If you or a family member has an intellectual or developmental disability and is seeking a Louisiana Medicaid waiver, one of the first questions you may have is:
How long will it take?
The most accurate answer is:
There is no single or guaranteed wait time for an OIDD Medicaid waiver in Louisiana.
Louisiana does not simply offer developmental disability waivers in the order people apply. Instead, waiver opportunities are prioritized based largely on the individual’s current urgency of need, the type of waiver that can meet those needs, available funding, and the person’s Request for Services Registry date.
That means two people who request waiver services at the same time may not receive a waiver opportunity at the same time.
Important: This article provides general educational information only. It does not predict when an individual will receive a Medicaid waiver opportunity and does not guarantee Medicaid or waiver eligibility. Waiver opportunities, eligibility determinations and service authorizations are made by the Louisiana Department of Health and other applicable authorities.
How Does the Louisiana OIDD Waiver Process Work?
Louisiana’s Office of Intellectual and Developmental Disability Supports (OIDD) administers four primary home and community-based developmental disability waivers:
- Children’s Choice Waiver
- Supports Waiver
- Residential Options Waiver (ROW)
- New Opportunities Waiver (NOW)
Each waiver serves different needs and has its own eligibility requirements.
A person who needs OIDD services generally begins by contacting their local Human Services District or Authority, sometimes referred to as the Local Governing Entity, to begin the developmental disability eligibility process.
If the person is determined eligible for OIDD services and needs waiver services, they may request placement on the Developmental Disability Request for Services Registry (RFSR).
Is the RFSR a Traditional Medicaid Waiver Waiting List?
Not exactly.
The Request for Services Registry is sometimes still informally called a “waiver waiting list,” but Louisiana’s current system is based on prioritized need rather than simply how long someone has been waiting.
When a person is added to the RFSR, Louisiana uses a Screening for Urgency of Need (SUN) to identify how urgently waiver supports are needed. Waiver opportunities are then offered based on prioritized need, available funding, and the individual’s registry date within the applicable priority group.
This is why asking:
“What number am I on the waiting list?”
does not necessarily tell a family when a waiver opportunity will become available.
The person’s current level of need matters significantly.
What Is the Screening for Urgency of Need?
The Screening for Urgency of Need, commonly called the SUN, is used by OIDD to assess how urgently an individual needs waiver services.
Louisiana’s tiered system identifies levels of need ranging from no currently identified waiver need through planning, critical, urgent and emergent needs.
LDH currently describes the SUN levels as:
- 4 — Emergent: services are needed immediately or within approximately 90 days
- 3 — Urgent: services are needed within approximately 3–12 months
- 2 — Critical: supports are anticipated within approximately 1–2 years
- 1 — Planning: supports are anticipated farther into the future
- 0 — None of the Above: no current unmet waiver need is identified or the anticipated need is farther into the future
The SUN category describes the urgency of the person’s needs. It is not a promise that a waiver will be received within that exact time period.
Who Receives a Waiver Opportunity First?
LDH states that an individual who:
- Meets applicable eligibility requirements,
- Is within the highest urgency priority category or categories currently being served based on funding, and
- Has the earliest applicable Request for Services Registry date
may be offered the next available OIDD waiver opportunity that is appropriate to meet their needs.
This means the process is not purely first-come, first-served.
For example, someone who has been on the registry for a shorter period but develops an emergent unmet need may be prioritized differently from someone whose current needs are adequately supported and whose waiver need is expected farther into the future.
Does Being on the RFSR Mean You Have Been Approved for a Waiver?
No.
Placement on the RFSR means the individual has requested OIDD waiver services and has entered the system used to identify and prioritize waiver need.
LDH specifically states that the full waiver application process does not begin until a waiver opportunity becomes available.
Once a waiver opportunity is offered and accepted, additional determinations must still occur.
These can include:
- Medicaid financial eligibility
- Disability eligibility, when applicable
- Medical or psychological eligibility
- Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) level-of-care requirements
- Development of and approval of the participant’s Plan of Care
Receiving a waiver offer therefore does not mean services begin immediately.
What Happens After a Waiver Opportunity Is Offered?
Once an appropriate waiver opportunity becomes available, the person or authorized representative receives information about the offer.
If the waiver opportunity is accepted, the next steps generally include completing the applicable Medicaid and waiver eligibility processes.
LDH describes the process as including simultaneous medical and financial determinations to verify that the individual meets the applicable requirements.
The participant will also select a Support Coordination Agency through Louisiana’s Freedom of Choice process.
The Support Coordinator then works with the participant, family or authorized representative, and others chosen by the participant to identify needs and develop the applicable person-centered Plan of Care.
Services can begin after the necessary eligibility, planning and authorization requirements have been completed.
How Long Does the Medicaid Application Part Take?
This is different from waiting for a waiver opportunity.
Louisiana Medicaid’s current eligibility manual generally allows:
- Up to 45 days for disposition of many Medicaid applications
- Up to 90 days when eligibility is based on disability and a disability determination is required
These are Medicaid application-processing standards. They should not be interpreted as a promise that someone will receive an OIDD waiver within 45 or 90 days of requesting one.
The potentially much longer and less predictable part of the process can be the period between requesting waiver services and receiving an appropriate waiver opportunity.
What If the Person’s Needs Get Worse While Waiting?
This is very important.
Because Louisiana’s OIDD waiver system prioritizes current urgency of need, families should not assume that the SUN screening is something that should simply be forgotten after the person is placed on the RFSR.
Circumstances can change.
Examples might include:
- A caregiver can no longer continue providing necessary support
- A primary caregiver becomes ill or dies
- The person’s medical, behavioral or support needs significantly increase
- Current supports are no longer sufficient or sustainable
- A significant change occurs in the person’s living arrangement
- The individual faces a new risk of institutional placement
A change in circumstances does not automatically result in a waiver opportunity. However, because waiver prioritization is tied to urgency of need, significant changes should be communicated to the appropriate Human Services District or Authority so the state can determine whether updated screening or other action is appropriate.
LDH’s current OIDD materials specifically describe the registry as a way for the state to respond when an individual’s needs change and become more urgent.
Does Everyone Eventually Receive the NOW Waiver?
Not necessarily—and this is another common misunderstanding.
Louisiana operates a tiered waiver system.
The four OIDD waivers are designed to provide different levels and types of support. The goal is to offer the waiver that can appropriately meet the individual’s identified needs rather than automatically moving everyone toward the New Opportunities Waiver.
LDH currently identifies the four developmental disability waivers as:
- Children’s Choice Waiver
- Supports Waiver
- Residential Options Waiver
- New Opportunities Waiver
Waiver opportunities are intended to be matched to the individual’s prioritized support needs.
So the important question is not necessarily:
“How long until I get NOW?”
It may instead be:
“Which OIDD waiver is appropriate for my current needs, and when might an opportunity for that waiver become available?”
Are There Services Available While Someone Is on the Registry?
Potentially.
Being on the RFSR does not necessarily mean the individual must go entirely without support until a waiver opportunity becomes available.
OIDD also identifies Individual and Family Support services that may assist eligible people with developmental disabilities when appropriate and when other resources are unavailable.
These supports may include areas such as:
- Respite
- Personal assistance
- Equipment and supplies
- Specialized medical or dental needs
- Communication services
- Crisis intervention
- Family education
- Other qualifying supports
Availability and eligibility can depend on the individual’s circumstances and local resources.
Children and young adults under age 21 who are Medicaid eligible may also have access to medically necessary services through EPSDT, which is separate from waiting for an OIDD waiver opportunity.
How Can I Check My Waiver Status?
For an OIDD waiver request, the most appropriate contact is generally the individual’s local Human Services District or Authority.
Families may want to confirm information such as:
- Whether the individual is currently on the RFSR
- The individual’s waiver request or registry date
- Their current Screening for Urgency of Need status
- Whether significant changes in circumstances should be reported
- Whether other OIDD services may currently be available
OIDD can also provide general information about its developmental disability waiver programs.
OIDD State Office: 225-342-0095
The Bottom Line
How long does it take to get a Medicaid waiver in Louisiana?
For an OIDD developmental disability waiver, there is no single waiting period or guaranteed timeline.
Louisiana prioritizes waiver opportunities using the individual’s:
- Eligibility
- Screening for Urgency of Need
- Priority category
- Request for Services Registry date
- Type of waiver needed
- Availability of funded waiver opportunities
A person with an emergent or urgent unmet need may be prioritized differently from someone whose waiver needs are expected farther into the future.
And once a waiver opportunity is offered, Medicaid financial eligibility, medical and level-of-care requirements, person-centered planning and service authorization still must be completed before waiver services begin.
Because circumstances can change, individuals and families on the RFSR should keep their contact information current and report significant changes in support needs to the appropriate Human Services District or Authority.
Important Information: This article is provided solely for general educational and informational purposes. It is not legal, financial, medical, Medicaid eligibility, or benefits-planning advice. Nothing in this article guarantees that an individual will qualify for OIDD services, Medicaid, a Medicaid waiver, a particular priority level, or any specific service, nor does it predict when a waiver opportunity will become available. Waiver availability, funding, eligibility requirements, priority processes and program rules may change and may apply differently based on individual circumstances. Eligibility, waiver opportunities, priority determinations and service authorizations are made by the Louisiana Department of Health, Louisiana Medicaid, OIDD, and other applicable government authorities.
Our agency is an independent Louisiana Support Coordination Agency and is not the Louisiana Department of Health, Louisiana Medicaid, OIDD, or another government agency. References to government programs are provided for informational purposes only.
