Monitored In-Home Caregiving Louisiana: How Family Members Get Paid to Provide Care

You quit your job — or cut your hours to almost nothing — to care for your parent after a hospital discharge. You're providing the same personal care (bathing, dressing, meal prep, medication reminders) that a hired aide would. And in Louisiana, there's a Medicaid program that can actually pay you for it.

Monitored In-Home Caregiving (MIHC) is one of the most underutilized services available through Louisiana's home-care waiver system. Most families never hear about it because the information is buried inside the Community Choices Waiver program documentation.

What Monitored In-Home Caregiving Actually Is

MIHC is a service available under the Louisiana Community Choices Waiver (CCW) that allows a family member to be hired and paid as the primary caregiver for a Medicaid-eligible individual. Instead of a home health agency sending a stranger into your parent's home, a family member already doing the work may be able to become the paid caregiver.

The research-backed point is that a family member can be paid as the primary caregiver through MIHC. The caregiver arrangement, authorized hours, payroll process, and tax treatment must be confirmed with OAAS and the program's fiscal intermediary before relying on them.

Who Qualifies

The care recipient (your parent) must:

• Be enrolled in the Community Choices Waiver program (not just on the CCW waitlist — this is a key distinction)
• Meet the Nursing Facility Level of Care (NFLOC) criteria as assessed through the state's screening process
• Have an approved Plan of Care that includes MIHC as an authorized service

The caregiver (you) must:

• Meet the program's current caregiver requirements; ask OAAS or the fiscal intermediary about age, background checks, training, relationship restrictions, and supervision.

The program's monitoring requirements and visit schedule are set by the approved Plan of Care and current program rules; confirm them with the Support Coordinator.

How Much MIHC Pays

Payment rates are set by the program and authorized hours depend on the approved Plan of Care. Confirm the current rate and hours with OAAS or the fiscal intermediary.

Authorized hours depend on the approved Plan of Care.

Do not budget on a fixed weekly amount: actual payment depends on the rate and hours authorized.

The CCW Waitlist Problem

Here's the catch that stops most families: MIHC is only available through the Community Choices Waiver, and the CCW has a registry waitlist — the Request for Services Registry (RFSR). Depending on your parent's priority group, the wait can range from months to years.

Priority access bypasses the standard waitlist:

• Priority Group 1: Adult/Elderly Protective Services referral due to abuse, neglect, or exploitation — immediate slot
• Priority Group 2: ALS diagnosis — immediate slot
• Priority Group 3: Residing in permanent supportive housing — prioritized registry selection
• Priority Group 4: Currently in a nursing facility for 90+ days — prioritized transition slot
• Priority Group 5: Not receiving care under another Medicaid waiver — prioritized

If your parent isn't in a priority group, they join the general registry by date of request. The sooner you get on the list, the sooner a slot opens.

How to Apply

Step 1: Contact Louisiana Options in Long-Term Care at 1-877-456-1146. This is the single-entry point for all OAAS home-care programs. Request an assessment for CCW eligibility.

Step 2: Your parent will be screened for Nursing Facility Level of Care using the state's assessment tools. If they meet the clinical threshold, they're added to the CCW registry.

Step 3: Once a CCW slot opens and your parent is enrolled, work with the assigned Support Coordinator to include MIHC in the Plan of Care. Specify that you (the family caregiver) will be the MIHC provider.

Step 4: Complete the background-check, training, and enrollment steps the fiscal intermediary identifies, if applicable.

Step 5: Begin providing documented care if and when the arrangement is authorized. Follow the fiscal intermediary's payment schedule.

While Waiting for CCW: The LT-PCS Alternative

If your parent qualifies for the Long-Term Personal Care Services (LT-PCS) program — which has no waitlist but is capped at 32 hours per week — you can receive in-home personal care through a state-contracted agency. However, LT-PCS does not typically allow family members to serve as the paid caregiver in the same way MIHC does. The aide is provided by a licensed agency.

LT-PCS is a valuable stopgap while waiting for CCW enrollment. Ask OAAS whether any family-caregiver option applies to your situation; do not assume LT-PCS creates the MIHC paid-caregiver arrangement.

Tax and Employment Implications

Payment and tax treatment can depend on the arrangement. Before accepting paid hours, ask the fiscal intermediary whether you are an employee or contractor, what withholdings apply, and what tax form you will receive. If you're claiming your parent as a dependent, consult a tax professional about the arrangement.

Getting Started After a Hospital Discharge

If your parent was just discharged from a Louisiana hospital and you're already providing daily care, don't wait to contact OAAS. Getting on the CCW registry immediately starts the clock on your wait time, even if a slot doesn't open for months.

The Hospital-to-Home Louisiana guide covers the full CCW enrollment process, LT-PCS as a stopgap, and exactly how to structure the MIHC request within your parent's Plan of Care.

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