Home and Community Based Service Providers (HCBS)

Add or Delete a Service Module

A licensed HCBS provider may request approval from Health Standards to add or delete service modules.

Home and Community Based Services (HCBS) providers may offer one or more of the following service modules:

  1. Personal Care Assistant (PCA) *
  2. Respite Care*- In Home or Center Based
  3. Supervised Independent Living (SIL) *
    1. SIL Shared Living Conversion
  4. Adult Day Care (ADC)
  5. Family Support
  6. Substitute Family Care (SFC)
  7. Supported Employment
  8. Monitored In Home Care (MIHC) *

* MIHC, PCA, Respite Care and SIL require Facility Need Review approval prior to submitting an application to Health Standards to add one or more of these services.  The FNR approval letter must accompany the application submitted to Health Standards.


Steps to Add or Delete a Service Module

  1. Complete HCBS license application.
  2. Mark "X" next to "Add a Service or Delete a Service".
  3. Mark "X" next to service module(s) you are adding or deleting in the section titled "Service Modules".
  4. Submit the completed application form and FNR approval letter(s) if applicable to:

    Health Standards Section
    P.O. Box 3767
    Baton Rouge, LA 70821


Applicable Fees:

$200 if adding ADC
$200 if adding Center-Based Respite

There is a $25 license print fee to add other service modules.

Fees must be in the form of certified check, company check, or money order made payable to the Louisian Department of Health. Fees shall be submitted in accordance with the HSS Payment Procedure found at: http://dhh.louisiana.gov/index.cfm/page/1737 .

Please refer to the HCBS Providers Minimum Licensing Standards published in the Louisiana Register for service module definitions, general provisions and operational requirements. A link to the regulations and HCBS program desk contacts are located on the HCBS home page.