Louisiana Legislative Auditor
Daryl G. Purpera, CPA, CFE

May 4, 2015

More Than 54,000 Waiting for Medicaid Home and Community-Based Services, Auditors Find

More than 54,000 Louisianans were waiting for Medicaid Home and Community-Based Services (HCBS) as of October 2014, according to a report released Monday by Legislative Auditor Daryl Purpera. The waivers are designed to provide the elderly and those who have developmental or physical disabilities to choose the services and supports that best suit their needs.

The report, compiled by LLA’s Performance Audit Services staff, is the third in a series of reports designed to establish a baseline of information as Louisiana shifts to a Medicaid managed care system for long-term care services. The two previous reports looked at nursing homes and intermediate care facilities for the developmentally disabled. These baseline reports will enable legislators and other stakeholders to evaluate the future impact of managed care in these areas.

The HCBS report also found that “the average wait times for waiver services ranged from 2.4 years to 10.4 years.” Wait times for programs for the elderly and individuals with physical disabilities averaged 3.4 years, while wait times for programs for individuals with developmental disabilities averaged 7.6 years. Both averages are higher than national averages. The national average wait time for waivers serving the elderly and individuals with physical disabilities is 10 to 13 months, and 3.9 years for individuals with developmental disabilities.

The average cost for HCBS programs ranged from approximately $21 to $135 per day per person. In comparison, nursing facility rates ranged from $139 to $187 per day and intermediate care facilities for the developmentally disabled rates averaged $160 per day. All six of Louisiana’s waiver programs have been cost-neutral for fiscal years 2012-2014, as federally required. This requirement dictates that the average per-person waiver costs must not exceed the average per-person costs of institutional care to those who require the same level of care.

The report also examined quality of care in the HCBS programs. DHH’s Health Standards Section is responsible for conducting surveys to determine provider compliance with state licensing requirements for the waiver programs. The most common provider deficiencies involved staffing issues. DHH also assessed financial penalties totaling more than $551,000 against HCBS providers between fiscal year 2011 and fiscal year 2014.

In addition, the report noted that AARP ranks Louisiana 37th in the nation in serving the elderly and individuals with physical disabilities in long-term care settings, while United Cerebral Palsy ranks the state 12th in serving individuals with developmental disabilities.

For more information contact:

Legislative Auditor
225.339.3800



###

Office of the Louisiana Legislative Auditor | www.LLA.La.gov