HJBR Jan/Feb 2023

HEALTHCARE JOURNAL OF BATON ROUGE I  JAN / FEB 2023 29 receive home- and community-based servic- es through the LDH Office of Aging and Adult Services (OAAS). Home- and community-based programs are a critical resource for Louisiana’s vulner- able population. The Community Choices Waiver (CCW) provides Medicaid in-home and community-based services as an alterna- tive to nursing home care for older adults and people who acquire a disability in adulthood. In 2017, the Registry for Community Choices Waiver had surpassed 29,000, with a 10-year wait for services. Long waiting lists put individ- uals waiting for services at high risk of nursing facility placement and make them susceptible to more expensive forms of care if their sup- port needs are not addressed within reason- able timeframes. Successful home- and community-based services rely on the availability of a competent and qualified workforce to help our vulnera- ble Louisiana residents remain living in their homes and communities. One major obsta- cle in accessing quality home- and communi- ty-based services is the shortage of qualified direct support professionals. Nationally and in Louisiana, the direct support professional workforce is shrinking while demand and need are increasing as more and more residents who need assistance choose to remain living at home. Without a qualified workforce for home- and community-based services, many Louisiana residents who are in our most vul- nerable populations will be at increased risk of not being able to remain living in their homes. Prior to the COVID-19 pandemic, many states, including Louisiana, were looking for opportunities to increase access to technol- ogy-based supports and assistive technology for people with intellectual and developmen- tal disabilities. This included technology- based support in the Developmental Disabili- ties Services System, which could broaden opportunities for social connections and build independence by meeting day- to-day needs within home, school, and work settings, while preserving an ability to monitor and respond should additional support be needed. Sec- tion 9817 of the American Rescue Plan Act of 2021 allowed for an opportunity to en- hance and expand activities in home- and community-based services. Many Louisiana residents, including those with intellectual and developmental disabilities, have limited access to technology, such as the internet. As an initial step toward building technology with remote support into the Developmental Dis- abilities Services System, LDH received CMS approval to use American Rescue Plan fund- ing to increase the availability of assistive technology for people in OCDD home- and community-based waivers. Goal 1: Increase the Community Choices Waiver response rate by 5%. Goal 2: Offer the Community Choices Waiver within 60 days of the date of request to those waiting with no other OAAS home- and community-based support. Strategy: Having successfully eliminated the wait for services for people living with devel- opmental disabilities, LDH now aims to extend access to the older adult population. LDH will focus on improving the waiver process — from initial request for services to approval for ser- vices — to increase the speed with which ser- vices can be provided, which will improve indi- viduals’ healthcare and quality of life. OAAS, through legislative approval during the 2022 Regular Session, received 250 new CCW slots. These new slots will enable OAAS to quickly offer new CCW opportunities to in- dividuals waiting for services. OAAS will also assess current practices to ensure effective communication between OAAS and individuals requesting servic- es. Based on the results of this assessment, OAAS will modify its offer delivery process to ensure individuals with an opportunity to re- ceive CCW are notified as efficiently as pos- sible, and that the agency receives a timely response. The FY22 CCW response rate was 40%. Goal 3: Reduce turnover rate of OAAS direct support professionals by 2.5% by the end of FY23. Goal 4: Reduce turnover rate of OCDD direct support professionals by 2.5% by the end of FY23. Strategy: LDH is assisting direct service pro- viders in their efforts to recruit and retain staff by providing rate increases and retention Commitment 2 / Initiative 5 / Goal 1 Commitment 2 / Initiative 6 / Goal 1 & 2 Commitment 2 / Initiative 6 / Goal 3 & 4