| Independent Care Waiver Program |
The ICWP operates under a Home and Community-Based Waiver [1915(c)] granted by the Center for Medicare and Medicaid Services (CMS). This waiver allows
the Division of Medicaid to use Title XIX funds to purchase services for adult individuals with physical disabilities or traumatic brain injuries to live in their own
homes and communities as an alternative to nursing facility placement. Individuals served by the program are required to meet the same level of care for
admission to a hospital or nursing facility and be Medicaid eligible or potentially Medicaid eligible. Individuals also must be between the ages of 21 and 64.
Payments to family members for care giving activities are prohibited except in a situation in which access to a non-related caregiver is limited because of the
geographic location of the individual. Approval to use a family member through the Traditional Option for ICWP must be obtained from the Division of Medicaid by
sending a request in writing to the DMA with written proof showing there is no other alternative provider available except relative.
The ICWP/TBI is a consumer-oriented program, with the following goals:
IThe ICWP/TBI offers the services described below as an alternative to institutional care.
A) Case Management assists eligible members in gaining and coordinating access to needed medical, social, educational and other needed services. Case
management is the focal point for service planning and delivery through the ICWP/TBI.
B) Adult Day services provide specialized treatment techniques for members with traumatic brain injuries in congregate community based settings. Adult Day
Services provide training to reduce inappropriate and/or maladaptive behaviors and behaviors which prevent effective use of community resources.
C) Behavior Management services provide individualized interventions designed to decrease the member’s severe maladaptive behavior, which, if not modified,
decreases the individual’s ability to remain in the community.
D) Respite Care services provide temporary relief for the individual(s) normally providing care.
E) Skilled Nursing provides treatments and health care procedures ordered by a physician, monitors the member’s health care condition and trains other
Independent Care service providers in areas within the scope of nursing such as dietary practices, sanitation and use of emergency medical services.
F) Counseling services assist members with developmental or physical disabilities in understanding their capabilities and limitations and addresses problem of
adjustment in their interpersonal relationships.
G) Environmental Modification services provide physical adaptations to the home, specified in the Individual Plan of Care, which are necessary to ensure the
health, welfare and safety of the member, or which enable the member to function with greater independence in the home and, without which, the member could
require institutionalization. Medicaid does not reimburse for modification to rental property.
H) Personal Emergency Response System provides two-way verbal and electronic communication with a central monitoring station seven (7) days a week, 24
hours a day to geographically and socially isolated members and lessens the need for 24 hours of care.
I) Personal Support Services (PSS) provide personal care tasks such as assistance with eating, bathing, dressing, personal hygiene, preparation of meals, light
housekeeping tasks, and other activities of daily living.
J) Specialized Medical Equipment and Supplies provides services for devices, controls, or appliances, specified in the Individual Plan of Care, which enable
members to increase their abilities to perform activities of daily living or to perceive, control, and communicate with the environment in which they live. Ceiling track
is not covered Medicaid equipment.
K) Consumer Directed Care Option (personal Support Services) allows individuals to direct their own care, by hiring training and terminating their care givers. A
care giver must assist or provide care for the member as define under personal support services.
L) Financial Support Services/ Fiscal Intermediary (FI) Services are provided to assure that consumers’ funds outlined in the Plan of Care are managed and
distributed as intended.
For additional Information about this program and the services please telephone Georgia Medical Care Foundation.
the Division of Medicaid to use Title XIX funds to purchase services for adult individuals with physical disabilities or traumatic brain injuries to live in their own
homes and communities as an alternative to nursing facility placement. Individuals served by the program are required to meet the same level of care for
admission to a hospital or nursing facility and be Medicaid eligible or potentially Medicaid eligible. Individuals also must be between the ages of 21 and 64.
Payments to family members for care giving activities are prohibited except in a situation in which access to a non-related caregiver is limited because of the
geographic location of the individual. Approval to use a family member through the Traditional Option for ICWP must be obtained from the Division of Medicaid by
sending a request in writing to the DMA with written proof showing there is no other alternative provider available except relative.
The ICWP/TBI is a consumer-oriented program, with the following goals:
- A) To provide quality services, consistent with the needs of the individual member, which are effective in developing, improving and maintaining the member’
s independence to live actively, safely and successfully in the community. - B) To provide cost effective services to assist individuals in living as independently as possible in the home and community.
- C) To involve the member or member’s representative in the provision and decision-making process regarding member care.
- D) To demonstrate compassion for those served by treating members with dignity and respect while providing quality services.
- The ICWP/TBI operates on a defined fiscal year budget and may not exceed budget allocations. When budget allocations are at maximum use, eligible
applicants needing services are placed on a waiting list to be admitted for services only as member discharges occur or additional funding becomes
available.
IThe ICWP/TBI offers the services described below as an alternative to institutional care.
A) Case Management assists eligible members in gaining and coordinating access to needed medical, social, educational and other needed services. Case
management is the focal point for service planning and delivery through the ICWP/TBI.
B) Adult Day services provide specialized treatment techniques for members with traumatic brain injuries in congregate community based settings. Adult Day
Services provide training to reduce inappropriate and/or maladaptive behaviors and behaviors which prevent effective use of community resources.
C) Behavior Management services provide individualized interventions designed to decrease the member’s severe maladaptive behavior, which, if not modified,
decreases the individual’s ability to remain in the community.
D) Respite Care services provide temporary relief for the individual(s) normally providing care.
E) Skilled Nursing provides treatments and health care procedures ordered by a physician, monitors the member’s health care condition and trains other
Independent Care service providers in areas within the scope of nursing such as dietary practices, sanitation and use of emergency medical services.
F) Counseling services assist members with developmental or physical disabilities in understanding their capabilities and limitations and addresses problem of
adjustment in their interpersonal relationships.
G) Environmental Modification services provide physical adaptations to the home, specified in the Individual Plan of Care, which are necessary to ensure the
health, welfare and safety of the member, or which enable the member to function with greater independence in the home and, without which, the member could
require institutionalization. Medicaid does not reimburse for modification to rental property.
H) Personal Emergency Response System provides two-way verbal and electronic communication with a central monitoring station seven (7) days a week, 24
hours a day to geographically and socially isolated members and lessens the need for 24 hours of care.
I) Personal Support Services (PSS) provide personal care tasks such as assistance with eating, bathing, dressing, personal hygiene, preparation of meals, light
housekeeping tasks, and other activities of daily living.
J) Specialized Medical Equipment and Supplies provides services for devices, controls, or appliances, specified in the Individual Plan of Care, which enable
members to increase their abilities to perform activities of daily living or to perceive, control, and communicate with the environment in which they live. Ceiling track
is not covered Medicaid equipment.
K) Consumer Directed Care Option (personal Support Services) allows individuals to direct their own care, by hiring training and terminating their care givers. A
care giver must assist or provide care for the member as define under personal support services.
L) Financial Support Services/ Fiscal Intermediary (FI) Services are provided to assure that consumers’ funds outlined in the Plan of Care are managed and
distributed as intended.
For additional Information about this program and the services please telephone Georgia Medical Care Foundation.
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Case Management
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