A snapshot of Georgia: Medicaid Long-Term Care, a program of the Georgia Department of Community Health [Jan. 2009]

A Progam Of The Georgia Department Of Community Health
A SNAPSHOT OF GEORGIA
Medicaid Long-Term Care

Overview

Medicaid Long-Term Care programs enable eligible Georgians to live

in the setting that is most appropriate for their needs, including nursing

PROGRAMS

facilities, their own 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, citizenship and Georgia residency. Waiver recipients must also qualify for the level of care provided in a nursing facility or other qualified institution.

Community Care Services Independent Care Waiver New Options Waiver Nursing Facility Service Options Using Resources in a Community

Environment

Georgia's Medicaid Long-Term Care Programs

Home Health Services

Hospice

Community Care Services Program

Community Mental Health

Community Care Services Program waiver provides home and

community-based services to elderly and/or functionally-impaired or disabled people. It includes care

management, adult day health care, alternative living services, personal care, home delivered meals,

extended home health, respite care and emergency response systems.

Independent Care Waiver Program (ICWP) ICWP offers services to a limited number of adult Medicaid members with physical disabilities, including persons with traumatic brain injuries (TBI). This program is for eligible Medicaid members between the ages of 21 and 64 who are severely physically disabled when they apply. ICWP services include personal support, home health, emergency response systems, specialized medical equipment and supplies, counseling and home modifications.

New Options Waiver Program/Comprehensive Supports Waiver Program (NOW/COMP) NOW and COMP offer home or community-based service for people with mental retardation or developmental disabilities. Five regional offices under the Georgia Department of Human Resources determine eligibility and coordinate service delivery for these programs. The programs cover day rehabilitation and supported employment, residential training and supervision, 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. Persons in nursing facilities need round-the-clock nursing oversight. These services also include Intermediate Care Facility/Mental Retardation and swing bed services.

2 Peachtree Street, Atlanta, Ga 30303 www.dch.georgia.gov

January 2009

A Snapshot Of The Georgia Long-Term Care
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 is based on a case management model that uses primary primary care physicians on the case management team. In addition to core services of monitoring and assistance with functional tasks, SOURCE individuals can have Assisted Living Services, 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 visits that can be reimbursed.
Hospice Hospice includes palliative medical care and services for persons who are terminally ill and their families. Hospice offers nursing care, medical social services, counseling, medications, medical appliances and supplies, home health aide and therapy services. Care may be provided in the member's home or in an in-patient facility, including nursing facilities.
Community Mental Health Services Community Mental Health Services are provided to persons of all ages who have mental illness or issues with substance abuse. Services are provided in out-patient facilities, clinics or short-term in-patient facilities. Community Mental Health Services include:
Diagnostic assessments Crisis intervention Psychiatric treatment Nursing assessment and care Individual, group and family outpatient therapies Medication administration Day treatment Substance abuse and detoxification services Short-term inpatient care for severely emotionally disturbed youth