Home and Community Based Services Louisiana: Every HCBS Program Explained

Louisiana operates multiple home and community based services (HCBS) programs through the Office of Aging and Adult Services (OAAS). Each serves a different population slice with different eligibility rules, waitlist status, and service packages. Most families only learn about one or two — usually whichever the intake worker mentions first — and miss programs they'd qualify for.

Here's every HCBS option available in Louisiana, what each covers, and which ones have waitlists.

Community Choices Waiver (CCW)

The CCW is Louisiana's flagship 1915(c) HCBS waiver — the primary alternative to nursing home placement. It covers the broadest set of services: support coordination (case management), personal care, respite, home-delivered meals, environmental accessibility adaptations (home modifications), assistive technology, adult day care, and monitored in-home caregiving.

Income limit: $2,982/month (2026). Asset limit: $2,000 single. Waitlist: Yes — the Request for Services Registry, prioritized by urgency (abuse/neglect referrals, ALS, nursing facility transitions) rather than simple chronological order.

The CCW is case-managed, meaning a Support Coordinator develops an individualized Plan of Care and monitors services. This is the program families should aim for if the parent needs comprehensive support.

Long-Term Personal Care Services (LT-PCS)

LT-PCS is a Medicaid state plan entitlement — if your parent meets the criteria, Louisiana must provide services. There is legally no waitlist.

The trade-off: the income limit is much lower ($994/month single), and the program only covers hands-on personal care assistance with Activities of Daily Living plus light housekeeping. No case management, no home modifications, no respite.

LT-PCS can authorize up to 32 hours of personal care per week. Critically, a parent receiving the maximum 32 hours of LT-PCS who still needs more support can qualify for an expedited opportunity on the CCW registry — this is one of the fastest paths off the waitlist.

Adult Day Health Care (ADHC) Waiver

A separate 1915(c) waiver that funds daytime supervision at licensed ADHC centers. Services include nursing oversight, personal care, therapeutic activities, meals, and transportation.

Enrollment cap: 935 statewide. Priority: Individuals discharged from the hospital within the last 30 days get priority placement. The ADHC waiver serves families who need structured daytime care while the primary caregiver works.

Program of All-Inclusive Care for the Elderly (PACE)

PACE provides comprehensive medical and long-term care services through an integrated model centered on an adult day health center. Participants receive primary care, specialist visits, therapy, medications, personal care, meals, transportation, and social services — all coordinated by a single interdisciplinary team.

Age requirement: 55+. Income limit: $2,982/month. Geographic limits: Only available in specific service areas around New Orleans, Baton Rouge, and Shreveport. No waitlist, but capacity is limited by the number of PACE organizations operating in the state.

Self-Direction Option

Not a separate program, but a service delivery model available under the CCW. Instead of receiving services through a licensed agency, the parent (or their authorized representative) acts as the employer — recruiting, hiring, scheduling, and supervising their own direct support workers.

A state-contracted Fiscal Employer Agent handles payroll, tax withholding, and Electronic Visit Verification (EVV) compliance. Louisiana's contracted fiscal agents include Acumen Fiscal Agent and Morning Sun Financial Services.

Important restriction: a spouse, tutor, power of attorney, legal guardian, or authorized representative cannot be hired as a direct support worker under self-direction.

How to Access Any of These Programs

Every HCBS program in Louisiana starts with the same entry point: call the Louisiana Options in Long-Term Care hotline at 1-877-456-1146. The intake coordinator screens your parent using the Level of Care Eligibility Tool (LOCET) to determine clinical eligibility, then guides you toward the programs that match their financial and care profile.

Have documentation ready before the call: Social Security card, Medicare card, all income sources, and 60 months of bank statements (for Medicaid financial eligibility).

The Louisiana Home Care Guide maps every program into a decision tree — which ones your parent qualifies for, which have waitlists, and the exact steps to apply for each — so you're not relying on a single phone call to navigate the full system.

See more Louisiana guides →