Waiver Description
The Louisiana Community Choices Waiver (CCW) is a program for elderly and / or disabled Louisiana residents. This program, which replaced the Elderly and Disabled Adult Waiver, provides a wide range of services and supports to assist elderly state residents in maintaining their independence. In other words, it helps to prevent institutionalization in nursing homes by providing support at home, in assisted living facilities, and in adult foster care homes.
In addition to in-home support services, this waiver offers a unique benefit called Monitored In-Home Caregiving (MIHC), which can loosely be compared to adult foster care. Under MIHC, a family member or friend can live with the care recipient and get paid to provide care. Adult children and even spouses can be compensated for providing care under MIHC.
Unfortunately, a waiting list to receive services may exist. In Louisiana’s Medicaid language, this is referred to as a Request for Services Registry (RFSR). Persons experiencing abuse or neglect receive the highest priority. Other conditions that increase priority include a diagnosis of Lou Gehrig’s disease (Amyotrophic Lateral Sclerosis), a lack of benefits from other Louisiana Medicaid waiver programs, and those individuals currently residing in nursing homes who are able to return home with services via the Community Choices Waiver.
What is a Medicaid Waiver?
Medicaid Waivers, also known as Home and Community Based Services (HCBS) Waivers, allow qualifying program participants to receive services outside of a nursing home. Medicaid’s standard benefit is to pay for nursing home care. However, those who wish to live at home, in assisted living or in adult foster care, sometimes Medicaid will pay for nursing-home-level care in those locations if it can be obtained at a lower cost than in a nursing home.
Eligibility Guidelines
General Requirements
The Community Choice Waiver is designed for residents of Louisiana age 65 and over and for physically disabled individuals between the ages of 21 and 64. Waiver participants must require the level of care provided in a nursing home, but choose to receive that care outside of a nursing home environment.
Financial Requirements
Income Limits
In addition to the medical eligibility requirements, individuals must be financially eligible to receive long-term care Medicaid. As of 2023, an individual’s monthly income cannot exceed more than 300% of the SSI Federal Benefit Rate (FBR). This currently means that an individual cannot have a monthly income greater than $2,742. For a married couple in which both spouses are applying, the income limit is doubled to $5,484.
For couples with only one spouse applying, the applicant spouse can transfer income to the non-applicant spouse as a Monthly Maintenance Needs Allowance. In 2023, the maximum amount that can be transferred is $3,715.50.
Asset Limits
In addition to income limits, asset limits also exist. An individual cannot have countable resources (assets) in excess of $2,000. For couples, the asset limit is slightly higher at $3,000.
When only one spouse of a couple is applying, the non-applicant spouse is able to retain up to $148,620 in assets. In addition, some assets are considered exempt (not counted toward the asset limit). One’s home, with an equity value up to $688,000, an automobile, household belongings, personal items, and burial trusts are all considered exempt items.
Over the Financial Limits?
One can still qualify for CCW if he or she exceeds the asset and /or income limits. For example, Louisiana Medicaid has a Medically Needy clause where individuals who have very high medical bills relative to their income can still qualify. Individuals who have questions about the Medically Needy process, or who exceed the asset and / or income limits should seek assistance qualifying for Medicaid before submitting their application paperwork. Learn more.
Benefits and Services
The Community Choices Waiver provides a wide variety of services and supports for the elderly and disabled residents of Louisiana. The following is a list of possible services; actual services are specific to the participant. Some of these services, such as personal assistance services, are open to consumer-direction. This means the program participant can choose the caregiver of their choice, including friends and some family members. (Spouses and legal guardians, with the exception of MIHC, cannot be hired to provide care.)
- Adult day health care / Adult day care
- Assistive technology – includes personal emergency response systems
- Case management
- Durable medical equipment
- Disposable medical supplies
- Home modifications to increase an individual’s independence – ramps, lifts, roll shower, widening of doorways, etc.
- Monitored In-Home Caregiving*
- Personal assistance with the activities of daily living, such as dressing, toileting, mobility, and bathing
- Personal assistance with instrumental activities of daily living, such as meal preparation, light housecleaning, and grocery shopping
- Meal delivery
- Physical, occupational, and speech therapy
- Respite care – in-home and out-of-home
- Supports and services to assist individuals moving out of nursing homes
- Skilled nursing (on a temporary basis)
*Applicants who choose Monitored In-Home Caregiving are not able to receive the following additional services while enrolled in this benefit: Adult day health care, meal delivery, and personal assistance services.
How to Apply / Learn More
One can read more about the Community Choices Waiver or begin the application process by accessing this PDF, or by calling the Louisiana Options in Long Term Care helpline at 877-456-1146. Limited information is also available on the Louisiana Department of Health website.
Current Waiting Lists and Alternatives
The waiting list for the Community Choices Waiver in Louisiana can be multiple years long. Some alternatives that seniors in Louisiana should consider include:
