ENROLLED
2019 Regular Session
HOUSE RESOLUTION NO. 282
BY REPRESENTATIVES THOMAS, BILLIOT, TERRY BROWN, CARMODY,
FALCONER, MARINO, STEFANSKI, WHITE, AND WRIGHT
A RESOLUTION
To urge and request the Louisiana Department of Health to establish a four-bed peer group
for intermediate care facilities for people with developmental disabilities for the
purpose of Medicaid reimbursement rate calculation for those facilities.
WHEREAS, intermediate care facilities for people with developmental disabilities,
referred to hereafter as "ICF/DD", are facilities that provide services to individuals with
developmental or intellectual disabilities who require twenty-four hours of care per day in
community, group, or residential home settings; and
WHEREAS, ICF/DDs are licensed and regulated by the Louisiana Department of
Health (LDH) in accordance with the provisions of R.S. 40:2180 et seq.; and
WHEREAS, under Louisiana's Medicaid state plan, ICF/DDs are grouped by number
of beds in resident rooms in a system known as peer group classification which is utilized
for purposes of calculating Medicaid reimbursement rates paid to the respective facilities;
and
WHEREAS, Louisiana's current ICF/DD peer groups are one-to-eight beds, nine-to-
fifteen beds, sixteen-to-thirty-two beds, and thirty-three or more beds; and
WHEREAS, Alexander Milne Developmental Services, known commonly as
"Milne", is a nonprofit organization that has provided services to people with intellectual and
developmental disabilities for over one hundred twenty years and was this state's first
community-based provider of such services; and
WHEREAS, after Hurricane Katrina irreparably damaged the New Orleans
residential facility that Milne had operated in the Gentilly neighborhood since 1913, Milne
and LDH agreed to a memorandum of understanding under which Milne would build and
operate four-bed group homes and participate in the Louisiana Medicaid program; and
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WHEREAS, while its residents remained in Laurel, Mississippi, where they
evacuated after the 2005 hurricane and where Milne acquired a former healthcare facility for
use as a temporary home, Milne worked to reestablish an ICF/DD in Louisiana and opened
its current residential community outside of Covington in April of 2015; however, this
community of four-bed group homes was placed in the one-to-eight-bed peer group for
Medicaid reimbursement purposes, causing Milne to be reimbursed below its costs for
providing services to its residents; and
WHEREAS, Milne has provided services to people with developmental and
intellectual disabilities since 2015 at a significant financial loss; and
WHEREAS, the establishment of a four-bed ICF/DD peer group by LDH would help
to ensure the viability of providers such as Milne, as well as any other provider similarly
situated on the date of filing of this Resolution, which developed four-bed group homes
pursuant to an agreement with the department, became licensed by the department to operate
four-bed group homes, and now furnish high-quality institutional-level care in four-bed
group home settings.
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 establish a four-bed peer group for intermediate care facilities for people with
developmental disabilities for the purpose of Medicaid reimbursement rate calculation for
those facilities.
BE IT FURTHER RESOLVED that the department shall promulgate rules and
regulations in accordance with the Administrative Procedure Act to provide for the ICF/DD
peer group called for in this Resolution and shall file a state plan amendment with the
Centers for Medicare and Medicaid Services to amend the Medicaid state plan as necessary
to establish this peer group.
BE IT FURTHER RESOLVED that the rules of the department and Medicaid state
plan shall ensure that four-bed ICF/DDs receive a fair allocation of the Medicaid share of
facility-specific costs directly incurred by such facilities as a result of their compliance with
the department's licensing of four-bed homes, and that payment of such costs be made
retroactive to the earliest date allowed by law.
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BE IT FURTHER RESOLVED that the department shall submit the Medicaid state
plan amendment required by this Resolution to the Centers for Medicare and Medicaid
Services no later than December 1, 2019.
BE IT FURTHER RESOLVED that a copy of this Resolution be transmitted to the
secretary of the Louisiana Department of Health.
SPEAKER OF THE HOUSE OF REPRESENTATIVES
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