Louisiana Medicaid Resources

• State Medicaid Website: Louisiana
• Louisiana Developmental Disabilities Council Website
• The Arc of Louisiana

Louisiana Medicaid Facts: From Kaiser Family Foundation Medicaid Fact Sheet (2009)

There are 199,000 people with disabilities covered by Medicaid in Louisiana. Louisiana spent $11,678 on each Medicaid recipient with a disability in 2007.

18% of all people covered by Medicaid in Louisiana have a disability, while the national percentage is 15%.

The state spends 52% of all the money it spends on Medicaid on services for people with disabilities, while the national percentage is 42%.

Community Care Program

This program provides access to some limited health care services for children and adults with disabilities unless they are also eligible for Medicare. It also does not cover people participating in some other waiver programs.

• Health: durable medical equipment, early and periodic screening, diagnosis and treatment, hearing, immunization, laboratory, outpatient hospital visits, physician services, vision, and x-ray services. Some of these services, such as laboratory and x-ray services, are limited.
• Home: home health care

Program of All-Inclusive Care for the Elderly (PACE)

PACE programs are designed for people 55 and older who need nursing home placement, which includes many people with disabilities. These programs provide integrated care and support including a high level of preventive care.  PACE programs must provide all services otherwise included in a person’s Medicaid or Medicare benefit, as well as all other services deemed medically necessary. Services are provided through PACE centers, so people must live close enough to an approved center to be eligible.

Ages: 55 and older

Level of Care: nursing

Restrictions: You must live close enough to an approved PACE center to receive care.

• Community: transportation (health-related), day care
• Health: primary and specialty care, nursing, physical, occupational and speech, and recreation therapy, prescription drugs
• Home:  home care, home and environmental modifications
• Social Services: social services

New Opportunities waiver

This waiver applies to people with intellectual and developmental disabilities get services they need in their homes and in the community rather than in an intermediate care facility.

Ages:  3 and older

• Health: residential habilitation, supervised independent living, emergency response, skilled nursing services
• Home:  environmental accessibility modifications, residential habilitation, supervised independent living

Adult Day Health Care waiver

This waiver applies to people with disabilities who are older than 22 and require the level of care provided by a nursing facility. Services can be provided in the person’s home or in another community setting, including adult day health care, health services, direct care services, social services, nutrition, and transportation.

Children’s Choice waiver

This waiver offers extra supports to children who have a developmental or intellectual disability and live at home with their families or a foster family. Services can be provided to them in the family home so the child can avoid having to live in an institution.

Ages:  18 and under

• Community: center-based (out-of-home) respite care
• Health: emergency response
• Home:  family support, family training, environmental modifications

Elderly and Disabled waiver

This waiver serves people with disabilities and older adults. Instead of an institutional placement, care can be given to clients at home or in community settings.

Level of Care: nursing

• Community: transitional services
• Home: personal care, household supports, personal supervision, environmental modifications
• Social Services: case management

Residential Options waiver

This waiver applies to people with disabilities of all ages. It is designed to help them avoid placement in an institutional facility or to move out of one of these facilities and live in the community again.

Supports waiver

 This waiver is for people with intellectual and developmental disabilities who would otherwise have to move into a facility for the developmentally disabled. It provides community-based vocational supports and focused activities. This waiver may have additional eligibility restrictions.

Ages: 18 and older

Level of Care: intermediate

• Health: day habilitation, personal emergency response systems
• Home: respite care
• Work:  supported employment, prevocational services