I/DD Waivers in Louisiana

All states: Medicaid disability services map

Louisiana I/DD services at a glance

Last verified against state sources: 2026-10-23.

Who runs I/DD services in Louisiana?

The Louisiana Department of Health (LDH) is the state Medicaid agency, and its Office of Intellectual and Developmental Disability Supports (OIDD) runs the state's four I/DD waivers. OIDD was formerly called the Office for Citizens with Developmental Disabilities (OCDD), and many older documents and rate sheets still use that name. OIDD is the single point of entry into the developmental disabilities system, and regional local governing entities serve as the front door.

• OIDD (LDH): decides whether a person meets Louisiana's definition of developmental disability, issues a Statement of Approval, keeps the Request for Services Registry and offers waiver slots. OIDD also operates two supports and services centers, Central Louisiana in Alexandria and Pinecrest in Pineville, that provide residential care in intermediate care facilities.
• Front door: the local governing entity in the person's region. These are the state's human services districts and authorities.
• Case management: called support coordination in Louisiana. It is required in all four waivers and provided by support coordination agencies. Coordinators contact the person every month, visit every quarter and give the person a freedom of choice list of providers.
• Contact: OIDD at 225-342-0095 or toll-free 866-783-5553.

What Medicaid waivers and programs serve people with I/DD in Louisiana?

Louisiana has four 1915(c) waivers for people with developmental disabilities, all run by OIDD. A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. The four waivers form a tiered system: people start in the waiver that fits their age and needs, and move to a more comprehensive waiver when their needs cannot be met where they are.

• Children's Choice Waiver (1915(c)): began in 2001 for children from birth through age 20 who live at home with family or a foster family, or are returning home from an institution. Each child's support package is capped at $20,200 a year. Services include family support, center-based respite, family training, therapies (aquatic, art, music, hippotherapy and sensory integration), environmental accessibility adaptations, specialized medical equipment and supplies, housing stabilization and support coordination. Children also receive Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services, the Medicaid benefit for children under 21. At 18 a youth who wants to work may move to the Supports Waiver, and everyone else moves to the most fitting waiver at 21.
• Supports Waiver (1915(c)): began July 1, 2006, as the adult entry tier for people 18 and older. It focuses on work and day services: individual and group supported employment, prevocational services, day habilitation, respite, habilitation, housing stabilization, a personal emergency response system and support coordination. Services have annual limits, and the waiver is not meant for 24-hour support. Participants may also get Long-Term Personal Care Services through the regular Medicaid state plan.
• Residential Options Waiver (ROW) (1915(c)): first approved by the Centers for Medicare and Medicaid Services (CMS) on October 1, 2009. It serves people of all ages whose developmental disability began before age 22, with an income limit of 300% of the federal Supplemental Security Income (SSI) benefit rate. Each person has an annual budget set by an assessment, and the waiver is not meant for 24-hour one-to-one support. Services include Community Living Supports, host home, shared living, companion care, center-based respite, day habilitation, prevocational services, supported employment, adult day health care, nursing and nurse consultation, dental services, community access transportation, housing stabilization and support coordination. Each participant must receive support coordination and a residential waiver service at least every 30 days.
• New Opportunities Waiver (NOW) (1915(c)): began in April 2003, replacing the earlier MRDD Waiver, and serves people age 3 and older whose needs cannot be met by another OIDD waiver. OIDD calls it the most comprehensive waiver in the system. Services include Individual and Family Support (IFS) day and night, Supported Living, Substitute Family Care, Adult Companion Care, day habilitation, prevocational services, supported employment, community integration and development, center-based respite, skilled nursing, professional services, housing stabilization and environmental accessibility adaptations.

All four waivers require ICF/IID level of care and an OIDD Statement of Approval. Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) are the institutional option that the waivers are an alternative to, and OIDD runs two of them. We did not confirm the CMS control numbers for the four waivers in a state or federal source, so they are not listed here.

Does Louisiana pay for I/DD services through managed care?

No. Louisiana pays for I/DD waiver services fee-for-service, meaning providers bill Louisiana Medicaid directly using the state's published rate sheets. The Healthy Louisiana health plans cover members' acute medical care, but the state's managed care rule leaves out the waivers.

• The rule: Louisiana Administrative Code (LAC) 50:I.3507 excludes all OIDD and Office of Aging and Adult Services (OAAS) 1915(c) waiver services, ICF/IID services and targeted case management from the health plans.
• Who pays claims: Louisiana Medicaid, through its fee-for-service system, using the rate sheets posted on LaMedicaid.com.
• Who coordinates services: support coordination agencies, which bill a fixed monthly rate ($207.81 a month on the New Opportunities Waiver sheet effective October 1, 2026, plus a one-time payment for initial planning).

Is there a waiting list for I/DD services in Louisiana?

Yes. The state limits waiver slots, and eligible people who want services join OIDD's Developmental Disability Request for Services Registry. Each person is screened for urgency of need, and waiver offers go to people in the highest urgency category being funded, with the earliest registry date breaking ties. The state does not publish a registry count that we could confirm.

• Screening for Urgency of Need (SUN): the screening OIDD uses to set each person's priority on the registry.
• Children first offered Children's Choice: when a child under 21 is prioritized, the first offer is a Children's Choice slot.
• Priority groups for ROW: ROW slots also go to people with I/DD moving from the OAAS Community Choices or Adult Day Health Care waivers, people leaving public or formerly public ICF/IIDs, and voluntary conversions of ICF/IID beds, as well as registry members with the highest need and earliest date.
• Count: OIDD reports to the Louisiana Developmental Disabilities Council include registry figures, but we could not read and confirm the current count. For a current number or a person's status, call OIDD at 225-342-0095 or 866-783-5553.

How do people apply for I/DD services in Louisiana, and how are budgets set?

A person starts with the local governing entity in their region. OIDD decides whether the person meets Louisiana's definition of developmental disability in state law (R.S. 28:451.1 to 455.2) and issues a Statement of Approval. The person can then join the Request for Services Registry, where the urgency screening sets their priority.

• When a slot opens: medical eligibility (ICF/IID level of care) and Medicaid financial eligibility are checked only when a waiver slot is available. A person-centered assessment then decides which waiver tier fits the person.
• Assessment tools: the Screening for Urgency of Need (SUN) sets registry priority. In the Residential Options Waiver, the Inventory for Client and Agency Planning (ICAP) sets the person's support needs and annual budget.
• Budgets and caps: Children's Choice is capped at $20,200 a year. Supports Waiver services carry annual limits. We did not find a published budget method for the New Opportunities Waiver.
• Self-direction: families in NOW, ROW and Children's Choice can choose to self-direct, acting as the employer of their own workers with help from one of two fiscal employer agents, Acumen Fiscal Agent or Morning Sun Financial Services. In ROW, all or part of Community Living Supports can be self-directed. In NOW, self-direction cannot be combined with Supported Living. The Supports Waiver does not offer self-direction.

What day and residential services can I/DD providers offer in Louisiana?

Day habilitation, prevocational services and supported employment are offered in NOW, ROW and the Supports Waiver, mostly billed in 15-minute units. Day habilitation and prevocational providers need an LDH home and community-based services (HCBS) provider license that meets the adult day care module rules. Residential supports are mainly in ROW and NOW and are paid hourly or per day.

Day and employment services

• Day habilitation (NOW, ROW, Supports): builds self-help, social and community living skills, onsite, in the community (community life engagement, 1:1 or 1:2 to 4) or virtually, up to eight hours a day. Providers need an LDH HCBS license meeting the adult day care module in LAC 48:I Chapter 50, which sets a minimum of 1 staff to 8 clients. Billed in 15-minute units (NOW onsite rate $2.48 per unit). Transportation is billed separately at a daily rate.
• Prevocational services (NOW, ROW, Supports): time-limited services that help a person move toward individual community jobs, onsite at 1:5 to 8, as community career planning (1:1 or 1:2 to 4) or virtually, up to eight hours a day. Same license as day habilitation. Billed in 15-minute units (NOW onsite rate $2.39 per unit).
• Supported employment (NOW, ROW, Supports): individual services cover work-based learning, job development and placement, initial job support and stabilization, extended job supports and follow-along supports. Group employment serves 5 to 8 people. Most services are billed in 15-minute units (for example job development $20.00, extended job supports $15.00 and group employment $2.76 per unit on the NOW sheet). The research did not confirm which license applies to supported employment providers.
• Adult day health care (ROW): a medical model day program licensed by LDH under LAC 48:I Chapter 42, with 1 direct service worker per 9 participants, billed in 15-minute units.

Residential and in-home services

• Community Living Supports (ROW): in-home and community help with daily living skills, which up to three people can share at a shared rate. Billed per 15 minutes ($4.77 for one person from October 1, 2026).
• Host Home (ROW): care in a host family's home for children under 18 and for adults, paid per day at four levels.
• Shared Living (ROW): support for up to three people living together, paid per day at four levels.
• Companion Care (ROW and NOW): a companion lives with the person and provides support, paid per day (NOW Adult Companion Care $94.90 a day).
• Individual and Family Support and Supported Living (NOW): hourly supports in the person's own or family home, day and night, with shared rates for two or three people (IFS day $4.77 per 15 minutes from October 1, 2026). NOW also offers Substitute Family Care.

We did not find which LDH license or licensing module applies to Community Living Supports, host home, shared living or companion care providers. Ask OIDD before applying.

How are I/DD provider rates set and how do agencies enroll in Louisiana?

Louisiana sets statewide rates for each waiver and posts them as rate and procedure code sheets on LaMedicaid.com. Most services are flat rates per 15-minute unit, with daily rates for host home, shared living, companion care and transportation, and a monthly rate for support coordination. New rate sheets for all four waivers took effect October 1, 2026, about 3% above the March 2026 sheets.

• Rate sheets: the OCDD fee schedule page links the current sheets for NOW, ROW, Supports and Children's Choice. On the NOW sheet, IFS day rose from $4.63 to $4.77 per 15 minutes and support coordination from $201.50 to $207.81 a month. Host home and shared living are tiered in Levels 1 to 4.
• Rate study: LDH released a home and community services rate study by Milliman on February 11, 2026, and said it wants a more objective way to set rates that helps raise direct care wages.
• Enrollment: agencies enroll as Louisiana Medicaid providers through LaMedicaid provider enrollment. Day habilitation and prevocational providers also need the LDH HCBS license described above. We did not find a separate OIDD provider approval guide.
• EVV: electronic visit verification (EVV) applies to I/DD waiver services. In-home services (NOW Individual and Family Support and Supported Living, ROW Community Living Supports, Supports Waiver respite and Children's Choice family support) must be recorded in LaSRS, the state's EVV system run by its vendor SRI, or in an approved third-party system that sends data to LaSRS. Day habilitation, prevocational services, center-based respite and supported employment must be recorded in LaSRS itself.

What is changing next for I/DD services in Louisiana?

As of October 23, 2026, we did not find a confirmed change with a set date for Louisiana's I/DD services. The most recent change, new rates for all four waivers, took effect October 1, 2026. We did not find a further rate step, waiver renewal or move to managed care with a firm date.

• Rate study follow-up: OIDD held a stakeholder mini-summit on July 17, 2026 to consult on how home and community services rate increases from the 2025 rate study would be structured. We did not find a state notice of any further increase beyond October 2026.
• Self-Direction Handbook: OIDD posted a draft revised Self-Direction Handbook for public comment from May 28 to June 12, 2026. A final version and its release date had not been published as of the last check.
• Nurse consultation in ROW: a nurse consultation service ($11.03 per 15 minutes, up to $750 per plan of care year) now appears on the ROW rate sheet.
• Provider quality: OIDD's January 2026 report to the Developmental Disabilities Council described value-based payments to 5 support coordination agencies ($600,000) and 200 providers ($5.5 million scheduled), and expanded monitoring of provider progress notes, with 51% compliance in 2025 and a 75% target for 2026.

For news on waiver amendments or renewals, check LDH's public notices or ask OIDD.

Louisiana I/DD sources

• Louisiana Department of Health: Office of Intellectual and Developmental Disability Supports (OIDD)
• LDH OIDD: New Opportunities Waiver
• LDH OIDD: Residential Options Waiver
• LDH OIDD: Supports Waiver
• LDH OIDD: Children's Choice Waiver
• La. Admin. Code tit. 50, I.3507 (services excluded from Healthy Louisiana)
• LaMedicaid: OCDD waiver fee schedules
• LaMedicaid: New Opportunities Waiver rate sheet (effective October 1, 2026)
• LDH: EVV third-party data integration process
• LDH: Self-direction

Related reading

• Disability Services and Independent Living Guide
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Disability Services DayHab has a dilemma - how to solve it
• Outcome Measures in Disability Services: Measuring what matters
• I/DD services in every state (map)
• Louisiana EVV requirements

Page history

• October 23, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.