HLS 17RS-3861 ORIGINAL
2017 Regular Session
HOUSE RESOLUTION NO. 211
BY REPRESENTATIVE HOFFMANN
HEALTH/HOME CARE: Urges the La. Department of Health to convene a Disability
Services Sustainability Committee
1 A RESOLUTION
2To urge and request the Louisiana Department of Health to convene a Disability Services
3 Sustainability Committee for the purposes provided in this Resolution, and to submit
4 quarterly reports to the legislature.
5 WHEREAS, providers of Medicaid-funded home-and-community-based services
6(HCBS), intermediate care facilities for persons with developmental or intellectual
7disabilities (ICF), and case management agencies provide long-term supports and services
8to individuals with disabilities and those who are aging; and
9 WHEREAS, services provided by HCBS, ICF, and case management agencies,
10collectively, help individuals with disabilities meet their health, education, employment,
11recreational, relationship, and community participation goals; and
12 WHEREAS, Medicaid reimbursement rates for HCBS, ICF, and case management
13agencies have been cut significantly over the past ten years; and
14 WHEREAS, most HCBS, ICF, and case management agencies serve Medicaid
15enrollees exclusively, and thus have no other payment source to offset their losses from
16Medicaid; thus any rate reduction or increase in operating cost has a direct negative impact
17on critical personal care services that keep individuals with disabilities healthy and safe,
18such as feeding, bathing, and administering medication; and
19 WHEREAS, the cumulative effect of rate reductions on providers whose only
20payment source is Medicaid, combined with increased operating costs and unfunded
21mandates, has brought the disability services system of this state to the brink of collapse; and
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1 WHEREAS, ensuring that the current disability services system is operating in the
2most efficient and effective manner, and reinvesting cost savings to enhance provider
3reimbursement rates is essential to sustainability of the system.
4 THEREFORE, BE IT RESOLVED that the House of Representatives of the
5Legislature of Louisiana does hereby urge and request the Louisiana Department of Health
6to convene a Disability Services Sustainability Committee, referred to hereafter as the
7"committee".
8 BE IT FURTHER RESOLVED that the committee be composed of the following
9members:
10 (1) The secretary of the Louisiana Department of Health or his designee.
11 (2) The executive director of the Community Provider Association or his designee.
12 (3) The executive director of The Arc of Louisiana or his designee.
13 (4) The executive director of the Supported Living Network or his designee.
14 (5) The executive director of People First of Louisiana or his designee.
15 (6) One representative of a local governmental entity appointed by the Human
16Services Interagency Council.
17 (7) The president of the Support Coordination Alliance or his designee.
18 BE IT FURTHER RESOLVED that the member representing the Louisiana
19Department of Health serve as the chairperson of the committee.
20 BE IT FURTHER RESOLVED that the committee adopt rules of procedure and any
21other policies as may be necessary to facilitate the work of the group.
22 BE IT FURTHER RESOLVED that the functions and purposes of the committee
23include, without limitation, all of the following:
24 (1) To identify and implement potential efficiencies and cost-saving strategies.
25 (2) To identify issues impacting the solvency of the disability services provider
26network, and to recommend means for immediate resolution of such issues whenever
27feasible.
28 (3) To develop a long-term plan for the disability services system which includes
29recommendations for legislative and administrative actions necessary to ensure sustainability
30of the system.
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1 (4) To submit quarterly reports to the legislature.
2 BE IT FURTHER RESOLVED that the quarterly reports of the committee include,
3without limitation, all of the following information:
4 (1) Information concerning billing, including identification of the current billing and
5payment processes for HCBS, ICF, and case management agencies, as well as strategies for
6streamlining these processes.
7 (2) Information concerning rate methodologies, including evaluation of the current
8reimbursement methodology for HCBS, ICF, and case management agencies to ensure that
9it takes into consideration not only current costs, but additional factors necessary to build a
10high-quality and stable workforce.
11 (3) Information concerning emergency protocols, including protocols for what
12constitutes an emergency; identification of the roles and responsibilities of the Louisiana
13Department of Health, human services districts and authorities, case management agencies,
14other provider agencies, and individuals and families during an emergency; and
15recommendations relative to automatic waiving of regulations under certain emergency
16situations.
17 (4) Information concerning Medicaid audits, investigations, and monitoring,
18including analyses of all audits, investigations, and monitoring of HCBS, ICF, and case
19management agencies to avoid duplication of efforts; identification of gaps in the system
20where monitoring, audits, or investigations are not being conducted; clear identification of
21expectations of provider agencies during an audit or investigation; and a written definition
22of what constitutes an audit finding and the related penalty or fine associated with the
23finding.
24 (5) Information concerning unfunded mandates, including identification of unfunded
25mandates for HCBS, ICF, and case management agencies; strategies for eliminating
26unnecessary unfunded mandates; and recommendations for minimizing the financial impact
27of each mandate.
28 (6) Information concerning abuse and neglect training, including identification of
29current abuse and neglect training requirements for department staff, and recommendations
30to ensure that abuse and neglect determinations are appropriate and consistent statewide.
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1 (7) Information concerning cost reporting, including mandatory cost reporting by
2HCBS to verify expenditures, and recommendations for ensuring that such reports include
3cost factors necessary to build a competent and stable direct support workforce.
4 (8) Information concerning background checks and onboarding costs, including
5identification of current background check requirements and other onboarding costs and
6strategies for securing federal matching funds to cover these expenditures.
7 (9) Information concerning case management and support coordination, including
8the status of action items identified in the report issued in January of 2012 pursuant to Act
9No. 299 of the 2011 Regular Session of the Legislature, and recommendations to streamline
10case management processes.
11 (10) Information concerning electronic visit verification (EVV), including
12identification of the actual cost to providers for implementing EVV and the total amount of
13cost savings and cost avoidance resulting from EVV implementation.
14 (11) Information concerning the plan of care approval process, including an analysis
15of the current process and strategies to streamline that process.
16 (12) Information concerning new technology-based solutions which would help the
17disability services system operate more efficiently.
18 (13) Information concerning fraud, waste, and abuse, including identification of
19potential risk areas for fraud, waste, and abuse; and strategies to eliminate or minimize fraud,
20waste and abuse.
21 (14) Information concerning provider manuals, including identification of manuals
22that contain outdated or inaccurate information (e.g. the Case Management Manual and
23Certified Medication Attendant Training Manual); the status of necessary updates to such
24manuals; and recommendations for a process to keep such manuals current.
25 (15) Information concerning written policies and procedures, including identification
26of all procedures that providers are expected to comply with but are not officially
27documented in rule, regulation, policy, procedures, guidelines, manuals, or any other
28publication of the Louisiana Department of Health; an update on development of written
29procedures; and strategies to ensure that all expected procedures are officially documented
30in writing and disseminated to all disability services providers.
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1 (16) Information concerning any other factor related to the efficiency and
2effectiveness of the disability services system.
3 BE IT FURTHER RESOLVED that the secretary of the Louisiana Department of
4Health shall take such actions as are necessary to ensure that the first meeting of the
5committee occurs no later than July 15, 2017.
6 BE IT FURTHER RESOLVED that the committee meet upon the call of the
7chairperson or upon request of a majority of the members of the committee.
8 BE IT FURTHER RESOLVED that the Louisiana Department of Health provide
9staff support for all meetings of the committee.
10 BE IT FURTHER RESOLVED that the committee submit written reports of its
11findings and recommendations to the House Committee on Health and Welfare on a
12quarterly basis.
13 BE IT FURTHER RESOLVED that legislative authority for the committee shall
14terminate thirty days after the convening of the 2020 Regular Session of the Legislature of
15Louisiana.
16 BE IT FURTHER RESOLVED that a copy of this Resolution be transmitted to the
17Secretary of the Louisiana Department of Health, the executive director of the Community
18Provider Association, the executive director of The Arc of Louisiana, the executive director
19of the Supported Living Network, the executive director of People First of Louisiana, the
20president of the Support Coordination Alliance, and the executive director of each human
21services district and authority of the state.
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)]
HR 211 Original 2017 Regular Session Hoffmann
Urges and requests the La. Dept. of Health to convene a Disability Services Sustainability
Committee (hereafter, "committee") composed of the following members:
(1)The secretary of the La. Dept. of Health or his designee.
(2)The executive director of the Community Provider Association or his designee.
(3)The executive director of The Arc of Louisiana or his designee.
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HR NO. 211
(4)The executive director of the Supported Living Network or his designee.
(5)The executive director of People First of Louisiana or his designee.
(6)One representative of a local governmental entity appointed by the Human Services
Interagency Council.
(7)The president of the Support Coordination Alliance or his designee.
Requests that the committee convene on or before July 15, 2017; meet upon the call of the
chairperson or upon request of a majority of committee members; and submit quarterly
reports to the House Committee on Health and Welfare concerning topics and with
recommendations relating to the efficiency and effectiveness of the Medicaid disability
services system.
Provides that legislative authority for the committee shall terminate 30 days after the
convening of the 2020 R.S.
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