HLS 14RS-192 ORIGINAL
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are additions.
Regular Session, 2014
HOUSE BILL NO. 635
BY REPRESENTATIVE BROADWATER
HEALTH/HOME CARE: Provides relative to fiscal/employer agents for direct service
workers
AN ACT1
To enact Chapter LXIX-A of Title 40 of the Louisiana Revised Statutes of 1950, to be2
comprised of R.S. 40:1300.325 through 1300.327, relative to direct service workers;3
to provide for the "Residential Options Waiver Fiscal Management Act"; to provide4
for definitions; to authorize a Medicaid enrollee who hires a direct service worker5
to choose a fiscal/employer agent; to provide for a fiscal/employer agent rotation list;6
to provide rulemaking authority; to require an opt-in period; to prohibit the7
Department of Health and Hospitals from recommending a fiscal/employer agent;8
to require reimbursement rates to be equal for all fiscal/employer agents; and to9
provide for related matters.10
Be it enacted by the Legislature of Louisiana:11
Section 1. Chapter LXIX-A of Title 40 of the Louisiana Revised Statutes of 1950,12
comprised of R.S. 40:1300.325 through 1300.327, is hereby enacted to read as follows:13
CHAPTER LXIX-A. RESIDENTIAL OPTIONS WAIVER14
FISCAL MANAGEMENT ACT15
§1300.325. Short title16
This Chapter shall be known and may be cited as the "Residential Options17
Waiver Fiscal Management Act".18 HLS 14RS-192 ORIGINAL
HB NO. 635
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§1300.326. Definitions1
When used in this Chapter, the following words and phrases have the2
meanings ascribed to them in this Section, unless the context clearly indicates a3
different meaning:4
(1) "Department" means the Department of Health and Hospitals.5
(2) "Direct service worker" means an unlicensed person who provides6
personal care or other services and support to persons with disabilities or to the7
elderly to enhance their well-being and which involves face-to-face direct contact8
with the person. Functions performed may include but are not limited to assistance9
and training in activities of daily living, personal care services, and job-related10
supports.11
(3) "Fiscal/employer agent" means a business that performs the Medicaid12
enrollee's employer-related payroll functions.13
(4) "Region" means any of the delineated set of administrative regions of the14
Department of Health and Hospitals. 15
(5) "Self-direction option" means a service delivery option which allows a16
Medicaid enrollee to become the employer of the direct service worker chosen by the17
Medicaid enrollee for hire to provide supports.18
§1300.327. Selection of fiscal/employer agent; rotation list; minimum requirements19
A. When a direct service worker is hired as a home-based attendant by a20
Medicaid enrollee pursuant to the self-direction option of the Residential Options21
Waiver program or its successor, the Medicaid enrollee shall select a fiscal/employer22
agent from a list of agents registered with the department to provide fiscal/employer23
agent services within the same region in which the Medicaid enrollee is located. If24
the Medicaid enrollee is unable to or chooses not to select a particular25
fiscal/employer agent, the next available registered company on the department's26
rotation list of approved fiscal/employer agents for the region in which the Medicaid27
enrollee is located shall be assigned to act as a fiscal/employer agent for the28
Medicaid enrollee.29 HLS 14RS-192 ORIGINAL
HB NO. 635
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B. The department shall establish and maintain a rotation list of approved1
fiscal/employer agents for each region. The department shall promulgate minimum2
standards, rules, and procedures, in accordance with the Administrative Procedure3
Act, for participation in a rotation list.4
(2) The rules established by the department shall contain, at a minimum, the5
requirement that a fiscal/employer agent located within Louisiana shall register only6
for the region in which the fiscal/employer agent is located. A fiscal/employer agent7
located outside of Louisiana shall choose one region in which the fiscal/employer8
agent will provide services upon registering with the department. If a9
fiscal/employer agent located outside of Louisiana does not choose a region at the10
time of registration, the department shall assign the fiscal/employer agent a region11
after considering the service needs of each region.12
(3) The rules shall also include an annual opt-in period of not less than thirty13
days each year, during which period any company may apply for approval by the14
department as a fiscal/employer agent and placement on the rotation list. During the15
annual opt-in period, the department shall review the qualifications of any16
fiscal/employer agent previously approved by the department and placed on the17
department's rotation list.18
C. The department shall not recommend a specific fiscal/employer agent to19
any Medicaid enrollee. Each Medicaid enrollee shall be referred to the department20
rotation list. When the Medicaid enrollee exercises an option to select a21
fiscal/employer agent, the selection shall be duly recorded by the department.22
D. The reimbursement rate paid by the department to a fiscal/employer agent23
shall be the same for each fiscal/employer agent registered with the department,24
regardless of whether the fiscal/employer agent is located within or outside of25
Louisiana.26 HLS 14RS-192 ORIGINAL
HB NO. 635
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are additions.
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
Broadwater HB No. 635
Abstract: Creates the "Residential Options Waiver Fiscal Management Act" to authorize
a Medicaid enrollee who hires a direct service worker as a home-based attendant to
choose a fiscal/employer agent.
Proposed law may be cited as the "Residential Options Waiver Fiscal Management Act".
Proposed law defines "department" as the Dept. of Health and Hospitals (DHH).
Proposed law defines "direct service worker" as an unlicensed person who provides personal
care or other services and support to persons with disabilities or to the elderly to enhance
their well-being and which involves face-to-face direct contact with the person. Functions
performed may include but are not limited to assistance and training in activities of daily
living, personal care services, and job-related supports.
Proposed law defines "fiscal/employer agent" as a business that performs the Medicaid
enrollee's employer-related payroll functions.
Proposed law defines "region" as any of the delineated set of administrative regions of DHH.
Proposed law defines "self-direction option" as a service delivery option which allows a
Medicaid enrollee to become the employer of the direct service worker chosen by the
Medicaid enrollee for hire to provide supports.
Proposed law requires a Medicaid enrollee, when hiring a home-based attendant pursuant
to the self-direction option of the Residential Options Waiver program or its successor, to
select a fiscal/employer agent from a list of agents registered with DHH to provide
fiscal/employer agent services within the same region in which the Medicaid enrollee is
located.
Proposed law requires DHH, if the Medicaid enrollee is unable to or chooses not to select
a particular fiscal/employer agent, to assign the next available registered company on DHH's
rotation list of approved fiscal/employer agents for the region in which the Medicaid enrollee
is located to act as a fiscal/employer agent for the direct service worker.
Proposed law requires DHH to establish and maintain a rotation list of approved
fiscal/employer agents for each region. Proposed law further requires DHH to establish
minimum standards, rules, and procedures for participation in a rotation list.
Proposed law requires a fiscal/employer agent located within La. to register only for the
region in which the fiscal/employer agent is located.
Proposed law requires a fiscal/employer agent located outside of La. to choose one region
in which the fiscal/employer agent will provide services upon registering with DHH. If a
fiscal/employer agent located outside of La. does not choose a region at the time of
registration, proposed law requires DHH to assign the fiscal/employer agent a region after
considering the service needs of each region.
Proposed law requires DHH to establish an annual opt-in period of not less than 30 days
each year, during which period any company may apply for approval by the department as HLS 14RS-192 ORIGINAL
HB NO. 635
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are additions.
a fiscal/employer agent and placement on the rotation list. Proposed law further requires
DHH, during the annual opt-in period, to review the qualifications of any fiscal/employer
agent previously approved by DHH and placed on the department's rotation list.
Proposed law prohibits DHH from recommending a specific fiscal/employer agent to a
Medicaid enrollee and requires each Medicaid enrollee to be referred to DHH's rotation list.
Proposed law requires DHH to duly record the selection of a Medicaid enrollee who
exercises an option to select a fiscal/employer agent.
Proposed law requires DHH to pay the same reimbursement rate to each fiscal/employer
agent, regardless of whether the fiscal/employer agent is located within or outside of La.
(Adds R.S. 40:1300.325-1300.327)