Overview
The Community Care Services Program (CCSP) in Georgia stands as a vital resource, offering Home and Community-Based Services (HCBS) designed to support elderly and disabled residents. This program is specifically tailored for individuals who are functionally impaired and face the risk of nursing home admission. CCSP’s core mission is to proactively prevent or postpone the need for intensive nursing home care by delivering customized support based on each participant’s unique needs and circumstances. The benefits under CCSP are diverse, encompassing personal emergency response systems, adult day care programs, respite care for caregivers, and essential assistance with Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). These encompass critical daily tasks such as mobility, eating, personal hygiene, grocery shopping, and meal preparation, ensuring a holistic approach to care.
Participants in the program have flexibility in their living arrangements, with options including their own homes, the homes of family members, or personal care homes, which provide a setting similar to assisted living facilities. It’s important to note that adult foster care homes are not currently included as eligible residential settings under CCSP.
A key feature of the Community Care Services Program is the flexibility in service delivery. Care can be provided by licensed professionals, or participants have the option to take control of their personal care through Personal Support Consumer Direction. This self-direction option empowers participants to choose their own caregivers, including adult children and other relatives (excluding spouses and parents of minor children). To manage the administrative and financial aspects of employing a caregiver, such as background checks, tax withholdings, and payments, a financial management services agency is utilized. It’s worth noting that self-direction is not available for individuals residing in personal care homes.
It’s crucial to understand that CCSP operates as a waiver program and not an entitlement. Therefore, meeting the eligibility criteria does not automatically guarantee immediate enrollment. The program has a limited number of participant slots, and when these are full, a waitlist is established.
CCSP is administered under Georgia’s Elderly and Disabled Waiver Program (EDWP), which is itself a 1915(c) Home and Community Based Services (HCBS) Medicaid Waiver. Another significant program operating under the same waiver is Service Options Using Resources in a Community Environment (SOURCE).
Understanding 1915(c) HCBS Medicaid Waivers: Historically, Medicaid’s coverage for long-term care was primarily limited to nursing homes. The introduction of 1915(c) HCBS Medicaid Waivers marked a significant shift, enabling states to offer benefits in community settings. HCBS programs are designed to reduce or prevent institutionalization by providing care in various environments, including private homes, family member’s homes, assisted living facilities, and adult foster care or adult family living settings. These waivers often target specific populations with Nursing Home Levels of Care needs and who are at risk of institutionalization, such as the elderly, individuals with disabilities, or those with conditions like Alzheimer’s disease. It is important to remember that these waivers are not entitlement programs, meaning that eligibility does not guarantee immediate benefits due to the limited number of available slots.
Benefits of the Community Care Services Program
The Community Care Services Program (CCSP) offers a comprehensive suite of long-term services and supports, tailored to meet the individual needs of each participant through a personalized care plan. A significant benefit is the option for self-directed personal care, allowing participants to choose their preferred caregiver. The services and supports available under CCSP include:
- Adult Day Health Care: Provides supervised medical care during daytime hours and specialized therapies like physical, occupational, or speech therapy in a community-based group setting.
- Alternative Living Services: Offers 24/7 supervision and personal care assistance within a personal care home environment.
- Assistive Technology: Access to devices and technologies that aid participants in their daily living activities and enhance their independence.
- Case Management & Enhanced Case Management: Coordination of HCBS, with enhanced case management providing integrated coordination with the participant’s primary medical care.
- Financial Management Services: Essential support for participants who choose to self-direct their personal care, managing the financial aspects of caregiver employment.
- Homemaker Services: Assistance with essential household tasks such as grocery shopping, meal preparation, and light housecleaning to maintain a safe and healthy living environment.
- Meal Delivery: Provision of nutritious meals delivered directly to the participant’s home, ensuring dietary needs are met.
- Personal Emergency Response Services (PERS): Access to emergency assistance through devices that participants can use to call for help in urgent situations, providing peace of mind and safety.
- Personal Care Assistance: Direct support with Activities of Daily Living (ADLs) to help participants maintain personal hygiene, mobility, and other essential self-care tasks.
- Respite Care: Temporary care provided outside the home to offer family caregivers a break from their caregiving responsibilities, promoting caregiver well-being and preventing burnout.
- Skilled Nursing / Home Health Aides: Professional medical care and assistance provided in the participant’s home, addressing specific health needs.
- Structured Family Caregiver: Financial assistance and supportive services, including counseling and health education, for family members (excluding spouses) who live with and care for the participant.
- Therapy Services: In-home delivery of physical, occupational, and speech therapies to aid in recovery, rehabilitation, and maintaining functional abilities.
- Transitional Services: Support for individuals moving from institutional settings back into the community, including pre-discharge planning, community case management, and services to establish a stable living environment and promote independence.
It is important to note that while CCSP provides extensive support services, it does not cover the costs associated with room and board in personal care homes. Participants are responsible for these living expenses.
Eligibility Requirements for the Community Care Services Program
To be eligible for Georgia’s Community Care Services Program (CCSP), applicants must be residents of Georgia and meet specific age and disability criteria. The program is designed for individuals aged 65 or older, or those under 65 who have a physical disability. Individuals who enroll before turning 65 can continue to receive program benefits after reaching age 65, provided they continue to meet other eligibility requirements. Further eligibility criteria are detailed below, covering both financial and medical needs.
For a preliminary assessment of eligibility, the American Council on Aging offers a helpful Georgia Medicaid Eligibility Test. Take the test.
Financial Criteria: Income, Assets & Home Ownership
Financial eligibility for CCSP is determined based on income, assets, and home ownership status, adhering to specific Medicaid guidelines.
Income: The income limit for applicants is capped at 300% of the Federal Benefit Rate (FBR), which is adjusted annually in January. For 2025, this translates to a monthly income limit of $2,901 for a single applicant, regardless of marital status. If both spouses are applying for CCSP, each spouse is assessed individually and can have an income of up to $2,901 per month. In cases where only one spouse is applying, the income of the non-applicant spouse is not considered when determining the applicant spouse’s eligibility. Moreover, to protect the financial stability of the non-applicant spouse, a Spousal Income Allowance, also known as the Monthly Maintenance Needs Allowance (MMMNA), allows for the transfer of monthly income from the applicant spouse to the non-applicant spouse.
In Georgia for 2025, the maximum Spousal Income Allowance is $3,948 per month. This ensures that the non-applicant spouse has a minimum monthly income of this amount. Non-applicant spouses with their own income at or above this threshold are not eligible for a Spousal Income Allowance.
Assets: Asset limits are also in place to determine financial eligibility. In 2025, the asset limit for a single applicant is $2,000. For married couples where both are applicants, the combined asset limit is $3,000. When only one spouse is applying for CCSP, Medicaid still considers the assets of both spouses due to the concept of jointly owned marital assets. In such cases, the applicant spouse can retain up to $2,000 in assets, while the non-applicant spouse is protected by the Community Spouse Resource Allowance (CSRA), which allows them to retain a larger portion of the couple’s assets. For 2025, the CSRA in Georgia allows the non-applicant spouse to keep assets up to $157,920.
Certain assets are considered exempt and are not counted towards Medicaid’s asset limits. These typically include the applicant’s primary residence, standard household furnishings and appliances, personal belongings, and one vehicle.
It is critical to be aware of Medicaid’s Look-Back Rule, which examines financial transactions within the 60 months prior to applying for long-term care Medicaid. Transferring assets or selling them below fair market value during this period can result in a Penalty Period of Medicaid ineligibility.
To assess potential asset levels relative to Medicaid limits and estimate potential spend-down needs, a Spend Down Calculator can be a valuable tool. Use our Spend Down Calculator.
Home Ownership: For many applicants, the home is their most valuable asset, raising concerns about potential Medicaid claims. Georgia Medicaid provides exemptions for the home under specific conditions:
- If the applicant currently resides in the home or has a demonstrated “Intent to Return Home”, and in 2025, their home equity interest does not exceed $730,000. Home equity is defined as the home’s current market value minus any outstanding mortgage balance. Equity interest refers to the applicant’s ownership portion of the home’s equity.
- If the applicant has a spouse living in the home, regardless of the applicant’s residency status.
- If a dependent relative of the applicant resides in the home. This can include a child, grandchild, in-law, parent, aunt, uncle, sibling, niece, nephew, or cousin.
While the home may be protected from asset calculations during Medicaid benefit receipt, it may still be subject to Medicaid’s Estate Recovery Program after the beneficiary’s death. Further information on this topic is available to understand the potential of Medicaid taking the home.
Medical Criteria: Functional Need
Meeting the medical criteria for CCSP requires applicants to demonstrate a need for an intermediate Nursing Facility Level of Care (NFLOC). Specifically, applicants must have functional impairments due to a physical condition and have unmet care needs. This assessment is conducted using the Determination of Need Functional Assessment-Revised (DON-R) tool. The evaluation considers the individual’s ability to perform Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) independently. These activities include essential tasks such as transferring, mobility, eating, toileting, meal preparation, managing finances, and household chores. Cognitive impairments, such as memory issues often associated with dementia, are also taken into account.
To formally determine if the NFLOC need is met, the Minimum Data Set Home Care (MDS-HC) assessment tool is used. This assessment is performed in person by a registered nurse and further evaluates ADLs, IADLs, and cognitive abilities. Additionally, a physician must certify that the applicant requires a Nursing Facility Level of Care. While conditions like Alzheimer’s disease and related dementias can be considered qualifying physical conditions, a dementia diagnosis alone does not automatically guarantee fulfillment of the NFLOC criteria.
For more detailed information on long-term care Medicaid eligibility in Georgia, further resources are available. Learn more about long-term care Medicaid in Georgia.
Qualifying When Over the Limits
Exceeding Medicaid’s income and/or asset limits does not automatically disqualify an applicant from receiving benefits. Various Medicaid planning strategies are available to assist individuals who would otherwise be ineligible to qualify for needed support. These strategies range in complexity, from straightforward to more intricate financial arrangements. Below are some of the most commonly utilized strategies:
For individuals with income exceeding the allowable limits, establishing a Miller Trust, also known as a Qualified Income Trust, can be an effective solution. “Excess” income is deposited into the trust, where it is no longer counted towards the applicant’s income for Medicaid eligibility purposes.
When assets exceed the limits, Irrevocable Funeral Trusts (IFTs) offer a viable option. These are pre-funded trusts specifically for funeral and burial expenses, which Medicaid exempts from countable assets. For individuals with a more substantial excess of assets, Medicaid Asset Protection Trusts can be considered. Assets placed within such trusts are no longer counted towards Medicaid’s asset limit. However, it is crucial to establish these trusts well in advance of needing Medicaid long-term care services due to look-back periods and other regulations. Numerous additional strategies exist to address situations where an applicant’s assets surpass Medicaid limits.
It is essential to recognize that inadequate planning or improper implementation of Medicaid planning strategies can lead to application denials or delays in benefit receipt. Professional Medicaid Planners possess specialized knowledge of Georgia’s Medicaid regulations and planning techniques, enabling them to guide individuals in meeting financial eligibility criteria while protecting access to essential care. Furthermore, advanced planning strategies can not only facilitate Medicaid eligibility but also offer options to protect assets for family inheritance. These more complex strategies often involve Medicaid’s 60-month Look-Back Rule and should only be undertaken with careful professional guidance. Medicaid Planners are adept at navigating these complexities and identifying compliant workarounds. Therefore, consulting a Medicaid Planner is highly recommended for individuals seeking to qualify for Medicaid when their income and/or assets exceed the standard limits. Find a Certified Medicaid Planner.
How to Apply for the Community Care Services Program
Before You Apply
Prior to initiating the application process for CCSP, it is essential for applicants to confirm they meet the program’s eligibility criteria. Applying when income and/or asset limits are exceeded without proper planning will likely result in benefit denial. The American Council on Aging provides a valuable Medicaid Eligibility Test to help individuals determine if they are likely to meet Medicaid’s eligibility requirements.
As part of the application process, applicants will need to gather necessary documentation for submission. This typically includes copies of Social Security cards, Medicare cards, life insurance policies, property deeds, pre-need burial contracts, bank statements covering the 60 months prior to application, and proof of income. A common cause of application delays is incomplete or missing documentation, or failure to submit documents in a timely manner.
Because the Community Care Services Program is not an entitlement program, a waitlist for program participation may exist. The Elderly and Disabled Medicaid Waiver, which authorizes CCSP, has an approved capacity of approximately 49,398 beneficiaries per year. Within this capacity, 100 slots are specifically reserved for individuals diagnosed with Alzheimer’s disease or related dementias, and 125 slots are reserved for individuals transitioning from institutional settings back to the community through the Money Follows the Person initiative. If a waitlist is in place, an applicant’s position on the waitlist is determined by their assessed need for supportive services. In some instances, applicants who apply later but demonstrate a greater need may be granted a participant slot before those who applied earlier.
Georgia also offers another program, Services Options Using Resources in Community Environments (SOURCE), for residents requiring long-term care. SOURCE provides benefits similar to CCSP but is specifically for individuals who are recipients of Supplemental Security Income (SSI). More information on SOURCE.
Application Process
To apply for the Community Care Services Program, individuals should contact their local Area Agency on Aging (AAA). Alternatively, they can call 866-552-4464. An initial telephone screening will be conducted to assess potential eligibility. If initial criteria appear to be met, an in-home functional needs assessment will be scheduled.
Applicants who are not already enrolled in Georgia Medicaid must also apply for Medicaid through the Department of Human Services’ Division of Family and Children Services. A Medicaid application can be downloaded here, or applicants can apply online via the Georgia Gateway portal here. Local Area Agencies on Aging (AAA) can provide assistance with the Medicaid application process. Learn more about CCSP.
The Community Care Services Program is jointly administered by the Georgia Department of Community Health (DCH) and Georgia’s Area Agencies on Aging (AAA). Financial eligibility determinations for CCSP are made by the Georgia Department of Human Services’ Division of Family and Children Services (DFCS).
Approval Process & Timing
The complete Medicaid application process, from initial application to receiving a determination letter of approval or denial, can take up to 3 months or potentially longer. Gathering all required documentation and completing the application itself typically takes several weeks. Incomplete applications or missing documentation will lead to further delays. Federal regulations mandate that Medicaid offices must process applications within 45 days (or up to 90 days for disability-based applications). Despite these guidelines, delays beyond these timeframes can occur. If a waitlist exists for CCSP, approved applicants may experience further delays of several months before actually receiving program benefits.
