Community Care Services Program: annual report, state fiscal year 2003

COMMUNITY CARE SERVICES PROGRAM
Annual Report State Fiscal Year 2003
"A partner in the Aging Network"
Division of Aging Services Georgia Department of Human Resources

Issued January 2004

PROVISIONS OF COMMUNITY CARE SERVICES ACT
This Annual Report reflects State Fiscal Year 2003 activities completed by the Georgia Department of Human Resources Division of Aging Services and other agencies. It is prepared in accordance with provisions set by the Community Care and Services for the Elderly Act for the following legislators and officers:
SPEAKER OF THE HOUSE OF REPRESENTATIVES PRESIDENT OF THE SENATE CHAIRMAN OF THE HOUSE HEALTH AND ECOLOGY COMMITTEE CHAIRMAN OF THE HOUSE HUMAN RELATIONS AND AGING COMMITTEE CHAIRMAN OF THE SENATE HEALTH AND HUMAN SERVICES COMMITTEE
The General Assembly, in enacting the Community Care and Services for the Elderly Act, indicated its intent (O.C.G.A. 49-6-60 [et seq. 49-6-64]) as follows:
To assist functionally impaired elderly persons in living dignified and reasonably independent lives in their homes or with their families or caregivers through the development, expansion and coordination of various community-based services; To establish a continuum of care for such elderly persons age 60 and older in the least restrictive environment suitable to their needs; To maximize use of existing community social and health services to prevent unnecessary placement of individuals in long-term care facilities; and, To develop innovative approaches to program management, staff training, and service delivery that impact on cost avoidance, cost effectiveness and program efficiency.
i

COMMUNITY CARE SERVICES PROGRAM
CONSUMER / CAREGIVER QUOTES
"I visited a [consumer] who lived with her daughter. She was not well and I observed that the daughter was exhausted. [The care coordinator] handled the situation well by offering additional respite assistance to the daughter and explaining the resources available to her and her mother and noting the needs in her notes. I understand better the benefits that the CCSP provides to Georgians in need of these services. All of the participants I saw needed service, but none of them wanted to be in a nursing home. In the past, a nursing home placement would have been the only resource available to address their needs. Now with CCSP, seniors are experiencing a much better quality of life."
Observing Community Care Services First-Hand, By Jim Martin Former Commissioner, GA Department of Human Resources
"I would not have been able to take mother out of the nursing home without the help from CCSP. My care coordinator is always looking out for us and has the consumer's best interest at heart. This has been the best therapy for mom."
Caregiver daughter, Female consumer, age 90 Washington (Central Savannah River Area Agency on Aging)
"I am always treated with courtesy and respect by the care coordination team. The care coordinator explained available services to my family and me. Questions were answered and calls returned promptly. The care coordinator kept appointments as scheduled. My family says they could not keep me at home without the help of this service."
Female consumer, age 90 Pickens County (Northwest GA Area Agency on Aging)
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"At one point my wife was so dependent that after using all of my leave time and donated leave time of fellow employees I had to quit my job to care for her. With CCSP services her health stabilized and I was able to do limited work. Now she has prosthetic limbs and states she is not afraid to be alone because the ERS is always available and the aide comes daily to help with personal care and home chores. I didn't believe that life could ever seem "normal" again until CCSP came along."
Caregiver husband, Female consumer, age 64 Emanuel County (Heart of GA / Altamaha Area Agency on Aging)
"The services have not only helped my elderly mother, but are a big help for me as a caregiver. The aide helps my mother with her personal care. She enjoys the meals and having the ERS is a safety thing."
Caregiver daughter, Female consumer, age 62 Columbus (Lower Chattahoochee Area Agency on Aging)
"We are both in wheelchairs. Seven days a week a home care aide comes to our house in the morning and helps us get out of bed; otherwise we would be bed bound and unable to perform daily activities of living. This way we can continue to live independently, in our own home which is where we want to be. The CCSP is a lifesaver to so many people who find it difficult to remain self-sufficient at home. It makes a significant contribution to the quality of our life together."
Caregiver husband, Female consumer, age 67 Atlanta (Atlanta Regional Commission Area Agency on Aging)
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TABLE OF CONTENTS
Page PROVISIONS OF THE COMMUNITY CARE
SERVICE ACT.............................................................. i COMMUNITY CARE SERVICES PROGRAM QUOTES....................ii-iii TABLE OF CONTENTS..................................................................1 INTRODUCTION..........................................................................2 STATISTICAL DATA.....................................................................3 PROGRAM STRUCTURE AND ADMINISTRATION...........................4 PROGRAM COSTS AND SAVINGS...............................................5-6 CONSUMER ASSESSMENTS AND WAITING LIST..........................7-9 CONSUMER DEMOGRAPHICS.................................................10-11 CCSP SERVICES PROVIDED....................................................12-13 SERVICE PROVIDERS.................................................................14 CCSP ACCOMPLISHMENTS.........................................................15 SERVICE DEFINITIONS
AND CONSUMER / CAREGIVER QUOTES..................16-21
1

INTRODUCTION
VISION The Division of Aging Services (DAS), its 12 Area Agencies on Aging (AAAs), and our service providers comprise Georgia's Aging Network. We assist older consumers, their families, and caregivers to achieve safe, healthy, independent and self-reliant lives. Georgia's Community Care Services Program (CCSP) is the leader in community-based care options, providing support and direction to the Aging Network to ensure that Georgians eligible for nursing home care have the option of remaining in their homes or communities.
SERVICES The CCSP has successfully completed its 21st year of operation. The program provides a range of community-based services designed to delay or prevent more costly nursing home placement. These services include telephone screening, faceto-face consumer assessment, care coordination, Home Delivered Services (Home Health), Adult Day Health, Alternative Living Services, Out-of-Home Respite Care, Personal Support Services, Home Delivered Meals, and Emergency Response System.*
ELIGIBILITY CCSP is the cost-effective alternative to nursing home placement. When funding allows, CCSP provides Medicaid eligible consumers with community based services that maintain the consumer at home or in the community. Consumers must meet the same medical, functional, and financial criteria as for placement in a nursing facility. A physician certifies that the consumer's needs may be met by the CCSP and available community resources.
FUNDING Under Title XIX of the Social Security Act, the Georgia Medicaid Program, funded with federal and state dollars, reimburses provider agencies for services through a federal Medicaid 1915(c) waiver for Home and Community-Based Services. Provider agencies render services in the consumers' homes, licensed personal care homes, or adult day health facilities. The Department of Human Resources (DHR), Division of Aging Services (DAS) administers and manages the CCSP through an inter-agency agreement with the Georgia Department of Community Health (DCH), Division of Medical Assistance (DMA).
* Refer to page 16 for CCSP SERVICE DEFINITIONS
2

STATISTICAL DATA SFY 2003
The CCSP served 14,687 consumers; Georgia taxpayers saved $16,315 for each consumer served by the CCSP instead of a nursing facility - a statewide savings of over $239 million; The cost to taxpayers to maintain a consumer in the CCSP was only 26% of the Medicaid cost to maintain a person in a nursing facility; Two percent of consumers served were 100 years of age or older; 16% were 90 or older; 29% were 85 or older; 58% were 75 or older; 83% of CCSP consumers were 60 or older; and, 17% of consumers were under age 60; Personal Support Services was utilized by 78% of consumers. It was the most frequently used CCSP service; The average length of stay for CCSP consumers was 40 months.
3

PROGRAM STRUCTURE AND ADMINISTRATION
Consumers receive CCSP services through the cooperation of the following state and local agencies and private businesses:
The Division of Aging Services of the Department of Human Resources has the primary responsibility for development and administration of the CCSP. Coordination of the various entities working together to provide quality, consumer-focused services is the priority of the CCSP.
The Division of Medical Assistance of the Department of Community Health reimburses service providers and monitors services for quality and appropriateness.
The Division of Family and Children Services of the Department of Human Resources determines consumer Medicaid eligibility and cost share for services.
The Division of Mental Health, Developmental Disabilities and Addictive Diseases of the Department of Human Resources provides consumer psychological and psychiatric evaluations and therapeutic services.
Area Agencies on Aging (AAAs) contract with the Department of Human Resource's Division of Aging Services to serve as Lead Agencies or regional managers of the CCSP. The twelve AAAs serve as the local "Gateway to Community Resources" for consumers and their families, service providers, and potential service providers. The AAAs manage service benefit allocations, assuring the CCSP does not exceed budget limitations.
Care coordinators assess consumers for CCSP eligibility, link consumers to service providers and other support services, and periodically monitor care. Care coordinators assure reliable, cost effective, consumer-focused service delivery, avoiding duplication and over-utilization of services.
Providers enrolled in the CCSP deliver services ordered by the consumer's care coordinator and physician. The Division of Aging Services recommends service providers for enrollment in the CCSP.
4

PROGRAM COSTS AND SAVINGS
EXPENDITURES

CCSP PROGRAM EXPENDITURES SFY 2000 - SFY 2003

CATEGORY
Consumer Service Benefits Care Coordination State Administration

SFY 2000 $71,289,084 $13,734,959
$722,857

SFY 2001 $78,200,923 $16,471,682
$1,242,719

SFY 2002 SFY 2003 $84,738,390 $85,717,353 $17,806,115 $17,806,114
$1,403,005 $1,035,747

TOTAL

$85,746,900 $95,915,324 $103,947,510 $104,559,214

Figure 1 In SFY 2003 the CCSP reimbursed provider agencies over $85 million for consumer services provided, yet state administrative cost was only 1% of total expenditure for the CCSP.

OTHER SERVICES

CARE COORDINATION COST - SFY 2003

DOLLARS EXPENDED

CONSUMERS SERVED

COST PER CONSUMER

$17,806,114

14,687

$1,212

Figure 2 Care coordination is key in providing consumer-focused care to CCSP consumers. Care coordination assures that consumers admitted to the program receive cost-effective, appropriate, and coordinated services.
5

MEDICAID SAVINGS

ANNUAL SAVINGS PER CONSUMER SERVED IN CCSP INSTEAD OF IN A NURSING FACILITY

SFY 2000

SFY 2001

SFY 2002

SFY 2003

AVG. SAVINGS SFY 2000 - 2003

$12,959

$13,090

$14,247

$16,315

$14,153

Figure 3 The above chart illustrates the cost effectiveness of CCSP.
COM PARISON: M EDICAID DOLLARS EXPENDED IN NURSING FACILITIES VS. THE CCSP

$25,000 $20,000 $15,000 $10,000
$5,000 $0

$17,760

$17,725

$19,335

$22,151

$4,801 SFY 2000

$4,635

$5,088

$5,836

SFY 2001

SFY 2002

SFY 2003

CCSP

NURSING FACILITY

Figure 4 Since SFY 2000, CCSP Medicaid per-consumer expenditure has averaged only 26% of nursing facility Medicaid expenditure.

SUMMARY
The CCSP saved the State and Federal governments over $239 million for SFY 2003, $16,315 per consumer. In SFY 2003, the average annual cost to the CCSP for a consumer's services was $5,836. If the consumer had received Medicaid reimbursed care in a nursing facility, the average annual cost to taxpayers would have increased to $22,151 per consumer.
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CONSUMER ASSESSMENTS AND WAITING LIST
ASSESSMENTS
Community Care Services Program (CCSP) consumers must meet the same medical, functional, and financial criteria as consumers receiving nursing home care under Medicaid.
Area Agencies on Aging staff and care coordinators conduct telephone interviews to screen consumers for potential service eligibility.
Consumers are prioritized for assessment based on the results of the telephone screening. Consumers with high impairment levels and unmet need are the first to enter services.
A face-to-face assessment determines the consumer's need for services. Care coordinators determine consumer medical eligibility. Eligibility staff at the Division of Family and Children Services
determine consumer financial eligibility for Medicaid.
The CCSP care coordinators re-assess consumers at least annually to assure they remain eligible for services and services are appropriate for consumer needs.

ASSESSMENTS COMPLETED - SFY 2003 Initial telephone assessments Average number on monthly waiting list Initial face-to-face assessments completed

12,889 5,560 1,897

Figure 5 Demand for the CCSP exceeds available funding: 12,889 telephone screenings were conducted, but only 1,897 face-to-face initial assessments were conducted with consumers because admission to the CCSP is dependent upon the availability of funding.

7

GEORGIA'S CCSP WAITING LIST

By 2030, there will be about 70 million older persons in the United States, more
than twice their number in 2000. People 65 and older represented 12.6% of the population in the year 2000, and will represent 20% by the year 20301.

Georgia had the sixth fastest growing elderly population in the United States during 1990-2000. Over the 20th century (1900-1999), the number of Georgians
ages 60 and above increased ten-fold, compared to a four-fold growth in the
population overall.

PERCENT INCREASE IN POPULATION AGES 65+

20.0%

12.6%

20.0%

13.5% 16.0%

10.0%

0.0%

1990-2000 Actual

2000-2010 Projected

United States Georgia

Figure 6 shows the projected increase in Georgia's elderly population from 1990 20102.

Georgia and United States, 1990 - 2010 % Increase in Population, by Age Group

300.0% 250.0%

264.9%

200.0% 15 0.0 % 10 0.0 % 50.0%
0.0%

8 1.6 % 33.7%

12 0.4% 4 1. 3 %

87.9%

60+

75+

Unite d S ta te s

85+ G e o rg ia

Figure 7 shows the projected increase, by age group, in Georgia's elderly population. This is significantly greater than the anticipated U.S. increase.

1 U.S. Bureau of the Census, Population Projections of the United States, by Age, Sex, Race and Hispanic Origin:

1993 to 2050, Current Population Reports, P25-1104. 2 US Bureau of the Census, Summary File 1, 1990 and 2000; Governor's Office of Planning and Budget

Projections 2010.

8

SFY 2000 2001 2002 2003

WAITING LIST SFY 2000 - SFY 2003
AVG. COUNT OF CONSUMERS 3,435 3,198 4,115 5,560

Figure 8

The above demonstrates the recent rise in the average number

of consumers on the CCSP Waiting List.

PROJECTION OF POTENTIAL CCSP CONSUMERS

Years
Estimated Number of Potential CCSP Consumers

2015 84,680

2020 102,453

2025 120,226

Figure 9

The above projections calculate the number of consumers who

may need CCSP services over the next 22 years. Projections are based on U.S.

2000 Bureau of the Census population statistics: older Georgians served by

Medicaid, or on waiting lists for this fund source, who have chronic conditions,

no spouse, and who are not in nursing facilities or candidates for services

provided by the Georgia Division of Mental Health, Developmental Disabilities

and Addictive Diseases.

SUMMARY
Growth projections for Georgia seniors with chronic conditions clearly demonstrate the growing future demand for home and community-based services.

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CONSUMER DEMOGRAPHICS

CONSUMERS SERVED BY CCSP

18,000 16,000 14,000 12,000 10,000
8,000 6,000 4,000 2,000
0

13,224 12,574 1993 1994

13,193 1995

14,185 12,681
1996 1997

15,228

16,873

14,194

14,848

1998 1999 2000 2001

16,653 14,687
2002 2003

Figure 10 The above illustrates a 17% increase in the number of consumers served since SFY 1993. The decreased number in SFY 2003 of consumers served reflects funding that has not increased proportionately to maintain current clients staying longer in the CCSP and to add additional consumers.

PROFILE OF CCSP CONSUMERS - SFY 2003

Unduplicated consumer count Consumers 100 years of age or older Consumers 90 years of age or older Consumers 85 years of age or older Consumers 75 years of age or older Consumers 60 years of age or older Consumers under 60 years of age Percentage of consumers who are female Percentage of consumers who are minorities (non-white)

14,687 2% 16% 29% 58% 83% 17% 76% 42%

Figure 11 In SFY 2003, the CCSP served 14,687 consumers. Seventysix percent were female. Fifty-eight percent were over the age of 75, and 29% of consumers were 85 or older. Seventeen percent of consumers served were younger than age 60. Over 200 consumers were age 100 or older.
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AVERAGE LENGTH OF STAY & DISPOSITION OF CONSUMER DISCHARGES
SFY 2003

Average Consumer Length of Stay

40 months

Disposition of Discharged Consumers:

- Death

46%

- Nursing facility placement

36%

- Refused Service/ Referred to Other

Community Agency/ Moved From Service

Area / Hospice/ Ineligible

18%

Figure 12 The above chart shows the average time a person remains in the CCSP. Thirty-six percent of those discharged from the CCSP enter a nursing facility because of their need for continuous higher level of skilled care services. In SFY 2003, an increase of 3 months in the average length of stay in CCSP resulted in 7% more consumers living in the community for the remainder of their lives.

CONSUMERS BY PAYMENT SOURCE - SFY 2003

Consumers receiving SSI Medicaid

45%

Consumers receiving Medical Assistance Only

51%

(MAO)

Consumers whose Cost Share covered service

4%

costs

Figure 13 Because consumer incomes are less than the federal Supplemental Security Income (SSI) level, 45% of CCSP consumer care is paid by Medicaid. Fifty-one percent of the consumers receive partial Medicaid payment for their services. According to their income levels Medical Assistance Only (MAO) consumers pay a portion of the cost of services known as Cost Share. Services for the remaining 4% are at no cost to the Medicaid Program because the consumer Cost Share pays the entire cost of the CCSP services received.
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CCSP SERVICES PROVIDED
UTILIZATION AND EXPENDITURES

CONSUMERS SERVED AND CCSP MEDICAID FUNDS EXPENDED BY SERVICE TYPE - SFY 2003

CCSP SERVICE
Adult Day Health (ADH)
Alternative Living Services (ALS) - Group Model - Family Model
Emergency Response System (ERS)
Home Delivered Meals (HDM)

CONSUMERS % TOTAL

FUNDS

% TOTAL

SERVED* CONSUMERS* EXPENDED FUNDS**

593

4% $3,291,546

4%

1,870 705
6,663
2,992

13% $9,703,204

11%

5% $3,797,279

4%

45% $1,525,769

2%

20% $3,642,988

4%

Home Delivered Services (HDS)
Home Health Services Medicaid Home Health (HHS)
Out-of-Home Respite Care (OHRC)
Personal Support Services (PSS, PSSX)

88 3,122

1% $145,720 Less than 1%

21%

0***

0%

15 Less than 1%

$42,859 Less than 1%

11,509

78% $63,567,989

74%

* Duplicated consumer count. Consumers may receive more than one service.

** Percentages are rounded.

*** Covered under state Medicaid plan.

Figure 14 The above shows the CCSP service types by number of consumers and expenditure of CCSP Medicaid dollars provided and expenditures for each service.
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CONSUMERS SERVED BY SERVICE TYPE SFY 2003

HDM 2,992

ADH 593 ALS 2,575

HDS 3,210

ERS 6,663

PSS 11,524*

Figure 15 This graph displays by service type the number of CCSP consumers who receive each service. Consumers may receive more than one service.
*NOTE: Personal Support Services consumer count includes Out-of-Home Respite Care consumers.
SUMMARY
Seventy-eight percent of CCSP consumers use Personal Support Services (PSS), the provision of personal assistance, stand-by assistance or supervision of consumers with inability to perform activities such as eating, dressing, bathing, toileting, transferring or walking, or light housekeeping. It may also provide respite care to the caregiver. This service accounts for 74% of total CCSP expenditures. Alternative Living Services (ALS) ranks second in expenditures (18%).
Accounting for only 2% of CCSP Medicaid expenditures, 45% of CCSP consumers use the cost-effective Emergency Response System (ERS) service.
13

SERVICE PROVIDERS

PROVIDERS BY SERVICE TYPE* - SFY 2003

Adult Day Health

33

Alternative Living Services - Family Model

20

Alternative Living Services - Group Model

163

Emergency Response System

12

Home Delivered Meals

30

Home Delivered Services

34

Personal Support Services

141

Out-of-Home Respite Care Services

8

* Some providers provide more than one service.

Figure 16 This chart indicates the number of providers enrolled in each CCSP Medicaid service.

The Community Care Services Program manages, coordinates, and provides services to consumers by partnering with 427 public and private licensed, CCSP enrolled businesses and agencies. The CCSP supports and grows small local businesses.

14

CCSP ACCOMPLISHMENTS IN SFY 2003
QUALITY INITIATIVES
Georgia's CCSP 1915(c) waiver for home and community based services was renewed for 5 years by the Centers for Medicare and Medicaid Services.
Client Assessment Protocols (CAPs) allow CCSP care coordinators to plan and measure the outcomes of interventions/activities around high risk areas such as falls, dehydration, cognitive deficits, and caregiver exhaustion.
Customer satisfaction outcomes were 85% + for the Administration on Aging Performance Outcome Measurement Project (POMP). Ninety-three percent of caregivers expressed overall satisfaction with CCSP services. Georgia was one of only 11 states selected for POMP by the Administration on Aging.
To provide better care to dementia consumers, CCSP care coordinators and providers in the Atlanta Regional Commission Area Agency on Aging are participating in the dementia demonstration project for the Center for Disease Control Community-Based Participatory Prevention Research Grant awarded to Rollins School of Public Health, Emory University. This project plans to go statewide if funding is available.
CCSP Area Agency on Aging and care coordination agency in Atlanta region were selected for involvement in a depression research project with Fuqua Research Center, Wesley Woods, Emory University. Future plans call for this project to go statewide.
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SERVICE DEFINITIONS
Care Coordination The care coordinator screens and assesses consumers' medical and social problems/needs to determine the appropriateness for Community Care and develops a specific plan of care for each consumer admitted to the CCSP.
The care coordinator brokers/monitors provider services for consumers by planning, arranging, coordinating, and evaluating the service delivery to assure that appropriate, quality services are provided in a timely and cost effective manner and assures that consumer costs are contained.
"I had fallen and was placed in a nursing home. I constantly worried about my husband being without me. He is in late stage Alzheimer's. With the help of CCSP I was able to return to my home and spouse. If I had problems I would just call my care coordinator. She does everything she can to help me. If she can't fix it, she knows who can. I would still be in the nursing home if it wasn't for this program and I just don't know where my husband would be. We need to be together just like we have always been."
Female consumer, age 80 Appling County (Heart of GA / Altamaha Area Agency on Aging)
"The CCSP care coordinator has been wonderful and has made my life so much easier. She is down to earth, friendly, and her suggestions are always excellent and most practical. She really knows her job and the available resources. Thank you for sending her to us."
Caregiver daughter, Male consumer, age 47 Brunswick (Coastal GA Area Agency on Aging)
"The care coordinator has been there to help with my mother's care as her needs changed. She lived in a personal care home until her needs became too great. At that point, knowing I would have an aide coming to assist with her care, I was able to move her into my home. She spent the last six weeks of her life surrounded by family and passed at home in her own bed. I will always be grateful for CCSP and the assistance we received."
Caregiver, Female consumer, age 86 Jones County (Middle GA Area Agency on Aging)
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"My sisters and I were trying to find some services to help our mother. We called the local Area Agency on Aging and were told about the CCSP and other services that our sister might qualify for. We were pleased with how we were treated. We all work and can't be there during the day to take care of mother. We take turns taking care of her in the evenings and at night. Community Care helps her stay in her home for as long as possible. These kinds of services are definitely needed."
Caregiver sisters, Female consumer, age 79 Chatsworth (Northwest GA Area Agency on Aging)
Adult Day Health (ADH) Provides care in a community-based day program for consumers who are functionally impaired. ADH provides a variety of health, therapeutic and social service activities in a group setting. Services include nursing care, special therapeutic services, personal care services, planned therapeutic activities, dietary services, transportation, and social work services.
"I like everything about CCSP. The program helps me stay motivated and to get up and try to go, even when I don't feel like it. I would probably have to go to a nursing home if it wasn't for this program. After being at home for so long, I am trying to get used to facing a lot of people. I really like the adult day health center and the attention they give us."
Female consumer, age 51 Thomson (Central Savannah River Area Agency on Aging)
"This service is so critical for us to keep our jobs and family together." Caregiver daughter, Consumer, age 75
Atlanta (Atlanta Regional Commission Area Agency on Aging)
"My mother goes to an adult day health program and we don't have to have a sitter during the day only at night. She loves going to the day care and getting out of the house. We are very thankful to have this available to us."
Caregiver, Female consumer, age 66 Walton (Northeast GA Area Agency on Aging)
17

Alternative Living Services (ALS) Provides twenty-four hour supervision, medically-oriented personal care, periodic nursing supervision, and health-related support services in a residential setting other than the consumer's home. This service is provided in state licensed personal care homes.
"I just love this place. I do not know what I would do without the help of CCSP and the care coordinator. I can still live as independently as possible right now with the help I receive. I don't want to go to the nursing home. I would just die."
Female consumer, age 68 Carrollton (Southern Crescent Area Agency on Aging)
"My doctor told me I couldn't live alone. I did not want to be a burden on my son. I told him I wanted to live at the assisted living facility with my friends. Without the CCSP, I could never have come here and had all this fun. I cannot thank them enough."
Female consumer, age 90 Cordele (Lower Chattahoochee Area Agency on Aging)
"I don't have to go to a nursing home, and it is more like my own home. Thank you for your services."
Consumer, age 86 Madison (Northeast GA Area Agency on Aging)

Emergency Response System (ERS) Provides an in-home electronic support system for two-way communication between isolated consumers and a communication control center twenty-four hours a day, seven days a week.

"I don't know what I would do without that "Button" (ERS). I fell and had to use

my "Button", otherwise I probably would have laid on the floor until one of my

children called or came by".

Female consumer, age 75

Statesboro (Coastal GA Area Agency on Aging)

"We don't know what we would do without the services. We take turns in the evening and at night staying with our mother. We need a break during the day. We do not want to put mother in the nursing home and CCSP provides services that maintain her in her own home."
Caregiver daughters, Female consumer, age 90 Chatsworth (Northwest GA Area Agency on Aging)

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Home Delivered Services (HDS) Medicaid Home Health Services (HHS) provides traditional home health on an intermittent basis to consumers in their homes. Includes skilled nursing services; physical, speech and occupational therapy; home health aide and medical social services. The State Medicaid Plan pays for the first 75 home health visits, and the CCSP pays for needed visits in excess of 75.
Home Delivered Meals (HDM) Ensures improved nutrition to enhance consumer health and well-being. Consumers may receive home delivered meals only in conjunction with another CCSP service.
"CCSP has really been a help to me. I probably wouldn't get a good bath if I didn't get an aide. I don't know what my daughter and I would do without the help we get from the aide. I also enjoy the meals. The people who deliver the meals are very friendly."
Female consumer, age 86 Waynesboro (Central Savannah River Area Agency on Aging)
Personal Support Services (PSS) Provides a range of support services for CCSP consumers. Services include assistance with activities such as light housekeeping, running essential errands, and basic personal care needs including eating, dressing, bathing, toileting, and transferring.
"Community Care is a life saver to me. It enables me to stay in my own apartment and lead a normal life. They have such a caring staff and aides are just a phone call away if needed. I can't thank them enough for the help ... They help me with the chores I can no longer do because of my diabetes."
Female consumer, age 54 Stockbridge (Atlanta Regional Commission Area Agency on Aging)
"I wouldn't be able to care for her at home without assistance. She looks forward to seeing the aides and they do a fantastic job with her."
Caregiver, Female consumer, age 94 Bacon County (South/Southeast Area Agency on Aging)
19

"Before I had home care I was very depressed. Since I have had the help I feel much better - mentally and physically. I have had several aides and they have all been a great help to me."
Female consumer, age 84 Macon (Middle GA Area Agency on Aging)
"It was a blessing I got into the program. The Community Care program is great and we need more programs like it. The program has helped me to remain in my home and has also been a relief for my spouse and caregiver."
Male consumer, age 72 Colquitt (Southwest GA Area Agency on Aging)
"What would I do without CCSP? I hope I never have to do without the program. It has answered my prayers and allowed me to keep my daughter in my home. Plus, she is able to live here with her two children and see them grow. The aides take wonderful care of my daughter and give her their undivided attention. They are so good to her. Without CCSP my daughter would have to go to a nursing home because I am not able to do all the care. We would all be terribly sad and upset. I pray we will always have CCSP."
Caregiver mother, Female consumer, age 30 White County (GA Mountains Area Agency on Aging)
Extended Personal Support Services (PSSX) Provides personal support services in a home setting that includes respite care for the full time caregiver over an extended period of time.
"CCSP has greatly improved the quality of life for my wife and me. She is bed bound due to complications from a stroke. I am responsible for her total care, but I had pace maker surgery two years ago and am unable to assist as I once did. As long as I have breath in my body I'll do whatever is needed to keep my wife safe and comfortable and out of the nursing home. I am grateful for the CCSP. It is really refreshing to have someone help with cleaning the house and giving my wife a bath. She is more comfortable having another lady do those things for her, and the best part is she is still in our home. We couldn't stay here together without CCSP."
Caregiver husband, Female consumer, age 79 Emanuel County (Heart of GA / Altamaha Area Agency on Aging)
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"If the CCSP aide did not come daily to help with my wife who needs total care, I would not be able to keep her at home. Thank God for you people!"
Caregiver husband, Female consumer, age 79 Hall County (GA Mountains Area Agency on Aging) "I want to take care of mother, I will not send her to the nursing home, it is very hard for me because my back hurts all the time and I am going blind, so I am very grateful that I get this help. The aide is able to lift my mother up and give her a bath, change her bedding and all that, and I don't know what I would do without this help. I get this help so I can take care of mother." Caregiver daughter age 79, Female consumer, age 99 Hall County (GA Mountains Area Agency on Aging) "The help I get from the girls is very helpful to my wife and me. They bathe her, dress her and fix her hair. They clean up the bathroom, kitchen bedroom and sit with her while I go out to pay bills and go to my appointments. I don't worry about her when they are here."
Caregiver spouse, Female consumer, age 67 Ware County (South/Southeast Area Agency on Aging)
Out-of-Home Respite Care (OHRC) Provides a period of rest or relief for family members or other full-time caregiver(s) responsible for performing or managing the care of the functionally impaired consumer through temporary substitute support or living arrangements for consumers.
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Community Care Services Program
Division of Aging Services Department of Human Resources
(404) 657 5307 (404) 657 5251 FAX Two Peachtree St., NW
Suite 9.398 Atlanta, GA 30303 3142
www.georgiacommunitycare.org www2.state.ga.us/departments/dhr/aging