Fact sheet: Medicaid Long-Term Care [Nov. 2013]

Fact Sheet

Medicaid Long-Term Care

Overview
Medicaid Long-Term Care programs enable eligible Georgians to live in the setting most appropriate for their needs nursing facilities, their own home, or a caregiver's home. To be eligible for long-term care assistance, applicants must meet both income and resource limits, which may be higher than the limits for other Medicaid programs. Other criteria considered are functional status, age (in the Independent Care Waiver Program {ICWP} only), citizenship and Georgia residency. Waiver recipients must also qualify for the level of care provided in a nursing facility or other qualified institution.
Georgia Medicaid Long-Term Care Programs
The Community Care Services Program (CCSP) The CCSP waiver provides home- and community-based services to elderly and/or functionally impaired or disabled members. The program includes case management, adult day health care, alternative living services, personal care, home-delivered meals and services, extended home health, respite care and emergency response services.
Independent Care Waiver Program (ICWP) ICWP offers services to a limited number of adult members with physical disabilities, including persons with traumatic brain injuries (TBI). This program is available for eligible Medicaid members who are severely physically disabled and between the ages of 21 and 64 when they apply. ICWP services include personal support, home health, emergency response services, specialized medical equipment and supplies, counseling and home modifications.

Programs
Community Care Services Independent Care Waiver New Options Waiver/ Comprehensive Supports Waiver Nursing Facility Service Options Using Resources in a Community Environment (SOURCE) Home Health Services Hospice Community Mental Health

Georgia Department of Community Health | 2 Peachtree Street NW, Atlanta, GA 30303 | www.dch.georgia.gov | 404-656-4507

November 2013

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Fact Sheet
An Overview of Medicaid Long-Term Care
New Options Waiver Program/Comprehensive Supports Waiver Program (NOW/COMP) NOW and COMP offer home- or community-based services for people with developmental disabilities or intellectual disabilities. Six regional offices under the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) determine eligibility and coordinate service delivery for these programs. The programs cover supported employment, residential services, personal care and respite services, specialized medical equipment and supplies, vehicle adaptations, home modifications, and behavioral support services.
Nursing Facility Nursing Facility services include skilled nursing care, rehabilitation services and health-related care in an institutional setting. People in nursing facilities need around-the-clock nursing oversight. These services also include Intermediate Care Facilities-Intellectual Disability/Developmental Disability (ICF-ID/DD) and swing-bed services.
Service Options Using Resources in a Community Environment (SOURCE) SOURCE serves frail, elderly and disabled Georgians who are eligible for Supplemental Security Income/ Medicaid. The SOURCE program uses primary care physicians on the case management team. In addition to core services of monitoring and assistance with functional tasks, SOURCE recipients can have Assisted Living Services (ALS), extended home health, personal care, home-delivered meals, adult day health care, emergency response services, and 24-hour medical access to a case manager and primary care physician.
Home Health Services Home Health Services include skilled nursing, home health aide, and physical, speech and occupational therapy services. Services are provided in the member's home and require physician orders. Because they are meant to be short term in nature, there is an annual limit on the number of home health visits that can be reimbursed.
Hospice Hospice includes palliative medical care and services for terminally ill persons and their families. Hospice offers nursing care, medical social services, counseling, medications, medical appliances and supplies, and hospice-aide. Care may be provided in the member's home or in an inpatient facility, including nursing facilities.

Georgia Department of Community Health | 2 Peachtree Street NW, Atlanta, GA 30303 | www.dch.georgia.gov | 404-656-4507

November 2013

2 of 3

MD-9-19-13

Fact Sheet
An Overview of Medicaid Long-Term Care
Community Mental Health Services Community Mental Health Services are provided to persons 4 years of age and older who have mental illness or issues with substance use or addiction. Services are provided in the community, in outpatient facilities, clinics or inpatient facilities. Services include:
Diagnostic assessments Crisis intervention Psychiatric treatment Nursing assessment and care Individual, group and family outpatient therapies Medication administration Behavioral health rehabilitation services Substance abuse and detoxification services Short-term, in-patient care for severely emotionally disturbed youth
For More Information
Visit the DCH website at www.dch.georgia.gov/long-term-care.

Georgia Department of Community Health | 2 Peachtree Street NW, Atlanta, GA 30303 | www.dch.georgia.gov | 404-656-4507

November 2013

3 of 3

MD-9-19-13