Increased Community Services (ICS) Program from Maryland Medicaid: Eligibility & Benefits

Program Description

The Increased Community Services (ICS) Program is for physically disabled or frail elderly nursing home residents of Maryland who wish to move back into their own home, the home of a relative, or an assisted living residence. In addition to providing transitional assistance, this program provides long-term care supports to enable the individual to live in their community. These supports include services such as adult medical day care, Personal Emergency Response Systems (medical alert services), home modifications, and assistance with Activities of Daily Living (ADL’s), like bathing, dressing/undressing, toiletry, and mobility.

This program provides a win-win for the state of Maryland, as well as the individual wishing to move back into the community. The expense to provide services outside of a nursing facility is less costly, thereby saving the state money, and those persons transitioning back into the community are able to live more independently.

ICS operates under Maryland HealthChoice, a section 1115 Demonstration Medicaid Waiver, and is administered by the Maryland Department of Health (MDH).

This program is nearly identical to the Maryland Community Options Medicaid Waiver, a 1915c Home and Community Based Services (HCBS) Waiver that provides long-term care services for seniors. In fact, the main difference between these two programs is that the financial eligibility requirement is different. For the Increased Community Services Program, seniors may qualify with a higher level of income.

 

Eligibility Guidelines
  • In addition to being a Maryland state resident, applicants must be a minimum of 18 years old and require a nursing home level of care
  • They must currently reside in a nursing home and have been there for a minimum of three months. 
  • They must have been Medicaid eligible for at least 30 of the days in which they have been residing in the nursing home (Medicaid in MD is also called Medical Assistance).
  • Their income cannot exceed the cost of their nursing home care. Details below.
  • The value of a single applicant’s assets cannot exceed $2,000. Details below.
  • The care services the individual receives once they have returned home or to assisted living must cost less than what Medicaid was paying for their nursing home services.

 

Income Eligibility Details
The applicant’s income cannot exceed the cost of their nursing home care. The daily rate for nursing home care in Maryland is approximately $300. However, Medicaid does not compensate nursing home that full amount. It is estimated MD Medicaid pays approximately $200 per day. Therefore, it is estimated the applicant’s monthly income cannot exceed $6,000. That said, several deductions are allowed, effectively lowering one’s countable income. This includes health insurance premiums, unpaid medical bills, and a personal allowance.

There is also an effective lower income limit for the Increased Community Services Program, as other programs become available to state residents with lower monthly income. In 2018, this lower limit is $2,250 per month.

Asset Eligibility Details
In 2018, the countable asset limit is $2,000 for a single applicant. That said, there are several resources that are not counted towards eligibility. This includes an applicant’s home, given the applicant or their spouse lives in it (or is returning to live it in), home furnishings, personal items, an automobile, and pre-paid funeral and burial plans. If one is over the asset limit, it is highly recommended one seek the counsel of a professional Medicaid planner. Medicaid eligibility can be complicated and a Medicaid planner can help reallocate assets in order to meet eligibility without violating Medicaid’s 5-year Look-Back Period. (Violating this period can result in a period of Medicaid ineligibility).

 

Benefits and Services

Via Maryland’s Increased Community Services Program, a variety of assistance and supports may be available:

  • Adult Medical Day Care
  • Assisted Living
  • Assistive Technology
  • Behavioral Consultations
  • Case Management
  • Environmental Assessments / Home modifications to improve accessibility 
  • Family Caregiver Training
  • Meal Delivery
  • Nutritionist Services 
  • Personal Care Assistance – aid with ADL’s
  • Personal Emergency Response Systems (PERS)
  • Transitional Services from nursing facility back into the community
  • Nurse Monitoring

In addition, some state Medicaid benefits are available via ICS. These include doctor/hospital/lab services, home health, pharmaceutical assistance, durable medical equipment, disposable medical supplies, and assistance with Medicare co-payments, deductibles, and premiums.

 

How to Apply / Learn More

For more information or to apply for the Increased Community Services Program, contact the Maryland Department of Health at 410-767-1739. For additional information, one can also call the Maryland Access Point at 1-844-627-5465. Very limited program information can be found on the Department of Health’s website.