Title V in Louisiana facilitates high-quality services and innovative practices that protect and promote the health of women, children, and children and youth with special health care needs (CYSHCN). Housed within the Louisiana Department of Health (LDH), Office of Public Health (OPH), Bureau of Family Health (BFH), Title V leads state efforts to improve health outcomes for these populations, in partnership with others in- and outside of government. BFH works to improve population health and strengthen health system capacity by:

• Monitoring data to identify, understand, and respond to complex challenges and opportunities
• Aligning efforts and resources to improve community health
• Testing, scaling, and spreading evidence-based solutions and best practices
• Building coordinated partnerships to advance system-level goals

 

Like other states, the health and well-being of women, children, and families in Louisiana is influenced by the strengths, challenges, and changes in state and local community systems. Louisiana Title V continues to adapt and respond to changes within these complex systems while increasing the state’s capacity to monitor population health and inform healthcare policy and practice.

 

The following sections describe the most significant changes that have occurred in recent years in the state and the healthcare system.

Understanding the Health Status and Needs of the MCH Population in Louisiana

Louisiana Overview:

The Place: Louisiana is the 31st largest state in the country, covering an area of 43,204 square miles along the Gulf of Mexico (Map 1). Louisiana consists of flat lowlands located on the coastal plain of the Gulf of Mexico and the Mississippi River’s alluvial plain. The economy is heavily dependent on its fertile soils and water to support farming and fishing industries. Louisiana also is one of the leading producers of natural gas and petroleum.

Of Louisiana’s 64 parishes (counties), 30 are considered rural per the U.S. Health Resources and Services Administration.1 The largest urban centers include New Orleans and Baton Rouge. Hurricanes, industrial contamination, and loss of wetlands threaten the economy, safety, and well-being of Louisiana’s communities and residents. Significant historical events in the past decade include severe flooding in 2016; tornados and flooding due to Hurricane Harvey in 2017, Hurricanes Laura, Delta, and Zeta in 2020, and Hurricane Ida in 2021.

The People: Louisiana’s population of about 4.6 million people encompasses a distinct multicultural and linguistic landscape that has been influenced by centuries of colonialism and servitude. Today, the majority of the population in Louisiana identifies as White (62.4%).2 Thirty-three percent of the population identify as Black, 5.6% identify as Hispanic/Latino, 1.9% identify as Asian, 1.8% identify as two or more races, and 0.8% identify as American Indian/Alaskan Native, with four federally recognized American Indian tribes and ten state/local tribes.2, 3 Nearly four out of every five residents were born in-state.2 A sizable majority (86%) of the state population self-identifies as religious, and nearly half of all Louisiana adults attend religious services at least once per week.4 The state is known for its strong community bonds and boasts some of the longest-lasting cultural traditions in the United States.

Unique Challenges and Strengths Impacting the Health Status of the MCH Population

There are many challenges and strengths present in Louisiana’s systems, politics, and communities that affect the health and wellbeing of the state’s maternal and child population. The Louisiana Title V Program identifies these challenges and strengths through the lens of the social determinants of health (SDOH): the conditions in which people are born, live, learn, work, and play. Specifically, social and community context, economic stability, education, neighborhood environments, and health and healthcare all pose various challenges and opportunities for health.

 

 

Louisiana’s history of colonization, slavery, and legalized racism disempowered and oppressed portions of Louisiana’s population over multiple centuries. While laws and policies have changed over time, these historical inequities continue to take a significant toll on communities in the state and are perpetuated – often unknowingly. The resulting, persistent racial disparities can be best interpreted in light of the conditions in which people are born and live--conditions largely affected by historical and institutional structures and policies that uphold differential access to resources and systems of influence and authority.

Economic instability poses a major challenge to the attainment of health for many Louisianans. In 2021, the share of Louisianans living at or below the Federal Poverty Level was the highest in the nation at 19.6%, with 26.7% of all children (under age 18) living in poverty.5  Women in Louisiana are more likely to live in poverty than men (21.5% vs. 17.6%), and Black (31.9%) and indigenous (20.6%) households are more likely to live in poverty than Asian (18.8%) or white (12.4%) households.5 The median household income in Louisiana is $52,087 (inflation adjusted 2021 dollars) – just 73.5% of the national median household income of $70,800.5 Low educational attainment is another challenge. Adults in Louisiana are less likely to finish high school than their peers across the US (13.8% vs. 11.1%).2 Conditions of poverty pose unique challenges for CYSHCN families. For parents and caregivers with CYSHCN, full-time employment means less time spent coordinating care for their children, and out-of-pocket medical expenses for this population are more extensive than those of non-CYSHCN, regardless of insurance coverage. 

Louisianans consistently experience poorer health outcomes compared to the rest of the nation. According to America’s Health Rankings 2022, Louisiana ranked 50th in the nation in overall health.6 Low birth weight (LBW), preterm birth (PTB), infant mortality, maternal mortality, and CYSHCN status remain significant challenges for the MCH population. Compared to the national average, Louisiana has a higher proportion of CYSHCN. Approximately one in four (23.2%) children in Louisiana ages 0-17 have a special health care need.7Louisiana has the second highest infant mortality rate in the US at 7.59 infant deaths per 1,000 live births8. Similar to nationwide trends, Black infants in Louisiana die at twice the rate of White infants. The state’s maternal mortality rate is also among the highest in the US. Significant racial disparities show that Black women are almost twice as likely to die from pregnancy-associated causes than White women. This disparity was even greater for pregnancy-related deaths.9 Drug and opioid abuse are growing areas of alarm. From 2019 to 2021, opioid-involved deaths increased by 134%, from 588 to 1378.9 Neonatal Opioid Withdrawal Syndrome (NOWS) is also a growing concern. Based on hospital discharge data, there were 360 cases of NOWS in Louisiana in 2017, representing an almost 50% rise from 2012 numbers.

Mental Health: According to the National Alliance on Mental Illness (NAMI), 715,000 adults in Louisiana have a mental health condition and 179,000 adults have a serious mental illness.11 In February 2023, 39.1% of adults in Louisiana reported symptoms of anxiety and/or depression, compared to 32.3% of adults nationally.12 Louisiana’s Adverse Childhood Experiences (ACE) rate is one of the highest in the nation. Nearly 19% of Louisiana children age 0-17 have experienced two or more ACEs, compared to 14% nationally.6 Suicide is another concern for children and young adults. According to the American Foundation for Suicide Prevention, suicide is the 3rd leading cause of death for Louisianans aged 10-24 and 25-34 .13 Mothers are also at risk for mental health issues. More than one in seven (16.8%) of Louisiana mothers experienced postpartum depression symptoms.14

Mental health care access remains a challenge for many in Louisiana. In February 2021, 47.5% of adults in Louisiana reported symptoms of anxiety or depression. 18.6% were unable to get needed counseling or therapy.11 Furthermore, of the 44,000 Louisianans age 12–17 who have depression, 62.3% did not receive any care in the last year.11 As of March 2023, Louisiana has 171 Mental Health Care Professional Shortage Areas (MHCPSA) as designated by the HRSA’s Bureau of Health Workforce. More than 3.6 million Louisianans live in areas without enough mental health services.15

Health Care Coverage: Historically, Louisiana had one of the highest uninsured rates in the nation. In July of 2016, Medicaid was expanded to all adults under 138% of the federal poverty line (FPL) (children were not part of this expansion population because children in that income range are already eligible for public insurance coverage). With that change in health policy, Louisiana experienced one of the largest reductions in the uninsured rate for any state. With the expansion of Medicaid, more than 516,000 adult men and women have gained health care coverage under public insurance. With the inclusion of the expansion population, Medicaid is now responsible for approximately 1.5 million child and adult participants in Louisiana.16 Furthermore, Medicaid expansion has had a significantly positive impact on Louisiana’s economy: within the first year of Medicaid expansion, more than 19,000 new jobs were created and $178 million in new state and local revenues were generated.17 Economic gains are expected to continue, with the state projected to save $1 billion by 2028 due to Medicaid expansion.18

Another strength in Louisiana is the long-standing commitment to facilitating healthcare coverage for children. Louisiana has achieved and sustained high rates of coverage for children. Between 2009 and 2016, the percentage of uninsured children decreased from 7% to 3%, and this decrease has been sustained for several years.17 More than half of CYSHCN in Louisiana have public insurance which is higher than the national average.19

Louisiana's early care and education system has also undergone significant change in an effort to better serve the state's families. Child care licensing was unified with other early education programs under the Louisiana Department of Education in 2015 in order to create a cohesive early childhood system and improve school readiness. This system has continued to stabilize and mature, though access to childcare subsidies remains more limited than a decade ago.  According to the State of Babies Yearbook 2022, Louisiana lags behind the national averages for every measure associated with positive early learning experiences.20

Louisiana has one of the highest incarceration rates in the world. According to the Prison Policy Initiative, 1,952 people per 100,000 are detained in prisons, jails, immigration detention, and juvenile justice facilities, compared to 566 nationally).21 This rate is impacted by sentencing laws for non-violent offenses, insufficient funding of jails and prisons, privatization of facilities, and a lack of investment in services and supports. Under Governor Edwards, the state has begun efforts to reform the criminal justice system. While these changes are promising, additional reform is necessary.

State Health Agency Priorities and Influence on Title V Service Delivery

Defined Roles and Responsibilities of the State Health Agency:

The Louisiana Department of Health includes the Office of the Secretary; Office of Aging and Adult Services; Office of Behavioral Health; Office for Citizens with Developmental Disabilities; Bureau of Health Services Financing (Medicaid); Office of Public Health; Office of Women’s Health and Community Health; five 24-hour healthcare facilities; Legal, Audit, and Regulatory Compliance; nine Human Services Districts and Authorities (HSDAs); Louisiana Emergency Response Network; and the Developmental Disabilities Council.

• The Office of the Secretary (OS) is comprised of LDH’s Executive Management Team as well as the teams that handle centralized LDH functions, including internal and external communications; legislative and governmental relations; policy and QI; human resources; training and staff development; legal, audit, and regulatory compliance; finance; and budget.
• The Office of Aging and Adult Services (OAAS) develops, provides, and enhances services that offer meaningful choices for people in need of care in long-term care facilities and in-home and residential settings through home- and community-based services.
• The Office of Behavioral Health (OBH) manages and delivers the services and supports necessary to improve the quality of life for residents living with mental health challenges and substance-related and addictive disorders. This program office monitors and serves as subject matter consultant for the children’s Coordinated System of Care program and the Medicaid Healthy Louisiana managed care plans, which manage behavioral health services. OBH also delivers direct care through hospitalization and has oversight of behavioral health community-based treatment programs through the HSDAs. Services are provided for Medicaid and non-Medicaid eligible populations.
• The Office for Citizens with Developmental Disabilities (OCDD) serves as the single point of entry into the developmental disabilities services system, overseeing public and private residential services and other services for those living with developmental disabilities. This program office works to ensure individuals living with developmental disabilities and their families have access to a seamless services system that is responsive to both individual needs and desires. In addition, OCDD promotes partnerships and relationships which empower people living with developmental disabilities’ inclusion in family and community social and economic life.
• Medicaid provides government-subsidized medical benefits to qualifying low-income individuals and families. Although the federal government establishes the general rules for Medicaid, specific requirements are established by each state. In Louisiana, more than 1.9 million residents receive healthcare coverage through Medicaid.
• The Office of Public Health (OPH) is responsible for protecting and promoting the health and wellness of all individuals and communities in Louisiana. OPH accomplishes this through educational initiatives, promoting healthy lifestyles, preventing disease and injury, enforcing regulations that protect the environment, sharing vital information, and assuring preventive services to uninsured and underserved individuals and families. This office also monitors the food Louisiana’s residents and visitors eat; keeps our water safe to drink; fights chronic and communicable disease; ensures we are ready for hurricanes, disasters, and other threats; manages, analyzes, and disseminates public health data; ensures access to vital records like birth certificates; and improves health outcomes with an emphasis on preventive health services.
• The Office of Women’s Health and Community Health (OWHCH) was created by Act 676 (SB 116) of the 2022 Regular Legislative Session, and signed by Governor John Bel Edwards on June 18, 2022. OWHCH will serve as a clearinghouse, coordinating agency, and resource center for women’s health data and strategies, services, programs, and initiatives that address women’s health-related concerns. This office will focus on health needs throughout a woman’s life, including chronic or acute conditions that significantly affect women, access to healthcare for women, and women’s health disparities. OWHCH also includes the Bureau of Community Partnerships and Health Equity (BCPHE), which is charged with developing and implementing agency-wide health equity plans, protocols, and tools that support the implementation of health equity and community engagement practices and standards across LDH.
• LDH also operates five 24-hour healthcare facilities. These facilities include the Central Louisiana State Hospital, Central Louisiana Supports and Services Center, Eastern Louisiana Mental Health System, Pinecrest Supports and Services Center, and the Villa Feliciana Medical Complex. Together, these facilities provide behavioral health, developmental disability, and long-term care services for over 1,400 Louisiana residents.
• Legal, Audit, and Regulatory Compliance (LARC) includes the Bureau of Legal Services, Internal Audit, Program Integrity, and Health Standards sections of LDH. The Bureau of Legal Services is the legal arm of the Department and is responsible for handling all legal matters including procurement and the provision of legal advice around state and federal regulations applicable to all Department offices. The Internal Audit Section is responsible for conducting internal audits of various Department programs to ensure efficient operations and appropriate controls geared at maintaining programmatic integrity. The Internal Audit section additionally acts as the liaison for the Department with the Legislative Auditor, and other audit entities, regarding external audits of the Department’s programs. The Program Integrity section is responsible for ensuring programmatic and fiscal integrity of the Department’s Medicaid program, along with other Medicaid-funded programming provided by other departments. Program Integrity is responsible for monitoring Medicaid-funded programs for provider and/or recipient fraud, waste, or abuse. Finally, the Health Standards Section is responsible for the licensing and certification of various healthcare facilities in Louisiana, which includes ensuring that facilities are maintaining compliance with applicable standards, statutes, rules, regulations, and policies. This is accomplished through periodic surveys and inspections, including complaint investigations of providers that are subject to licensure and/or certification by the Department.
• Human Services Districts and Authorities (HSDAs), also known as local governing entities (LGEs), are established by Louisiana state law to direct the operation and management of community-based programs and services relative to mental health, intellectual/developmental disabilities and challenges, and substance-related and addictive disorders. HSDAs were established by Louisiana state law beginning in 1989 with the last entity authorized in 2013.
• The Louisiana Emergency Response Network (LERN) is responsible for developing and maintaining a statewide system of care coordination for patients suddenly stricken by serious traumatic injury or time-sensitive illness (such as heart attack and stroke). It is a system also designated to serve as a vital healthcare resource in the face of large-scale emergencies and natural disasters.
• The Developmental Disability Council’s mission is to increase independence, self-determination, productivity, integration, and inclusion for Louisianans with developmental disabilities and challenges by engaging in advocacy, capacity building, and systems change.

Targeted interests of the state health agency and influence on delivery of Title V services:

There are several significant priorities within LDH, OPH, and OPH BFH that affect Title V programming:

• Office on Women’s Health and Community Health: During the 2021 Regular Session of the Louisiana State Legislature, Act 676 was signed into law to establish an Office on Women's Health and Community Health within the Louisiana Department of Health. The new Office is charged with “leading and coordinating efforts within the Louisiana Department of Health that are intended to improve women’s health outcomes through policy, education, evidence-based practices, programs, and services.” The law also establishes a new Assistant Secretary position and states that “the department may consolidate efforts on women's health and community health within the department as deemed appropriate by the secretary of the department.” At the time of this submission, it is unclear how Title V programs and services will be impacted. While it is likely that women-serving Title V programs and services will be impacted, the manner of and extent to which they will be is not defined in the legislation. As planning and implementation for the new Office commences, the Title V Director will work with LDH leadership to ensure any impacted Title V programs and services are adequately supported throughout the transition. (Please refer to the Title-V supported assessment of women’s health activities across LDH, completed in 2022). 
• State Health Assessment/State Health Improvement Plan: In 2019, LDH OPH earned accreditation through the Public Health Accreditation Board. As part of OPH’s ongoing efforts to maintain accreditation, OPH conducted a State Health Assessment (SHA) from June 2021 and April 2022. This process reached nearly 6,000 Louisiana residents via two sets of meetings in each of Louisiana’s nine public health regions, a statewide electronic survey, community leader interviews, and public health system representative interviews. A report on the findings was published by OPH in July 2022. The following priority areas were identified for inclusion in the State Health Improvement Plan (SHIP): Behavioral Health, Chronic Disease, Community Safety, and Maternal & Child Health. BFH has been represented on the core SHA/SHIP steering committee since the beginning of the SHA process. In addition to representation on the steering committee, other BFH staff participated in the implementation of the assessment activities. In 2022, OPH established a Maternal and Child Health Workgroup, which is open to all residents of Louisiana, to facilitate the development of the MCH portion of the SHIP.
• LDH Business Plan: Since 2020, the Secretary of LDH has charged Office and Bureau leadership across the Department to develop a comprehensive annual LDH Business Plan to promote coordinated strategy and accountability across the Department. Most recently, Louisiana Title V, WIC, and Medicaid worked together to develop new strategies for SFY 2023 related to improving health outcomes from pregnancy through childhood, strengthening, expanding, and diversifying Louisiana’s healthcare workforce; and improving systems to support people living with Sickle Cell Disease. Most of these strategies directly align with those outlined in the FFY 2024 Title V State Action Plan.

 

Components of Louisiana’s Systems of Care for Vulnerable and Underserved Populations

Population Served: Louisiana families from birth through the next generation

Health Services Infrastructure: Overall, Louisiana is recognized as having a substantial and growing unmet need for primary care services.  As of March 2023, the US Health Resources and Services Administration’s (HRSA) Bureau of Health Workers recognized 184 primary care shortage areas in the state, compared to 155 in 2021 and 176 in 2022.22  Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) are essential to addressing these needs. Louisiana currently has more than 300 FQHCs operated by 39 community health center organizations, and 217 RHC providing primary care and mental health services in the state. Furthermore, a statewide network of 58 school-based health centers affiliated with OPH BFH provide additional access, in particular for adolescents.

The number of mental health shortage areas also increased; there are now 171 recognized mental health shortage areas, compared to 151 in 2021 and 163 in 2022.15 Services related to mental health are a critical need, as reflected in the federal shortage area designations, the OPH State Health Assessment, and the 2020 Title V Needs Assessment. The Healthy Louisiana Managed Care Organizations (MCOs) are required to ensure network adequacy based on the Centers for Medicare and Medicaid Services (CMS) guidelines and assist their members with making arrangements for access to services, including transportation upon request. The Early and Periodic, Screening, Diagnostic and Treatment mandate makes fulfilling this need a state obligation, in addition to a contractual obligation. However, the specific gaps and problems are not well documented. Assessing the health system performance related to mental health needs will be a priority for Title V. In addition, Title V has begun to prepare for scaling provider capacity-building interventions. Provider-to-provider consultation to support first-line identification and management of social-emotional and psychiatric concerns is one such system-strengthening intervention that has been gaining interest in Louisiana.

Changes in OPH Services: Louisiana's statewide network of OPH Parish Health Units (PHUs) once served as the state’s main provider of primary care for low-income women, children and families. Over the past 20 years; however, care has been transitioned to private providers (such as FQHCs) as Medicaid has become more widely accepted. PHUs now primarily provide essential public health services, with a focus on high-quality family planning and sexually transmitted disease (STD) services, WIC (Women, Infants, and Children), Children and Youth with Special Health Care Needs (CYSHCN) safety-net specialty services, immunizations, and tuberculosis testing and treatment. Funded through Title V federal and state allocations, PHUs in LDH Regions 2-9 (see Figure 2 below) provide a total of 22 sub-specialty and genetics clinics for CYSHCN. Clinics must accept Medicaid and be able to schedule an appointment with transferred patients within 2 months of transfer.

Figure 2. Louisiana Department of Health Administrative Regions

Additionally, 57 of the 73 PHUs provide Title X-sponsored reproductive health services, with programmatic oversight provided by the BFH Reproductive Health Program (RHP).

Over the past several years, OPH leadership has made critical investments in the overall infrastructure needed to modernize the PHU clinical service system and support sustainability. Most notably, OPH established the Bureau of Regional and Central Operations (BRCO), a new unit with dedicated roles to oversee the operations of the OPH PHU clinic system. BFH is in the process of transitioning the day-to-day management of the OPH PHU clinics fully to BRCO. Currently, there are many policy and oversight functions that are shared between BFH and BRCO, and leadership from the two Bureaus have been working to delineate a new scope and role for each Bureau in the administration of Title V and Title X clinical services offered through OPH.

Financing and Integration of Services: In 2012, Louisiana Medicaid began transitioning from a fee-for-service system to a network of managed care organizations (MCOs) to cover Medicaid services for children and adults. As of 2015, the state's MCOs have been responsible for both physical health and behavioral health benefits.

Mandatory MCO populations include the majority of Medicaid eligible population groups including children under 19 years of age, individuals and families receiving Temporary Assistance for Needy Families (TANF), Child Health and Maternity Program (CHAMP)-Child Program, Deemed Eligible Child Program, foster care children, youth aging out of foster care, former foster care children through the age of 26, Regular Medically Needy Program, Louisiana Children’s Health Insurance Program (LaCHIP), Blind/Disabled Children, eligible parents and caregiver relatives, pregnant women, LaMOMs, breast and cervical cancer program, aged, blind and disabled adults, Supplemental Security Income (SSI) Program, individuals diagnosed with tuberculosis and the new adults expansion population. Although there are populations excluded from managed care such as dual-eligible (those who receive both Medicare and Medicaid), waiver recipients, and individuals in long-term care, individuals receiving services through the 1915(c) Home and Community Based Waivers, such as Children’s Choice, are considered voluntary opt-in populations for MCO services and benefits. Furthermore, some dual-eligible are mandatorily enrolled in the MCOs for Specialized Behavioral Health Services, and non-emergency medical transportation.

The MCOs are required to cover all state plan services including the EPSDT at or above the Medicaid published rate, unless the provider/MCO contract allows a different reimbursement rate. These plans also have flexibility to provide other services that will help meet their members' needs through value-added benefits or additional network coverage. Plans are required to report on certain quality measures, with plans offering incentives to both providers and members. Examples of various incentives for members include gift cards for preventative care such as wellness checks, sexually transmitted infection (STI) screenings and prenatal and postnatal care. Extra benefits offered include dental care and hearing aids for adults, tobacco cessation and weight management.

In June 2021, LDH released a Request for Proposals for MCO contracts, with an emphasis on health equity, maternal and child outcome improvement, behavioral health integration, delivery system reform, disaster planning and recovery, Department of Justice settlement agreement requirements, fraud, waste and abuse initiatives, and increased MCO accountability. In June 2022, LDH announced an intent to award contracts to six MCOs. The new MCO contracts became effective in January 2023.

 

 

 

Louisiana State Statutes and Regulations

Louisiana Revised Statutes

LA Rev Stat 40:1081.2- Providers attending newborn children must test for LDH approved/required genetic diseases.

 

LA Rev Stat 40:1081.5 - LDH establishes and operates clinics in cooperation with medical schools at LSU and Tulane to treat those with sickle cell anemia.

 

LA Rev Stat 40:1081.1 -LDH to establish programs for combating phenylketonuria, congenital hypothyroidism, galactosemia, sickle cell disease, biotinidase deficiency, and other genetic conditions.

 

LA Rev Stat 40:2018.3 - LDH establishes the Louisiana Sickle Cell Commission.

 

LA Rev Stat 40:1081.7 - LDH to establish local programs to treat victims of sickle cell anemia and components of treatment.

 

LA Rev Stat 40:1081.8 - Outlines functions of the sickle cell navigator program, to be administered by LDH under direction of Sickle Cell Commission; implemented upon appropriated funding.

 

LA Rev Stat 40:1071-5 - (CSHS Enabling legislation): Designates OPH to cooperate with Title V of the Social Security Act; receive and expend federal funds for services to extend and improve services for children with special health care needs.

LA Rev Stat §40:31.3 - (ASHP Enabling legislation): The Office of Public Health, Department of Health and Hospitals [currently Louisiana Department of Health], shall establish an adolescent school health initiative.

 

LA Rev Stat 40:2018 (Perinatal Commission Enabling Legislation) - Establishes the Commission on Perinatal Care and Prevention of Infant Mortality. 

 

LA Rev Stat 22:1059.1 - Establishes the Louisiana Doula Registry Board.

LA Rev Stat 40:2019 - (Child Death Review Enabling Legislation) - Establishes a child death review panel, protocols, criteria for reporting and investigations for the unexpected deaths of children below the age of fifteen and the ability to suggest recommendations within the agencies presented on the state panel.

 

LA Rev Stat 40:2024.3 – Establishes the Louisiana Domestic Abuse Fatality Review Panel

 

LA Rev Stat 40:1122.1 – Establishes the Rare Disease Advisory Council.

 

LA Rev Stat 40:1081.1-7 (Newborn Screening and Sickle Cell Programs Enabling Legislation) - Authorizes LDH to screen for and establish programs designed to reduce mortality and morbidity from sickle cell disease and other genetic conditions.

 

LA Rev Stat 40:1285.1-.5 (Lead Screening Program Enabling Legislation) - Establishes a program for the prevention, screening, diagnosis, and treatment of lead poisoning in the Office of Public Health; Mandatory reporting of lead poisoning cases required; comprehensive records.

 

LA Rev Stat 46:2263-4 (Newborn Hearing Screening Enabling Legislation) - Establishes within OPH a program to provide for the early identification and follow-up of infants susceptible to a hearing disability, of deaf or hard of hearing infants, and of infants who have a risk factor for developing progressive hearing loss; establishes an advisory council.

 

LA Rev. Stat. 46.2351-2356 (Louisiana Commission for the Deaf Enabling Legislation) - Establishes the Louisiana Commission for the Deaf within the Louisiana Department of Health; defined duties; permits LDH hiring of executive officer of the commission; permits receipt of money from any source.

 

LA Rev. Stat. 40; 31.41-48 - (LBDMN Enabling Legislation): Establishes a system to collect, analyze, and disseminate data regarding birth defects and to provide information to families regarding services available and prevention programs.

 

LA Rev Stat 46:447.1 (Reproductive Health Program Enabling Legislation)- Establishment of a family planning program to provide family planning education and contraceptives for public assistance recipients.

 

LA Rev Stat 46:973 - Allows the Office of Public Health to provide a special program of preventive, health, and medical care and health education services for adolescents that concentrates on adolescent pregnancy and pregnancy prevention.

 

LA Rev Stat 46:974 - Asks that OPH maintain a statewide toll-free number to advise pregnant women on available resources.

 

LA Rev Stat 40:1061.17 - Pertains to Abortion Alternatives/Woman’s Right To Know.

 

LA Rev Stat 13:5713 - Instructs the coroner to report SIDS to the Director of the Parish Health Unit within 48 hours.

 

LA Rev Stat 40:1086.1-4 - Defines Shaken Baby Syndrome and Sudden Unexpected Infant Death Prevention major public health priorities for the state and authorizes LDH to conduct public awareness activities.

 

LA Rev Stat 17:407.40 - Assigns OPH to provide information and resources to the state Department of Education for such training and for other areas of training required for employees of early learning centers in promoting the health, safety, and welfare of children.

 

LA Rev Stat 17:407.23 - Louisiana Early Childhood Education Act (Act 3, 2012) - Establishes the Early Childhood Care and Education Network; Board of Ed must coordinate with the DCFS and LDH to align the standards for the licensing of child care facilities, including the requirements for participation in the Louisiana Quality Start Child Care Rating System, with the standards established for early childhood education programs.

 

LA Rev Stat 40:1075.4 - Emergency Medical Services for Children Program (1995) -

Establishes an Emergency Medical Services for Children Program and shall include a full-time coordinator, education programs for EMS personnel, guidelines for referring, guidelines, inter-hospital transfer system for critically ill or injured children and pediatric rehabilitation units. 

 

LA Rev Stat 40:1086.12 - Neonatal opiate withdrawal syndrome pilot project

Charges LDH with creating a pilot demonstration project to optimize outcomes associated with Neonatal Opioid Withdrawal Syndrome (NOWS).

 

Early Childhood Care and Education Commission (Act 693) -

Establishes the Early Childhood Care and Education Commission charged with establishing pilot programs in high-performing community early childhood care and education networks that will further efforts to improve kindergarten readiness.

 

Impact and Care related to Maternal Depression and Anxiety (HCR 103, 2021)

Requests that certain state agencies address the impacts of maternal depression and anxiety and provide evidence-based preventive care, early identification, and treatment services

Louisiana Maternal Mental Health Task Force (HCR 105, 2021)

Establishes the Louisiana Maternal Mental Health Task Force for the purposes of advancing education and treatment and improving services relating to maternal mental health

Women’s Health Assessment (Act 210, 2021)

Directs the Louisiana Department of Health to assess all activities engaged in or services provided by the Department that may specifically impact the health or quality of life of women.

Training on ACEs and Trauma-Informed Education (Act 353, 2021)

Requires in-service training for teachers and certain other school personnel on adverse childhood experiences and trauma-informed education.

 

Access to Transformative Therapies for Sickle Cell Disease (SCR 66, 2021)

Requests the Department of Health to provide for equitable access to transformative therapies for sickle cell disease.

Fertility in Women SR 97, 2021

Requests the Department of Insurance to create a task force to study the causes of infertility in women and mandating insurance coverage of fertility treatments for women.

Perinatal Mental Health Policy (Act 188, 2022)

Requires hospitals and birthing centers to provide pregnant women and their family members information about perinatal mood and anxiety disorders. Directs the Louisiana Department of Health to make this information available to hospitals and birthing centers, as well as on their website. Requires healthcare providers providing postnatal care to screen for symptoms of postpartum depression and other related disorders (if that is believed to be in the best interest of the patient). Directs the Louisiana Department of Health to work with Medicaid to identify providers who specialize in pregnancy-related or postpartum depression as well as postpartum substance use disorders. Directs the Louisiana Department of Health and Medicaid to develop network adequacy standards for treatment of pregnant and postpartum women with depression or related mental health disorders or substance use disorders.

 

Breastfeeding Policies for High School Students (Act 472, 2022)

Requires each governing authority of a public high school to adopt policies regarding attendance, breastfeeding, and child care for students who are pregnant or parenting.

 

Dispensing of Contraceptives (Act 708, 2022)

Provides relative to the dispensing of up to a six month supply of contraceptives.

 

Medicaid and Insurance coverage for human breast milk (Acts 488 and 489, 2022)

Act 488 provides for Medicaid coverage of prescription breast milk; Act 489 provides for insurance coverage of prescription breast milk.

 

Establishes an assistance program for pregnant women and parents (Act 561, 2022)

Establishes a continuum of care program for certain pregnant women and parents of young children and to create a statewide telecare support network.

 

Provides for information regarding emergency contraception (Act 513, 2022)

Provides for procedures for victims of sexually-oriented criminal offenses and requires all licensed hospitals and healthcare providers to provide victims information regarding emergency contraception and following negative pregnancy test, to provide emergency contraception at victim’s request.

 

Establishes the Office of Women’s Health (Act 676, 2022)

Creates the office on women's health within the Louisiana Department of Health.

 

 

 

Provides for genetic testing of infants (Act 501, 2022)

Provides for Medicaid and commercial health insurance coverage of genetic testing for critically ill infants with no diagnosis.

 

Provides relative to opioid treatment programs for pregnant women (Act 309, 2022)

Provides relative to opioid treatment programs for pregnant women and requires certain treatment facilities to provide onsite access to at least one form of FDA-approved opioid agonist treatment.

 

Access to Transformative Therapies for Sickle Cell Disease (HCR 76, 2022)

Expresses support for equitable access to transformative therapies for sickle cell disease.

 

Sickle Cell Registry (Act 647, 2022)

Establishes a state sickle cell disease registry.

 

Study on establishment of “baby bonds” (HCR 94, 2022)

Requests a study regarding the potential establishment of a program to provide children born to low- to moderate-income parents with a trust that, at maturity, can be used for postsecondary education, the purchase of a home, or formation of a business.

 

Modernizes statute for Louisiana Commission for the Deaf (Act 128, 2022)

Provides relative to the Louisiana Commission for the Deaf.

 

Provides relative to adolescents giving birth (SR 87, 2022)

Requests the Louisiana Department of Health  to enact policies relative to children giving birth.

 

Establishes the Study Commission on Maternal Health and Wellbeing (SR 131, 2022)

Establishes the Study Commission on Maternal Health and Wellbeing to make recommendations on connecting pregnant women and new mothers, particularly in rural and underserved areas, with resources for the health and wellbeing of the mother and child.

 

Commission to Study Child Sexual Abuse Prevention (SR 167, 2022)

Creates a commission to study best practices for deterring sex offenses against children.

Insurance Coverage for Maternity Support Services Provided by Doulas (Act 270, 2023)

INSURANCE/HEALTH:  Provides relative to maternity support services of doulas.

Medicaid Reimbursement for Midwifery (Act 207, 2023)

Provides relative to Medicaid reimbursement for services provided by a licensed midwife or certified nurse midwife.

 

Study Related to Medicaid Coverage of Gene Therapy (HCR 92, 2023)

Requests study by Louisiana Department of Health to consider Medicaid coverage of gene therapy.

Subcommittee to Study Effectiveness of Sickle Cell Treatment Practices (HR 201, 2023)

Creates a subcommittee to study the effectiveness of sickle cell healthcare treatment practices in this state.

Request to Extend Medicaid Pregnancy Coverage (HR 273, 2023)

Urges and requests the Louisiana Department of Health to amend the state Medicaid plan to extend pregnancy coverage.

Task Force on Nursing and Improvement of Maternal Outcomes (SCR 20, 2023)

Requests the Louisiana Department of Health to convene a task force to make recommendations regarding nursing involvement to improve maternal outcomes.

Perinatal Mental Healthcare Awareness (SR 136, 2023)

Urges and requests the Louisiana Department of Health to assist in the development of a public service campaign to foster awareness and education on perinatal mental health care.

Requests Extension of Medicaid Pregnancy Coverage to at or below 185% FPL (SR 145, 2023)

Urges and requests the Louisiana Department of Health to amend the state Medicaid plan to extend pregnancy coverage to individuals at or below 185% of the federal poverty level.

 

Human Trafficking Awareness (SR 179, 2022)

To urge and request the Louisiana Department of Health, Department of Transportation and Development, and Department of Revenue, office of alcohol and tobacco, to post human trafficking awareness posters.

 

Louisiana Administrative Code (Regulations):
LAC Title 48, Public Health-General, Book 2 of 2; Part V; Subpart 17. Children’s Special Health Services Chapters 49 - 59

 

LAC Title 48, Public Health-General, Book 2 of 2; Part V; Subpart 55. Birth Defects Surveillance System Chapter 161-163

 

LAC Title 48, Public Health-General, Book 2 of 2; Part V; Subpart 19. Genetic Diseases Services Chapter 63 Neonatal Screening; 6303.

 

LAC Title 48, Public Health-General, Book 2 of 2; Part V; Subpart 18. Disability Prevention Program Chapter 70. Lead Poisoning Prevention Program; 7001-7009

 

LAC Title 48, Public Health-General, Book 2 of 2; Part I; Subpart 13. Family Planning Chapter 35-37
 

LAC Title 51, Sanitary Code, Part XXI Day Care Centers and Residential Facilities, Chapter 3, Child Day Care Centers, #9
 

DOE Child Care Development Fund Bulletin 137 – Early Learning Site Licensing Regulations requires three hours of training by a child health care consultant on infectious diseases, health, safety, and/or food service preparation.

 

LAC Title 5, Chapter 65,6501, 6503 (April, 1987) - Authorizes LDH to operate Regional Genetic Clinics

 

LAC Title 5, Chapter 69, 6901, 6903 (Aug, 2014) - LDH establishes Genetic Diseases Program Advisory Committee

 

Louisiana Children’s Code:
LA Child Code 609. Mandatory and permitted reporting