La. Admin. Code tit. 48 § I-10703

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-10703 - Inventories

A. The inventory of on-going programs underlines the gaps and insufficiencies of services in the identified areas.

B. Inventory of State-Administered Programs

C. In the left margin are initials designating which state agencies administer the described service. Initials are:

1. DHHR Department of Health and Human Resources;

2. OMR-DD Office of Mental Retardation-Developmental Disabilities (DHHR);

3. OMR Office of Mental Retardation;

4. OMH Office of Mental Health (DHHR);

5. OHD Office of Human Development (DHHR);

6. OH Office of Hospitals (DHHR);

7. OCHNO Office of Charity Hospital in New Orleans (DHHR);

8. OFS Office of Family Security (DHHR);

9. OPPHS Office of Preventive and Public Health Services (DHHR);

10. OPRADA Office of Prevention and Recovery from Alcohol and Drug Abuse (DHHR);

11. D. EDUC. Department of Education

D. Alternatives to Institutionalization

1. This is an inventory of services and programs administered by state agencies encompassing any inpatient or outpatient service which prevents, postpones or terminates long term institutionalization of the functionally impaired.

a. Supportive services, to enable individuals to function outside of long-term care institutions and to realize full potential for employment and/or independent living:

i. OMR-DD Independent Living Program-provides support services to developmentally disabled individuals; Statewide for physically handicapped (assessment and technical assistance only); Shreveport and New Orleans for MR adults; New Orleans for children and adolescents;

ii. OMH Community Living Skills-offered in New Orleans; provides training in living to individuals recently deinstitutionalized or in danger of institutionalization (chronically mentally ill);

iii. OMR-DD/ Supervised Apartment Living-the OMR-DD contracts with private OMH providers for supervised apartment living programs in seven of eight regions;

iv. OMR-DD Planning for Independent Living-offered in Lake Charles region; provides case management, counseling and advocacy training for the physically handicapped;

v. OMR-DD Adult Day Services-offered statewide through contracts with providers; provides sheltered employment, training, limited recreation and transportation for mentally retarded/developmentally disabled adults ages 22 years and older;

vi. OMR-DD Infant Intervention Services-offered statewide through contract with private providers who provide language stimulation, motor development and self-help skills in either a home-based or center-based setting to mentally retarded/developmentally disabled infants from birth-two years.

vii. OMR-DD Respite Care-provided directly by state staff at Opelousas Developmental Center and Southwest State School.

viii. OMR-DD Community Homes/Group Homes-group homes provide residential care and habilitation services to 7-15 mentally retarded/ developmentally disabled individuals. Community homes provide the same type of services, but in smaller residential settings (4-6). These homes are located statewide with the vast majority being privately operated serving 6 or fewer clients.

ix. OMR-DD Substitute Family Care-Substitute Family Care provides residential care, supervision, and training in individually recruited family homes. Such placements exist in every region of the state, although programs are actually operated out of six of the eight regions. Participants are adults and children who previously resided in institutional settings, or for whom institutional placement was being sought. The program is administered by OMR /DD state schools and community services regional offices.

x. OMR-DD Minor Home Renovation-services to enable a handicapped individual to continue to live at home through minor renovation to the client's residence.

xi. OHD Independent Living Program-New Orleans, Lake Charles and Shreveport-state operated center for disabled adults offering assistance with information, referral, support services of all types and home aide services. Approximately 910 clients are served annually at these centers at a cost of $200,000.

xii. OMH Community Living Program and Day Treatment/ Hospitalization Programs-psychiatric day care, including psycho-social treatment, rehabilitation and educational services, offered in 11 centers throughout the state, for adults, adolescents and children. Services are designed to meet the needs of persons who do not require full time hospitalization, and to assist with transition from institutionalization to community living.

xiii. OMH Transitional Living Units-Located at Southeast Louisiana Hospital and Central Louisiana State Hospital. Services are provided to assist psychiatric patients in autonomous living skills and to assist with outpatient transition, work and living arrangements after release from inpatient care.

xiv. OMH Adult Residential Services for the Chronically Mentally Ill-Transitional residential/rehabilitative services which include case management, socialization and pre-employment training for the adult mentally ill. Group home sites range in size from six to 15 beds. Locations of current programs are the New Orleans, Baton Rouge, Houma and Lafayette areas.

xv. OMH Fairweather Programs-Self-supported projects in congregate living available in Pineville and New Orleans for small groups of chronic, long-term hospitalized patients. Participants form a corporation and arrange to govern themselves, move out of the hospital setting as a group and earn sufficient money to provide for living expenses.

xvi. OHD Respite Care Program-contract services purchased with State funds to provide temporary care for functionally impaired individuals and relieve their families of the burden of on-going care of the severly impaired. Purchased services are available in-home or center-based up to a maximum of 720 hours of care every six months. Respite Care Centers are available regionally throughout the state.

xvii. OHD Halfway House for the Psychiatrically Disabled-four houses operated by OHD employees in New Orleans, Baton Rouge and Shreveport offer short-term housing for individuals in transition between psychiatric institutionalization and independent community living.

xviii. OPRADA Halfway House and other residential services for Recovering Substance Abusers-five contract programs involving purchase of service from private providers offering residential living services to individuals in substance abuse rehabilitation program.

xix. OHD /Non-emergency Transportation-services are available to Medicaid OFS eligibles to enable recipients without personal or public means of access to needed medical care to obtain transportation to medical treatment. Such services enable some individuals to remain in their own homes.

xx. OMH Psychosocial Clubhouses-Resource coordination, employment development, sheltered employment, socialization and daily living skills for the chronically mentally ill. Category includes Alliance House in Baton Rouge and Friends of the Psychologically Handicapped in New Orleans and other such programs in Monroe, Alexandria and Lafayette.

xxi. OMH Supervised Apartment Living/Clustered Apartment Living-Offered in New Orleans, Baton Rouge and Lafayette; provides structured support services to chronically mentally ill individuals living in the community.

xxii. OMH Adolescent Community Home Programs-Transitional residential services based upon a teaching family model of residential care for severely emotionally disturbed adolescents between 12 and 18 years of age. Project sites are in Shreveport, Pineville, Baton Rouge and Kenner.

xxiii. OFS Medical Day Care Services-available through Title XIX funds for Medicaid eligible persons; day care services for persons needing medical care to assist the family in keeping the individual at home to avoid or delay institutionalization.

xxiv. D. Educ. Special Education Services-mandated education services provided statewide for identified special education students, ages three through 21. These services include, but are not limited to: identification, referral, evaluation, and placement in a special education program.

b. Direct mental and physical health services which offer outpatient treatment or short-term hospitalization as a preferable alternative to long term institutionalization:

i. OH Tri-Med Services-short-term, acute medical treatment for individuals with alcohol or drug abuse problems, or mental illness; discharge planning and referral services offered at eight state-supported general hospitals.

ii. OPPHS Home Health Services-offered to residents, primarily over 60 years of age, in all parishes except Orleans and Plaque-mines who could not otherwise obtain/afford such needed services.

iii. OPRADA Outpatient Clinic Program-primary and specialty physician care to maintain health and prevent acute episodes requiring hospitalization, available at 16 contracted outpatient clinics and the operation of 24 outpatient clinics throughout the state by OPRADA. Services are directed toward preventing hospitalization and include screening, diagnosis, counseling, group therapy and referral.

iv. OMH/OFS Outpatient Mental Health Services-Consists of 45 full-time community mental health centers or clinics and 55 part-time outreach clinics operated throughout the state with services directed in part toward preventing hospitalization or re-hospitalization. Clinical outpatient services include: screening, evaluation and diagnosis, individual, group and family therapy; crisis care; medication administration and management; specialized services for identified target populations such as children and adolescents, the elderly, and criminal justice interface clients; and transportation services.

v. OCHNO Mental Health Crisis Intervention Unit-80 bed psychiatric and 37 bed chemical dependency units operated at New Orleans Charity Hospital offering immediate, community-based short-term services to individuals in crisis because of mental or substance abuse problems.

vi. OFS Home Health Services-covered under Title XIX for Medicaid eligibles (up to a maximum of 50 services per year)-services consist of physical therapy, part-time skilled nursing, home health aide service and medical supplies needed by recipients to enable them to remain in their own homes.

vii. OFS Durable Medical Equipment-Medical equipment, supplies,and appliances provided to title XIX recipients who, in many cases, would otherwise be unable to function independently and live in their own homes.

viii. OPPHS Adult Health-services available in twelve parishes offering screening for chronic disease and illness. Program involves referral and some follow-up treatment; early diagnosis and treatment in elderly patients is directed toward maintaining health and postponing or preventing long-term care.

ix. OPPHS Tuberculosis Control Program-provides screening, diagnosis and treatment. Maintenance services provided by the Tuberculosis Control Program are responsible for preventing the long-term institutionalization of many of the state's residents who have been diagnosed as having tuberculosis.

x. OPRADA Inpatient Detoxification-purchase of substance abuse detoxification services from three contracted detox programs and the provision of detoxification services at one OPRADA operated detox program.

c. Direct rehabilitation services:

i. OH/OCHNO Physical Therapy and/or Occupational Therapy-In-patient and out-patient services for the physically handicapped (temporary and permanent), instruction to patient and families in P. T. exercises, and referrals appropriate to community service agencies for home follow-up, medical equipment (wheelchairs, braces, etc.), and vocational rehabilitation.

ii. OCHNO Louisiana Rehabilitation Institute-provides comprehensive rehabilitation services (physical therapy, speech therapy and occupational therapy) to physically handicapped, including spinal cord and paraplegic patients on an inpatient and outpatient basis. Services are directed toward reducing disability and restoring skills and abilities needed for independent living. Admissions are open on a space available basis.

iii. OFS Rehabilitation Services-services covered by Title XIX for Medicaid eligibles.

d. Indirect services-referrals, counseling and third party payment:

i. OHD Client Placement Services-evaluation, referral and placement services available to any functionally impaired individual of any age if mentally retarded, up to age 25 if mentally ill, with some exceptions for continuing care beyond age 25, if out-of-home care is required. This is a placement and third party reimbursement program, with emphasis on community rather than institutional placement, in the least restrictive environment. Placement services are rendered by OHD staff.

ii. OPPHS Health-related Social Services-social work counseling, case management and referral services available to clients receiving services through various OPPHS programs. Within the Handicapped Children's Program, these services are directed at assisting parents in maintaining handicapped children in their own homes and obtaining needed medical care. Services are funded through various available sources, according to the eligibility of the client.

iii. D. Educ. Regional Technical Assistance Specialists for Special Education - preschool coordinators and special education regional coordinators are based in each of the eight congressional planning districts to provide technical assistance to parents, school system personnel, and other service providers on how to best program for special education students in the least restrictive environment.

iv. D. Educ. Joint Project for Parent and Children Services-a special project designed to improve early identification, referral, and evaluation of high risk infants and handicapped youth in an 11 parish area (Region II).

E. Statewide Programs with full range of health-related services:

1. OHD Specialized Foster Care-offers specialized placement for foster children with medical problems, who would otherwise be placed in a larger, formalized institution.

2. OHD Subsidized Adoption-offers a subsidy to adoptive parents, when a foster child with special medical problems is adopted, and the family could not otherwise adopt the child because of medical costs.

3. OFS Medical Coverage for Children in Custody of the OHD (foster children, former ECA children, ete.)-costs of most medical care for these special children are paid through Title XIX funds, to encourage foster home placement for children who might otherwise be institutionalized.

4. OHD Title XX Contract Services-for eligible persons and other persons in need of services; family planning; general health care services; home delivered and congregate meals; homemaker services; information, referral, and placement services; medical transportation services.

5. OPPHS Handicapped Children's Program-medical and social services offered state-wide on a regional basis to children age 0-21 who have physical handicaps.

F. Health Promotion

1. Introduction. This is an inventory of services and programs administered by state agencies which are directed toward a goal of reducing the incidence of death, illness and disease among citizens through educating the public to be aware of health risks and symptoms and to take responsibility for preserving and enhancing their own health and preventing illness.

a. OH Patient Advisory Councils (PAC)-established in each of eight state-supported general hospitals provide an avenue for each facility to learn community needs and concerns and address them jointly.

b. OPPHS Community Health Protection and Promotion-activities of a regulatory nature offered statewide through OHSEQ, including:

i. Retail Food Sanitation Program;

ii. Building and Premises Sanitation Program;

iii. Seafood Sanitation;

iv. Milk and Dairy Products Inspection;

v. Food, drug and cosmetic manufacturing and warehouse inspection;

vi. Drinking water supply sampling and analysis.

c. OPPHS Maternal and Child Health-Programs offered statewide to promote wellness in newborns, infants, children and women of childbearing age:

i. Improved Pregnancy Outcome provides equipment and special training programs for parish health units, area professionals and patients;

ii. preventive health care is offered to females of child-bearing age and children 0-21 years of age;

iii. Child Health Clinics are available at parish health units statewide offering screening, immunization and follow-up of children;

iv. School Health Programs offer screening and follow-up services for common health problems among school children.

d. OPPHS Family Planning-offered to all persons who voluntarily seek family planning services. The services are directed toward health and sex education, contraceptive services and family planning counseling.

e. OPPHS Supplemental Food Program for Women, Infants and Children (WIC Program)-offers food vouchers to low income pregnant, post partum, and breast feeding women, infants and children determined to be nutritionally at risk by the parish health unit.

f. OPPHS Fluoridation of community drinking water supplies-offered to communities of 1,000 + population (to promote dental health).

g. OPPHS Refugee Health Program-integrates Indochinese refugees into the health system.

h. OPPHS Immunization Administration-immunization is available as needed against polio, diptheria, measles, tetanus, rubella, mumps and pertussis. Yellow fever vaccine is available to international travelers at a few metropolitan health units. Influenza vaccine is available to persons at high risk of developing serious complications from influenza infections. Immune serum globulin is given to household members where cases of hepatitis type A are reported.

i. OMH Community Education and Consultation-Staff at all mental health centers available for public speaking and education programs directed toward preventing mental illness and educating the public to take responsibility for maintaining health and reducing risk related to mental illness. In some areas, efforts involve regularly scheduled presentations via public media.

j. OPRADA Alcohol Prevention Services-Designs and implements strategies for preventing primary and secondary alcohol and drug abuse through education, community development and early casefinding. Coordinates substance abuse programs and activities with public and private school systems and with the Criminal Justice system.

k. OFS/OPPHS Early Periodic Screening, Diagnosis and Treatment Program - through Title XIX funds, eligible children under the age of 21 receive periodic medical screening, immunizations and referral services to prevent and detect disease and illness.

l. OCHNO Patient Education Programs-videotaped health education programs are shown in most areas of the hospital and in the emergency room to patients and their families. These are directed at improving health habits and teaching patients how to take personal responsibility for their health.

m. OPPHS Health Education-offers counseling, nutrition advice and educational health services to encourage patients to take responsibility for their own health (a part of all patient services rendered by OPPHS staff in all parish health units and special service sections).

n. OPPHS AIDS Prevention-The provision of sound information about AIDS/HTLV III infection and risk reduction counseling to the general public, especially to adolescents and young adults who are forming the life styles which will determine their long-term risk of contracting the disease.

o. OH/OCHNO Nutrition Programs-nutrition counseling is offered to patients at all nine state-supported acute care general hospitals.

p. OFS Monthly mailout notices on subjects related to health services sent to recipients eligible for Title XIX services. Notices inform the recipient population of available services and encourage appropriate use of health care services.

q. OCHNO Health Risk Appraisal-OCHNO has implemented the Health Risk Appraisal system for all employees-Programs to date have included a promotion of the use of seat belts and promotion of a one day moratorium on smoking.

r. OCHNO Multidisciplinary Case Conferences-OCHNO is holding regular multidisciplinary staff meetings in each hospital center to resolve patient's health problems.

s. OCHNO Hospital Satellite Network Staff Development-includes staff development programs for various employee groups, including employees in high risk situations.

G. High Costs of Health Care

1. Introduction

a. This is an inventory of programs and initiatives set in place within DHHR agencies which are directed toward a goal of reducing the overall costs of providing health care.

b. All programs addressed in Alternatives to Institutionalization can be considered as serving to reduce the costs of medical care, since costs related to an overnight stay or long term care placement in health care facilities are reduced. All programs addressed in Health Promotion also indirectly serve to reduce costs of health care through prevention and early detection of illness and disease.

2. Inventory

a. OH/OCHNO Unit Dose System-provides a system of dispensing drugs in quantities no larger than needed for a single dose. This system controls usage and minimizes waste and theft of prescription drugs.

b. OH/OCHNO Reduction of Patient Length of Stay-on-going initiatives to reduce the overall length of patient stays in the nine state-supported acute care hospitals have resulted in reductions in the average length of stay to 5.6 days in hospitals administered by the Office of Hospitals and 7.9 days in New Orleans Charity Hospital.

c. OH/OCHNO Inventory Control System-automated management control system for distributing supplies and material so that waste and theft are reduced. The system is active in New Orleans Charity Hospital and is slated for the future in other state-supported acute care hospitals. At present the material management system in other state-supported hospitals is manually operated.

d. OFS Medicaid Management Information System-Title XIX claims are processed through an automated claims processing system which monitors provider claims for duplicate billings, medical necessity of service, eligibility of recipient and many other factors which might be indicators of an ineligible or questionable claim.

e. OM&F Section 1122 Project Review (Bureau of Health Planning)-Section 1122 of the Social Security Act requires that a proposed health facility-related capital expenditure over $600,000 or a proposed change in services or number of beds in a health care facility obtain prior approval from the designated planning agency in order to be reimbursed by Medicare and Medicaid for costs related to the capital expenditure. The purpose of this provision is to assure that federal funds are not used to support unnecessary capital expenditures by health care facilities.

f. OH/OCHNO/OMH Quality Assurance and Utilization Review-as a requirement of accreditation by the Joint Commission on Accreditation of Hospitals, health services rendered in state-supported hospitals are reviewed for appropriateness of service and efficient use of technology and corrective action is planned and implemented on an on-going basis.

g. OPPHS Central Pharmacy-all drugs prescribed in parish health units throughout the state are dispensed through a central pharmacy in New Orleans which results in a substantial savings.

h. OPPHS Management Control System-a system of personnel management involving review of staffing levels and staffing mix. Information is used to improve efficiency in staff utilization and distribution.

i. OMR-DD Preventive Dentistry Program-provides preventive dentistry techniques, including screening, referrals and coordination of tooth brushing to developmentally disabled individuals in New Orleans and Lafayette.

j. OMR/DD Family Subsidy-services designed to provide financial assistance, to help parents offset the unusual costs of specific services for keeping their children at home.

k. OH/OCHNO Day Surgery Services-day surgery services available in all nine state-supported acute care general hospitals. Surgical procedures requiring anesthesia and recovery services, but not necessitating overnight stay, are performed in these units.

l. OH/OCHNO Minor Surgery Clinic-minor medical/surgical procedures not requiring anesthesia are performed in outpatient clinics at all nine state-supported acute care general hospitals.

m. OMHSA Mental Health Management Information System-incorporates measures of efficiency/effectiveness through reporting of data elements such as client/patient data, direct services data, indirect services data, and assessment data.

n. OCHNO Energy Conservation Measures-Increased energy conservation and/or fuel efficiency from:

i. replacing a steam turbine chiller with two electric chillers;

ii. replacing incandescent with fluorescent fixtures in the hospital warehouse; and

iii. recovering heat from hospital laundry waste water for use in preheating water.

o. OCHNO Promote Use of Alternative Health Delivery Systems for Employees-OCHNO encourages employees to attend open sessions on Health Maintenance Organizations as an alternative to Group Insurance.

p. OCHNO Expand Use of Orientation Sessions-includes hospital orientation for residents and orientations, in many hospital centers, to their policies and procedures. OCHNO plans to expand the use of this mechanism to all hospital centers.

H. Private Sector Initiatives in Priority Areas

1. Introduction

a. Data related to the private health care delivery and advocacy system is scarce. There is no central or uniform reporting required for private and voluntary agencies. Information about private agencies may or may not appear in community service directories or in public information published by the agency itself. This is unfortunate since the tradition of voluntary action in the organization of health care is very strong. Through cooperative efforts, voluntary private health agencies can serve as valuable resources for the state's citizens and as allies to federal, state, and local government health care organizations.

b. A survey of private agencies and organizations was conducted by the Health Planning and Development Agency in the fall of 1981. The purpose was to elicit information from the private health-related agencies about their roles in the provision of services in the three established priority areas (Alternatives to Long-Term Institutionalization, Health Promotion and High Costs of Health Care). The survey instrument consisted of listing and describing types of services directed toward the priority areas. Open-ended questions regarding populations served and eligibility requirements were also used. The mailing list was composed of statewide private health agencies thought to be offering services in one of the priority areas. This list included private health agencies participating in the statewide priority survey, additional names supplied by those agencies initially surveyed and others taken from various parish directories. For those agencies that had many chapters located within the parishes (e.g. Red Cross, YMCA) a representative sample was used, since it was thought that all of these chapters would participate in the same common goals and objectives. All statewide private health agencies were not included since some were either unknown or unrecognized as functioning with the priority areas.

c. A total of 317 surveys were mailed out; 99 surveys were completed and returned, 21 were returned unopened by the Postal Service because of out-of-date addresses or discontinued service. There was, therefore, a return rate of 32.3 percent (n99 of 306).

Table 5.1 Agencies Reporting Alternatives to Institutionalization Activities*
Activity or Service Areas	Percent Agencies
Chemical dependency and substance abuse	22.6
Elderly needs	5.7
Emotional and mental disorders	15.0
Physical disabilities and handicaps	35.8
Programs for specific diseases	22.6

* n . 53; 56.3%

Table 5.2 Agencies Reporting Health Promotion Activities*
Activity or Service	Percent Agencies
Public Education (i.e. speakers, workshops, seminars, pamphlets, films, etc.)	76.0
Professional education	1.8
Public and Professional Education	21.8
Deaf/Blind	1.8
Dental	1.8
Disabilities (physical and mental)	16.4
Drug and Substance Abuse	16.4
Elderly	3.6
Nutrition and diet	5.4
Prenatal and Child care	7.3
Specific diseases and disorders (i.e. heart disease, cancer, arthritis, tuberculosis, etc.)	29.1
Youth	7.3
Multiservice (i.e. YMCA, Red Cross)	10.9

* n=55; 58.5%

d. Approximately 56.3 percent of the responding health-oriented agencies stated they engaged in providing services which assisted in offering alternatives to long-term institutionalization; 58.5 percent reported that health promotion activities were a part of the services provided. Data collected on cost containment activities was not suitable for interpretation because of a general misunderstanding of what was meant by "cost containment". What was seen in the various agencies' reports was that major thrusts in cost containment are, in fact, initiatives in developing or providing alternatives to long-term institutionalization and in promoting good health and preventing illness.

e. An inventory of reported programs sponsored by private agencies follows this narrative. This should not be interpreted as being a comprehensive examination of on-going programs addressing the priority health areas, but rather as a representative sample of the types of programs which are in place in the state's health care system.

2. Inventory

a. Alternatives to Institutionalization

i. Supportive services, to assist individuals to function outside of long term care institutions and to realize full potential for employment and/or independent living:

(a). Desire Narcotic Rehabilitation Center, Inc.-Supportive services, including individual, group and family counseling, employment and academic counseling-Serves persons 18 years or older in the Orleans, Jefferson, St. Bernard and St. Tammany area.

(b) Education and Treatment Council, Inc.-Outpatient drug abuse counseling for adolescents and their families (in connection with the Mental Health Association)-Serves Calcasieu, Allen, Beauregard, Cameron and Jefferson Davis parishes.

(c). Alcoholics Anonymous-Group therapy, individual counseling and referrals, serving statewide population.

(d). Family Counseling and Children's Services-Individual, couple and family counseling for chemical dependency and mental disorders-Serves the Caddo-Bossier, Baton Rouge, and New Orleans areas.

(e). St. Martin, Iberia, Lafayette, Community Action Agency (SMILE, CAA)-Home delivered meals, homemaker services (including personal health care and transportation to health care facilities)-Serves persons over 60 years of age in the St. Martin, Iberia, and Lafayette areas.

(f). YWCA Senior Center-(New Orleans)-Resources for housing sites for the elderly and informal health education and recreation within the community-Services persons over 60 years of age in the New Orleans area.

(g). Vermilion Association for Retarded Citizens-Day developmental training center offering training in self help and community living skills, for persons 22 years of age and over who are evaluated as mentally retarded-Statewide.

(h). Ouachita Association for Retarded Citizens-Group home/work activity center serving planning district VIII.

(i). Calcasieu Hop Centers, Inc.-Adult program assists those with mental and developmental handicaps in independent living skills and self care training; provides physical therapy and infant stimulation services-Serves Lake Charles and the Calcasieu parish area.

(j). Recovery, Inc.-Self help programs and group sessions for persons over age 18 with mental or nervous disorders-Serves the New Orleans, Baton Rouge, Lafayette, and Shreveport areas.

(k). Mental Health Association of Louisiana-Social rehabilitation club for persons recovering from mental illness; and training in living skills for the chronically mentally ill.

(l). Lighthouse for the Blind-Provides training to blind individuals in those skills necessary for independent living-Serves the New Orleans area.

(m). Kingsley House-Adult day care, personal care and supervision, and social, recreational and educational services for persons 18 years of age or older with moderate physical or mental handicaps-Serves the New Orleans area.

(n). Goodwill Rehabilitation Center-Vocational rehabilitation, evaluation and training of handicapped individuals 16 years and over-Serves the New Orleans area.

ii. Direct mental and physical health services which offer outpatient treatment or short-term hospitalization as an alternative to longterm institutionalization:

(a). Insight Program-Detoxification and substance abuse clinic-Serves the Greater New Orleans area.

(b). Alcohol and Drug Detoxification Center-Detoxification services and outpatient treatment for the chemically dependent-Serves the Baton Rouge area.

(c). Drug Rehabilitation Clinic-Chemotherapy and methadone outpatient treatment for opiate and other drug users-Serves the Orleans, Jefferson and St. Bernard areas.

(d). Alcohol Recovery Unit (Metairie General Hospital-"One Day at a Time")-28 day inpatient chemical dependency treatment, and outpatient counseling-statewide.

(e). F. Edward Hebert Hospital (Chemical Dependency Unit-Outpatient treatment (intensive and primary therapy for drug and alcohol abuse) and aftercare, serving statewide population.

(f). Baton Rouge General Hospital 1) Adolescent Chemical Dependency Unit provides short term (6-7 week) inpatient treatment and a two year aftercare program. 2) Chemical Dependency Unit (adult) offers a 28 day inpatient program and aftercare.

(g). DePaul Community Health Center and DePaul Center for Psychotherapy-Aftercare services after institutionalization for chemical dependency, psychiatric disorders and emotional disturbances of children and adolescents-Serves the New Orleans area.

(h). Speech and Hearing Center of Southwest Louisiana, Inc.-Speech and hearing evaluation, screening, consultation and speech therapy for groups and individuals-Serves statewide population.

(i). Southwest Louisiana Health Couseling Services-Direct services, in-home counseling, and physical and occupational therapy for physically handicapped persons-Serves Allen, Beauregard, Calcasieu, Cameron, and Jefferson Davis parishes.

(j). Calcasieu Multi-Handicapped Center, Inc.-Individual discharge planning and rehabilitation for the institutionalized mentally and physically disabled-Serves statewide population.

(k). Visiting Nurses Association of Greater New Orleans-In-home nursing and homemaker services for the disabled and chronically ill-Serves the New Orleans area.

(l). Physical Therapy and Rehabilitation Center-Private physical therapy and chronic and acute pain treatment, particularly for crippled children and stroke victims. Services provided at the Center of in the client's home-Serves the Houma area, including Terrebonne, Lacfourche and St. Mary parishes.

(m). Opelousas Area Cerebral Palsy Treatment Center-Physical and speech therapy and home care for cerebral palsy clients aged 0-21 years-Serves St. Landry parish and the surrounding area.

(n). United Cerebral Palsy of Greater New Orleans-Medical, therapeutic and counseling services, continuing education and work activity-Serves Jefferson, New Orleans, St. Tammany and St. Bernard parishes.

(o). Muscular Dystrophy Association, Inc.-Five comprehensive outpatient clinics for diagnostic and follow-up care; orthopedic equipment use for home care; and physical and occupational therapy-Serves statewide population.

(p). National Society for Autistic Children-Direct services and in-home counseling, physical therapy, and occupational therapy-Serves statewide population.

(q). United Cerebral Palsy Association of Southwest Louisiana-Direct services and in-home counseling, physical therapy, and occupational therapy-Serves statewide population.

iii. Direct Care-(Home health and respite) to prevent longterm institutionalization.

(a). Ouachita Association for Retarded Citizens-Respite center and respite-in-home services-Serves Planning District VIII.

(b). St. Landry Area Agency on Aging-Professional home care services to persons over 60 years of age in St. Martin, Iberia and Lafayette parishes.

(c). Home Health Agency VNA of Southwest Louisiana-Professional home health services for persons residing in Calcasieu parish and parts of Jefferson Davis, Cameron and Beauregard parishes.

(d). Professional Home Health Services of Alexandria-In-home nursing-Serves patients in Rapides, Grant, LaSalle, and Natchitoches parishes.

(e). Home Health Services (2)-Skilled nursing, physical therapy, speech therapy, occupational therapy and home health aide services-Serves the Lake Charles area (Calcasieu, Beauregard, Cameron, Jefferson Davis parishes) and Jefferson and St. Bernard parishes.

(f). Professional Home Health Services of Allen-Home Health care (nursing, physical therapy)-Serves Allen, Evangeline, Vernon and Beauregard parishes.

(g). American Community Services, Inc.-Respite care in-home for those with long term handicaps not due to aging-Serves Franklin, Jackson, Ouachita, Richland, Rapides, and Winn parishes.

(h). Respite Services of Southwest Louisiana-In home respite care for persons with chronic disabilities-Serves Allen, Beauregard, Calcasieu, Cameron and Jefferson Davis parishes.

(i). Project HELP-Respite Care for the non-elderly disabled in Orleans, Jefferson, and St. Bernard parishes.

(j). Louisiana State Society for Autistic Children-Summer residential camps as respite for autistic children-Serves statewide population.

iv. Alternative Living Arrangements

(a). Volunteers of America-Group homes for mentally retarded and supervised apartment living for disabled adults-Serves statewide population between the ages of 18-40 years.

v. Indirect services-referrals, transportation, family counseling, etc.

(a). Easter Seal Society for Crippled Children and Adults of Louisiana, Inc.-Transportation services for handicapped and elderly adults, and equipment for home health care-Serves statewide population.

(b). Association of Deaf Counseling-Counseling to help families cope with the deaf/blind patient-Serves statewide population.

(c). Louisiana Chapter Arthritis Foundation-Arthritis clinics and information about home care-Serves statewide population.

(d). Charles and Elizabeth Wetmore Foundation-Financial assistance to people with tuberculosis for medical equipment for home care-Serves statewide population.

(e). American Cancer Society-Provision of equipment and supplies for the home care of cancer patients; financial assistance for transportation, medicine, and equipment; emotional support and counseling-Serves Greater Baton Rouge and Greater New Orleans area, East and West Baton Rouge, Livingston, East and West Feliciana, St. Helena, Pointe Coupee, Iberville and Ascension parishes. Different chapters are established statewide.

b. Health Promotion Activities

i. Deaf/Blind. La. Association of Deaf Counseling and Service Coordination Program for Deaf-Visually Impaired-Genetic counseling for Usher's syndrome, and vocational and consumer health counseling-Serves statewide deaf-blind population.

ii. Dental. Northeast Louisiana University-Dental hygiene clinic, instruction in dental prophylaxis-Serves Northeast Louisiana.

iii. Disabilities (physical and mental)

(a). Calcasieu Hope Centers, Inc.-Training in self care and living skills, films on personal hygiene-Serves Lake Charles, and Calcasieu parish.

(b). Mental Health Association of Louisiana-Mental health education activities including films and seminars-Serves statewide population (25 chapters).

(c). DePaul Community Health Center and DePaul Center for Psychotherapy-Community education on mental health and enhancement of mental health, effectiveness and communication training and stress management-Serves New Orleans.

(d). Professional Home Health Services of Allen-Education of patients and families on the benefits of proper diet, exercise, illness prevention and care-Serves Allen, Evangeline, Vernon, and Beauregard parishes.

(e). Home Health Services (2)-Skilled nurses teach home care skills to families of patients in the Lake Charles area (Calcasieu, Beauregard, Cameron, Jefferson Davis parishes,) and the New Orleans area (St. John the Baptist, Plaquemine, New Orleans, Jefferson, and St. Bernard parishes).

(f). Easter Seals Society for Crippled Children and Adults of Louisiana, Inc.-Health education and information on prevention of specific disabilities; screening and education on scoliosis-Serves statewide population.

(g). Southwest Louisiana Health Counseling Services-Community education on developmental disabilities and professional training and education-Serves Allen, Beauregard, Calcasieu, and Jefferson Davis parishes.

iv. Drug and Substance Abuse

(a). Insight Program-Lectures on drug use-Serves Greater New Orleans area.

(b). Alcohol and Drug Abuse Council of Greater Baton Rouge Area-Professional and corporate education, including speakers, workshops, seminars and films on alcohol and drugs-Serves Greater Baton Rouge area, East and West Baton Rouge, Ascension, Iberville, St. James, and Livingston parishes.

(c). Alcoholics Anonymous-Pamphlets, books, tapes, speakers on alcoholism and alcohol abuse-Serves Statewide.

(d). F. Edward Hebert Hospital-Chemical Dependency Unit-Presentations on drug abuse and chemical dependency to industries, schools and health-related social services-Serves statewide population.

(e). Louisiana A. Philip Randolph Institute of Drug Abuse-Job site substance abuse committees, awareness programs, seminars and speakers-Serves statewide population (mainly Union members).

(f). Community Organization for Drug Abuse Concerns (CODAC)-drug information program in Caddo-Bossier school system (alternative ways of dealing with stress, health hazards, associating with these who use drugs), serving the Caddo-Bossier parishes.

(g). Education and Treatment Council Inc. of Lake Charles-Drug Abuse Prevention Program-alternative actions-Serves Lake Charles area, Allen, Beauregard, Calcasieu, Cameron, and Jefferson Davis parishes.

(h). Committee on Alcohol and Drug Abuse for Greater New Orleans-Public education, information, referral on drug and alcohol abuse,-Serves Greater Metropolitan New Orleans, including Jefferson, St. Bernard and St. Tammany parishes.

(i). Alcohol Recovery Unit-Metairie General Hospital-One Day at a Time-Community and industry educational program on chemical dependency and effects, serving statewide population.

v. Elderly

(a). SMILE, Inc., Community Action Agency-Educates and counsels those over 60 years of age on medication and side effects and provides information on high blood pressure-serves St. Martin, Iberia and Lafayette parishes.

(b). YWCA Senior Center-Informal health education on the psychological and physical aspects of aging-Serves the New Orleans area.

vi. Nutrition and Diet

(a). Diet Counseling Service of Physicians and Surgeons Hospital-Patient and professional education seminars-Serves northwest Louisiana, and the Louisiana/Arkansas and Louisiana/Texas border areas.

(b). Southwest Louisiana Dietetic Association-Nutritional education and diets for preventive health (especially in hospitals and nursing homes)-Serves Calcasieu, and Beauregard parish areas.

(c). Hammond District Dietetic Association-Continuing nutritional education for members of the dietetic profession; community nutrition projects and research-Serves Livingston, Washington, St. Tammany and Tangipahoa parishes.

vii. Prenatal and Child Care

(a). Genetic Desease Center of Louisiana-Sickle cell anemia education, screening and counseling services, referral and follow-up,-Serves Metropolitan New Orleans (Southeast and south central parishes by request).

(b). Calcasieu Women's Shelter-Promotion of good health care and practices; personal hygiene, child care, and nutrition education-Serves Calcasieu, Beauregard, Jefferson Davis, and Cameron parishes (especially battered women and children).

(c). Ouachita Parenting and Childbirth Association (OPCA)-Public information program on pregnancy, child care, parenting, C-sections; prenatal education classes; consumer voice in obstetric and pediatric care-Serves the Northeast Louisiana area.

(d). March of Dimes Birth Defects Foundation-Educational programs on starting healthy families; films and pamphlets on alcohol and drug use during pregnancy, and nutrition practices-Serves statewide population.

viii. Specific Disorders and Diseases

(a). Cancer Association of Greater New Orleans-Public education programs on cancer; cooperation with Seventh Day Adventist church on "Stop Smoking" program-Serves statewide population.

(b). American Cancer Society (Louisiana Division, Inc.) (2)-Public education activities including "Quit Smoking" Clinics, breast self-exam information, information on the warning signals of cancer, health fairs, free screening, pamphlets, films, speakers, and educational programs for adults and youth-Serves Greater Baton Rouge (East Baton Rouge, West Feliciana, Iberville, Ascension, Livingston, West Baton Rouge, St. James), Greater New Orleans area and statewide.

(c). Louisiana Chapter of Arthritis Foundation-Health fairs, literature and group lectures on arthritis and rheumatism-Serves statewide population.

(d). United Cerebral Palsy Association of Greater New Orleans and southwest Louisiana-Health fairs, cerebral palsy information for the public, community and professional education-Serves New Orleans area including Jefferson, St. Tammany and St. Bernard parishes, and the Louisiana area.

(e). American Diabetes Association (Louisiana Affiliate Inc. (3)-Public, professional and diabetic patient education on diabetes treatment, care, detection; activities include speakers, seminars and meetings-Serves statewide population (located in Baton Rouge, Shreveport and Houma)

(f). American Heart Association-Professional and public education on heart disease, CPR and heart attacks; community services-Serves Caldwell, East Carroll, Franklin, Jackson, Lincoln, Madison, Ouachita, Richland, Tensas, Union, West Carroll parishes.

(g). Greater New Orleans Ostomy Association (Chapter of United Ostomy Association, Inc.)-Emotional support and information to ostomy patients and families, public information on rehabilitative ostomy surgery, gastrointestinal and urological disorders and diseases, treatment and prevention-Serves Orleans, Jefferson, St. Bernard, St. Tammany and St. Charles parishes.

(h). National Association for Autistic Children-Counseling and professional and community education in autism-Serves Allen, Beauregard, Calcasieu, Cameron, and Jefferson Davis parishes.

(i). Muscular Dystrophy Association Inc.-Public health education and an intensive program one week per year for special emphasis on MD and neuromuscular disease-Serves statewide population.

(j). Southwestern Sickle Cell Anemia Foundation, Inc.-Patient support groups, genetic counseling, in-service training and public information including pamphlets-Serves Lake Charles and Allen, Beau-regard, Calcasieu, Cameron, and Jefferson Davis parishes.

(k). Spina Bifida Association of Louisiana-Public and patient information on Spina Bifida, including literature and speakers-Serves statewide population.

(1). Charles and Elizabeth Wetmore Foundation-Education, including treatment information and films on medicine and lifestyle changes for those with tuberculosis-Serves Orleans, Jefferson, St. Bernard, Plaquemine, and St. Tammany parishes.

ix. Maternal and Child Health

(a). Children's Council of Region I.- Press releases on health topics related to child care-Serves Orleans, Jefferson, St. Bernard, St. Tammany and Plaquemines parishes.

(b). Children's Council of District V-Public awareness program to promote good health habits (in conjunction with public health clinics)-Serves Allen, Beauregard, Cameron, Calcasieu and Jefferson Davis parishes.

(c). Capital Area Regional Children's Council-Health education activities including public formums and activities to increase public awareness of legislation affecting mental and physical health-Serves East and West Baton Rouge, East and West Feliciana, Pointe Coupee, Iberville, Ascension, Livingston, Washington, Tangipahoa, and St. Helena parishes.

(d). Ouachita Multi-Purpose CAP Head Start-Comprehensive health services to preschool children and education services for families and children,-serves Ouachita parish (primarily for children 3-5 years).

x. Multiservice

(a). American Red Cross (Northwest Chapter)-public information, including courses on topics such as "You and the Aging" and "Preparation for Parenthood" and pamphlets on Family Health and Home Nursing Care-Serves Northwest Louisiana.

(b). American Red Cross (New Orleans Chapter)-Courses in first aid, emergency preparedness and CPR-Serves New Orleans and Tangipahoa, St. Tammany, St. John, and St. Charles parishes.

(c). American Red Cross-(Calcasieu-Cameron Chapter)-Courses in First Aid, Vital Signs, Home Nursing and CPR-Serves Calcasieu and Cameron parishes.

(d). Baranco-Clark Branch YMCA-Public education with an emphasis on preventive health care, controlling blood pressure, films on health related activities for the elderly population-Serves South Baton Rouge Area.

(e). YWCA-New Orleans-Physical fitness and exercise programs and information on proper nutrition-Serves Orleans, St. Tammany, St. Bernard, and Jefferson parishes.

(f). Baton Rouge Area YWCA-Encore support group for post-mastectomy patients; prenatal exercise classes; stress management, fitness and nutrition programs,-Serves the Greater Baton Rouge area, Ascension, Livingston St. James and Iberville parishes.

La. Admin. Code tit. 48, § I-10703

Promulgated by the Department of Health and Human Resources, Office of Management and Finance., LR 13:246 (April 1987).

AUTHORITY NOTE: Promulgated in accordance with P.L. 93-641 as amended by P.L. 96-79, and R.S. 36:256(b).