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Medicaid in the Community

by Ira M. Leff, Esq.

April 27, 2009

Many prior issues of ELDER LAW MINUTE have dealt with nursing home Medicaid issues. You may wonder whether it is possible to receive Medicaid assistance in the community or in assisted living. In fact, it is possible. There are at least two Medicaid programs which address this need.

The Community Care Services Program (CCSP) of Medicaid provides day care, personal care home placements, emergency response systems, home delivered services, personal support services and respite care.

The Independent Care Waiver Program (ICWP) of Medicaid provides case management, companion services, counseling, emergency response systems, environmental modifications, homemaker services, occupational therapy, personal care services, skilled nursing, specialized medical equipment and supplies, and transportation.

Why then do you hear so little about these programs? The answer is that they are not entitlement programs. In Georgia, there is a very limited budget for these programs. So even if an applicant needs these services and qualifies financially to receive them, he may never make it to the top of the waiting list.

I currently have an 85 year old woman in a personal care home waiting for a slot. I have a 95 year old woman living with her daughter who is still on the waiting list. And, I have a 59 year old man who suffered irreversible brain damage who has been told that it might take up to two years for him to receive a slot.

These precious slots are assigned each month to the most needy recipients in terms of health. Just because you have been on the waiting list for a long time does not indicate that you should be awarded a slot in the future. It just depends upon how many other people currently have applied for slots and what their health needs are.

Therefore, I don't do a lot of work in these areas because there are not a lot of slots out there. Nursing home Medicaid alternatively is an entitlement program so if an applicant qualifies, he will receive funding regardless of how many others have applied.

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