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