Providers press for $53.6 million to raise HCBS rates and $3.3 million for 750 waiver slots

Representatives of provider groups and advocacy coalitions told the House Appropriations Committee they are facing a workforce and rate crisis in Louisianas home- and community-based services (HCBS) system.

Kelly Monroe (Arc of Louisiana), Heather Matthews (Arc GNO), Kristin Powers (Arc Caddo-Bossier) and others described a Milliman rate study completed for LDH that identified a $53.6 million state general-fund need to bring reimbursement in line with the cost of delivering HCBS and to raise direct support professional (DSP) wages. Providers said current reimbursement does not cover rising costs such as wages, insurance and transportation, and that many organizations are operating on narrow margins, cutting capacity or declining referrals as a result.

Andrew Mull of AARP Louisiana and other coalition speakers separately requested 750 additional Community Choice waiver slots in FY26-27 at a state cost of about $3.3 million to reduce a wait list the coalition estimated at about 11,828 people (roughly a 10-year wait). They argued HCBS is less expensive than institutional care and that expanding slots will reduce pressure on nursing homes and long-term institutional spending.

Providers asked legislators to consider phased or targeted approaches if full funding is not immediately feasible and offered to work with LDH and the committee on implementation details. Committee members asked about assumptions in the rate study and how to phase increases without destabilizing budgets.