How to start an IDD waiver provider in Louisiana

Louisiana requires a HCBS provider license (single license with service modules: Adult Day Care, Family Support, Personal Care Attendant, Respite, Substitute Family Care, Supervised Independent Living incl. Shared Living Conversion, Supported Employment, Monitored In-Home Care) from Louisiana Department of Health, Health Standards Section (HSS); waivers operated by the Office for Citizens with Developmental Disabilities (OCDD) to operate an IDD waiver provider. Fee: HSS publishes a 'Fees for Waiver Programs' schedule; amounts not captured here.

License required

Yes

License

HCBS provider license (single license with service modules: Adult Day Care, Family Support, Personal Care Attendant, Respite, Substitute Family Care, Supervised Independent Living incl. Shared Living Conversion, Supported Employment, Monitored In-Home Care)

Issuing agency

Louisiana Department of Health, Health Standards Section (HSS); waivers operated by the Office for Citizens with Developmental Disabilities (OCDD)

Fee

HSS publishes a 'Fees for Waiver Programs' schedule; amounts not captured here.

Survey and inspection

HSS conducts an initial licensing survey only after a complete application and required training are on file; HSS is also the state survey agency for ongoing monitoring.

Certificate of need

Required

Regulation

LAC 48:I Chapter 50 (HCBS provider licensing standards) and Chapter 51

1. Read the HCBS minimum licensing standards (LAC 48:I Chapters 50 and 51)
2. For PCA, Respite, Supervised Independent Living or Monitored In-Home Care modules, first obtain Facility Need Review (FNR) approval
3. Watch the HSS regulatory training videos and print the completion certificates
4. Submit a complete HCBS licensing application with the initial licensing checklist items and fee
5. Pass the HSS initial licensing survey
6. Enroll as a Medicaid provider for the OCDD waiver services

Training

• HSS HCBS regulatory training videos (certificates required with the license application)

Program

Louisiana Medicaid (Louisiana Department of Health) — Healthy Louisiana

Enrollment portal

Louisiana Medicaid Provider Enrollment Portal (via www.lamedicaid.com)

Fiscal agent

Gainwell Technologies (Louisiana Medicaid fiscal intermediary; runs provider enrollment and screening)

Application fee

Federal rule (42 CFR 455.460): the state must collect the CMS application fee from institutional providers that are newly enrolling or re-enrolling; individual physicians and non-physician practitioners are exempt, as are providers already enrolled in (or that already paid the fee to) Medicare or another state's Medicaid/CHIP. CMS set the fee at $750 for calendar year 2026.

Fingerprinting

Louisiana applies fingerprint-based criminal background checks by risk level at enrollment and at every revalidation. Federal rule (42 CFR 455.434, 455.450(c)): providers the state places in the 'high' categorical risk level, and anyone owning 5% or more of such a provider, must submit fingerprints for a criminal background check.

Site visit

Louisiana applies site visits by risk level at enrollment and at every revalidation. Federal rule (42 CFR 455.432, 455.450(b)-(c)): the state must do site visits before and after enrollment for providers in the 'moderate' or 'high' risk levels, and any enrolled provider must allow unannounced on-site inspections.

Revalidation

Louisiana revalidates all providers, including ordering/referring providers, at least every five years, and DMEPOS providers every three years. Notices go out by email and letter; there are no exemptions or extensions, and missing the due date means denied claims and deactivation, requiring a full new application. Federal rule (42 CFR 455.414): every enrolled provider must be revalidated at least once every 5 years.

Full Louisiana Medicaid enrollment guide →

For this business

Required (licensing source)

CON program

Yes

Program

Facility Need Review (FNR)

Agency

Louisiana Department of Health, Health Standards Section (FNR program)

Services covered

• nursing facilities and nursing facility beds (licensed and Medicaid-certified)
• HCBS providers: personal care attendant, supervised independent living, monitored in-home caregiving and respite
• hospice providers and inpatient hospice facilities
• pediatric day health care facilities
• behavioral health providers offering psychosocial rehabilitation (PSR) and/or community psychiatric support and treatment (CPST)
• residential substance abuse treatment
• opioid treatment program clinics
• ICF/IID

Moratoria

A statutory moratorium (R.S. 40:2116.1(B)) bars new FNR approvals for nursing facilities or additional nursing facility beds until it expires; the rules separately allow relocation, conversion and abeyance of existing beds.

Louisiana certificate of need details →

Model

hybrid

State vendor

Statistical Resources, Inc. (LaSRS)

Services in scope

• personal care
• home health
• HCBS waiver services

Alternate EVV allowed

Yes

Program

https://ldh.la.gov/medicaid/electronic-visit-verification

Louisiana EVV requirements →

State minimum wage

$7.25 an hour

Effective

2009-07-24

Scheduled increases

No scheduled change found in the official sources reviewed.

Direct-care wage floor

OCDD waivers (New Opportunities, Children's Choice, Supports, Residential Options): since 2021-10-01 direct support workers must be paid at least $9.00/hour, alongside a $2.50/hour rate increase.

HCBS 80/20 rule

Federal baseline: 42 CFR 441.302(k) requires the state to show that each provider spends at least 80% of Medicaid payments for homemaker, home health aide and personal care services under 1915(c) waivers on direct care worker pay and benefits. Compliance starts 2030-07-09 (for managed care, the first rating period starting on or after that date); annual payment-adequacy reporting under 441.311(e) starts 2028-07-09. A state may set a lower share for state-defined small providers and exempt providers facing hardship, each only through a public notice-and-comment process. The eCFR text has not changed since 2024-07-09. No state-published 80/20 implementation step (small-provider criteria, hardship exemption or reporting guidance) was found for this state in the official sources reviewed.

Intellectual/developmental disability residential facilities — active organization NPIs (NPPES)

888 (as of Sep 13, 2026)

Total Medicaid and CHIP enrollment (latest reported month)

1,264,327 (as of Jun 1, 2026)

All Louisiana IDD / waiver Medicaid rates, ranked →

• Adult Day Health Care (ADHC) Waiver (1915(c))
• Children's Choice (CC) Waiver (1915(c))
• Community Choices (CC) Waiver (1915(c))
• Coordinated System of Care (CSoC) Severely Emotionally Disturbed (SED) Children's Waiver (1915(c))
• New Opportunities Waiver (NOW) (1915(c))
• Residential Options Waiver (ROW) (1915(c))
• Supports Waiver (1915(c))

Louisiana waivers and waiting lists →