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Getting paid to care for a parent in Louisiana

Updated 2026-08-10 · Every figure below is dated and sourced · Rules change — confirm with the agency
The short answer: Louisiana's door is Community Choices Waiver (CCW) Self-Direction option (with Monitored In-Home Caregiving, MIHC, as the live-in family caregiver track inside the same waiver), run by Louisiana Department of Health (LDH), Office of Aging and Adult Services (OAAS). Pay: Two tracks. (1) CCW Self-Direction: the family sets the worker's hourly wage inside a state-approved monthly budget; the state's regulatory wage floor for direct service workers is $9.00/hr (LAC 50:XXI.9503, in effect since 2022; real-world wages typically run $9-$13/hr depending on the budget). (2) Monitored In-Home Caregiving (MIHC): a per-diem stipend paid through an MIHC agency — Tier 1 $59.60/day, Tier 2 $89.40/day by care needs (OAAS MIHC fact sheet, checked Aug 4, 2026); MIHC operator Careforth advertises "up to $1,800/month."

One or more details on this page could not be fully confirmed against official sources at publish time — confirm specifics with the agency below.

Who can be the paid caregiver

Adult children, siblings, grandchildren, other relatives, and friends can be hired as the Direct Service Worker under CCW Self-Direction; curators, guardians, and POA holders may also be hired if they meet worker requirements (18+, valid SSN, pass criminal background and exclusion checks). Under MIHC the caregiver must live in the same home as the parent and is contracted through a licensed MIHC provider agency. Under LT-PCS (the no-waitlist state plan program) care must come through a licensed agency — a family member can be paid only if the agency hires them.

The spouse question

Not by default, but there is a real path. Under CCW Self-Direction a spouse is a "legally responsible individual" and can only be paid if OAAS approves them under Extraordinary Care criteria (there is a specific LRI/Spouse-as-DSW request form; a March 2024 rule change expanded who can serve as a paid in-home caregiver). MIHC also allows a live-in spouse as the paid principal caregiver. For an adult child caring for a parent — the Resbit question — the spouse rule is moot: adult children are allowed without special approval.

Waitlist reality

CCW is not an entitlement: it has a Request for Services Registry (waitlist) when slots are full, with priority for abuse/neglect referrals, ALS, nursing-home residents moving home, and permanent supportive housing residents; everyone else is served first-come, first-served by request date. Historically the registry ran years long; Louisiana cleared much of it with pandemic-era funds, and the state does not publish a current wait time — ask where you stand when you call. LT-PCS (state plan personal care, agency-only) has no waitlist and is the faster door while you wait for a waiver slot. MIHC is a CCW service, so it sits behind the same registry.

Worth knowing: Money facts are from official sources: the $9/hr self-direction wage floor is in state regulation and the MIHC per-diems ($59.60/$89.40) are on the current OAAS fact sheet, but OAAS does not publish a typical self-directed wage or the current registry wait time — that is why confidence is 'partial', not because program facts are shaky. Disqualifiers to name plainly: the parent must need nursing-facility level of care and pass Medicaid financial rules (~$2,982/month income, $2,000 assets for a single person in 2026, with a spend-down option and spousal protections); Louisiana has a 60-month look-back, so informal cash payments to family before applying can trigger penalties — use a written personal care agreement. The caregiver cannot be the participant's designated 'responsible representative' (the person who signs as employer), cannot be under 18, and must clear a criminal background check with a list of barred offenses. Spouses need OAAS Extraordinary Care approval in self-direction; MIHC is the cleaner spouse route but requires living in the same home. MIHC caregivers get support from an agency nurse and care manager but give up hourly flexibility (per-diem, one caregiver). Rule change worth watching: a March 2024 CCW rule expanded who may serve as a paid in-home caregiver and added Financial Management Services to self-direction, and another CCW amendment was posted for comment Sept-Oct 2025, so recheck rates and caregiver eligibility language after it takes effect. Careforth's site implies the caregiver must also be Medicaid-eligible — that is not an OAAS requirement and appears to be a screening-form artifact; do not repeat it.

Other doors in Louisiana

ProgramWhat to know
Monitored In-Home Caregiving (MIHC)Louisiana's structured-family-caregiving equivalent, inside the Community Choices Waiver: a caregiver (relative or spouse allowed) lives with the person and gets a daily stipend ($59.60 or $89.40/day by tier, checked Aug 2026) plus a care manager and nurse from the MIHC agency. Best fit for heavy, round-the-clock family care.
Long-Term Personal Care Services (LT-PCS)Medicaid state plan personal care — no waitlist, but agency-only and no self-direction. A family member gets paid only if a licensed home care agency hires them; spouses and the person's own responsible representative cannot be the paid worker.
Veteran-Directed Care (VDC)Confirmed in Louisiana only through Shreveport (Overton Brooks VAMC, partnered with the Caddo Council on Aging area agency); not listed for New Orleans or Alexandria as of Aug 2026. Veterans in VDC can hire family, including spouses.
VA caregiver benefits (PCAFC and Aid & Attendance)If the parent is a veteran: PCAFC pays a monthly tax-free stipend to a family caregiver (generally requires a 70%+ service-connected rating); Aid & Attendance adds pension money that can pay a family member under a care agreement.
National Family Caregiver Support Program (via Louisiana's Area Agencies on Aging / Governor's Office of Elderly Affairs)Not a paycheck — respite, supplies, and counseling for the caregiver. Louisiana has no state-funded program that pays family caregivers outside Medicaid and VA routes.

Wartime veteran or surviving spouse in the family? VA Aid & Attendance stacks on top of state programs — see the national guide.

How to apply — step by step

  1. 1. Call Louisiana Options in Long Term Care at 1-877-456-1146 (TTY 711), Mon-Fri 8am-5pm, and ask for a long-term care screening for your parent. Ask to be put on the Community Choices Waiver Request for Services Registry the same day — the date of this call sets their place in line.
  2. 2. If your parent is not yet on Medicaid, apply at mymedicaid.la.gov or 1-888-342-6207. For 2026, waiver financial limits are roughly $2,982/month income and $2,000 countable assets for a single person (spousal protections apply if your other parent is at home).
  3. 3. While waiting for a waiver slot, ask the same 877 number about Long-Term Personal Care Services (LT-PCS) — no waitlist; a home care agency provides the hours and some agencies will hire a qualifying family member (not a spouse) as the worker.
  4. 4. When a CCW slot opens, an OAAS assessor and support coordinator build the plan of care. Tell the support coordinator you want either Self-Direction (you hire the family caregiver) or Monitored In-Home Caregiving (live-in caregiver, per-diem stipend).
  5. 5. Self-Direction path: pick a Fiscal Employer Agent — Acumen Fiscal Agent (1-855-514-9938) or Morning Sun Financial Services (1-833-239-3768) — hire the family member, and they pass a background check before their first paid shift. MIHC path: enroll with an MIHC provider agency (e.g., Careforth, 1-844-838-4696), which contracts and pays the live-in caregiver.

Where to start: Louisiana Options in Long Term Care (single entry point for CCW, LT-PCS, and the registry): 1-877-456-1146, TTY 711 — program info at ldh.la.gov/office-of-aging-and-adult-services/community-choices-waiver-ccw

Do it yourself vs. get help

Free, accredited help first, always: your Area Agency on Aging (eldercare.acl.gov) walks families through these applications at no charge, and your county Veterans Service Officer files VA claims free. Where Resbit fits: if you're working a job and don't have hours for hold music, Resbit finds what your family qualifies for, fills out the paperwork down to the signature line, and does the chasing — flat $49/month, and the screener that starts it is free.

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Sources & dates checked: Program rules and payment rates change. Everything here is educational — real eligibility is decided by the agencies, based on your family's details.