Louisiana Personal Care Attendant Program: Your Guide to In-Home Support

Overview

The Louisiana Long Term–Personal Care Services (LT-PCS) Program, often referred to as the Louisiana Personal Care Attendant Program, is designed to enable seniors and adults with disabilities to live comfortably and safely at home. This vital program offers assistance with daily living activities, helping individuals avoid or postpone nursing home placement and facilitating returns home from such facilities. Participants in the Louisiana Personal Care Attendant Program receive support with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), which include essential tasks like bathing, dressing, mobility, medication reminders, toileting, meal preparation, eating, laundry, and basic housecleaning.

It’s important to note that unlike some Home and Community Based Services (HCBS) Medicaid programs, the Louisiana Personal Care Attendant Program does not allow participants to self-direct care by hiring their own caregivers. Instead, services are delivered through licensed Medicaid providers. However, program participants do have the option to choose their preferred provider from an approved list, ensuring they receive care that meets their specific needs.

For Louisiana seniors, the Adult Day Health Care Waiver is another valuable option to consider, providing adult day health care services. It’s possible to be eligible for both the Adult Day Health Care Waiver and the Long Term–Personal Care Services Program simultaneously. Additionally, the Community Choices Waiver (CCW) presents another avenue for obtaining a range of HCBS, including personal assistance and adult day health care.

Beneficiaries of the Louisiana Personal Care Attendant Program can receive services in their own home or the home of a family member. However, they cannot reside in adult foster care homes or assisted living residences with built-in personal care services to prevent service duplication.

The LT-PCS Program operates as an entitlement. This means that if you meet Louisiana Medicaid’s eligibility requirements, you are guaranteed to receive program benefits without facing waitlists for personal care services.

The Louisiana Personal Care Attendant Program is not a standalone program but rather a benefit under Louisiana’s Regular Medicaid State Plan. Most individuals access their Medicaid benefits through Healthy Louisiana, a managed care program.

Understanding State Plan Medicaid vs. Medicaid Waivers: HCBS can be offered through Medicaid Waivers or a state’s Regular Medicaid Plan. A key distinction is that HCBS under State Plans, like the Louisiana Personal Care Attendant Program, are entitlements. Meeting eligibility criteria ensures benefit receipt. Medicaid Waivers, on the other hand, are not entitlements and often have enrollment caps, leading to waitlists. Furthermore, Medicaid Waivers typically require a nursing home level of care, which isn’t always the case for State Plan HCBS.

Benefits of the Louisiana Personal Care Attendant Program

The Louisiana Personal Care Attendant Program offers crucial support through verbal reminders and hands-on assistance with daily living activities. The specific services and the number of service hours (up to 32 hours per week) are determined based on a functional evaluation of the individual’s needs. Here are some of the activities for which assistance may be provided:

• Bathing and Grooming
• Dressing and Undressing
• Eating
• Household Tasks: Laundry, grocery shopping, light housecleaning
• Meal Preparation and Cleanup
• Medication Oversight: Reminders, dosage checks, help opening medication containers
• Mobility Assistance: Walking, wheelchair use, repositioning in bed
• Toileting
• Transferring: Moving between bed, chair, wheelchair, and standing positions
• Transportation Assistance: Accompanying to medical appointments

Eligibility Requirements for the Louisiana Personal Care Attendant Program

To be eligible for the Louisiana Personal Care Attendant Program, applicants must be Louisiana residents who are either elderly (65+) or adults with disabilities (21+). They must also meet one of the following conditions:

1. Currently reside in a nursing home but are capable of returning to community living with personal care assistance.
2. Anticipate needing nursing home admission within 120 days.
3. Have a primary caregiver who is disabled or aged 70 or older.

It’s important to note that the LT-PCS program does not provide support coordination. Therefore, applicants must be able to direct their own care or have a designated representative to manage their care on their behalf. Additional eligibility criteria, particularly relevant for seniors aged 65 and over, are detailed below.

For a quick assessment of potential Medicaid eligibility, the American Council on Aging provides a helpful Medicaid Eligibility Test for LA seniors who require long-term care.

Financial Criteria: Income, Assets, and Home Ownership

Income Limits: The income limit for applicants is tied to 100% of the Federal Benefit Rate (FBR), which is adjusted annually in January. For 2025, the monthly income limit for a single applicant is $967. For married couples, the combined monthly income limit is $1,450, regardless of whether one or both spouses are applying.

Unlike some HCBS Medicaid programs that allow a non-applicant spouse to retain more income and assets, the Louisiana Personal Care Attendant Program does not have this provision. In contrast, Louisiana’s Adult Day Health Care Waiver and Community Choices Waiver offer non-applicant spouses a Monthly Maintenance Needs Allowance and a Community Spouse Resource Allowance.

Asset Limits: In 2025, the asset limit is $2,000 for a single applicant. For married couples, the limit is slightly higher at $3,000, whether one or both are applicants.

Certain assets are considered exempt and are not counted towards Medicaid’s asset limit. These typically include the applicant’s primary residence, essential household furnishings and appliances, personal belongings, and a vehicle.

While a 60-month Look-Back Rule exists for Nursing Home Medicaid and Medicaid Waiver applications, where Medicaid reviews past asset transfers, it is generally understood that this rule does not apply to the Louisiana Personal Care Attendant Program.

To estimate potential asset levels relative to Medicaid limits, you can utilize a Spend Down Calculator.

Home Ownership Considerations: The home is often a significant asset, and many worry about Medicaid implications. For eligibility under the Louisiana Personal Care Attendant Program, LA Medicaid considers the home exempt (non-countable) under these conditions:

• The applicant lives in the home or intends to return (“Intent to Return”) home, and in 2025, their home equity interest is $730,000 or less. Home equity is the home’s current market value minus any outstanding mortgage, and equity interest is the applicant’s ownership portion.
• The applicant’s spouse resides in the home.
• The applicant has a minor child (under 21) living at home.
• The applicant has a child of any age who is blind or disabled and lives in the home.

For more detailed information, explore the potential of Medicaid taking the home.

Medical Criteria: Functional Need

Applicants for the Louisiana Personal Care Attendant Program must demonstrate a need for a Nursing Facility Level of Care (NFLOC). The Level of Care Eligibility Tool (LOCET) is used to assess whether this requirement is met. There are multiple pathways to qualify for NFLOC. A common pathway involves needing assistance with Activities of Daily Living (ADLs), such as transferring, mobility, eating, toileting, personal hygiene, and bathing. Another pathway, relevant for individuals with Alzheimer’s disease or related dementias, is the cognitive performance pathway, which evaluates short-term memory, daily decision-making, and communication abilities. A dementia diagnosis alone does not automatically qualify an individual for NFLOC.

Regardless of the pathway, applicants must require assistance with at least one Activity of Daily Living to meet the medical criteria for the Louisiana Personal Care Attendant Program.

Further details about long-term care Medicaid eligibility in Louisiana can be found here.

Qualifying for the Louisiana Personal Care Attendant Program When Over the Limits

Exceeding Medicaid’s income and/or asset limits does not automatically disqualify you from the Louisiana Personal Care Attendant Program. Several planning strategies can help individuals who might otherwise be ineligible to qualify. Some strategies are straightforward, while others are more complex. Here are common approaches:

Louisiana offers a Medically Needy Spend-Down Program for those with high medical expenses relative to their income. This allows applicants to spend “excess” income on medical expenses and health insurance premiums, including Medicare Part B, to meet Medicaid’s income limit. Learn more about the Medically Needy Pathway.

For applicants with assets exceeding the limits, Irrevocable Funeral Trusts (IFTs) are a viable option. IFTs are pre-funded funeral and burial trusts that Medicaid exempts from countable assets. Individuals can also “spend down” excess assets on allowable expenses such as home repairs (plumbing upgrades, water heater replacement), home modifications (first-floor bedroom addition, grab bar installation), or replacing an older vehicle. Numerous other asset spend-down options are available.

Inadequate planning or incorrect implementation of Medicaid planning strategies can lead to benefit denial or delays. Consulting with professional Medicaid Planners is highly recommended. These experts are knowledgeable about Louisiana-specific planning strategies to help individuals meet Medicaid’s financial eligibility criteria while protecting their access to care. While various planning strategies exist, some, like Medicaid Asset Protection Trusts, are subject to Medicaid’s 60-month Look-Back Rule and should be implemented well in advance of needing long-term care. However, strategies like Modern Half-a-Loaf offer workarounds, and Medicaid Planners are well-versed in these options. For personalized guidance on qualifying for the Louisiana Personal Care Attendant Program when over income or asset limits, find a Medicaid Planner.

How to Apply for Louisiana’s Long Term-Personal Care Services Program

Before You Apply

Before applying for the Louisiana Personal Care Attendant Program, ensure you meet the general eligibility criteria for Louisiana Medicaid. Applying while exceeding income and/or asset limits without proper planning will likely result in denial. Utilize the American Council on Aging’s Medicaid Eligibility Test to assess your potential eligibility.

Gather necessary documentation for your application, including copies of Social Security cards, Medicare cards, life insurance policies, property deeds, pre-need burial contracts, recent bank statements, and proof of income. Incomplete documentation is a common cause of application delays.

Application Process

To apply for the Louisiana Personal Care Attendant Program, you must first be eligible for Louisiana Medicaid. You can apply:

• Online: Apply online through the Louisiana Department of Health portal
• Medicaid Hotline: Call 888-342-6207
• Medicaid Application Centers: Contact a Medicaid Application Center near you.
• Mail: Complete and mail an Application for Health Coverage.

Individuals already receiving Medicaid should contact Louisiana Options in Long-Term Care at 877-456-1146.

For more information about the Louisiana Personal Care Attendant Program, you can visit Louisiana Department of Health Program Page and LT-PCS Fact Sheet. You can also reach out to Louisiana Options in Long-Term Care at 877-456-1146 or the Office of Aging and Adult Services Helpline at 866-758-5035.

The Louisiana Office of Aging and Adult Services (OAAS), a division of the Department of Health, administers the LT-PCS Program.

Approval Process & Timing

The Medicaid application process can take up to 3 months or longer from initial application to receiving an approval or denial letter. Completing the application and gathering supporting documents typically takes several weeks. Incomplete applications or missing documentation will cause further delays. Federal law mandates Medicaid offices to review and decide on applications within 45 days (up to 90 days for disability-based applications). Despite these guidelines, application processing times can sometimes exceed these periods.