La. Admin. Code tit. 48 § I-13705

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

Section I-13705 - Client Eligibility

A. Client must be HIV infected and require medical and/or nursing intervention.

B. Client desires home based care as determined and documented by the social worker/case manager, and client's primary care physician.

C. Service is not covered by any other third-party coverage. This program should be used when all other sources of payment for home based care have been exhausted. This program will supplement gaps in existing third-party coverage for services listed including covering beyond the amount and frequency covered by medicaid.

D. Client must have a household income less than 200 percent of the federal poverty guidelines updated annually and available resources less than $4,000 based on Medicaid guidelines.

E. Client must have a physician who will provide orders in writing or verbally to the agency prior to the initiation of care, act as that client's primary care physician, maintain a consistent plan, and communicate changes from the initial plan directly to the agency or the physician must be willing to transfer the client to the care of the agency physician. If verbal orders are given to the agency, written orders must follow within 48 hours.

F. Client is certified by the agency and the client's physician as not being in need of acute care.

G. Client's physician or physician's associates are available 24 hours a day by phone or beeper or agrees that the home based care agency may refer the client to an emergency room for problems.

La. Admin. Code tit. 48, § I-13705

Promulgated by the Department of Health and Hospitals, Office of the Secretary, Bureau of Health Resources Management, LR 20:1011 (September 1994).

AUTHORITY NOTE: Promulgated in accordance with R.S. 36:256 et seq.