Louisiana · waiver service
Community Choices Waiver (CCW) in Louisiana
The Community Choices Waiver is a Louisiana Medicaid home and community-based waiver for older adults and adults with disabilities who would otherwise need a nursing home. It pays for in-home help such as Personal Assistance Services (PAS), and a family member can be hired as the paid PAS worker, either through a provider agency or through the self-direction option with a financial management services (FMS) provider handling payroll. The waiver also includes Monitored In-Home Caregiving, which pays a live-in caregiver a daily stipend.
Also called: CCW · Community Choices Waiver · Louisiana CCW · OAAS waiver · CCW self-direction
Who do you care for?
Quick facts
- Pay
- Hourly PAS wage — not published for family workers
- Adult children & other relatives
- Yes
- Spouse
- Sometimes
- Parent of a minor child
- Not right now
- Waitlist
- long
Who qualifies for CCW
- Meets long-term care (LTC) Medicaid financial eligibility.
- Is 21 years old or older.
- Meets nursing home (nursing facility) level of care.
- Has been offered a CCW opportunity from the Request for Services Registry; priority groups (abuse or neglect referrals, ALS, Permanent Supportive Housing, nursing home residents on Medicaid, people approved for maximum LT-PCS who need expedited help) are offered slots first, then everyone else by request date.
Who can be paid as the caregiver
- Adult children & other relatives Yes
- adult children and other relatives are not on the list of people barred from being PAS workers, so they can be hired through an agency or self-direction if they meet worker requirements.
- Spouse Sometimes
- under the rule amended in 2024, a spouse may be the paid PAS worker only when it is determined the participant needs extraordinary care; OAAS uses a Legally Responsible Individual request form sent to the regional office.
- Parent of a minor child Not right now
- CCW serves adults 21 and older, so the parent-of-a-minor question does not apply.
- Living together
- a PAS worker does not have to live with the participant; Monitored In-Home Caregiving is the CCW service that requires a live-in caregiver.
Who employs the caregiver: Either. The participant can use a licensed PAS provider agency that employs the worker, or choose self-direction, where the participant (or a representative) is the employer and a financial management services provider handles payroll and taxes.
Spouse rules differ by program — see spouse pay in Louisiana.
How much CCW pays
Hourly PAS wage — not published for family workers. LDH pays the provider agency (or the FMS under self-direction) a Medicaid rate for PAS billed in 15-minute units. The wage a family worker takes home is set by the agency or, under self-direction, within the participant's budget; LDH does not publish a single family-caregiver wage. For the live-in daily stipend, see Monitored In-Home Caregiving.
Hours and budget: A support coordinator builds a plan of care from the OAAS interRAI Home Care assessment. Approved PAS hours follow the plan of care, and the waiver states it does not provide help 24 hours per day.
Compare with other Louisiana programs on the Louisiana caregiver pay page, or across states in pay rates by state.
Is there a waitlist?
CCW is not an entitlement. People are placed on the CCW Request for Services Registry and offered opportunities by priority group, then first-come, first-served by the date they asked for services. The rule reserves 75 slots for people with ALS and up to 300 for emergency expedited cases.
How to apply for CCW
- Call Louisiana Options in Long Term-Care at 1-877-456-1146 and ask to be placed on the Community Choices Waiver Request for Services Registry.
- Complete the level-of-care screening so OAAS can confirm nursing home level of care.
- When a CCW opportunity is offered, apply for long-term care Medicaid if you do not already have it, and choose a support coordination agency.
- Work with the support coordinator on the plan of care, pick agency or self-direction for PAS, and name the family member you want to hire (a spouse needs the OAAS Legally Responsible Individual request).
- Louisiana Options in Long Term-Care (CCW intake) · 1-877-456-1146 · official site
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CCW questions
Can I get paid to take care of my parent under the Community Choices Waiver?
Yes, in most cases. Adult children are not on the list of people barred from being Personal Assistance Services workers, so a parent with a CCW slot can hire an adult child through a PAS agency or through self-direction.
Can a spouse be paid under CCW in Louisiana?
Only in limited cases for PAS. The 2024 rule change lets a spouse be the PAS worker when the participant needs extraordinary care, using an OAAS request form. A spouse can also be the live-in principal caregiver under Monitored In-Home Caregiving.
Is there a waiting list for the Community Choices Waiver?
Yes. CCW has a Request for Services Registry. Certain priority groups are offered slots first, and everyone else is offered a slot in order of the date they first asked for services.
Does CCW provide 24-hour care?
No. LDH states the program does not provide help 24 hours per day. Monitored In-Home Caregiving can help people who need a lot of supervision because the caregiver lives in the home.
Who handles payroll if I self-direct?
A financial management services provider. Financial management services was added as a CCW service so self-directing participants have help with payroll and taxes for the workers they hire.
Can my power of attorney or legal guardian be my paid worker?
The responsible representative cannot be the paid worker. LDH's rules list the people allowed to be PAS workers and separately bar the responsible representative, so check with your support coordinator before naming that person.
Sources: ldh.la.gov · ldh.la.gov · law.cornell.edu · ldh.la.gov · Updated 2026-10-08. Program rules change — always confirm with the program.
Where most Louisiana caregivers are
Counties with the most residents aged 65 and older. The rules are the same everywhere in Louisiana — pick yours for the local picture.
Across the line
States that border Louisiana
Each state writes its own rules, and they differ more than people expect — a spouse who can be paid on one side of the line often cannot be on the other.