Key takeaway
Louisiana pays family caregivers through Medicaid Long-Term Personal Care Services (LT-PCS) and the Community Choices Waiver (CCW). Both can use Self-Direction so the care recipient hires a family member.
- LT-PCS: Medicaid state plan service that pays family caregivers for personal care.
- Community Choices Waiver (CCW): HCBS waiver for adults 65+ or with disabilities; allows Self-Direction.
- Self-Direction: The participant chooses, hires, and supervises a family caregiver (not a spouse).
- Veterans: Aid & Attendance and Veteran Directed Care can pay family, including spouses under VDC.
Overview
Louisiana Medicaid, administered through the Louisiana Department of Health (LDH) and the Office of Aging and Adult Services (OAAS), funds paid family caregiving through two main pathways. Long-Term Personal Care Services (LT-PCS) is a Medicaid state plan benefit that pays for in-home attendant care. The Community Choices Waiver (CCW) is a 1915(c) HCBS waiver that adds expanded supports and Self-Direction for adults 65 and older or adults with disabilities.
Both LT-PCS and CCW can be delivered through a Self-Direction model that lets the care recipient hire a family member as their paid attendant. Louisiana excludes spouses, legal guardians, and certain household members from being paid under these Medicaid options. Veterans have separate VA paths including Veteran Directed Care, which is the only program that can pay a spouse.
Programs that pay family caregivers in Louisiana
| Program (Type) | Care recipient eligibility | Paid family caregiver provisions |
|---|---|---|
| Long-Term Personal Care Services (LT-PCS) (Medicaid state plan) | Louisianans 21+ on Medicaid who need help with activities of daily living and meet a nursing-facility level of care. | Pays an attendant for ADL/IADL help. Self-Direction allows hiring family caregivers (not spouses or legal guardians). |
| Community Choices Waiver (CCW) (Medicaid 1915(c) waiver) | Louisianans 65+ or 21+ with a disability who meet nursing-facility level of care and Medicaid financial limits. | Includes personal care, adult day, environmental modifications, and Self-Direction to hire family caregivers. |
| New Opportunities Waiver (NOW) (Medicaid 1915(c) waiver) | Louisianans with an intellectual or developmental disability needing ICF/IID level of care. | Includes individualized and family support services that can pay family caregivers under Self-Direction. |
| Adult Day Health Care (ADHC) Waiver (Medicaid 1915(c) waiver) | Adults 65+ or with disabilities needing structured day services to avoid nursing-home placement. | Provides supervised day services that complement family caregiving at home. |
| Aid & Attendance Pension (VA benefit) | Wartime veteran or surviving spouse needing help with daily activities; meets VA pension rules. | Boosts the veteran's pension to cover care costs; can pay adult children and relatives. Spouses are not paid directly. |
| Veteran Directed Care (VDC) (VA program) | Veterans in VA health care needing nursing-home level care, living in a participating VAMC area. | Monthly care budget the veteran manages to hire caregivers, including spouses. |
Louisiana Medicaid programs
Louisiana Medicaid funds paid family caregiving primarily through Long-Term Personal Care Services (LT-PCS) and the Community Choices Waiver (CCW). LT-PCS is a state plan service that entitles eligible Medicaid members to attendant care, while CCW is a 1915(c) waiver that adds expanded supports for older adults and adults with disabilities.
Long-Term Personal Care Services (LT-PCS)
LT-PCS is the most common Medicaid benefit used to pay family caregivers in Louisiana. As a state plan service, it is an entitlement for those who qualify, so there is generally no waitlist.
- Care recipient must be 21+ on Medicaid and meet a nursing-facility level of care.
- Up to a maximum number of hours per week (typically 32 hours) is authorized after assessment.
- Self-Direction allows hiring a family member; spouses, legal guardians, and certain household members are excluded.
- OAAS or its contracted assessor completes the level-of-care evaluation.
Community Choices Waiver (CCW)
CCW is the primary Louisiana HCBS waiver for older adults and adults with disabilities. It funds personal care plus additional services and uses a Self-Direction option to pay family caregivers.
- Must be 65+ or 21+ with a disability and meet nursing-facility level of care.
- Includes adult day, environmental modifications, transition services, and respite.
- Self-Direction lets the participant hire family caregivers (not spouses or legal guardians).
- CCW historically operates with a waitlist; ask OAAS about your Request for Services Registry position.
Louisiana Area Agencies on Aging and OAAS supports
Outside of Medicaid, Louisiana's Area Agencies on Aging and the Office of Aging and Adult Services coordinate caregiver supports under the Older Americans Act and state-funded programs. These rarely replace a full caregiver wage but offset the cost of providing care.
Counseling, training, respite vouchers, and supplemental supports for unpaid family caregivers of older adults.
A no-cost information and assistance line that helps families navigate Medicaid, waivers, and AAA resources in Louisiana.
Who qualifies
- Family caregivers of adults 60+ or of any age with Alzheimer's/related dementia.
- Grandparents 55+ raising grandchildren may also qualify for some services.
- Availability and stipend amounts vary by AAA region and funding year.
Veterans' programs
Louisiana veterans and surviving spouses can fund in-home care through VA benefits. The Southeast Louisiana Veterans Health Care System (New Orleans), the Alexandria VA Health Care System, and the Overton Brooks VA Medical Center (Shreveport) coordinate the Caregiver Support Program, and Veteran Directed Care is available through participating service areas.
Aid & Attendance Pension
A&A increases a qualifying veteran's or surviving spouse's pension to cover care costs when they need help with daily activities. The increase can fund a family caregiver.
- Wartime service, ADL need, and income/asset limits required.
- Commonly used to pay adult children and other relatives.
- Spouses cannot be paid directly through A&A.
Veteran Directed Care (VDC)
VDC provides a flexible monthly care budget the veteran manages with help from a financial management service. It is the only VA path that can pay a spouse.
- For veterans meeting nursing-home level of care in VA health care.
- Family caregivers, including spouses, can be hired.
- Availability depends on participating Louisiana VAMCs.
Long-term care insurance
A qualifying long-term care insurance policy may pay benefits used to compensate a family caregiver depending on policy terms.
What to check in the policy
- Policy must cover in-home personal care, not just nursing-facility care.
- Cash/indemnity policies that pay the policyholder directly are the most flexible.
If the policy only reimburses licensed agencies, families sometimes have the caregiver hired through a licensed Louisiana home care agency so the insurer will pay.
How to apply in Louisiana (step-by-step)
- Identify the path: LT-PCS, Community Choices Waiver, NOW Waiver, VA benefits, or LTC insurance.
- Gather documents: ID, proof of Louisiana residency, income/asset records, medical history, and (for veterans) DD-214.
- Contact the right agency:
- LT-PCS or CCW: contact the Louisiana Office of Aging and Adult Services (OAAS) or call 1-877-456-1146 to request a Request for Services Registry assessment.
- NOW Waiver: contact your regional Office for Citizens with Developmental Disabilities (OCDD) Human Services District/Authority.
- AAA supports: call your local Area Agency on Aging or Louisiana's ADRC line.
- VA paths: speak with a VA social worker at your nearest Louisiana VAMC about A&A and VDC.
- Complete a level-of-care assessment and a financial eligibility review through Louisiana Medicaid.
- Choose Self-Direction and identify your family caregiver; enroll with the contracted financial management service for payroll.
- Begin services; submit timesheets and care notes; renew eligibility annually.
Louisiana paid caregiver FAQs
Can a spouse be paid as a caregiver in Louisiana?
No under Louisiana Medicaid LT-PCS or the Community Choices Waiver. A spouse can be paid as a caregiver under VA Veteran Directed Care when the veteran qualifies.
How much do caregivers get paid in Louisiana?
Self-Directed personal care wages under LT-PCS and CCW typically run about $10 to $15 per hour, set within Louisiana Medicaid guidelines and the participant's budget.
Can I be paid to care for my parent in Louisiana?
Yes. Adult children are commonly paid as attendants through LT-PCS or the Community Choices Waiver under Self-Direction. VA A&A and VDC also allow paying adult children.
What is LT-PCS in Louisiana?
Long-Term Personal Care Services (LT-PCS) is a Louisiana Medicaid state plan benefit that authorizes attendant care for ADLs and IADLs (up to a weekly hour cap). As a state plan service, it is generally an entitlement and has no waitlist when eligibility is met.
How long does the Community Choices Waiver take to approve in Louisiana?
CCW typically operates with a Request for Services Registry (waitlist). Once a slot is offered, completing the assessment and financial review usually takes several weeks. LT-PCS is generally faster because it is a state plan entitlement.
