The National Demonstration Model for HCBS Integrity

Modernizing Louisiana's IDD & OAAS Programs: Real-Time Care Intelligence

Recent Legislative Audits cited neglect and abuse accountability gaps, attributing them to a "lack of systems infrastructure". Today, fewer than 50% of Louisiana IDD recipients receive services according to their Plan of Care. EVV proves attendance — it does not prove care delivery.

The Louisiana Coalition for Disability Services Accountability — representing Easterseals Louisiana, Gulf Coast Social Services, and Cura OS — has deployed the state's largest provider-driven quality initiative. Backed by $6 million in private investment, this operational infrastructure is already transforming care across the state.

Active Footprint

Operating Today Across
All 9 LGE Regions

This is not a concept — it is Louisiana innovation already serving thousands of citizens. It provides the infrastructure needed to support LDH's "One Door" initiative and OAAS's rebalancing mandates.

35+

Provider agencies actively using the platform across all Louisiana Medicaid regions

3,300+

Beneficiaries across IDD, aging, and personal care populations

9/9

Louisiana Medicaid regions with active deployments — full statewide coverage

The Evidence

Closing the 50% Service Gap
at the Point of Care

We analyzed thousands of Support Plans and Progress Notes. A representative example — a 62-year-old Louisiana NOW waiver recipient with profound ID, asthma, and a severe shellfish allergy — revealed zero condition-specific observations or allergy checks over three months. Here is how Plan-Driven Service Validation changes the reality on the ground:

Today's Reality

The Problem

"Good — because he's smiling"

Copied across every shift. No clinical basis.

"No issues today"

Zero condition-specific observations for asthma or allergy.

"I gave him his meds"

No individual medication verification. No timestamp.

With Cura OS

The Solution

Structured wellness assessment: respiratory, cardiovascular, pain, and mental status — completed at every shift.

Plan-driven prompts tied to individual health profile.

Voice-guided clinical prompts: "Any wheezing, breathing changes, dizziness today?" — triggered by asthma and allergy conditions.

Condition-specific observations generated automatically.

Timestamped medication verification: each medication verified by name with exact timestamp and DSP attestation.

Individual audit trail for every administration event.

Financial Stewardship

Validating the Investment:
A 12x to 19.8x ROI

LDH recently released a rate study recommending $103.4M in annual OCDD increases. The proposed Cura OS pilot is the only mechanism available to measure whether those rate increases actually translate to improved outcomes.

The Pilot Proposal

~$3M

18–24 month investment

A bounded investment to demonstrate statewide infrastructure under LDH oversight — the only mechanism to validate whether Louisiana's rate increases translate to measurable care improvements.

Projected Annual Value to Louisiana

$16M – $27M

$6.8M – $10.1M

Avoided institutionalizations through early warning and placement prevention.

$5M – $8M

Healthcare utilization reduction by monitoring the "Fatal 5" — aspiration, dehydration, constipation, seizures, sepsis.

$4M – $6M

DSP workforce stabilization and retention through structured tools and reduced administrative burden.

$3M – $6M

PERM error avoidance and fraud prevention through real-time service delivery validation.

Critical Capabilities

Built for Louisiana's Unique
Structural Requirements

Emergency Evacuation Tracking

Real-time GPS location and status tracking during hurricanes — ensuring vulnerable beneficiaries are accounted for when manual methods fail.

OAAS Rebalancing Support

Community placement saves significant expense compared to nursing facility beds. Cura OS provides the transparent operational evidence needed to safely transition medically complex populations to lower-cost waivers.

Multi-Agency Incident Routing

Automated capture and routing of neglect/abuse incidents to proper authorities (LDH, CPS, EPS) with a complete audit trail — directly answering the Legislative Audit.

Plan-Driven Service Validation

Real-time confirmation that authorized services are delivered according to individual Plans of Care — closing the gap that EVV cannot address.

Next Steps

Transition from
Aspiration to Proof

The Cura OS pilot gives Louisiana the validated evidence and scalable framework needed for statewide adoption.