Caregiver Programs in Louisiana: Paid, Respite, Support

Louisiana pays family members to provide care through the Community Choices Waiver, and a spouse can be paid as a live-in caregiver under Monitored In-Home Caregiving.1

If you are caring for an aging parent, a spouse, or an adult child with a disability in Louisiana, the hard part is rarely whether help exists. It is knowing what is there and where to start. This guide maps every major caregiver program in the state for 2026.

You don't have to figure this out alone, and you don't have to fund all of it from your savings.

In This Guide

• Louisiana Caregiver Programs at a Glance
• Louisiana Caregiver Programs That Pay Family Members
• How to Start Community Choices (CCW)1
• Respite Care Programs
• Where to Get Help in Louisiana
• VA Caregiver Benefits in Louisiana
• Taxes for Louisiana Caregivers
• Frequently Asked Questions
• Learn More

Louisiana Caregiver Programs at a Glance

Louisiana Caregiver Programs That Pay Family Members

When you are already doing the daily work of caring for someone you love, asking to be paid for it can feel awkward, or even out of reach. It is neither. Louisiana delivers paid family care through the Department of Health, Office of Aging and Adult Services (OAAS), primarily under the Community Choices Waiver (CCW), a Section 1915(c) home and community-based services waiver for people 21 and older with adult-onset disabilities or older adults who meet a nursing-facility level of care.1

CCW Self-Direction

Under the CCW self-direction option, a participant acts as the employer of record and can hire, train, supervise, and dismiss their own Direct Service Worker (DSW) for personal assistance, with a Fiscal Employer Agent handling payroll.2

The spouse rule: the participant's spouse is treated as a Legally Responsible Individual (LRI) and cannot be paid as the DSW by default. For a spouse to be hired, the spouse must meet Extraordinary Care criteria and the arrangement must be approved by OAAS: the participant notifies the employer of record, who completes the LRI/Spouse-as-DSW Request Form and emails it to the OAAS Regional Office. If OAAS approves, the hiring proceeds. Non-spouse relatives such as an adult child do not require this exception and may be hired directly.2

Monitored In-Home Caregiving (MIHC)

Monitored In-Home Caregiving (MIHC) is a CCW service in which a principal caregiver lives in the same private home as the participant (a model similar to adult foster care) and provides hands-on help with basic self-care. The live-in principal caregiver can be a friend or relative, including an adult child or a spouse, and is paid to provide the care. MIHC is delivered through a contracted MIHC provider agency that trains and supports the caregiver and uses technology to monitor care. It is structured as a caregiver payment arrangement rather than the participant running their own payroll.1

Long Term-Personal Care Services (LT-PCS)

LT-PCS is a Louisiana Medicaid State Plan benefit administered by OAAS that helps people 21 and older with activities of daily living. It is the agency-delivered personal care option that complements the CCW; because it does not allow self-direction, care is provided through a licensed provider agency rather than a worker you hire.6

For the full guide to paid pathways: How to Get Paid as a Family Caregiver in Louisiana.

How to Start the Community Choices Waiver

Here is the part families are often not told up front: the Community Choices Waiver is not an entitlement. There are a limited number of enrollment slots, and when they are full, the state places applicants on a waiting list called the Request for Services Registry. Getting your name on that registry early is the single most useful thing you can do, even if care is not needed the moment you call.1

Respite Care Programs

Medicaid Respite (CCW)

The Community Choices Waiver authorizes respite as a covered service within the participant's plan of care. Ask your OAAS support coordinator to include respite hours.3

NFCSP Grants Through Louisiana's Area Councils on Aging

The National Family Caregiver Support Program (NFCSP), funded by Title III-E of the Older Americans Act, flows through the Governor's Office of Elderly Affairs to Louisiana's parish-based Area Councils on Aging. Services include in-home respite, adult day vouchers, caregiver training, and counseling, with no income test for respite services. Call 1-866-758-5659.3

For the full respite guide: Respite Care in Louisiana.

Where to Get Help in Louisiana

You do not have to know which program you need before you call. One call to the right office can sort out what your parish offers and start an application, and these lines are free.1,3

If your loved one is already enrolled in the CCW, your OAAS support coordinator is the person to call to adjust the plan of care, including adding respite or arranging a paid family worker.

VA Caregiver Benefits in Louisiana

If your loved one served, you may have a second set of doors to knock on, and they often open wider than Medicaid does. Veterans enrolled in VA health care in Louisiana have access to caregiver support programs that are separate from Medicaid and frequently more generous.

VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

The PCAFC pays a monthly stipend to the Primary Family Caregiver of an eligible veteran. The stipend is calculated from the federal GS-4, Step 1 annual rate for the veteran's locality, divided by 12, then multiplied by a level factor. It is federal tax-free and allows paid spouses. To qualify, the veteran must have a VA disability rating, individual or combined, of 70 percent or higher. Primary Family Caregivers also receive CHAMPVA health coverage if otherwise uninsured and at least 30 days of respite care a year.7

Veteran-Directed Care (VDC) is also available in Louisiana, letting the veteran direct a flexible budget toward caregiver pay, including a spouse, without the OAAS exception process the CCW requires. Ask the Caregiver Support Coordinator at your VA medical center, such as the Southeast Louisiana Veterans Health Care System in New Orleans, whether Veteran-Directed Care is offered in your area.4

VA Aid and Attendance Pension

Wartime veterans and surviving spouses who meet the functional criteria and have countable assets and income under the net-worth limit ($163,699 in 2026) may receive the Aid and Attendance pension. A single veteran with Aid and Attendance receives up to $2,424 per month ($29,093 per year); a veteran with one dependent up to $2,874 per month. The pension goes to the veteran, who typically pays a family caregiver from it.8

The Louisiana Department of Veterans Affairs and parish Veterans Service Officers help file at no cost. To reach a VA Caregiver Support Coordinator, call the VA Caregiver Support Line listed in the resources above.

Taxes for Louisiana Caregivers

IRS Notice 2014-7

If you live in the same home as the person you care for and are paid through a Medicaid program, your wages may be excluded from federal gross income under IRS Notice 2014-7. This applies to many Louisiana CCW self-direction and MIHC arrangements. Talk to a tax preparer familiar with the rule before filing.

Louisiana State Income Tax

For tax years beginning on or after January 1, 2025, Louisiana taxes individual income at a flat 3 percent, replacing the state's old graduated brackets. Because Louisiana starts from your federal adjusted gross income, the IRS Notice 2014-7 exclusion may carry through to your Louisiana return and lower what the state counts too.5

VA PCAFC Stipend

The PCAFC monthly stipend is federal tax-free and is not reported on a W-2.

Learn More

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.