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BHF FORM 1HPE REV 02/16Assessment Tool for Hospital Presumptive Eligibility (HPE) Only Facility HPE Provider Number Date of Interview Parish of Residence Section A. Individuals Information Individuals
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Obtain a waiver services application form from the Louisiana Department of Health.
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Fill out the application form completely, providing all required information.
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Submit the completed application form along with any supporting documents requested.
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Wait for the application to be processed by the Louisiana Department of Health.
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If approved, you will receive notification and further instructions on accessing waiver services.
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Follow the instructions provided to access and utilize the waiver services in Louisiana.

Who needs waiver services - louisiana?

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Individuals with disabilities: Waiver services are available for individuals with physical, intellectual, or developmental disabilities.
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Elderly individuals: Waiver services can also be beneficial for elderly individuals who need assistance with daily activities and care.
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Low-income individuals: Waiver services may be available for individuals with limited financial resources who require additional support.
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Individuals in need of home and community-based services: Waiver services provide alternatives to institutional care, allowing individuals to remain in their homes and communities.
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Waiver services in Louisiana refer to programs that provide necessary services and supports to individuals with disabilities so they can live and work in the community instead of in an institution.
Individuals with disabilities who are in need of services and supports in order to live and work in the community are required to file for waiver services in Louisiana.
To fill out waiver services in Louisiana, individuals can contact the Louisiana Department of Health or a Medicaid waiver provider for assistance with the application process.
The purpose of waiver services in Louisiana is to help individuals with disabilities live independently in the community and receive the necessary supports they need to do so.
Information such as medical history, disability documentation, support needs, and living situation must be reported on waiver services in Louisiana.
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