CCSP in Georgia:What the Community Care Services Program Covers

CCSP, Georgia's Community Care Services Program, is a Medicaid program that pays for help at home so an older or disabled adult can avoid a nursing home. It covers hands-on personal care, day programs, meals, respite for family caregivers and a care coordinator who manages it all.

Today CCSP sits inside Georgia's Elderly and Disabled Waiver Program, or EDWP. The Georgia Department of Community Health (DCH) lists CCSP and SOURCE as the two parts of EDWP. If you searched "CCSP" and found a cybersecurity certificate, that is a different thing. This guide is only about the Georgia Medicaid program.

CCSP at a glance

• Full name: Community Care Services Program
• What it is now: one of the two service paths inside EDWP, Georgia's Medicaid waiver for older and disabled adults
• Who runs it: DCH, through Georgia's twelve Area Agencies on Aging (AAAs)
• Who decides Medicaid: the Division of Family and Children Services (DFCS)
• Who it is for: adults who need a nursing-home level of care but choose to live at home or in the community
• What it costs: nothing for some members; others pay part of the cost, based on income
• Front door: the statewide aging line, 866-552-4464, or the Atlanta Regional Commission at 404-463-3333 in metro Atlanta

Who qualifies for CCSP in Georgia?

DCH sets the rules, and they cover both health and money. In its current EDWP fact sheet, DCH lists the core tests. Your loved one should be able to check each line below.

• Age. Be 21 or older. Georgia's case management manual sends Medicaid members under 21 to a different program, GAPP.
• Physical need. Have a functional impairment caused by physical limitations. Alzheimer's disease and other dementias count as physical conditions.
• Level of care. Have unmet care needs, and be approved for an intermediate nursing-home level of care.
• Doctor's sign-off. Have a care plan approved by a physician.
• Medicaid. Be eligible for Medicaid, or potentially eligible after a financial screening.
• Choice. Prefer care at home or in the community over a nursing home.
• One waiver. Be enrolled in only one Georgia Medicaid waiver at a time.

Lesser-known rules families miss

The fact sheet adds a few rules that rarely appear on other websites. Medicare home health or hospice must not already meet the person's needs. Home-delivered meals cannot be the only service needed. The home must be free of illegal activity and threats of bodily harm.

The cost of care at home must also stay within what Medicaid pays, on average, for a nursing home. Good news: your loved one does not have to be homebound. They can still go to church, the store or the doctor.

Does a Medicare Savings Program count?

No. A DCH provider notice says CCSP members cannot be covered only by QMB, SLMB or QI. Those programs help with Medicare costs. They are not full Medicaid. If that is all your parent has, ask DFCS about a full Medicaid application.

What does CCSP cover?

CCSP pays for services, not cash. A care coordinator picks the mix that fits your loved one's needs. Georgia's EDWP general services manual defines each one.

How does care coordination work in CCSP?

Every CCSP member has a care coordinator, also called a case manager. The coordinator assesses needs, builds the care plan, arranges services and checks that they happen. Georgia's case management manual says the coordinator reassesses each member and confirms their level of care at least once a year.

The same agency cannot both manage your loved one's case and deliver the hands-on care. That rule keeps the coordinator independent. Referrals to providers are based on the member's choice and on which providers are available.

Traditional case management

This is the standard model. Nurses and social services staff run the case. They work with the family and the person's doctor to keep the plan current.

Enhanced case management

Some members need closer medical oversight. Georgia Medicaid says enhanced case management, coordinated through a primary care physician, is available to those who need it. The manual says this model runs under a medical director. The team writes to the member's primary care doctor at the start and then every six months.

How does someone get into CCSP?

The path below follows DCH's own CCSP overview and its provider notices. Timing varies, because funding decides when new members start.

1. 1

   Phone screening

   Call 866-552-4464, or the Atlanta Regional Commission in metro Atlanta. Staff ask about your loved one's health, daily needs and finances.

2. 2

   Waitlist ranking

   If your loved one appears eligible, they join a waitlist ranked by their Determination of Need score.

3. 3

   Medicaid application

   If your loved one is not on Medicaid yet, they apply through their county DFCS office. DFCS makes the final Medicaid decision.

4. 4

   In-home assessment

   When a funded opening comes up, a care coordination agency visits the home and builds a care plan with your loved one and the family caregiver.

5. 5

   Level-of-care review

   A physician signs off on the level of care and the care plan. The state's review contractor also checks the level of care.

6. 6

   Services begin

   The care coordinator arranges services with the providers your loved one chooses.

What is the Determination of Need score?

The Atlanta Regional Commission defines the Determination of Need-Revised (DON-R) as a standard tool for measuring functional capacity. In plain terms, it scores what your loved one can and cannot do alone. DCH says people with the greatest need get priority.

Does CCSP cost anything?

It depends on your loved one's income and Medicaid category. DCH's community care fact sheet says some eligible people pay part of the cost of services and others pay nothing. This share is called the cost share. DFCS works out whether there is one and how much it is.

The EDWP fact sheet describes two main routes into Medicaid. People who get SSI usually have Medicaid through their Social Security application. People who do not get SSI can apply to DFCS under a category called Medical Assistance Only. Members in that second group may pay part of their service costs. You can find the current income figures in the DCH EDWP fact sheet.

Can a family member be paid through CCSP?

Yes, in some situations. Personal support under CCSP includes the Structured Family Caregiver option, often called SFC. SFC supports a relative who lives with the member. Our guide to Structured Family Caregiving explains who can be the caregiver. Spouses face a special rule, covered in can a spouse be paid as a caregiver.

Consumer-directed personal support is another route. The member hires and supervises their own worker. The care coordinator can explain whether either option fits.

Is CCSP the right path, or is SOURCE?

Both paths sit inside EDWP and offer similar services. SOURCE links home care with a primary care doctor and requires full Medicaid. CCSP can also serve people who are only potentially eligible for Medicaid when they apply. Our EDWP explainer shows how the two paths compare, and the screener will tell you which one your loved one can use.

How A1-GA Healthcare Agency helps

A1-GA Healthcare Agency is a Georgia DCH-approved Medicaid home care provider in Norcross. We have provided in-home care since 2008 and staffed caregivers since 2004. Once your loved one is approved for CCSP, they can choose us for EDWP services such as in-home personal support and respite. We also offer Structured Family Caregiving.

Not sure where to begin? Call us and we will walk you through the steps, from the first screening call onward. You can also check your family's fit with our short eligibility form.

• Phone: 678-446-1832
• Hours: Monday to Friday, 8am to 6pm
• Email: [email protected]
• Office: 4505 Peachtree Industrial Blvd, Suite K, Norcross, GA 30092