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-born infrastructure already serving thousands of citizens, providing the operational foundation for 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 costs a fraction of a nursing facility bed. 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.