HLS 23RS-270 ENGROSSED
2023 Regular Session
HOUSE RESOLUTION NO. 200
BY REPRESENTATIVE TURNER
HEALTH CARE/FACILITIES: Requests the Louisiana Department of Health to form a
group to study alternative tools to inform reimbursement rates for intermediate care
facilities
1 A RESOLUTION
2To urge and request the Louisiana Department of Health to form a work group to study
3 alternative instruments that could be used to inform reimbursement rates for
4 Intermediate Care Facilities for the Developmentally Disabled residents.
5 WHEREAS, Intermediate Care Facilities for the Developmentally Disabled are
6facilities that are licensed to provide residential services to four or more individuals with
7developmental disabilities who require twenty-four-hour care; and
8 WHEREAS, Intermediate Care Facilities for the Developmentally Disabled
9(ICF/DD) are licensed by the Louisiana Department of Health (LDH) Health Standards
10Section (HSS); and
11 WHEREAS, according to the most recent Medicaid Annual Report for the 2021-2022
12Fiscal Year, there are four thousand three hundred thirty-four individuals residing in
13ICF/DDs in Louisiana; and
14 WHEREAS, each ICF/DD resident is assessed with the Inventory for Client and
15Agency Planning (ICAP) assessment instrument upon admission and while residing in the
16ICF/DD in accordance with LDH regulations; and
17 WHEREAS, the ICAP is a standardized instrument for assessing adaptive and
18maladaptive behavior and includes an overall service score; and
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HR NO. 200
1 WHEREAS, this ICAP service score combines adaptive and maladaptive behavior
2scores to indicate the overall level of care, supervision, or training required to support the
3resident; and
4 WHEREAS, this score informs the daily reimbursement rate that Medicaid pays to
5the ICFF/DD to provide care for the individual; and
6 WHEREAS, ICF/DD providers across the state have expressed concern that the
7ICAP tool, which has been in use in Louisiana since 2005, is outdated and does not
8accurately capture the needs of the current population of ICF/DD residents; and
9 WHEREAS, the ICAP only assesses adaptive and maladaptive behaviors when
10determining an individual's score; and
11 WHEREAS, additional individual characteristics such as medical issues, diseases,
12physical disabilities, equipment needs, and mobility issues are not factored into the score and
13thus not factored into the individual's per diem reimbursement rate and these kinds of details
14are key in determining an individual's true level of need and should be considered in the rate
15methodology; and
16 WHEREAS, the limitations of the ICAP assessment instrument are becoming a
17growing issue as the ICF/DD population ages and the nonbehavioral needs have become a
18larger priority for many of these individuals; and
19 WHEREAS, ICF/DD providers have reported referral denials for individuals with
20more complex medical issues, physical disabilities, equipment needs, and mobility issues
21because such needs are not covered in the per diem determined by the ICAP; and
22 WHEREAS, ICF/DD providers have urged LDH to study alternative assessment
23tools that might better capture the needs of this population and inform a more appropriate
24rate methodology for a number of years and it is the duty of the Louisiana Legislature to
25ensure that the study is conducted.
26 THEREFORE, BE IT RESOLVED that the House of Representatives of the
27Legislature of Louisiana does hereby urge and request the Louisiana Department of Health
28to form a work group to study alternative instruments that could be used to inform
29reimbursement rates based on the level of need of individual ICF/DD residents.
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HR NO. 200
1 BE IT FURTHER RESOLVED that the group shall consider the possibility of using
2a standard assessment tool for all programs that serve individuals with disabilities, including
3home and community-based services.
4 BE IT FURTHER RESOLVED that the following individuals shall participate in the
5study group:
6 (1) A representative from the Louisiana Medicaid program.
7 (2) A representative from the Office for Citizens with Developmental Disabilities.
8 (3) The executive director of the Community Provider Association or his designee.
9 (4) The secretary of the Louisiana Department of Health or his designee.
10 BE IT FURTHER RESOLVED that on or before February 1, 2024, the group shall
11submit to the House Committee on Health and Welfare and the David R. Poynter Legislative
12Research Library a written report of its findings and recommendations.
13 BE IT FURTHER RESOLVED that a copy of this Resolution be transmitted to the
14secretary of the Louisiana Department of Health, the executive director of the Community
15Provider Association, and the designated representative from the Louisiana Medicaid
16program.
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 200 Engrossed 2023 Regular Session Turner
Requests the Louisiana Department of Health to form a work group to study alternative
instruments that could be used to inform reimbursement rates for Intermediate Care
Facilities for the developmentally disabled residents.
Page 3 of 3