Residential Options Waiver (ROW)

The Residential Options Waiver was approved by CMS October 1, 2009 with the first participants being served July 1, 2010, state fiscal year of 2010.  This waiver offers eligible individuals of all ages services designed to support them to move from Intermediate Care Facilities for the Developmentally Disabled (ICF/DD) and nursing facilities to the community.

The Residential Options Waiver is appropriate to persons whose health and welfare and for whom home and community-based waiver services represent a least restrictive treatment alternative through a Plan of Care.  It is a capped waiver with the person's individual annual budget being based on the person's support needs and the current ICF/DD budget rate. 


An individual may be offered a ROW waiver opportunity who meets all of the following eligibility criteria:

  • Have a developmental disability as defined in the Developmental Disability Law

Age: Birth through end of life with a developmental disability manifesting prior to age 22. Must meet the Louisiana definition for developmental disability.

There is no age-specific requirement for the ROW. The waiver may be used by people from birth to end of life.

  • All ROW participants must meet the Louisiana definition of Developmental Disability as outlined in Louisiana law R.S. 28:451.1-455.2, which manifested prior to the age of 22.
  • Meet financial and non-financial Medicaid eligibility criteria for home and community-based waiver services: Income equals 300% of the Supplemental Security Income (SSI) Federal Benefit Rate (FBR).
  • Meet Intermediate care facility for people with developmental disability (ICF/DD) level of care criteria, and
  • All other non-financial requirements such as:
  • Citizenship (U.S. citizen or qualified alien),
  • Be a Resident of Louisiana,


  • Have a Plan of Care (POC) that is sufficient to assure the health and welfare of the waiver applicant in order to be approved for waiver participation or continued participation. Health and welfare requirements of the person must be assured within the cost limit of the ROW (100% of the cost of care for the highest acuity level for persons in private ICFs/DD).Criteria for one of the following target groups:
  • Meet the ICF/DD level of care and needs Home and Community-Based Services (HCBS) due to a heath and/or safety crises situation (crisis diversion)
  • Is an adult in a nursing facility (NF) who is appropriate for transition to HCBS residential services, meets the level of care (LOC) to qualify for ROW eligibility and who is on the Request For Services Registry (RFSR)
  • Is a child (birth through age 18) in a NF requiring high-need rates who is appropriate for transition to HCBS residential services and who meets the LOC to qualify for ROW eligibility
  • Is a resident in an ICF/DD who wishes to transition to HCBS residential services through a voluntary conversion opportunity; or
  • Is a resident in an ICF/DD who is on the RFSR who wishes to transition to HCBS residential services and are eligible for the ROW: or
  • Is a resident in a Supports and Services Center who wishes to transition to HCBS residential services.

Children in NF's along with persons residing in ICFs/DD who wish to transition to HCBS residential services, who are eligible for the ROW and who are on the RFSR have a choice of participating in the MFP Rebalancing Demonstration.  All persons who participate must meet criteria for participation established by OCDD protocol and must meet demonstration operational parameters (e.g. available funding) established by the demonstration award. 

To remain eligible for waiver services, a recipient must receive Support Coordination and a Residential waiver service every thirty days.

ROW Covered Services

  • Support Coordination
  • Community Living Supports
  • Host Home Services
  • Companion Care Services
  • Shared Living
  • Respite Care-Out of Home
  • Personal Emergency Response System
  • One Time Transition Services
  • Environmental Accessibility Adaptations
  • Assistive Technology/Specialized Medical Equipment and Supplies
  • Transportation-Community Access
  • Professional Services
  • Nursing Services
  • Dental Services
  • Supported Employment
  • Prevocational Services
  • Day Habilitation
  • Housing Stabilization Service
  • Housing Stabilization Transition Services
  • Adult Day Health Care

ROW Population Requirements

OCDD developed the ROW with the goal of providing different types of residential options to people with developmental disabilities.  The ROW provides you with the choice to live in the community, rather than in an institution.  For that reason, the ROW is making opportunities available to people who live in ICFs/DD and nursing facilities.  Specifically, ROW is initially making opportunities available to:

  • People ages - birth to end of life
  • People in crisis situations who are at risk of being admitted to an institution
  • Children and adults with developmental disabilities who are living in nursing facilities
  • People who are living in ICFs/DD converting to ROW services

How Do I Apply?

To apply for the Residential Options Waiver, individuals and families should call or visit their local regional community services office. As waiver opportunities and funding is limited, those applying for services are placed on the Louisiana Request for Services Registry and notified when a Residential Options Waiver opportunity becomes available. To locate a local district or authority, click here

ROW Fact Sheet

Additional Information