A. For the purpose of these CMA guidelines, the following definitions shall apply.
Abuse (adult/elderly)-the infliction of physical or mental injury, or actions which may reasonably be expected to inflict physical injury, on an adult by other parties, including but not limited to such means as sexual abuse, abandonment, isolation, exploitation, or extortion of funds or other things of value (R.S. 15:503).
Abuse (child)-any of the following acts which seriously endanger the physical, mental, or emotional health and safety of the child:
a. the infliction or attempted infliction, or, as a result of inadequate supervision, the allowance or toleration of the infliction or attempted infliction of physical or mental injury upon the child by a parent or any other person;
b. the exploitation or overwork of a child by a parent or any other person;
c. the involvement of the child in any sexual act with a parent or any other person, or the aiding or toleration by the parent or the caretaker of the child's sexual involvement with any other person or of the child's involvement in pornographic displays, or any other involvement of a child in sexual activity constituting a crime under the laws of this state (Childrens Code, article 1003).
Authorized Instructor-a registered nurse (RN), with a minimum of one-year experience working with people with developmental disabilities, who has completed the training for instructors, and has a current authorization by OCDD to teach the 60-hour medication attendant course.
CMA Applicant-an employee of an intermediate care facility for people with developmental disabilities or an in-home Medicaid home and community-based service who is enrolled in the 60-hour course curriculum.
Certified Medication Attendant (CMA)-the designation given an employee who has successfully completed the 60-hour course and passed the OCDD initial certification exam and has been issued a certificate by OCDD.
Department-the Department of Health (LDH).
Exploitation (adult/elderly)-the illegal or improper use or management of the funds, assets, or property of a person who is aged or an adult with a disability, or the use of power of attorney or guardianship of a person who is aged or an adult with a disability for one's own profit or advantage (R.S. 15:503).
Extortion (adult/elderly)-the acquisition of a thing of value from an unwilling or reluctant adult by physical force, intimidation, or abuse of legal or official authority (R.S. 15:503).
Falsification of Participant Medical Records-includes, but is not limited to, falsification of time, dosage, date, amount, and documentation of prescribed treatment that did not occur
Falsification or Alteration of CMA Certificate- includes, but is not limited to, altering expiration date, CMA name, OCDD coordinators signature, or attempting to use another persons certificate.
HCBS (Home and Community-Based Services)-one or more of the following services:
a. personal care attendant services-services required by a person with a disability in order to become physically independent or to remain in or return to the community;
b. respite care services-the temporary care and supervision of a person with a disability or an infirm elderly person so that the primary caregiver can be relieved of such duties. Respite care services may be performed either in the home of the person with a disability or infirm elderly person or in a facility owned by the home- and community-based service provider who provides respite care services. For the purposes of this Section, person with a disability shall mean a person with a physical, mental, or medical condition or an adult who requires assistance with activities of daily living;
c. supervised independent living services-necessary training, social services, and medical services to enable a person who has mental illness or who has developmental disabilities and who is living in congregate or individual apartments to live as independently as possible in the community;
d. family support services-advocacy services, family counseling, including genetic counseling, family subsidy programs, parent-to-parent outreach, legal assistance, income maintenance, parent training, homemaker services, minor home renovations, marriage and family education, and other related programs;
e. adult day care services-a group program designed to meet the individual needs of functionally impaired adults which is structured and comprehensive and which provides a variety of health, social, and related support services in a protective setting for a portion of the 24-hour day. The group program shall provide for 10 or more functionally impaired adults who are not related to the owner or operator of the home- and community-based service provider. For the purposes of this Section, functionally impaired adults shall mean individuals aged 17 years of age and older who are physically, mentally, or socially impaired to a degree that supervision is necessary;
f. substitute family care services-services providing 24-hour personal care, supportive services and supervision to adults who meet the criteria for having a developmental disability;
g. supported employment-a system of supports for people with disabilities in regards to ongoing employment in integrated settings. Supported employment can provide assistance in a variety of areas, including:
i. job development;
ii. job coaches;
iii. job retention;
iv. transportation;
v. assistive technology;
vi. specialized job training; and
vii. individually tailored supervision;
h. monitored in-home caregiving-services provided by a principal caregiver to a client who lives in a private unlicensed residence. The principal caregiver shall reside with the client, and shall be contracted by the licensed HCBS provider having a monitored in-home caregiving service module.
Home- and Community-Based Service Provider-an agency, institution, society, corporation, person or persons, or any other individual or group that provides one or more home- and community-based services as defined in this Section. The term home- and community-based service provider shall not include any of the following:
a. any person, agency, institution, society, corporation, group, or entity that solely prepares and delivers meals, that solely provides sitter services, or that solely provides housekeeping services;
b. any person, agency, institution, society, corporation, group, or entity who provides gratuitous home-and community-based services;
c. any individual licensed practical nurse or registered nurse who has a current Louisiana license in good standing, and who provides personal nursing services in the home to an individual, provided that the nurse has contracted with the individual or family for such services and payment of such services;
d. staffing agencies which supply contract workers to a health care provider licensed by the department;
e. any person who is employed as part of a department authorized self-direction program (R.S. 40:2120.2).
ICF/DD (Intermediate Care Facility for People with Developmental Disabilities)-an institution (or distinct part of an institution) that:
a. is primarily for the diagnosis, treatment, or rehabilitation of people with developmental disabilities or persons with related conditions; and
b. provides, in a protected residential setting, ongoing evaluation, planning, 24-hour supervision, coordination, and integration of health or rehabilitative services to help each individual function at his or her greatest ability (CMS 42 CFR 435.1009).
Institutional Abuse or Neglect-any case of child abuse or neglect that occurs in any public or private facility that provides residential child care, treatment, or education (Childrens Code, article 603).
Misappropriation of Property-to take possession, without permission, of any and all of an individuals personal belongings.
Neglect (adult/elderly)-the failure, by a caregiver responsible for an adult's care or by other parties, to provide the proper or necessary support or medical, surgical, or any other care necessary for his/her well-being. No adult who is being provided treatment in accordance with a recognized religious method of healing in lieu of medical treatment shall, for that reason alone, be considered to be neglected or abused (R.S. 15:503).
Neglect (child)-the refusal or failure of a parent or caretaker to supply the child with necessary food, clothing, shelter, care, treatment, or counseling for any injury, illness, or condition of the child, as a result of which the child's physical, mental, or emotional health and safety is substantially threatened or impaired. Whenever, in lieu of medical care, a child is being provided treatment in accordance with the tenets of a well-recognized religious method of healing which has a reasonable, proven record of success, the child shall not, for that reason alone, be considered to be neglected or abused. Disagreement by the parent regarding the need for medical care shall not, by itself, be grounds for termination of parental rights. However, nothing herein shall prohibit the court from ordering medical services for the child when there is substantial risk of harm to the child's health or welfare (Childrens Code, article 1003).
Office-the Office for Citizens with Developmental Disabilities (OCDD).
Supports and Services Center-a state ICF/DD operated by the Office for Citizens with Developmental Disabilities.
Waiver Program Services-other services approved by the Centers for Medicare and Medicaid Services for home-and community-based waivers for the Louisiana Medicaid Program.
La. Admin. Code tit. 48, § IX-903