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.
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
- Programs That Pay Family Caregivers
- Respite Care Programs
- Support, Training, and Area Councils on Aging
- 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 (spouse needs OAAS exception) | CCW participants 21+ at nursing-facility level of care | Free (paid by Medicaid) |
| Monitored In-Home Caregiving (MIHC) | Live-in caregiver, including a spouse, is paid | CCW participants with a live-in principal caregiver | Free (paid by Medicaid) |
| NFCSP respite grants | Free in-home respite, adult day vouchers, training, counseling | Caregivers of adults 60+ or person with ADRD; no income test | Free |
| VA PCAFC | Monthly tax-free stipend; pays spouses | Veteran with 70%+ disability in VA health care | Free (VA benefit) |
| VA Aid and Attendance | Pension up to $2,424/mo to veteran; caregiver paid from it | Wartime veteran or surviving spouse under net-worth limit | Free to apply (VSO help) |
Programs That Pay Family Caregivers
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) HCBS waiver for people 21 and older with adult-onset disabilities or older adults who meet a nursing-facility level of care.
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.
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.
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.
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.
For the full guide to paid pathways: How to Get Paid as a Family Caregiver in Louisiana.
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.
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.
For the full respite guide: Respite Care in Louisiana.
Support, Training, and Area Councils on Aging
Louisiana's parish-based Area Councils on Aging are the front door for most caregiver support that is not tied to a Medicaid waiver. They deliver NFCSP services, adult day referrals, caregiver training, counseling, and local resource information.
Call 1-866-758-5659 to reach your parish Council on Aging, or dial 211 for the broader social-services network. These calls are free. A counselor will identify what is available in your parish and help you start an application.
If your loved one is enrolled in the CCW, the OAAS support coordinator is your key contact for adjusting the plan of care, including adding respite or arranging a paid family worker.
VA Caregiver Benefits in Louisiana
Veterans enrolled in VA health care in Louisiana have access to caregiver support programs that are separate from Medicaid and often 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 needs a service-connected disability rating of 70 percent or higher, a need for in-person personal care for at least six continuous months, and enrollment in VA health care.
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.
Louisiana VA facilities: The Southeast Louisiana Veterans Health Care System in New Orleans, the Overton Brooks VA Medical Center in Shreveport, and the Alexandria VA Health Care System are the main VA medical centers.
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/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.
The Louisiana Department of Veterans Affairs and parish Veterans Service Officers help file at no cost.
VA Caregiver Support Line: 1-855-260-3274
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
Louisiana levies a flat individual income tax. Because Louisiana generally starts from federal adjusted gross income, the IRS Notice 2014-7 exclusion may flow through to the Louisiana return. Confirm the current rate with the Louisiana Department of Revenue.
VA PCAFC Stipend
The PCAFC monthly stipend is federal tax-free and is not reported on a W-2.
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
Yes, in two ways. Under Monitored In-Home Caregiving, a live-in caregiver including a spouse can be paid. Under CCW self-direction, a spouse can be the paid Direct Service Worker only with an OAAS-approved Extraordinary Care exception. If your spouse is a veteran, the PCAFC stipend and Veteran-Directed Care can pay a spouse without that exception.
MIHC is a Community Choices Waiver service where a principal caregiver lives in the participant's home and provides hands-on daily care, similar to adult foster care. The live-in caregiver, who can be a friend, relative, adult child, or spouse, is paid through a contracted MIHC provider agency that trains and monitors the care.
An adult child or other non-spouse relative, friend, or neighbor who meets the worker requirements may be hired directly. A spouse is a Legally Responsible Individual and requires an OAAS-approved Extraordinary Care exception.
Yes. The National Family Caregiver Support Program provides free respite through Louisiana's Area Councils on Aging with no income test. Call 1-866-758-5659.
Call 1-866-758-5659 to reach your parish Council on Aging, or dial 211. They handle NFCSP respite grants, adult day referrals, and caregiver training.
Learn More
- How to Get Paid as a Family Caregiver in Louisiana
- Respite Care in Louisiana
- Caregiver Burnout: Signs, Stages, and How to Get Support
- VA Aid and Attendance in Louisiana
- Medicaid Planning Strategies
Find personalized help navigating Louisiana caregiver programs 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.