Overview

The Independent Care Waiver Program (ICWP) offers services that help a limited number of adult Medicaid members with physical disabilities live in their own homes or in the community instead of a hospital or nursing home. ICWP services are also available for persons with traumatic brain injuries (TBI). The program operates through the Georgia Department of Community Health (DCH) under a Home- and Community-Based Waiver (1915c) granted by the Centers for Medicare & Medicaid Services (CMS).

Eligibility Criteria

The Independent Care Waiver is designed for eligible Medicaid members with severe physical disabilities who are between the ages of 21 and 64 when they apply and when services are started and who meet the criteria below. They must:

  • Be capable of managing their own services (individuals with a TBI do not have to meet this criteria).
  • Have a severe physical impairment and/or TBI that substantially limits one or more activities of daily living and requires the assistance of another individual.
  • Do not have a primary diagnosis of a mental disorder (mental retardation/mental illness).
  • Be medically stable but at risk of placement in a hospital or nursing facility if community- based support services are not available; and
  • Be safely placed in a home or community setting.

Services Provided

  • Members are offered case management, personal support, adult day health, home-care services, emergency response, respite, specialized medical equipment and supplies, counseling and/or home modification appropriate to their Alternative Living Services (ALS) are offered in a residential setting for those who qualify.
  • Participants and their families, their case managers and providers work together to establish a plan of care. The plan assesses the individual’s present circumstances, strengths, needs, goals, services requires, available providers and projected budget. Funds must be available for the plan to be approved by the DCH Division of Medical Assistance Plans

Other factors also help determine whether eligible applicants can receive waiver services, including currently residing in a hospital or nursing facility, length of time on the waiting list, ability to live independently, and the estimated cost of care (based on the projected care plan).

Individuals who are considering nursing home or other institutional care may be eligible for home- and community-based services as an alternative through Georgia’s Medicaid waiver program.

To qualify for the waiver programs, individuals must meet the criteria for Medicaid payment in an institution and certain other criteria as outlined above.

Applicants are then offered the choice between community-based services or institutional care as long as the community services do not cost more than the institutional care.

How to Apply for ICWP

To apply for ICWP, contact Alliant Health Solutions at 888-669-7195 Alliant will complete a screening by asking potential members questions over the phone. If screening requirements are met, Alliant will have the potential member submit an application. After receiving the application, Alliant will schedule an in-person assessment. Based on the information provided, applicants may be eligible for ICWP and approved to receive services as funding becomes available.