The Community Choices Waiver or LT-PCS?

What is the difference between the Community Choices Waiver and LT-PCS?

LT-PCS is a Medicaid state plan program that pays for assessed hours of hands-on personal care for eligible enrollees, while the Community Choices Waiver is a slot-limited waiver that adds a broad package, including support coordination, personal assistance, adult day health care, meals, home modifications, nursing and respite, for people who meet nursing home level of care.

Both are run by LDH's Office of Aging and Adult Services, both require nursing home level of care, and neither provides 24-hour care. LT-PCS is narrower but does not use the CCW's Request for Services Registry; the CCW is broader but slots are offered by priority group and request date.

Who qualifies for each program?

Both require Medicaid eligibility, age 21 or older and nursing home level of care; LT-PCS adds that the person needs at least limited help with one daily activity and is in a nursing home and able to leave, likely to need one within 120 days, or has a primary caregiver who is disabled or at least 70.

The CCW's financial rules are those of long-term care Medicaid: in 2026, income up to $2,982 a month or a spend-down, and resources up to $2,000 for an individual.

Can someone get both?

The programs connect: a person approved for 32 hours of LT-PCS who would otherwise need a nursing home is one of the CCW's priority groups for an expedited waiver offer, while LDH's first-come group is described as people not already receiving PACE, LT-PCS or another Medicaid home and community-based program.

1. People referred by protective services who would otherwise need a nursing home because of abuse or neglect
2. People with ALS
3. People living in, or linked to, a Louisiana Permanent Supportive Housing unit
4. Nursing home residents whose stay is paid only by Medicaid
5. People approved for 32 hours of LT-PCS who would otherwise need nursing home placement (expedited)
6. Everyone else, first come, first served by request date on the Request for Services Registry

Ask OAAS through Louisiana Options in Long-Term Care how the two would combine in your parent's case.

Which is faster to get?

LT-PCS is usually faster for someone already on Medicaid, because it is not limited by waiver slots, while the CCW depends on priority group and place on the Request for Services Registry.

That is why families often start with LT-PCS and ask to be placed on the CCW registry at the same time. Call 1-877-456-1146 to request either.

What does neither program cover?

Neither pays for an ARCP, 24-hour care, companionship or sitter services; LT-PCS also excludes nursing, medication administration and therapy, which the CCW can cover through its nursing and skilled maintenance therapy services.

For coordinated medical care plus home support in one program, compare PACE Greater New Orleans, available in listed ZIP codes.