Louisiana Community Choices Waiver Family Caregiver Pay (2026)

A family member caring for a parent, spouse or other relative at home in Louisiana can be paid through Medicaid, as a worker the person hires, and some can be paid as live-in caregivers.1,2 Both routes belong to the Louisiana Community Choices Waiver (CCW), and family caregiver pay starts with one call to join its waiting list.2

Which Family Caregivers Can Be Paid Under Louisiana's Community Choices Waiver?

The CCW is Louisiana's Medicaid home and community-based services waiver for people 65 and older and adults 21 to 64 with physical disabilities who meet a nursing facility level of care, run by OAAS.2 The CCW's June 2024 rule (Louisiana Administrative Code 50:XXI.8307 and 8329) and the OAAS Self-Direction Employer Handbook, reissued July 11, 2024, set who the CCW can pay.1 Other Louisiana routes, including VA programs, are in how to get paid as a family caregiver in Louisiana.

A yes in the MIHC column means the rule allows that person, not that they'll be paid: the licensed MIHC provider must still assess and approve the home and approve and train the caregiver before it contracts with them.1

The MIHC rule doesn't name adult children and bars only the responsible representative, so ask OAAS or the MIHC provider: "Can an adult child be the MIHC principal caregiver?"1

Self-Direction: Your Parent Hires You

Personal Assistance Services is the only CCW service that can be self-directed, which makes the participant the employer of the workers they choose.2 To self-direct, a CCW participant must be able to do it without a decline in care or added risk to health and welfare, complete the support coordinator's mandatory overview, understand the responsibilities of managing their own care and budget, and follow wage and overtime law.2

If your parent can't make decisions independently, CCW self-direction requires a responsible representative to act as the employer, and the OAAS handbook bars the employer and the responsible representative from being the paid worker.2 So if you're the daughter who manages everything and you want to be the paid worker, someone else has to be the employer and responsible representative.

If the worker would be a spouse. To be paid as a CCW self-direction worker, a spouse counts as a Legally Responsible Individual under the OAAS handbook and must meet Extraordinary Care criteria approved by OAAS, which sends its decision to the employer, the Fiscal Employer Agent and the support coordinator.2 The request form, the criteria and what happens on a no are in getting paid to care for your spouse in Louisiana.

Monitored In-Home Caregiving: Paid to Live With and Care for Them

A MIHC principal caregiver lives with the participant and helps with basic self-care such as dressing and bathing. MIHC providers must be licensed home and community-based services providers with a monitored in-home caregiving module, and the provider pays per diem stipends to caregivers.1 The Louisiana Department of Health (LDH) lists no stipend amount on its CCW page, so ask each provider what it pays.2

The MIHC rule names the spouse outright, with no Extraordinary Care step, though the provider must still approve, train and contract with the spouse as caregiver. While a participant receives MIHC, they can't also receive CCW Personal Assistance Services or home-delivered meals.1,2

How Family Caregiver Pay Works Under Louisiana's Community Choices Waiver

Under Louisiana CCW self-direction, your parent chooses a Fiscal Employer Agent (FEA), Acumen Fiscal Agent or Morning Sun Financial Services. The FEA processes CCW self-direction payroll at least every two weeks, makes the required tax withholding and deposits, helps with workers' compensation and unemployment insurance, and runs the background and database screening. You're your parent's employee, not the FEA's.2

To be a paid CCW self-direction worker in Louisiana, you must be at least 18, be able to do the tasks on the Plan of Care, have a valid Social Security number, and pass criminal history, adverse actions list and exclusion database checks. The CCW employer repeats the database checks monthly, and Medicaid can't pay a CCW worker until the checks are verified.2 CCW work done before the FEA issues its Good to Go date isn't paid.2

The FEA helps with budgeting, so ask it or the support coordinator what hourly rate your parent's budget supports before you count on a paycheck.2 PAS hours aren't unlimited, but neither the June 2024 CCW rule nor the OAAS handbook states a fixed weekly number. Under self-direction, the OAAS handbook says hours are approved in your parent's plan of care, based on their needs, and can't exceed the annual budget allocation set by their assessment.1

How to Start in Louisiana

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Find personalized help getting paid as a family caregiver through Louisiana's Community Choices Waiver at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.