Louisiana program
Nursing and personal care at home (Louisiana Medicaid)
Louisiana Medicaid can pay for nursing and personal care at home when a child needs extra hands-on care.
What it is
Louisiana Medicaid can pay for nursing and personal care at home when a child needs extra hands-on care.
Nursing and personal care can make hospital-to-home care more manageable. The decision depends on the tasks your child needs and the medical evidence. A cancer diagnosis alone does not establish how many hours qualify.
Eligibility rules
- Extended skilled nursing serves Louisiana Medicaid members ages 0 through 20.
- An aide for personal care needs a doctor’s care plan showing your child needs help with at least two everyday tasks beyond what a child that age normally needs; the plan is renewed every six months. Nursing has its own assessment.
What you get
- No family charge for approved Medicaid nursing and personal care at home.
What the help covers
- Hours depend on medical need. A child under 21 can receive medically necessary care within Medicaid benefit categories.
- A clinical review sets nursing and personal-care hours from your child’s actual needs. EPSDT can require medically necessary services within Medicaid benefit categories. The care manager must confirm current service limits, exceptions and whether a parent or other legally responsible relative can be paid under this specific benefit. A separate waiver or self-direction program does not establish that permission.
If you decide to apply
- Ask the discharge planner to work with the home-care agency on a request for nursing or personal care.
- Have your child’s Medicaid card, equipment list and medicine list ready.
- Ask the oncology team to describe the daily tasks and hours of care.
Your child’s Medicaid care manager and discharge planner · Official page ↗
After you apply
- The plan must answer a nursing request within seven days, or 72 hours when the doctor says it is urgent. A yes is a decision, not a nurse; ask the discharge team how the hours will be staffed.
Good to know
Approval and finding available staff are separate. The discharge team can explain how care will be provided safely while arrangements are completed.
Other details
- The request can be discussed during discharge planning. A decision and actual staffed hours are separate questions.
Official sources
“Could nursing or an aide help with my child’s care at home? What are the benefits and limits, and could you help the team request a review if it fits?”
Why I’m asking: I want to know which care tasks can be shared and how reliable the help would be.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Describe the daily care honestly: hours awake, tasks, what happens if nobody is there.
Your social worker
The discharge planner and the agency submit the authorisation request.
The care team
The oncologist writes what the child needs each day, in hours and tasks.
- Who decides
- The child's Medicaid health plan, or Gainwell Technologies where support coordination is in place.
- Ask your social worker
- “Can we request extended skilled nursing and personal care hours before discharge, and can the doctor write down the hands-on care in hours and tasks?”
How to apply
First step: The discharge planner can coordinate an assessment, authorization, available staffing and a safe interim plan. If discharge is close, the clinician can identify whether expedited review is needed.
- The discharge planner can coordinate an assessment, authorization, available staffing and a safe interim plan. If discharge is close, the clinician can identify whether expedited review is needed.
- Ask the oncologist to write the daily care in hours and tasks.
- The denial notice identifies the appeal route: managed care uses the plan appeal and then a state hearing; fee-for-service uses its state hearing route. Keeping existing services during an appeal has a separate shorter deadline and conditions.
Official application / program page ↗
Where it starts: The discharge planner can coordinate an assessment, authorization, available staffing and a safe interim plan. If discharge is close, the clinician can identify whether expedited review is needed.
What to gather
- The oncologist's description of daily care
- The Medicaid card and health plan name
- A list of equipment and medicines used at home
How long: For covered non-drug Medicaid prior authorization, the federal rules effective January 1, 2026 generally require a decision as quickly as the condition requires, within 7 calendar days for standard requests or 72 hours for expedited requests, subject to limited extensions. Approval does not mean an agency has staff available.
What a yes looks like
An authorisation naming the hours a week and the agency that will provide them.
What a no looks like, and the next move
The denial notice identifies the appeal route: managed care uses the plan appeal and then a state hearing; fee-for-service uses its state hearing route. Keeping existing services during an appeal has a separate shorter deadline and conditions.
Watch out
- A discharge plan needs both authorized services and available staff. The care team can arrange an interim plan if either is missing.
- The program confirms whether a parent can be paid for the specific service and arrangement.
- The doctor documents daily tasks and hours; Medicaid decides what services meet its coverage and medical-need rules.
Dates that change this
2026-09-10: Whether a parent can be paid to give this care is not established. The state self-direction training document returned an error and no current rule about paying a legally responsible person was read. (not yet confirmed against the final rule)
The numbers and the rules
The arcane layer, kept on purpose. Checked September 11, 2026.
What it is worth
Skilled nursing hours and personal care at home for a child aged 0 to 20, by prior authorisation, with no service limit published for personal care.
Covers: Extended skilled nursing at home for Medicaid recipients aged 0 to 20 · Personal care services with no published service limit · Everything medically necessary that Medicaid can cover for a child under 21
Legal protection: A child under 21 on Medicaid is entitled to all medically necessary care Medicaid can cover
What it costs the family: No cost to the family on Medicaid.
The eligibility facts, as published
- Age
- 0 to 20 for extended skilled nursing
- Coverage
- Louisiana Medicaid
- Authorization
- prior authorisation required; the personal care agency submits the request, and Gainwell Technologies authorises it for children receiving support coordination
- Unknowns
- The care team confirms the delivery system, applicable extension rules, appeal route and whether a parent can be paid.
The trap: Payment to a parent depends on the current program and service rules. The care coordinator confirms the arrangement before the family relies on that income.
Where I read this
- Medicaid Services directory — Louisiana Department of Health, read September 10, 2026
- LaCHIP — Louisiana Department of Health, read September 10, 2026
- Self-Direction — Louisiana Department of Health, read September 10, 2026