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ICAP tool, which has been in use in Louisiana since 2005, is outdated and does not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