The Community Choices Waiver: How Baton Rouge Families Get Medicaid Help at Home

What is the Community Choices Waiver?

The Community Choices Waiver is a Louisiana Medicaid home and community-based services waiver run by LDH's Office of Aging and Adult Services. It serves adults 21 and older who meet long-term care Medicaid eligibility and nursing facility level of care, and it pays for services that let them stay at home instead of entering a nursing home. It does not provide help 24 hours a day; it is built to support family caregiving, not replace it.

What does it pay for?

A support coordinator builds a plan of care from a menu of services:

Assistive devices, medical supplies, assistive technology, therapies and financial management services for self-directed workers are also on the list.

Why is there a wait, and who goes first?

Requests go on the Request for Services Registry. Slots are offered first to people referred by protective services who would otherwise need a nursing home, people with ALS, people in or linked to Louisiana Permanent Supportive Housing, nursing home residents paid only by Medicaid, and people approved for 32 hours of LT-PCS who would otherwise need a nursing home. Everyone else is served in order of request date.

Because the date sets your place, the best time to call is as soon as a parent might qualify, even if help is not needed yet.

How does LT-PCS fit in?

Long Term-Personal Care Services is a Medicaid state plan service rather than a waiver, so it has no registry of its own. It pays for hands-on personal care hours for people who meet nursing home level of care and one of three risk conditions, including having a primary caregiver who is 70 or older or disabled. Many Baton Rouge families start with LT-PCS and move to the CCW when a slot opens.

How do we request it in the Baton Rouge area?

Call Louisiana Options in Long-Term Care at 1-877-456-1146 (TDD 1-877-544-9544), weekdays 8 a.m. to 5 p.m., to request the waiver and a level-of-care screening, and apply for Medicaid through the Self-Service Portal or Medicaid Customer Service at 1-888-342-6207. The East Baton Rouge Council on Aging ((225) 923-8000) and the Capital Area Agency on Aging ((225) 922-2525) can help with the calls and forms.

In East and West Baton Rouge parishes, PACE Baton Rouge is another route for people 55 and older; elsewhere in the region, the CCW and LT-PCS are the main options.

How does the CCW work day to day?

Once a slot is offered and eligibility confirmed, a support coordinator meets the participant and family, assesses needs and writes a plan of care that lists services and hours. Services are delivered by licensed providers the participant chooses, or in some cases through self-direction, where the participant hires workers and a financial management service handles payroll. The support coordinator reviews the plan regularly and when needs change.

The waiver works best when family can cover the gaps, especially nights. For a parent who needs supervision around the clock, the CCW alone is usually not enough.

What if my parent needs help before a slot opens?

Use the time: request LT-PCS if your parent meets its risk test, ask the parish council on aging about home-delivered meals, respite and sitter services, and look at adult day health care, which the ADHC Waiver can fund for people who qualify. In East and West Baton Rouge parishes, PACE Baton Rouge is another option for people 55 and older. And keep your place on the registry; it is the date, not the urgency, that moves you up, unless your parent falls into a priority group.