Louisiana Community Choices Waiver (CCW)

The Community Choices Waiver (CCW) is Louisiana Medicaid’s main home and community-based waiver for older adults and adults with physical disabilities who need a nursing facility level of care. For the wider picture, see our Louisiana Long-Term Care Medicaid guide.

Figures change periodically. Double-check current amounts before relying on them.

At a glance

Item	Details
Type of program	Medicaid home and community-based services (HCBS) waiver
Who runs it	Louisiana Department of Health, Office of Aging and Adult Services (OAAS)
Age	65 and older, or 21 to 64 with a physical disability
Care need	Needs a nursing facility level of care
Louisiana 2026 income rule (long-term care)	$2,982 a month (special income level)
Louisiana 2026 asset limit (single applicant)	$2,000
Waiting list	Yes. The CCW Request for Services Registry

The CCW in brief

In short, the CCW is run by Louisiana Department of Health, Office of Aging and Adult Services (OAAS). It serves 65 and older, or 21 to 64 with a physical disability, and the care requirement is: Needs a nursing facility level of care. Waiting list status in 2026: Yes. The CCW Request for Services Registry. More detail on each point follows, and the Louisiana state guide covers the shared financial rules. Families weighing the CCW against other Louisiana options can use the related pages at the end to compare programs side by side.

What the program is

OAAS runs the CCW. Before anyone can receive it, their name must be on the CCW Request for Services Registry. When a slot is offered, the person chooses a support coordination agency, whose support coordinator completes the assessment and writes a plan of care. CCW services can be agency-based, and some can be self-directed.

The CCW is a “waiver” because federal Medicaid lets Louisiana waive certain rules in order to pay for care at home and in the community. Slots are limited each year, every participant has an individual care plan, and a case manager or coordinator puts services in place. Waiver services sit on top of regular Medicaid, which still covers doctors, hospitals and prescriptions (after Medicare, for people who have it). See our overview of HCBS waivers.

Who qualifies in 2026

To get the CCW, a person generally has to meet each of these:

Is 65 or older, or 21 to 64 with a physical disability
Needs a nursing facility level of care
Qualifies for full Medicaid under Louisiana’s long-term care financial rules (see the money test below)
Lives in Louisiana and is a U.S. citizen or qualified non-citizen
Has been offered a CCW slot from the Request for Services Registry

Financial eligibility. The CCW requires full Medicaid eligibility under Louisiana’s long-term care financial rules. The table’s figures are Louisiana’s 2026 long-term care numbers, taken from our state guide. The home (up to the equity limit, when the person or a spouse lives there or plans to return), one vehicle, belongings and a small burial fund are generally not counted by the Louisiana Department of Health. Married couples get extra protection in Louisiana: the spouse at home keeps a share of assets and may get some of the applicant’s income. See Spousal impoverishment rules.

About the level-of-care assessment. For the CCW, an assessor checks how much help the person needs with bathing, dressing, eating, toileting, mobility and medications, and whether memory loss calls for supervision. The visit is normally face to face, at home or in a hospital or facility. Have a relative present to describe the hard days, and keep a medication and diagnosis list handy. See Nursing home level of care and Activities of daily living.

What services it can pay for

Services depend on the person’s assessed needs and written care plan. Depending on the plan, they can include:

Support coordination
Nursing and skilled therapy
In-home monitoring systems
Home accessibility changes
Assistive technology
Personal assistance services
Home-delivered meals
Monitored in-home caregiving (pays a live-in caregiver)
Caregiver respite
Adult day health care

Not every participant gets every service; the plan reflects assessed need and the help family already gives. A change in health is a reason to request a reassessment.

Directing your own care and paying family

CCW participants can self-direct some services, hiring their own workers, and monitored in-home caregiving pays a live-in caregiver through an agency.

How to apply

There are two tracks, a financial one and a care one, and both must say yes. The usual path for the CCW is:

Ask to be placed on the CCW Request for Services Registry (through the Louisiana Department of Health’s long-term care access line or your regional OAAS office).
While waiting, request Long-Term Personal Care Services (LT-PCS), which has no waitlist.
When offered a slot, choose a support coordination agency.
Complete the Medicaid financial application and the level of care assessment.
The support coordinator writes the plan of care.

For the paperwork, use our documents checklist before applying for the CCW; Applying for a waiver explains the general process.

Waiting lists

The CCW is offered from the Request for Services Registry. Louisiana changed how the registry is prioritized in 2026, using a risk-based approach, and reported waits of roughly 11 to 12 months. Getting on the registry early protects your place in line.

More on how lists work: Waiver waiting lists.

How it relates to nursing home Medicaid

The CCW uses the same nursing facility level of care and Louisiana’s 2026 income rule ($2,982 a month) and asset limit as nursing home Medicaid. Nursing home care has no registry.

What is the same as nursing home Medicaid. Louisiana’s financial rules for the CCW track the nursing home rules closely. Gifts and below-value transfers in the five-year look-back can trigger a penalty period for home care as well as nursing home care. After death, estate recovery can reach services paid from age 55 on. Some participants pay a monthly share of income toward services.

Personal needs allowance. If the person does move to a nursing home, Louisiana’s 2026 personal needs allowance is $45 a month. Most of the rest of their income goes toward the cost of care. Our state guide covers the nursing home rules in detail.

Tips for families

Begin before it is urgent. Every step of the CCW takes time, and an early request protects your place.
Keep copies of every the CCW form, notice and letter, and write down the name of each person you speak with and the date.
Use your appeal rights. Notices that deny or reduce services explain how to request a fair hearing; acting quickly can protect current services.
Report changes in income, assets, address or living situation to the Louisiana Department of Health when they happen.
Mark renewal dates. Eligibility and the care plan are usually reviewed annually; see Renewals.
Think about the spouse at home. Couples have extra protections, but they have to be claimed. A certified Medicaid planner or a legal aid office can explain how the rules apply to a particular family.

Common questions

Can I get help while waiting? Yes. LT-PCS is available without a waitlist to people who qualify.

What is monitored in-home caregiving? A CCW service that pays a principal caregiver who lives with the participant, with oversight by a provider agency.

Can family be paid? Yes, in some cases. A spouse can be the paid live-in caregiver under monitored in-home caregiving, if the provider agency approves, trains and contracts with them. A spouse generally cannot be a paid personal assistance worker unless OAAS approves an extraordinary-care exception.

Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.