Louisiana Medicaid Waiver Waitlist: How the Registry and SUN Score Work

Your parent qualifies clinically for the Community Choices Waiver (CCW), but the case worker says they are "on the registry." What registry? How long? And is there anything you can do to move faster?

The CCW is Louisiana's most comprehensive home-based Medicaid program — covering personal care, home modifications, emergency response systems, respite, and even stipends for family caregivers. But unlike Long-Term Personal Care Services (LT-PCS), which is a State Plan entitlement with no waitlist, the CCW is a waiver with capped enrollment slots. When all slots are filled, applicants go on the Request for Services Registry (RFSR) — Louisiana's official waitlist.

How the Registry Works

The RFSR is managed by the Office of Aging and Adult Services (OAAS) and operates on a first-come, first-served basis by the date of the initial request. You can initiate a request by calling Louisiana Options in Long-Term Care at 1-877-456-1146.

When a slot opens, it is offered to the next person on the registry — unless someone in a higher priority tier is waiting. Registry position is determined by your request date, not your application date, so calling early matters even if your parent does not immediately need services.

The Priority System

Louisiana uses the Screening for Urgency of Need (SUN) tool to score applicants and assign priority tiers. The SUN score ranges from 0 (needs are being met) to 4 (emergent, immediate need), and it determines who gets served ahead of the standard first-come-first-served queue.

The six priority groups, in order:

1. Adult/Elderly Protective Services referrals — individuals referred by APS or EPS due to active abuse or neglect who would require immediate nursing home admission without the waiver
2. ALS diagnosis — individuals diagnosed with Amyotrophic Lateral Sclerosis
3. Permanent Supportive Housing (PSH) residents — individuals linked to a State of Louisiana PSH unit
4. Medicaid-funded nursing home residents — current nursing home residents funded by Medicaid who want to transition back to community living
5. Expedited waiver diversion — individuals currently approved for 32 hours of LT-PCS who face imminent nursing home placement without a waiver slot
6. No other HCBS services — individuals not currently receiving PACE, LT-PCS, or other Medicaid home-care programs

If your parent falls into one of these categories, their application is prioritized above standard registry positions. Category 5 is particularly relevant for families whose parent is already receiving LT-PCS and deteriorating — if the parent is at 32 hours (the LT-PCS maximum) and the next step without the waiver would be nursing home placement, expedited processing is available.

How Long Is the Wait?

Louisiana does not publish a public estimate of average wait times. Historically, the waitlist has ranged from several months to over a year depending on the region, available funding, and annual budget appropriations from the state legislature. Slot availability is not uniform across the state — some regions have faster turnover than others.

Two things affect how quickly you move through:

• Regional allocation: Slots are distributed across the state's OAAS regions. A region with higher turnover (more people aging out of the program or moving to nursing homes) opens new slots faster.
• Budget cycle: The number of active CCW slots is tied to annual legislative appropriations and CMS waiver approval. Midyear budget adjustments can expand or contract availability.

What to Do While Waiting

Waiting on the registry does not mean waiting without care. Build a bridge:

Apply for LT-PCS simultaneously. LT-PCS is an entitlement — if your parent qualifies clinically and financially, there is no waitlist. Services are more limited than the CCW (no case management, no home modifications, no emergency response systems), but the personal care hours can keep your parent safe at home while you wait for the waiver slot.

Contact your Area Agency on Aging (AAA). The regional AAA/ADRC offices coordinate non-Medicaid services — Meals on Wheels, SenioRx prescription assistance, caregiver respite grants, and volunteer transportation. These are federally and state funded and do not require Medicaid eligibility.

Explore PACE. The Program of All-Inclusive Care for the Elderly provides comprehensive medical and social services through adult day health centers in New Orleans, Baton Rouge, Lafayette, and Alexandria. If your parent is dual-eligible (Medicare + Medicaid), there is zero out-of-pocket cost, and PACE does not operate on a registry waitlist — enrollment is open as long as the program has capacity.

Document escalating care needs. If your parent's condition deteriorates while on the registry, contact the case manager to request a SUN score reassessment. A move from standard priority to Category 5 (expedited diversion) can significantly shorten the wait.

The Louisiana care decision toolkit includes a waitlist tracking worksheet and a SUN score preparation guide — helping you document your parent's care situation in the terms the state uses to assess urgency, so the assessment accurately reflects how much help they actually need.

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