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LOUISIANA STATE PROFILE

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STATE TASK FORCE*

Louisiana has no active Autism Task Force at this time.

STATE INSURANCE COVERAGE*

On July 1, 2008, Governor Bobby Jindal signed H.B. 958 into law a mandate requiring health insurance coverage for the diagnosis and treatment of autism spectrum disorders in individuals under the age of 17. Covered services include habilitative or rehabilitative care; pharmacy; psychiatric and psychological care, and therapeutic care, including applied behavior analysis. Individual and group plans of fifty employees or less are exempted. Benefits are subject to a maximum of $36,000 per year and a lifetime benefit of $140,000 per year. La. Rev. Stat. Ann. § 22:1050 (2008 La. Acts, P.A. 648; HB 958 of 2008: Fiscal Note)

On June 28, 2012, Gov. Bobby Jindal signed H.B. 771 to expand Louisiana's autism insurance reform law. The cap was raised to 21 years of age, and the $144,000 cap on lifetime benefits was removed. Also, families paying expensive insurance premiums can start continuing coverage for the screening, diagnosis, and treatment of autism spectrum disorder for children ages 16-20, beginning in 2013. 2012 La. Acts, P.A. 208 (2012 House Bill 771: Fiscal Note)

MEDICAID*

Louisiana Home and Community-Based Services Waiver: LA New Opportunities Waiver
Implemented on July 1, 2011 this waiver helps people ages 3 and above with developmental disabilities, including autism, who meet the ICF/MR level of care to remain living at home and in their community. Services provided include: center-based respite, day habilitation, employment related training, supported employment, supported living, skilled nursing, specialized medical equipment and supplies, community integration and development, environmental accessibility adaptations, individual and family support, one-time transitional, PERS, professional services, and substitute family care. This waiver expires on June 30, 2016.

Louisiana Home and Community-Based Services Waiver: LA Supports Waiver
This waiver, implemented on July 1, 2009, provides day habilitation, habilitation, prevocational services, respite, support coordination, supported employment, and PERS for individuals 18 and older with autism, mental retardation, and developmental disabilities. This waiver expires on June 30, 2014.

Louisiana Home and Community-Based Services Waiver: LA Children's Choice
This waiver, implemented on February 21, 2009, provides center-based respite care, support coordination, environmental accessibility adaptations, family support service, and family training for individuals up to age 18 with autism, mental retardation, and developmental disabilities. This waiver expires on February 20, 2014.

Louisiana Home and Community-Based Services Waiver: LA Supports Waiver
This waiver, implemented on July 1, 2009, provides day habilitation, habilitation, prevocational services, respite, support coordination, supported employment, and PERS for individuals 18 and older with autism, mental retardation, and developmental disabilities. This waiver expires on June 30, 2014.
http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/Waivers.html

 

EDUCATION*

H.B. 670 was introduced for the Louisiana Department of Health and Hospitals to manage services for individuals with autism and to establish a center of excellence for autism spectrum disorder within the Louisiana Office for Citizens with Disabilities and operated by the Louisiana Department of Education and related agencies, such as Louisiana State University Health Sciences Center. The center will support services for individuals with autism spectrum disorders and provide training to educators of individuals with autism. Services include early diagnosis and intervention, and education. The legislation was signed by Gov. Bobby Jindal on June 12, 2008.

OTHER STATE FUNDING*

In April 2009, Rep. Patrick Williams introduced H.B. 516 to establish the Center of Excellence for Autism Spectrum Disorder Fund and the Walking the Walk for Our Kids Fund in the state treasury. The former would be used to establish and operate a center of excellence for autism spectrum disorders. The latter would treat and prevent childhood obesity. The bill was passed by the Senate and the House but was vetoed by the governor on July 7, 2009 on the grounds that these funds were contingent upon the passage of legislation that had failed.

STATE'S TOTAL FISCAL EFFORT FOR I/DD SERVICES **

Fiscal Effort is a ration that can be utilized to rank states according to proportion of their total statewide personal income devoted to financing of I/DD services.

Louisiana ranks 13th 

Fiscal Effort is defined as a state's spending for I/DD services per $1000 of total statewide personal income.

Louisiana I/DD spending per $1000 of state aggregate personal income is $5.13; the United States average is $3.81.

 

SUMMARY OF SERVICES * * *

Services and supports for people with ASD

 

The Louisiana OCDD serves as the lead agency and single point of entry into the developmental disabilities services system for individuals with ASD across the lifespan. In addition to managing

the home- and community-based waiver programs, OCDD oversees public and private residential and nonresidential services, administers Individual and Family Supports and Flexible Family Funds, and manages the state’s Community Support Teams.

 

• The Individual and Family Supports program provides state-funded services that are not available from any other resource to allow people with developmental disabilities to live in their own homes or with their families. Many individuals who are on the RFSR waitlist receive this support. The funding is flexible and provides for services such as personal care, respite, equipment, and rent/utilities (Office for Citizens with Developmental Disabilities, n.d.[b]).

 

• The Flexible Family Fund program is intended to assist families of children from birth to age 18 with the most severe disabilities. The program provides a monthly stipend of $268, which can be used on any number of services and supports to help children remain in their home. There is currently a waitlist for these funds. Both the Individual and Family Supports and Flexible Family Fund program have been in existence for more than  20 years; Louisiana was one of the first states to pass community and family supports legislation (Office for Citizens with Developmental Disabilities, n.d.[b]).

 

• OCDD also manages nine Community Support Teams that provide supports and services to people with developmental disabilities who need intensive treatment intervention to remain in their community setting. The teams provide initial and ongoing assessment, psychiatric services, family support and education, support coordination, and other services critical to an individual’s success. Services are provided in the community rather than in an office-based setting and combine skill teaching and clinical management (Office for Citizens with Developmental Disabilities, 2013).

 

Early intervention

 

OCDD is home to Early Steps—Louisiana’s early intervention program. Early Steps provides IDEA Part C services to families and children from birth to age 3 who have developmental delays or a medical condition likely to result in a developmental delay. Children with a delay of 1.5 standard deviations from the mean in two areas of development are eligible for services, including cognitive, motor, vision, hearing, communication, social-emotional, or adaptive development. The program receives approximately 10,000 to 11,000 referrals each year from a variety of sources, most commonly families, physicians, and the referral hotline. Early Steps services are provided in the child’s natural environment, such as the home, childcare, or another appropriate community setting, and include:

 

• Assistive technology

• Audiology

• Health services

• Medical services (evaluation only)

• Nutrition services

• Occupational, physical, and speech therapy

• Psychological services

• Service coordination

• Social work services

• Special instruction

• Transportation (to and from Early Steps services only)

• Translation interpreter services (foreign language and sign language)

• Vision services (Office for Citizens with Developmental Disabilities, n.d.[a])

 

School-aged children

 

The Louisiana DOE provides special education services for all children aged 3–21 with

disabilities. Programs and services are provided by local school districts according to a student’s

Individualized Education Program (IEP) and include:

 

• Adapted physical education

• Assistive technology

• Extended school year

• Games Uniting Mind and Body

• Homebound services

• Occupational, physical, and speech/language therapy in the educational setting

• Orientation and mobility

• School psychology

• School social work

• Transition services

• Educational interpreter services

• School-based Medicaid services (Louisiana Department of Education, n.d.[a])

 

The Louisiana State University Human Development Center (HDC) has partnered with DOE to run the Louisiana Autism Spectrum and Related Disabilities (LASARD) Project. The goals of the LASARD Project are to (1) improve educational practices and outcomes for students with ASD and related disabilities and (2) develop statewide capacity to provide high quality educational programs for these students. Currently, nine school districts participate in the project, each of which contracts directly with HDC for training and technical assistance from LASARD facilitators. In addition, the LASARD Project is developing the Louisiana Autism Quality Indicators for Schools, a tool that will help schools evaluate and improve the quality of their programs for students with ASD. To complement the assessment tool, the LASARD Project is developing ASD-specific electronic professional development modules focused on key areas such as:

 

• Transition Practices for Students with ASD

• Assistive Technology

• Behavior Intervention Practices for Students with ASD and Related Disabilities

• Communication

• Inclusive Practices for Students with ASD and Related Disabilities

• Collaboration & Teaming

• Social Skills Instruction for Students with ASD and Related Disabilities 

• Curriculum and Instruction

• Environment Supports for Students with ASD and Related Disabilities (Louisiana State University Human Development Center, 2012)

 

Adults

 

In addition to services provided through OCDD, the LRS works with adults aged 18 and older with disabilities to obtain or maintain employment and achieve independence in their communities. The LRS has eight regional offices throughout the state through which many services are provided. They also contract with Community Rehabilitation Programs to provide more intensive services, such as supported employment. Rehabilitation counselors and clients develop an Individual Plan for Employment, which combines the professional expertise of counselors with the needs and choices of clients. Some of the services offered through the regional LRS include:

 

• Vocational evaluations

• Vocational guidance and career counseling

• Job placement

• Training up to and including college

• Assistive technology (e.g., computers, software)

• Personal assistance services (e.g., personal care attendant, scribe, reader, interpreter)

• Books and supplies

• Transportation

• Mental health counseling

• Transition services (Louisiana Rehabilitation Services, 2011)

 

To be eligible, individuals must meet the following federal criteria: (1) have a physical or mental disability which results in a substantial impediment to employment; (2) be able to benefit from

vocational rehabilitation services in terms of employment; and (3) require vocational rehabilitation services to prepare for, enter, engage in, or retain gainful employment (Louisiana Rehabilitation Services, 2011). Due to budget constraints, LRS operates under an Order of Selection; individuals must meet Category 1 of 5 (having the most significant needs) in order to receive services. This requires functional limitations in at least four out of eight areas. Most individuals with ASD fall into this category; in 2011, 348 out of the 393 individuals with ASD referred to LRS were in Category 1. Moreover, 123 of these individuals received supportive employment services. It is important to note that some individuals with autism may not have been categorized as having ASD because their primary diagnosis is something else.

 

Promotion of services and supports for people with ASD

 

Individuals and families learn about services and supports for ASD through several channels. As efforts for early identification and screening improve, knowledge of and entry into the service system begin at a younger age. Early Steps has regional community outreach specialists responsible for coordinating activities and events to increase awareness of developmental delays and early intervention services. Additionally, the Louisiana Developmental Disabilities Council provides funding to Families Helping Families (FHF; http://www.fhfgbr.org/), a predominately parent-run organization that provides information, referral, education, and training for families and individuals with disabilities. FHF has 10 regional centers throughout the state that coordinate outreach events, advertise services, and conduct other activities to spread the word about supports, services, and issues related to disabilities.  Early  identification and connection to services is a continuous struggle, particularly in rural areas. The Louisiana Developmental Disabilities Council 5-year strategic plan outlines funding and technical assistance to increase capacity of the regional FHF centers as well as efforts to educate hospitals and health care providers on available resources to individuals with developmental disabilities.

 

Transitions and coordination of services

 

Early intervention to school

 

Transition from early intervention to school occurs according to the requirements of the Individuals with Disabilities Education Act (IDEA). Transition is discussed at every opportunity as soon as a child is eligible for early intervention services. As a child nears his or her third birthday, a notification is sent to the local educational agency (LEA), and the early intervention coordinator and family discuss services in more detail. This can involve in-person meetings with the transition coordinator and visits to school programs. By the child’s third birthday, an official transition conference takes place in which a representative from the LEA attends. The family, LEA representative, transition coordinator, service providers, and others discuss necessary and available services and supports. Additionally, the family determines what information will be exchanged between early intervention and school staff.

 

School-aged to employment

 

Transition services for individuals leaving school begin by age 16 or earlier as required by IDEA. This includes development of the transition services plan, a coordinated effort among the student, parents, schools, and adult service providers to achieve a desirable future for the student. The Louisiana Transition Services Web site is available as a guide for students, families, educators, and service providers to improve post school outcomes for students with disabilities (Louisiana Department of Education, n.d.[b]).

Transition services from school to employment are in need of improvement. Louisiana does not provide the state match due to lack of funds to draw down all available federal dollars for vocational rehabilitation. Consequently, employment services in the schools are lacking and students are often placed in sheltered workshops, rather than integrated employment settings.

 

Long-term plans to develop new or expanded supports and services (2–5 years)

 

Louisiana is one of 23 states participating in the State Employment Leadership Network, a joint initiative of the National Association of State Directors of Developmental Disabilities Services. In July 2011, the OCDD, along with several state partners, launched an Employment First Initiative with the goal of improving the lives of people with disabilities by promoting employment (Office for Citizens with Developmental Disabilities, 2011). The official position statement of OCDD is as follows: “Employment will be the primary outcome for all persons receiving OCDD services who are of working age. Employment is characterized by typical jobs with competitive compensation that are fully integrated into the workplace. A more thorough implementation statement with further detailed definitions, desired outcomes and operational procedures will be released as they are finalized.” Accordingly, OCDD has set targets for all of their regionals offices to improve employment outcomes for individuals with disabilities. Additionally, the Louisiana Developmental Disabilities Council, the DOE, and the LRS are currently meeting to discuss how to improve transition to more integrated employment for students with disabilities. 

 

Types of Service(s) Offered

State Profiles

Additional Information

* This information is excerpted from the 2011 State Autism Profiles. Visit the Easter Seals website for the complete profiles.

**This information is excerpted from the State of the States: http://www.stateofthestates.org/ Source: Braddock, D., Coleman Institute and Department of Psychiatry, University of Colorado, 2013

***This information is excerpted from Autism Spectrum Disorders (ASD) State of the States of Services and Supports for People with ASD 2014 

 

 

 

 

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