The department must change Medicaid and related rules to expand prenatal and infant health access, simplify eligibility, set service standards, and develop training and provider-recruitment programs, but only if it can finance the expansion with self-generated revenues.
§447.2. Pregnant women and infants; access to health care; expansion of Medicaid eligibility A. The legislature hereby finds and declares that: (1) Early, high quality, comprehensive prenatal care is the most effective means for reducing the state's rate of infant mortality. Despite this finding, the legislature has determined that universal access to prenatal care has not been achieved in Louisiana. (2) It is the intent of the legislature that certain pregnant women and infants, regardless of their economic status, geographic location, or ethnic background, have access to appropriate healthcare services. B. The department shall amend the Medicaid state plan to provide for: (1) Eligibility for Medicaid services for all pregnant women with an income of up to one hundred eighty-five percent of the applicable federal poverty guideline as published in the Federal Register by the United States Department of Health and Human Services. (2) Eligibility criteria for Medicaid services for pregnant adolescents based on the income of the pregnant adolescent and not on the income of her parents. (3) A program of care coordination for high-risk pregnant women. The care coordination program shall include the following components: (a) Manageable case loads, outcome evaluations, and home visitations. (b) Risk assessments to identify priority needs and areas of the state. (c) A full range of family services. (d) Maximum utilization of federal matching funds through block grants and entitlement programs. (e) The use of skilled professional and trained volunteers as part of community-based care coordination teams. (f) Utilization of the private sector's resources or the establishment of public and private partnerships. C. The department shall establish procedures to simplify the Medicaid eligibility process. At a minimum, these procedures shall include: (1) A simplified application form on which applicants may provide all of the information necessary to determine eligibility for Medicaid. (2) Provisions for receipt and initial processing of applications for medical assistance at locations which are frequented by persons likely to be eligible for services. D. The department shall promulgate regulations requiring that all public health programs which render prenatal, postpartum, or infant healthcare services shall provide at a minimum for the following: (1) Expanded or flex-time hours of operation so that healthcare services are available to pregnant women and children during evening and weekend hours. (2) An initial appointment within two weeks of request and minimal waiting time to receive services after entering a healthcare facility. (3) Procedures to assure that pregnant women are receiving and continue to receive prenatal services. E. The department shall develop and implement: (1) A program to enhance the courteous and professional delivery of health services through staff training and effective personnel recruitment and retention policies. This program shall include staff development programs to improve cultural sensitivity and interpersonal skills as well as training in providing specialized assistance to women who have low literacy skills or for whom English is a second language. (2) A program to develop innovative recruitment techniques to enroll private providers in the Medicaid program. F. The provisions of this Section shall not be implemented unless the department can finance the expansion through self-generated revenues. Acts 1992, No. 790, §1; Acts 2018, No. 206, §5.