La. Admin. Code tit. 48 § I-10907

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

Section I-10907 - Department of Health and Human Resources Health-Related Offices Implementation Activities

A. Development of services at the community level directed toward informing, educating and motivating the public to accept responsibility for protecting their health.

1. Office of Preventive and Public Health Services (OPPHS)

a. To motivate industries and groups to initiate health promotion activities for their employees and/or members. Planned activities include:

i. general Health Risk Appraisal (HRA) information to new requestors;

ii. HRA demonstration or orientation to a potential new user;

iii. follow-up HRA information or assistance to potential new user;

iv. HRA batch processing for client or potential new user group;

v. target completion date: June 30, 1987 (and ongoing);

vi. resource requirement: Continuation of state funding at standstill level.

b. To sponsor, assist and monitor new HRA users. Key activities to be recorded will include:

i. new HRA users sponsored or assisted;

ii. the number of formal training sessions for HRA and the number of individuals trained;

iii. HRA User Status Reports solicited from users to obtain baseline data that would provide direction for health promotion in the state;

iv. target completion date: June 30, 1987 (and ongoing);

v. resource requirement: State funding at standstill level.

c. To develop and print a statewide Health Education Resource Directory which provides resource information by region. Component activities will be:

i. to obtain Health Education Resource information from eight regions;

ii. format Health Education Resource information onto computer disc;

iii. to print a minimum of 500 directories;

iv. target completion date: February 28, 1987;

v. resource requirement: State funding at 100 percent level.

d. To provide health education resources, equipment and audiovisuals to DHHR, OPPHS Programs and selected target populations. These materials will include:

i. pamphlets, posters and artistic designs created for health promotion activities of OPPHS programs;

ii. audio-visual materials and equipment loaned to support program activities;

iii. target completion date: June 30, 1987 (and ongoing);

iv. resource requirement: State funding at standstill level.

e. To plan and implement educational/media campaigns for vari ous health promotion activities. These will include but not be limited to:

i. World Health Day;

ii. Great American Smoke-Out;

iii. Diabetes Awareness Campaign;

iv. Secretary's Health Promotion Awards;

v. component activities will include:

(a). developing, printing and distributing flyers;

(b). developing news articles and proclamations, and distributing media packets;

(c). assisting various DHHR Programs.

vi. target completion date: June 30, 1987 (and ongoing);

vii. resource requirement: State funding at standstill level.

f. Aids prevention:

i. to provide information, risk reduction counseling, and antibody testing for high-risk persons;

ii. to provide information and risk reduction counseling to adolescents and young adults who are forming the lifestyles that will determine their long-term risk of contracting the disease;

iii. to make information about AID/HTLV-III infection effectively available to the public;

iv. to collect epidemiological information from clients in our service programs;

v. benefits: approximately 200 new cases of AIDS are expected to occur in Louisiana during the coming year. Most of these will become the medical responsibility of the state. For each case prevented, approximately $100,000 in treatment costs will be saved; treatment costs which are increasing as survival time increases;

vi. target completion date: On-going (annual update).;

vii. resource requirement: $1,060,000 per year.

2. Office of Prevention and Recovery from Alcohol and Drug Abuse (OPRADA)

a. To coordinate national media campaign activities in Louisiana aimed at preventing alcohol and drug abuse ("The Chemical People," "Just Say No", "Fetal Alcohol Syndrome Awareness", "Drunk and Drugged Driving Week", etc.):

i. target completion date: June 30, 1987;

ii. resource requirement: Continuation of current funding.

b. To plan and coordinate a "Substance Abuse Awareness Week" in October of each year. This event, which will be proclaimed by the governor, will include media and community events to publicize deleterious effects of alcohol and drug abuse. The events will be geared toward the adult and youth population of Louisiana:

i. target completion date: June 30, 1987;

ii. resource requirement: Continuation of current funding.

c. To conduct a statewide media campaign to coincide with the governor's proclaimed "Fetal Alcohol Effects Awareness Week" in April, 1987. This event is designed to impact 1.5 million women.:

i. target completion date: June 30, 1987;

ii. resource requirement: Continuation of current funding.

d. To disseminate information on alcohol and drug abuse from state office, Regional Clearinghouses for Drug and Alcohol Information, and OPRADA clinics to all parts of the state. This will be a continuous process:

i. target completion date: June 30, 1987 (and ongoing);

ii. resource requirement: Continuation of current funding.

e. To coordinate the development of employee assistance programs for persons with alcohol or drug-related problems in each department of state government by the end of FY 87-88:

i. target completion date (first phase): June 30, 1987;

ii. resource requirement: Continuation of current funding.

f. To conduct one regional alcohol and drug abuse prevention workshop per quarter in FY 86-87 aimed at galvanizing communities to establish local comprehensive prevention programs:

i. target completion date: June 30, 1987;

ii. resource requirement: Continuation of current funding.

g. To continue interfacing with other state agencies to coordinate efforts for the prevention of alcohol and drug abuse, via cooperative and interagency agreements:

i. target completion date: June 30, 1987 (and ongoing);

ii. resource requirement: Continuation of current funding.

h. To establish, at the state and local levels in all regions, networks of agencies, groups, and individuals to stimulate planned, concerted actions to prevent alcohol and drug abuse, by the end of Fiscal Year 1986/87:

i. target completion date: June 30, 1987 (and ongoing);

ii. resource requirement: Continuation of current funding.

i. To facilitate the development of at least one privately funded new women's initiative to combat alcohol and drug abuse in Louisiana's major population centers (Baton Rouge, Monroe and New Orleans) by the end of FY 87:

i. target completion date: June 30, 1987;

ii. resource requirement: Continuation of current funding.

3. Office of Hospitals (OH)

a. To develop a primary health care model program to provide Health Maintenance Organization (HMO) services, including a wellness component, to the indigent and uninsured in Louisiana. If grant funding is secured, activities for the first year would include formulation of a small task force to study the relevant requirements for organizing and implementing the HMO and to develop written suggestions for its implementation:

i. target completion date: June 30, 1987;

ii. resource requirement: Robert Woods Johnson Foundation grant funds.

B. Goal 2: Containment of the Rapidly Rising Costs of Health Care and Promotion of Greater Efficiency in the Health Care Delivery System

1. Office of Preventive and Public Health Services (OPPHS)

a. To establish a home care system of services, in cooperation with the Office of Family Security and Children's Hospital, for families with ventilator dependent or assisted children, through:

i. obtaining a federal SPRANS grant for training of families and community outreach personnel (including Handicapped Children's Services (HCS) staff);

ii. planning for the future without a Medicaid Model Waiver;

iii. successfully placing 24 children at home;

iv. Target completion date: December 31, 1986;

v. Resource requirement: Medicaid Model Waiver questionable. An estimated $500,000 per year will be needed for training and case management of ongoing community networks.

b. To reduce the number of premature heart attacks, strokes, and kidney failures, and the state health expenditures by maintaining and improving the High Blood Pressure Control program available through the local health units:

i. target completion date: June 30, 1987 (and ongoing);

ii. resource requirement: $673,108 from Preventive Health Block Grant.

c. To develop and maintain a diabetes control program to provide:

i. demonstration projects to 1) assess needs, 2) develop and implement programs to meet these needs, 3) obtain funds from third party carriers for out-patient education programs and 4) evaluate program accomplishments;

ii. education for health professionals and patients which will enable better use of knowledge available on diabetes control and treatment. This is expected to reduce hospitalization and delay the onset of debilitating complications which result in costly hospitalizations and disability;

iii. target completion date: June 30, 1987 (and ongoing);

iv. Resource requirement: Centers for Disease Control continuation funding.

d. To prevent or facilitate the prevention of health problems associated with medically indigent infants and children, promote their health and participate in efforts to reduce infant mortality and morbidity in Louisiana by:

i. provision of child health nursing services targeted to medically indigent children ages birth to five years;

ii. provision of limited child health physician services targeted to medically indigent children ages birth to five years;

iii. provision of nutrition services to indigent children and their parents;

iv. provision of lead poisoning screening, treatment and follow-up services for indigent young children at risk of or suffering from lead poisoning in areas with excessively high lead levels;

v. provision of audiological screening, vision screening, and diagnostic clinic services to pre-school and school age children and training for school nurses and other persons;

vi. provision of preventive and orthodontic dental services to handicapped and medically indigent children;

vii. provision of medical social services for a Sudden Infant Death Syndrome (SIDS) follow-up for high-risk medically indigent infants and young children;

viii. target completion date: June 30, 1987;

ix. resource requirement: Continuation of Maternal and Child Health (MCH) funding at FY 85-86 levels.

e. To prevent or facilitate the prevention of health problems of medically indigent pregnant women and adolescents, promote their health and participate in efforts to reduce infant and maternal mortality and the high rate of adolescent pregnancy in Louisiana through:

i. provision of targeted maternity nursing services to low-risk medically indigent women and adolescents in areas with 1983 infant mortality rates of 13.2 per 1000 births or higher where no other maternity services are available;

ii. provision of limited targeted maternity physician services to low-risk medically indigent women;

iii. provision of nutrition services to indigent pregnant women and adolescents;

iv. provision of medical social services to pregnant women and adolescents;

v. provision of comprehensive family planning services and health education in all regions of the State;

vi. target completion date: June 30, 1987 (and ongoing);

vii. resource requirement: Continuation of MCH and Family Planning funding at FY 85-86 levels.

2. Office of Prevention and Recovery from Alcohol and Drug Abuse (OPRADA)

a. Subgoal: To ameliorate the problems and reduce the costs associated with alcohol and drug abuse through the statewide provision of services including prevention, early intervention and provision of care to the substance abuser and his/her family.

i. To fund and implement at least one publicly financed treatment program for females in the northern and southern parts of the state, by the end of FY 87:

(a). target completion date: June 30, 1987;

(b). resource requirement: Continuation of current funding.

ii. To analyze the unmet need for substance abuse prevention and recovery services and develop proposals for meeting these needs in conjunction with the Louisiana Commission on Alcohol and Drug Abuse:

(a). target completion date: June 30, 1987;

(b). resource requirement: No additional funds.

iii. To provide geographically accessible screening, evaluation and treatment services to the approximately 200,000 substance abusers dependent on public treatment resources in order to provide services to clients with as little disruption to their lives as possible:

(a). target completion date: June 30, 1987;

(b). Resource requirement: $768,499.

iv. To provide for the special needs of addicted women through development of four 10 bed programs of social detoxification:

(a). target completion date: June 30, 1987;

(b). resource requirement: No additional funds.

3. Office of Hospitals (OH)

a. To evaluate the possibility of privatizing in-house functions in the Office of Hospitals system as a cost reduction measure. One such possibility is contracting with a private provider for laser dine technology in the medical records department:

i. target completion date: June 30, 1987;

ii. resource requirement: No additional funds.

C. Goal 3: Development and promotion of a comprehensive array of services directed toward preventing or postponing long term institutionalization and terminating inappropriate institutionalization.

1. Office of Preventive and Public Health Services (OPPHS)

a. To locate and provide habilitation or rehabilitation services to 20,000 handicapped children in order to prevent their institutionalization:

i. to develop a case management system for ventilator assisted children at home;

ii. to continue training of community based personnel for ventilator dependent children;

iii. to assist with planning for group homes as the least restrictive environment for ventilator dependent children;

iv. target completion date: June 30, 1987;

v. resource requirement: Approximately $500,000 a year for five years.

b. Maintain Genetics clinics in 10 locations (of them utilizing Handicapped Children's Services (HCS) clinics and staff):

i. hold specialty outpatient clinics;

ii. hospitalize when necessary;

iii. provide appliances to the HCS staff nurses assigned to hold Genetics clinics;

iv. target completion date: June 30, 1987 (and ongoing);

v. resource requirement: Maintain standstill budget for HCS program, and maintain Genetics program funding for staff.

c. To enable persons who are essentially confined to their homes and who currently have no insurance coverage to receive necessary nursing and related health care at home, in order to reduce the incidence of prolonged hospitalization, and prevent or postpone unnecessary costly institutionalization.

i. target completion date: June 30, 1987 (and ongoing);

ii. resource requirement: $250,000.

d. To maintain clinics for the treatment of children with Juvenile Rheumatoid Arthritis in 5 Handicapped Children's Districts:

i. target completion date: June 30, 1987 (and ongoing);

ii. resource requirement: Maintain Handicapped Children's Services Program standstill budget.

2. Office of Human Development (OHD)

a. To provide physically and/or mentally handicapped individuals with specialized services designed to (a) develop, enhance or create their employment potential and/or (b) assist them in acquiring personal skills to meet the demands of daily living:

i. target completion date: June 30, 1987;

ii. resource requirement: undetermined.

b. To provide adoption services to eligible children who are determined to be in need of such services and are available for adoption, and to increase by 36 percent the number of adoptive placements for children with special needs resulting from their age, race, nationality, physical/ mental and/or emotional condition or from being a member of a sibling group which should not be separated. (There are 171 subsidized adoptive placements projected for 1986-87):

i. target completion date: June 30, 1987;

ii. resource requirement: $2,284,000. Services will be provided directly by OHD Division of Children, Youth and Family Services.

c. To provide eligible individuals with counseling to assist with their inter/intra-personal functioning, resolve problems, alleviate emotional/situational stresses, and change maladaptive behavior:

i. target completion date: June 30, 1987;

ii. resource requirement: $228,000. Service will be provided directly by OHD staff.

d. To assist eligible individuals to alleviate stressful family situations; to acquire or improve their self-care and social skills; to prepare for, secure, or maintain employment, or to recuperate from temporary disabilities by providing day care for children.

i. target completion date: June 30, 1987;

ii. resource requirement: $11,525,651. These services will be provided directly through vendor agreements with $9,592,605 and indirectly with $1,933,045 in purchase of services contracts with private providers.

e. To provide family services to eligible families determined by OHD to need such services:

i. to provide pre-placement or preventive or reunification services to 13,880 families determined eligible by OHD-DCYFS or DYS staff;

ii. to reduce the placement of children out of their homes as a result of abuse or neglect by 4 percent;

iii. to limit the number of children in long-term placements (over 24 months) to 55 percent of the total foster care population;

iv. target completion date: June 30, 1987;

v. resource requirement: $12,437,916. These services will be provided directly by OHD staff with $12,061,920 and indirectly with $375,996 in purchase of service contacts with private providers.

f. To allow eligible individuals and families to improve, maintain or develop the capacity for independent functioning in their own homes, family setting or other living arrangement by providing homemaker services:

i. target completion date: June 30, 1987;

ii. resource requirement: These services are to be provided directly by OHD staff, but the expenditures are included in Family Services and Protection for adults categories.

g. To assist individuals to locate, access and utilize Title XX and related services by providing information and referral services:

i. target completion date: June 30, 1987;

ii. resource requirement: These services will be provided directly by OHD staff to persons in need of emergency assistance with the cost being absorbed by all other services.

h. To enable eligible individuals to achieve their maximum potential for independent functioning so that they can remain in or move into the optimum environment in which they are able to function:

i. target completion date: June 30, 1987;

ii. resource requirement: $2,347,656. Services being provided directly by OHD staff. This dollar amount excludes the cost of room and board estimated $56.50 per day.

i. To provide respite care services to eligible disabled/handicapped individuals so their families can benefit from temporary relief from caregiving responsibilities. This serves to support the family as principal care-giver in order to prevent or delay placement of such disabled/handicapped individuals in restrictive settings:

i. target completion date: June 30, 1987;

ii. resource requirement: $1,076,629 in purchase of service contracts with private providers.

j. To provide temporary, but stable parenting, nurturing and/or oversight for eligible individuals (including those eligible for IV-E funded services) in foster family homes while permanent plans are being made for restoring the family unit, for adoptive placement or for independent living:

i. Target completion date: June 30, 1987;

ii. Resource requirement: $8,342,012. These services will be provided directly by OHD staff at a cost of $8,204,472. They will also be provided through purchase of service contracts with private providers with expenditures of $137,540. These dollar amounts exclude the cost of room and board estimated at $7.74 per day.

k. Transportation - Terminated

3. Office of Mental Health

a. Sub-Goal: Development and promotion of a comprehensive array of services directed toward preventing or postponing long term hospitalization or terminating inappropriate, long term hospitalization.

i. To provide acute day hospitalization care on a regional basis for all adults determined to be in need of this level of care:

(a). target completion date: June 30, 1987 (ongoing);

(b). resource requirement: With possible budget reductions and associated manpower reductions, this objective may require revision.

ii. To continue research into and development of residential programs which offer an alternative to long-term hospitalization, e.g, supervised boarding homes and substitute foster care:

(a). target completion date: Ongoing;

(b). resource requirement: No additional funds.

iii. To provide residential services in each region for all patients determined to be in need of:

(a). residential backup for acute day hospital services;

(b). transitional residential services during rehabilitation;

(c). long-term residential rehabilitation services (chronically mentally ill population); and

(d). respite care.

(e). target completion date: June 30, 1987 (ongoing);

(f). resource requirement: With possible budget reductions and associated manpower reductions, this objective may require revision.

iii. To provide case management services for every client determined to be in need assistance in:

(a). brokering services provided by other community caretakers;

(b). socialization/rehabilitation services so individualized they cannot be offered through other programmatic elements; and

(c). arranging transportation to essential services identified in individual treatment plans.

(d). target completion date: June 30, 1987 (ongoing);

(e). resource requirement: With possible budget reductions and associated manpower reductions, this objective may require revision.

iv. To provide essential outpatient mental health services to priority and target populations at the level possible with existing resources:

(a). to provide in at least one location in each OMH Region 24-hour telephone availability, 24-hour walk-in availability, on-call professional staff, medical staff back-up and inpatient availability;

(b). target completion date: June 30, 1987 (ongoing);

(c). resource requirement: With possible budget reductions and associated manpower reductions, this objective may require revision.

v. To provide adequate assessment, individualized treatment planning and treatment for all OMH patients through adequate staffing of all community mental health centers:

(a). target completion date June 30, 1987 (ongoing);

(b). resource requirement: With possible budget reductions and associated manpower reductions, this objective may require revision.

vi. To provide essential inpatient mental health services to priority and target populations at the level possible with existing resources:

(a). to provide short-term and acute inpatient care on a regional basis for all individuals determined to be in need of this level of care;

(b). target completion date: June 30, 1987 (ongoing);

(c). resource requirement: With possible budget reductions and associated manpower reductions, this objective may require revision.

La. Admin. Code tit. 48, § I-10907

Promulated 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).