1. A. Direct Support/Service Worker Wage Floor and Other Benefits

   1. 1. DSWs providing self-direction PAS on or after July 31, 2022 shall be paid a minimum wage floor of $9 per hour.
   2. 2. Adult day health care (ADHC) providers that were providing ADHC services on or after October 1, 2021 and employing ADHC direct support workers will receive a rate increase. The ADHC reimbursement rates shall be rebased resulting in an average increase of $4.31 per hour (rates differ based on facility specific transportation rate).
   3. 3. All PAS and ADHC providers affected by this rate increase shall be subject to passing 70 percent of their rate increases directly to the direct support/service worker in various forms. These forms include a minimum wage floor of $9 per hour and other wage and non-wage benefits. These wage floor and wage and non-wage benefits are effective for all affected direct support/service workers, including contracted workers, of any working status, whether full-time or part-time.
   4. 4. The Department of Health (LDH) reserves the right to adjust the direct support/service worker wage floor and/or wage and non-wage benefits as needed through appropriate rulemaking promulgation consistent with the Administrative Procedure Act.

2. B. Direct Support/Service Worker Workforce Bonus Payments

   1. 1. The PAS and ADHC direct support/service worker who provided services from April 1, 2021 to October 31, 2022 to participants, must receive at least $250 of this $300 monthly bonus payment paid to the provider. This bonus payment is effective for all affected direct support/service workers, including contracted workers, of any working status, whether full-time or part-time.

3. C. Audit Procedures for Direct Support/Service Worker Wage Floor, Other Benefits, and Workforce Bonus Payments

   1. 1. The wage enhancements, wage and non-wage benefits and bonus payments reimbursed to providers shall be subject to audit by LDH.
   2. 2. Providers shall provide to LDH or its representative all requested documentation to verify that they are in compliance with the direct support/service worker wage floor, wage and non-wage benefits and/or bonus payments.
   3. 3. This documentation may include, but is not limited to, payroll records, wage and salary sheets, check stubs, copies of unemployment insurance files, etc.
   4. 4. Providers shall produce the requested documentation upon request and within the timeframe provided by LDH.

   5. 5. Non-compliance or failure to demonstrate that the wage enhancements, wage and non-wage benefits and/or bonus payments were paid directly to direct support/service workers may result in the following:

      1. a. sanctions; or
      2. b. disenrollment from the Medicaid Program.

4. D. Sanctions for Direct Support/Service Worker Wages, Other Benefits, and Workforce Payments

   1. 1. Providers will be subject to sanctions or penalties for failure to comply with this Rule or with requests issued by LDH pursuant to this Rule. The severity of such action will depend on the following factors:

      1. a. failure to pass 70 percent of the PAS and ADHC provider rate increases directly to the direct support/service workers in the form of a floor minimum of $9 per hour and in other wage and non-wage benefits and/or the $250 monthly bonus payments;
      2. b. the number of employees identified that the PAS and ADHC provider has not passed 70 percent of the provider rate increases directly to the direct support/service workers in the form of a floor minimum of $9 per hour and in other wage and non-wage benefits and/or the $250 monthly bonus payments;
      3. c. the persistent failure to not pass 70 percent of the PAS and ADHC provider rate increases directly to the direct support/service workers in the form of a floor minimum of $9 per hour and in other wage and non-wage benefits and/or the $250 monthly bonus payments; or
      4. d. failure to provide LDH with any requested documentation or information related to or for the purpose of verifying compliance with this Rule.

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, Bureau of Health Services Financing and the Office of Aging and Adult Services, LR 49:684 (April 2023), LR 51:299 (February 2025).