State health officials updated the Legislative Audit Council on Sept. 8 about corrective actions taken and planned after performance audits of Home- and Community-Based Services (HCBS) and intermediate care facilities for people with intellectual and developmental disabilities (ICF/DD).

Julie Foster Hagen, assistant secretary for the Office for Citizens with Developmental Disabilities, told the council that “many of our LDH field offices are currently meeting the goal of serving HCBS providers every 3 years,” and described a series of policy reviews, training plans and monitoring changes the department is implementing. Colin Brewer, long-term care manager in the Health Standards Section, said ICF/DDs will move to a CMS internet quality system in February 2026 and that the Health Standards Section has revised complaint categories “to track the allegations of noncompliance specifically related to abuse and neglect.”

Why it matters: The audits flagged problems in complaint handling, timely surveys, incident reporting and public access to provider deficiency information. Lawmakers pressed the department for dates, clearer metrics and evidence that it is both meeting recommendations and documenting where it cannot without additional resources.

Key updates and timelines
- Surveys and monitoring: LDH officials said several field offices are meeting the three‑year licensing survey cycle; they identified two offices with staffing turnover and said training of new surveyors is underway. Foster Hagen told the council that policies and interpretive guidance for support coordination monitoring will be updated in September, statewide training will follow in October, and the department plans to implement a revised support coordination monitoring process in January.
- Complaint categories and reporting: Brewer said Health Standards has revised complaint categories to better identify allegations of abuse and neglect and is tracking facility‑reported incidents that are not reported within the 24‑hour window required by law.
- Public posting of deficiency statements: LDH said statements of deficiencies are already publicly releasable on request and that providers are required under state rules to post their most recent statements on site. The department said it lacks funding to post all statements online and estimated—based on conversations with other states—that posting would require roughly six full‑time equivalent staff for manual review and redaction each year because review is necessary to avoid releasing protected health information. LDH said it did not receive appropriation for that work; subject to legislative funding it plans to begin posting certain statements July 1, 2026.
- Enforcement and sanctions: LDH told the council it disagreed with a recommendation to begin issuing fines for late facility reports because the step would require significant additional resources and likely statutory changes that were not authorized for 2025. The department said it is reviewing performance agreements with support coordinators and considering criteria for adverse actions.

Questions from lawmakers
Members repeatedly pressed LDH staff for more precise evidence. Senator Luno asked for hard numbers where the department used words such as “many,” and for dates and documentation showing which field offices meet the three‑year survey goal; LDH staff responded that three of the agency’s five field offices were on a three‑year rotation and two offices had experienced high turnover. Lawmakers asked LDH to provide the council the underlying documentation the department sends to auditors and its own internal monitoring results so the council can verify progress.

What remains unresolved
LDH said it will continue data comparisons of Medicaid emergency room claims to SIMS reports to detect critical incidents and will use Medicaid data to flag possible ICF/DD regulatory violations. The agency said it must ensure protected health information is not released publicly and that posting all statements of deficiencies would be resource‑intensive; it requested legislative appropriation if the Legislature wants LDH to implement statewide web postings.

Who spoke (selected)
Julie Foster Hagen, assistant secretary, Office for Citizens with Developmental Disabilities, Louisiana Department of Health (presenter)
Colin Brewer, long‑term care manager, Health Standards Section, Louisiana Department of Health (presenter)
Darren Guillory, operations manager, Health Standards Section, Louisiana Department of Health (present)
Senator Luno (council member, questioner)
Vice Chair Luna (roll call/motions)

Discussion vs. decisions
- Discussion: LDH described policy revisions, improved complaint categorization and an internal plan for training and monitoring. Council members pressed for supporting documentation and clearer, quantified commitments.
- Direction: Lawmakers asked LDH to provide the council with detailed documentation of completed and planned corrective actions, and to return with evidence of compliance and timetables.
- Formal action: The council did not take formal enforcement action at the meeting; it accepted the agency’s updates and requested additional documentation.

Clarifying details extracted from the hearing
- LDH estimated about 1,100 providers in some provider categories (ICFs + other provider types) that would need individual review to post statements online.
- Department staffing: LDH indicated it has five field offices for HCBS licensing; three of five met a three‑year survey rotation, two did not because of staff turnover.
- Posting costs: LDH said manual review and redaction to post provider statements online would likely require roughly six FTEs annually, according to state‑to‑state comparisons.
- Timetables: policy revisions by September 2025; statewide training in October 2025; new support coordination monitoring process implemented January 2026; website posting of certain statements contingent on appropriation beginning July 1, 2026.

Authorities referenced in the hearing
- Louisiana Revised Statutes (as cited in testimony) — referenced by LDH staff and witness statements regarding reporting and sanctions
- Local Government Budget Act — referenced by auditors in municipal discussions during the meeting
- CMS (Centers for Medicare & Medicaid Services) and QCOR/QC OR (CMS quality and oversight reporting) — referenced by LDH (ICF/DD quality reporting)
- SIMS (Safety Incident Management System) — referenced by LDH as the reporting system for incidents
- State administrative code citation referenced in testimony as “administrative code 48 I 5 0 1 9” (as cited by LDH staff)

Searchable tags: ["LDH","HCBS","ICF-DD","support coordination","provider deficiencies","SIMS","CMS","public posting","Louisiana Revised Statutes"]

Provenance:
- topicintro: transcript segment starting with the presenter invitation and introduction of LDH updates (excerpt: "Moving along, we're going to go to the follow-up on performance audit reports presented at the July 29, 2025, meeting. Louisiana Department of Health...")
- topfinish: transcript segment where LDH concluded its HCBS/ICF/DD updates and lawmakers finished questioning (excerpt: "That covers our updates to the HCBS audit... Do you guys have any questions?" )