devices/technology and medical supplies procedures; and
   4. 4. financial management services.

5. E. The following services shall be reimbursed on a per-visit basis:

   1. 1. certain nursing and skilled maintenance therapy procedures; and
   2. 2. personal assistance services furnished via “a.m. and p.m.” delivery method.
6. F. Reimbursement shall not be made for Community Choices Waiver services provided prior to the department’s, or its designee’s, approval of the POC and release of prior authorization for the services.
7. G. The minimum hourly rate paid to direct support professionals shall be at least the current federal or state minimum hourly rate.
8. H. Personal assistance service providers and Self-Direction employers must pay their direct services workers (DSW) a minimum of $9 per hour.
9. I. ADHC providers must pay their ADHC direct support workers a minimum of $9 per hour.
10. J. The state has the authority to set and change provider rates and/or provide lump sum payments to providers based upon funds allocated by the legislature.

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 37:3525 (December 2011), amended LR 39:322 (February 2013), LR 39:508, 508 (March 2013), repromulgated LR 39:1048 (April 2013), amended LR 39:1779 (July 2013), LR 40:793 (April 2014), LR 42:897 (June 2016), amended by the Department of Health, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 44:1902 (October 2018), LR 47:886 (July 2021), LR 49:487 (March 2023), LR 50:788 (June 2024), LR 51:299 (February 2025).