Louisiana's Community Choices Waiver can pay a family caregiver two ways: as a self-directed worker the participant hires, or as a live-in principal caregiver under Monitored In-Home Caregiving.Louisiana Department of Health. (2024). Final Rule - Home and Community-Based Services Waivers, Community Choices Waiver (LAC 50:XXI.Chapters 81-95), LDH Bureau of Health Services Financing and OAAS (June 2024) - ldh.la.gov. ldh.la.gov. Retrieved Oct 14, 2026, from https://www.ldh.la.gov/assets/medicaid/Rulemaking/FinalRules/June2024FinalRules.pdf
A spouse can be the self-directed worker only with Extraordinary Care approval from the state, but the waiver's rule allows a spouse to be the live-in caregiver under Monitored In-Home Caregiving, if the licensed provider approves the home and the caregiver.Centers for Medicare & Medicaid Services. (1915). CMS Medicaid.gov — Louisiana 1915(c) Waiver Factsheet (LA Community Choices (CC) Waiver, 0866.R02.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/LA,Louisiana Department of Health. (2024). Final Rule - Home and Community-Based Services Waivers, Community Choices Waiver (LAC 50:XXI.Chapters 81-95), LDH Bureau of Health Services Financing and OAAS (June 2024) - ldh.la.gov. ldh.la.gov. Retrieved Oct 14, 2026, from https://www.ldh.la.gov/assets/medicaid/Rulemaking/FinalRules/June2024FinalRules.pdf The other Louisiana caregiver programs below add personal care, respite and VA help.
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)Centers for Medicare & Medicaid Services. (1915). CMS / Medicaid.gov - Louisiana 1915(c) Waiver Factsheet (LA Community Choices (CC) Waiver 0866.R02.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/LA
- 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
| Program | What It Offers | Who Qualifies | Cost to You |
|---|---|---|---|
| CCW self-direction | Participant hires their own Direct Service Worker (a spouse must meet Extraordinary Care criteria and get OAAS approval) | CCW participants who meet the self-direction requirements | Paid by Medicaid |
| Monitored In-Home Caregiving (MIHC) | A live-in principal caregiver helps with basic self-care, and the provider pays a per diem stipend (amount not in rule or LDH page); a spouse, curator, tutor, legal guardian or POA may be the caregiver, subject to provider approval, the responsible representative may not | CCW participants | Paid by Medicaid |
| NFCSP | Information, access help, counseling, support groups, training, respite, limited supplemental services | Caregivers of adults 60+ or of a person of any age with Alzheimer's or a related disorder; respite and supplemental services only when the older adult is frail | Ask your Area Agency on Aging |
| VA PCAFC | Monthly stipend to the Primary Family Caregiver; spouses can qualify | Veteran rated 70%+ who also meets VA's other requirements | VA benefit |
| VA Aid and Attendance | Pension up to $29,093/yr for a veteran with no dependents, less countable income | Wartime veteran or surviving spouse under the net-worth limit | LDVA files claims free |
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 Medicaid home and community-based services waiver. CMS describes the people it serves as those 65 or older and those 21 to 64 with physical disabilities who meet a nursing-facility level of care. LDH also notes that CCW does not provide help 24 hours a day.Centers for Medicare & Medicaid Services. (1915). CMS / Medicaid.gov - Louisiana 1915(c) Waiver Factsheet (LA Community Choices (CC) Waiver 0866.R02.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/LA
CCW Self-Direction
Self-direction is a CCW service delivery option that allows participants to become the employers of the people they choose to hire to provide supports for them, called Direct Service Workers (DSWs). Personal Assistance Services is the only CCW service that can be self-directed. A Fiscal Employer Agent (FEA), either Acumen Fiscal Agent or Morning Sun Financial Services, processes payroll at least every two weeks and handles the required tax withholding.Centers for Medicare & Medicaid Services. (n.d.). CMS / Medicaid.gov - Louisiana Waiver Factsheet (LA Community Choices (CC) Waiver 0866.R02.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/LA
Self-direction has its own entry test. Among the handbook's requirements, the participant must be in CCW, be able to self-direct without a lapse or decline in the quality of care or an increased risk to health and welfare, understand the rights, risks and responsibilities of managing their own care and budget, and comply with all state and federal laws and regulations, including wage and overtime requirements. A participant who cannot make decisions independently needs a responsible representative to act as the employer.Centers for Medicare & Medicaid Services. (1915). CMS Medicaid.gov — Louisiana 1915(c) Waiver Factsheet (LA Community Choices (CC) Waiver, 0866.R02.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/LA
Who can be the paid worker: the worker must be at least 18, able to do the tasks in the plan of care, have a valid Social Security Number, and pass criminal background, adverse actions list and exclusion database checks. The employer must repeat those database checks monthly, and Medicaid cannot pay the worker until the checks are verified. The worker is not paid for any work done before the FEA issues the "Good to Go" date. The worker cannot be the participant, the participant's employer, or the participant's responsible representative. Because of that list, an adult child who acts as the participant's employer or responsible representative cannot also be the paid worker.Centers for Medicare & Medicaid Services. (1915). CMS Medicaid.gov — Louisiana 1915(c) Waiver Factsheet (LA Community Choices (CC) Waiver, 0866.R02.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/LA
The spouse rule: the participant's spouse is treated as a Legally Responsible Individual (LRI). 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, who completes the LRI/Spouse Request Form and emails it to the OAAS Regional Office. If OAAS approves, the hiring proceeds. If it does not, the spouse cannot be the employee and another worker must be found.Centers for Medicare & Medicaid Services. (1915). CMS Medicaid.gov — Louisiana 1915(c) Waiver Factsheet (LA Community Choices (CC) Waiver, 0866.R02.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/LA
Monitored In-Home Caregiving (MIHC)
Monitored In-Home Caregiving (MIHC) is a CCW service in which, in LDH's words, "a principal caregiver lives with you and helps you with basic self-care, such as dressing, bathing, etc."Centers for Medicare & Medicaid Services. (1915). CMS Medicaid.gov — Louisiana 1915(c) Waiver Factsheet (LA Community Choices (CC) Waiver, 0866.R02.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/LA Our structured family caregiving guide compares MIHC with similar programs elsewhere.
Who may be that caregiver is set by Louisiana's CCW rule (LAC 50:XXI.8329, as amended in June 2024). The participant's spouse, curator, tutor, legal guardian, or the person holding power of attorney is allowed to be the MIHC principal caregiver. The participant's responsible representative is not. Unlike self-directed Personal Assistance Services, the rule attaches no Extraordinary Care condition to a spouse for MIHC. Being on that list does not by itself make someone the paid caregiver. The provider, a licensed home and community-based services provider with an MIHC module, must approve the home and contracts only with caregivers it has approved and trained. It pays them per diem stipends, but neither the rule nor LDH's CCW page states an amount, so ask the provider. While a participant receives MIHC, they cannot also receive CCW Personal Assistance Services or home-delivered meals. The rule neither names nor bars an adult child, so if an adult child would be the caregiver, ask your support coordinator how OAAS treats that case.Louisiana Department of Health. (2024). Final Rule - Home and Community-Based Services Waivers, Community Choices Waiver (LAC 50:XXI.Chapters 81-95), LDH Bureau of Health Services Financing and OAAS (June 2024) - ldh.la.gov. ldh.la.gov. Retrieved Oct 14, 2026, from https://www.ldh.la.gov/assets/medicaid/Rulemaking/FinalRules/June2024FinalRules.pdf
Long Term-Personal Care Services (LT-PCS)
LT-PCS is a Louisiana Medicaid program of OAAS that helps with activities of daily living such as eating, bathing, dressing, and toileting. To qualify, a person must receive Medicaid, be 21 or older, qualify for nursing home care, need at least limited assistance with one activity of daily living, and be able to direct their care independently or through a responsible representative. They must also be in a nursing facility and able to be discharged if community-based services were available, be likely to need nursing facility admission within 120 days, or have a primary caregiver who has a disability or is at least 70. LT-PCS does not pay for help already being given by family or others, and LDH lists self-direction under CCW, not LT-PCS.Centers for Medicare & Medicaid Services. (2022). Louisiana SPA LA-22-0014 (CMS-approved Attachment 3.1-A, Item 26, Personal Care Services, eff. July 1, 2022) - medicaid.gov. medicaid.gov. Retrieved Sep 29, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/LA-22-0014.pdf
Who can be the paid LT-PCS worker: Louisiana's LT-PCS rule bars payment to the recipient's spouse, curator, tutor, legal guardian, designated responsible representative, or the person holding power of attorney. LDH's Medicaid Services Manual (Chapter 30, issued April 21, 2025) repeats the same list. An adult child is not on that list unless they also hold one of those roles, and family members who provide LT-PCS must meet the same employment standards as unrelated caregivers. LT-PCS is limited to up to 32 hours a week, with hours authorized case by case from the plan of care. A participant may live in the worker's home only if the worker is related by blood or marriage and it is the participant's choice; OAAS can waive that in writing.Centers for Medicare & Medicaid Services. (2022). Louisiana State Plan Amendment TN 22-0014 - Attachment 3.1-A, Item 26 (Personal Care Services), effective July 1, 2022 - medicaid.gov. medicaid.gov. Retrieved Oct 14, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/LA-22-0014.pdf
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: meeting the requirements does not, by itself, get you into the Community Choices Waiver. LDH keeps a Request for Services Registry for people requesting CCW services, offers openings first to six priority groups, and gives everyone else an offer on a first-come, first-served basis based on the date they asked for services. The date you first ask is what counts, so call early.Centers for Medicare & Medicaid Services. (1915). CMS / Medicaid.gov - Louisiana 1915(c) Waiver Factsheet (LA Community Choices (CC) Waiver 0866.R02.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/LA
Call Louisiana Options in Long-Term Care
Dial 1-877-456-1146 to request Community Choices Waiver services and be placed on the Request for Services Registry.Centers for Medicare & Medicaid Services. (1915). CMS / Medicaid.gov - Louisiana 1915(c) Waiver Factsheet (LA Community Choices (CC) Waiver 0866.R02.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/LA
Check eligibility
Your loved one must meet long-term-care Medicaid eligibility, be 21 or older, and meet nursing-home level of care. CMS describes the people served as those 65 or older, or 21 to 64 with a physical disability.Centers for Medicare & Medicaid Services. (1915). CMS / Medicaid.gov - Louisiana 1915(c) Waiver Factsheet (LA Community Choices (CC) Waiver 0866.R02.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/LA
Know where you stand in line
The priority groups are people who have been abused or neglected and are referred by protective services who, without CCW services, would need to go to a nursing home to prevent further abuse and neglect; people with ALS; people in or linked to Permanent Supportive Housing; nursing-home residents for whom Medicaid is the only payer; people approved for 32 hours of LT-PCS who would otherwise need a nursing home; and people not getting PACE, LT-PCS, or another Medicaid home and community-based program. Everyone else gets an offer in order of the date they asked.Centers for Medicare & Medicaid Services. (1915). CMS / Medicaid.gov - Louisiana 1915(c) Waiver Factsheet (LA Community Choices (CC) Waiver 0866.R02.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/LA
Build the plan of care with your support coordinator
Once enrolled, ask about caregiver respite, personal care, and monitored in-home caregiving, which are all CCW services, and whether you want to self-direct Personal Assistance Services, the only CCW service that can be self-directed.Centers for Medicare & Medicaid Services. (1915). CMS / Medicaid.gov - Louisiana 1915(c) Waiver Factsheet (LA Community Choices (CC) Waiver 0866.R02.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/LA
Respite Care Programs
Medicaid Respite (CCW)
CCW's respite service is called Caregiver Temporary Support: short-term relief to allow caregivers time for rest. As a CCW service, it runs through the CCW eligibility rules and registry described above. Ask your support coordinator to include it.Administration for Community Living. (n.d.). National Family Caregiver Support Program. acl.gov. Retrieved Jun 3, 2026, from https://acl.gov/programs/support-caregivers/national-family-caregiver-support-program
NFCSP Through Louisiana's Area Agencies on Aging
The National Family Caregiver Support Program (NFCSP), funded by Title III-E of the Older Americans Act, makes federal grants to states, and its services are provided by an area agency on aging or an entity it contracts with. In Louisiana, the Governor's Office of Elderly Affairs (GOEA) administers home and community based services through a network of Area Agencies on Aging.U.S. Government Publishing Office. (2024). 42 U.S.C. §3030s-1 — Program authorized (Older Americans Act, Title III Part E; U.S. Code 2024 ed., govinfo.gov). govinfo.gov. Retrieved Oct 12, 2026, from https://www.govinfo.gov/link/uscode/42/3030s-1?link-type=html,goea.louisiana.gov. (n.d.). Louisiana State Aging / ADRC Network. Retrieved Jul 13, 2026, from https://goea.louisiana.gov/
The program funds information about services, help getting access to them, counseling, support groups and caregiver training, respite care, and limited supplemental services. Caregivers of someone 60 or older, or of someone of any age with Alzheimer's disease or a related disorder, can qualify. Respite and supplemental services carry an extra condition: the older adult must be frail, meaning unable to perform at least two activities of daily living without substantial help, or needing substantial supervision because a cognitive or other mental impairment makes their behavior a serious health or safety hazard.U.S. Government Publishing Office. (2024). 42 U.S.C. §3030s-1 — Program authorized (Older Americans Act, Title III Part E; U.S. Code 2024 ed., govinfo.gov). govinfo.gov. Retrieved Oct 12, 2026, from https://www.govinfo.gov/link/uscode/42/3030s-1?link-type=html
For the full respite guide: Respite Care in Louisiana.
Where to Get Help in Louisiana
You do not need to know which program fits before you call.Centers for Medicare & Medicaid Services. (1915). CMS / Medicaid.gov - Louisiana 1915(c) Waiver Factsheet (LA Community Choices (CC) Waiver 0866.R02.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/LA,goea.louisiana.gov. (n.d.). Louisiana State Aging / ADRC Network. Retrieved Jul 13, 2026, from https://goea.louisiana.gov/
The VA Caregiver Support Line is open Monday through Friday, 8:00 a.m. to 8:00 p.m. ET. If you or the veteran are in crisis or having thoughts of suicide, use the Veterans Crisis Line instead: call 988 and press 1, or text 838255.U.S. Department of Veterans Affairs. (n.d.). VA's National Caregiver Support Line (CSL) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Aug 1, 2026, from https://www.caregiver.va.gov/help_landing.asp
VA Caregiver Benefits in Louisiana
If your loved one served, you may have a second set of doors to knock on. VA runs caregiver programs that are separate from Medicaid, each with its own eligibility rules.
VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)
The PCAFC pays a monthly stipend to the Primary Family Caregiver of an eligible veteran, and a spouse can be that caregiver. A VA disability rating, individual or combined, of 70 percent or higher is only one of VA's four requirements: the veteran must also have been discharged or have a date of medical discharge, need at least 6 months of continuous, in-person personal care services, and be enrolled in VA health care. Even then, you and the veteran apply together, and VA decides eligibility through that application process. The caregiver must be at least 18 and either a family member or someone who lives full time with the veteran, or is willing to.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp
Primary Family Caregivers may also get access to CHAMPVA health care benefits if they don't already qualify for care under another health plan, and at least 30 days of respite care a year. The stipend is paid only by direct deposit.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp
The stipend starts from the federal GS-4, Step 1 annual rate for the veteran's locality, divided by 12, then multiplied by a stipend factor. Under 38 CFR 71.40(c)(4)(i) that factor comes from one of two schedules, depending on how the veteran qualifies:U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp
- Current program (the veteran was approved under the eligibility criteria now in force): the factor is 0.625, or 1.00 if VA determines the veteran is unable to self-sustain in the community.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp
- Legacy participant or legacy applicant (the household was already in PCAFC, or had applied, before the program's October 1, 2020 expansion): the factor is set by the sum of the veteran's 2019 clinical ratings, and no self-sustain determination is required. It is 1.00 if that sum is 21 or higher, 0.625 if it is 13 to 20, and 0.25 if it is 1 to 12.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp
A veteran who meets both sets of criteria is paid at whichever factor is higher, so a legacy household whose 2019 ratings summed to 21 or more reaches 1.00 on the rating schedule alone, with no self-sustain finding. A legacy participant's stipend also cannot fall below what the caregiver was eligible for on September 30, 2020, while the veteran stays at the address VA has on record. The legacy rules end on October 1, 2028. Confirm your figure, and which schedule you are on, with your VA Caregiver Support Coordinator.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp
Veteran-Directed Care (VDC) is for veterans who need personal care services and help with activities of daily living, such as bathing, dressing, or fixing meals. According to ACL, through the management of a flexible service budget, enrolled veterans may hire family, friends, or neighbors to provide services. Neither VA nor ACL says whether a spouse can be paid, so confirm with the VA medical center serving you before you plan around it. ACL says VA medical centers work directly with local aging and disability network agencies, such as area agencies on aging and aging and disability resource centers, to deliver VDC.U.S. Department of Veterans Affairs. (n.d.). Veteran-Directed Care - Geriatrics and Extended Care. va.gov. Retrieved Jun 3, 2026, from https://www.va.gov/geriatrics/pages/Veteran-Directed_Care.asp
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.U.S. Department of Veterans Affairs. (n.d.). Eligibility For Veterans Pension. va.gov. Retrieved Jul 31, 2026, from https://www.va.gov/pension/eligibility/ The maximum annual rate for a single veteran with Aid and Attendance is $29,093, and $34,488 for a veteran with one dependent. That rate is a ceiling: VA pays the difference between it and your income for VA purposes, and unreimbursed medical expenses above 5 percent of the rate can lower that income. VA computes the monthly payment by dividing the yearly amount by 12, rounded down to the whole dollar.U.S. Department of Veterans Affairs. (n.d.). Current Pension Rates For Veterans. va.gov. Retrieved Sep 3, 2026, from https://www.va.gov/pension/veterans-pension-rates/
The Louisiana Department of Veterans Affairs says its VA-accredited veterans assistance counselors file VA claims, including pension claims, free of charge.U.S. Government Publishing Office. (n.d.). 38 CFR 14.636 — Payment of fees for representation by agents and attorneys in proceedings before Agencies of Original Jurisdiction and before the Board of Veterans' Appeals. ecfr.gov. Retrieved Aug 1, 2026, from https://www.ecfr.gov/current/title-38/chapter-I/part-14/subject-group-ECFR6d0a8c39a3b0d19/section-14.636 For a VA Caregiver Support Coordinator, call the Caregiver Support Line above.
Taxes for Louisiana Caregivers
IRS Notice 2014-7
IRS Notice 2014-7 treats certain payments to individual care providers under a state Medicaid Home and Community-Based Services waiver program described in section 1915(c) of the Social Security Act as difficulty of care payments excludable from gross income. The exclusion only applies to payments for care in the individual care provider's home where the care recipient lives under the recipient's plan of care, and it may apply whether the care provider is related or unrelated to the person receiving care. For a state program other than such a waiver, the IRS says the treatment will depend on the nature of the payments and the purpose and design of the program, so do not assume every Medicaid program qualifies. Talk to a tax preparer familiar with the rule before filing.Internal Revenue Service. (n.d.). Certain Medicaid waiver payments may be excludable from income. irs.gov. Retrieved Jul 10, 2026, from https://www.irs.gov/individuals/certain-medicaid-waiver-payments-may-be-excludable-from-income
Louisiana State Income Tax
For tax years beginning on or after January 1, 2025, Louisiana taxes individual income at a flat 3 percent, and the state's old graduated brackets were repealed. The same law raised the standard deduction from $4,500 to $12,500 for single and married-filing-separately filers, and from $9,000 to $25,000 for married couples filing jointly, heads of household and qualifying surviving spouses. The amounts adjust for inflation each year starting January 1, 2026, so check the figure for the year you file. It also repealed the additional exemptions for dependents, blind persons, and people over 65, so if you claimed one of those, compare the old and new rules before assuming you come out ahead.revenue.louisiana.gov. (n.d.). What are the individual income tax rates and brackets?, Louisiana Department of Revenue. Retrieved Aug 1, 2026, from https://revenue.louisiana.gov/tax-education-and-faqs/faqs/income-tax-reform/what-are-the-individual-income-tax-rates-and-brackets/
VA PCAFC Stipend
In its 2020 proposed PCAFC rule, VA described the monthly stipend as a nontaxable benefit.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
Not sure which Louisiana caregiver program fits your family? Chat with Brevy's care navigator for a personalized comparison based on your loved one's Medicaid enrollment, veteran status, and whether you live together.
Frequently Asked Questions
Can I get paid to care for my spouse in Louisiana?
Possibly, with approval. Under CCW self-direction, a spouse can be the paid Direct Service Worker only if the spouse meets Extraordinary Care criteria and OAAS approves the LRI/Spouse Request Form.Centers for Medicare & Medicaid Services. (1915). CMS Medicaid.gov — Louisiana 1915(c) Waiver Factsheet (LA Community Choices (CC) Waiver, 0866.R02.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/LA If your spouse is a veteran who qualifies for PCAFC, VA lets a spouse be the Primary Family Caregiver who receives the stipend.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp Monitored In-Home Caregiving is a second route, and its rule attaches no Extraordinary Care condition: the CCW rule allows a spouse to be the live-in caregiver if the licensed provider approves the home and the caregiver.Louisiana Department of Health. (2024). Final Rule - Home and Community-Based Services Waivers, Community Choices Waiver (LAC 50:XXI.Chapters 81-95), LDH Bureau of Health Services Financing and OAAS (June 2024) - ldh.la.gov. ldh.la.gov. Retrieved Oct 14, 2026, from https://www.ldh.la.gov/assets/medicaid/Rulemaking/FinalRules/June2024FinalRules.pdf LT-PCS is not a route for a spouse, because its rule bars paying the recipient's spouse.Centers for Medicare & Medicaid Services. (2022). Louisiana State Plan Amendment TN 22-0014 - Attachment 3.1-A, Item 26 (Personal Care Services), effective July 1, 2022 - medicaid.gov. medicaid.gov. Retrieved Oct 14, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/LA-22-0014.pdf
What is Monitored In-Home Caregiving?
MIHC is a Community Choices Waiver service in which a principal caregiver lives with the participant and helps with basic self-care, such as dressing and bathing.Centers for Medicare & Medicaid Services. (1915). CMS Medicaid.gov — Louisiana 1915(c) Waiver Factsheet (LA Community Choices (CC) Waiver, 0866.R02.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/LA Louisiana's CCW rule allows the participant's spouse, curator, tutor, legal guardian or power of attorney to be that caregiver and bars the responsible representative. The licensed provider must approve the home and the caregiver, and pays a per diem stipend. Neither the rule nor LDH's page states the amount, so ask the provider.Louisiana Department of Health. (2024). Final Rule - Home and Community-Based Services Waivers, Community Choices Waiver (LAC 50:XXI.Chapters 81-95), LDH Bureau of Health Services Financing and OAAS (June 2024) - ldh.la.gov. ldh.la.gov. Retrieved Oct 14, 2026, from https://www.ldh.la.gov/assets/medicaid/Rulemaking/FinalRules/June2024FinalRules.pdf
How do I apply for the Community Choices Waiver in Louisiana?
Call Louisiana Options in Long-Term Care at 1-877-456-1146 to request CCW services and be placed on the Request for Services Registry. Outside six priority groups, offers go first-come, first-served by the date you asked, so it is worth calling early.Centers for Medicare & Medicaid Services. (1915). CMS / Medicaid.gov - Louisiana 1915(c) Waiver Factsheet (LA Community Choices (CC) Waiver 0866.R02.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/LA
Who can be a paid Direct Service Worker under CCW self-direction?
The worker must be at least 18, able to do the tasks in the plan of care, have a valid Social Security Number, and pass background and database checks. The worker cannot be the participant, the employer, or the responsible representative. A curator, tutor, legal guardian, or power of attorney can be hired, and a spouse can be hired only if the spouse meets Extraordinary Care criteria and OAAS approves. An adult child who is the employer or responsible representative cannot also be paid.Centers for Medicare & Medicaid Services. (1915). CMS Medicaid.gov — Louisiana 1915(c) Waiver Factsheet (LA Community Choices (CC) Waiver, 0866.R02.00). medicaid.gov. Retrieved Sep 4, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/LA
Can I get respite in Louisiana without Medicaid?
Possibly. The National Family Caregiver Support Program funds respite through area agencies on aging, but only when the older adult you care for is frail, meaning they need substantial help with at least two activities of daily living or substantial supervision because a cognitive or other mental impairment makes their behavior a serious health or safety hazard. The Governor's Office of Elderly Affairs, which administers home and community based services through a network of Area Agencies on Aging, is at (225) 342-7100.U.S. Government Publishing Office. (2024). 42 U.S.C. §3030s-1 — Program authorized (Older Americans Act, Title III Part E; U.S. Code 2024 ed., govinfo.gov). govinfo.gov. Retrieved Oct 12, 2026, from https://www.govinfo.gov/link/uscode/42/3030s-1?link-type=html,goea.louisiana.gov. (n.d.). Louisiana State Aging / ADRC Network. Retrieved Jul 13, 2026, from https://goea.louisiana.gov/
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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.
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