Georgia Community Care Services Program (CCSP) Medicaid Waiver

What is a Medicaid Waiver?
For persons with limited financial resources, Medicaid pays for nursing home care. For those who wish to live at home or in assisted living, sometimes Medicaid will pay for care in those locations if it can be obtained at a lower cost than in a nursing home. It does this through "Medicaid Waivers."

Waiver Description

Georgia Medicaid’s Community Care Services Program (CCSP) operates under the Elderly and Disabled Waiver. CCSP is a program designed to help frail older adults remain living in their own homes or communities and to receive services in those locations as an alternative to nursing homes. Sometimes referred to as a nursing home diversion program, this type of program helps the state keep nursing home costs low and is generally preferred by families.

The state of Georgia allows participants in this waiver program a degree of freedom to direct the services that they want. This is sometimes referred to as ‘Cash and Counseling.’ This means individuals are empowered to choose their own personal caregivers.

In most states, this "consumer direction" of services is interpreted as having the ability to hire family members as paid caregivers. However, in Georgia, the rules are different. While it is legally possible to hire family members, in practice, this is exceedingly rare. Only in situations in which a participant lives in a rural area or has a unique condition where it is difficult to find a home care provider, can relatives be hired. Spouses cannot be hired to provide care. Persons should not pursue this program if their sole goal is to achieve compensation for a family member providing care.

In July 2016, CCSP was moved from the Division of Aging Services in the Department of Human Services to the Department of Community Health. The Department of Community Health also operates the SOURCE waiver, which also operates under Georgia’s Elderly and Disabled Medicaid Waiver. This reorganization does not impact the delivery of services and is only an internal change.

The CCSP Program often has a waiting list and individuals are prioritized based on their levels of impairment and unmet needs.

 

Eligibility Guidelines

To qualify for CCSP, individuals must first qualify for Georgia Medicaid. Applicants must be a resident of Georgia, and functional and financial eligibility requirements must be met. Functionally, applicants must have physical limitations and require the level of care provided in a nursing home. Documentation from a doctor indicating this is the case must be provided. Make note, CCSP recognizes Alzheimer’s disease and related dementias as conditions that limits one physically.

Unlike some states, Georgia has the same income limits for individuals receiving care in nursing homes as those receiving care in the community (on Home and Community Based Services (HCBS) waivers). For 2018, this monthly gross income limit is $2,250 (or $27,000 per year). For married applicants with both parties applying for CCSP, the income limit for each spouse remains the same as for a single applicant. Persons over this income limit should work with a professional to have them set up a special income trust.

The value of an individual’s resources or assets must be less than $2,000. Couples can retain up to $3,000. If only one spouse applies than the non-applicant spouse can have up to $123,600 in assets, plus the individual applicant asset limit of $2000. The asset limit excludes the applicant’s primary vehicle and the value of their home equity up to $572,000, given the applicant or their spouse lives in the home.

An exception to the income limit also exists when one spouse of a married couple is not applying for Medicaid. A certain amount of the applicant’s income can be shifted to the non-applicant spouse to provide them with a livable income.

 Persons with income or assets in excess of Medicaid limits or couples with only one spouse applying for Medicaid should consult with a professional Medicaid planner in advance of applying.  Free assistance is available. Read more.

 

Benefits and Services

The CCSP program provides a variety of services and supports to individuals in their homes or in non-nursing home residential care. Services are determined on a case-by-case basis and can include any of the following.  Program participants are given the flexibility (within limits) to select from whom they receive these care services.  Providers must be qualified and willing to accept the Medicaid payment rates.

  • Adult Day Health Care 
  • Alternative Living Services / Assisted Living Services
  • Errand Assistance
  • Home Delivered Meals
  • Home Health Care – includes skilled nursing, speech, physical, and occupational therapy
  • In Home and Out-Of-Home Respite Care
  • Personal Emergency Response Services – 24-hours per day / 7-days per week
  • Personal Support Services – Housecleaning, shopping, assistance with meal preparation, and assistance with activities, such as bathing, mobility, using the bathroom, etc. 
  • Self-Directed Personal Support Services – allows eligible applicants the flexibility to hire and manage the worker of their choosing

 

How to Apply / Learn More

More information about the CCSP waiver is available on this page.

To apply for the program, individuals should contact their local Area Agency on Aging. Once the AAA has screened the applicant and there are available slots for new participants, then the applicant must complete the Medicaid application through the Division of Family and Children Services, if they are not already enrolled in Georgia Medicaid.