The Elderly and Disabled Waiver Program (EDW) is a Medicaid program that provides in-home and community-based services for people who are older or disabled and functionally impaired to continue to live independently. The EDW is an alternative to institutional care, such as nursing homes or intermediate care facilities, allowing eligible individuals to receive care in their homes or the community. The Georgia Department of Community Health (DCH) administers the EDW through the Area Agencies on Aging (AAA).
The Elderly and Disabled Waiver Program aims to help people stay in their homes instead of going to nursing homes or institutionalized care. It provides services to support elderly and disabled individuals. These services include medical and community support, all working together to help people stay independent for as long as possible.
Two primary programs under the Elderly and Disabled Waiver are the Community Care Services Program (CCSP) and Service Options Using Resources in a Community Environment (SOURCE).
Both programs offer a range of services to help participants maintain their independence while receiving the care they need at home or in the community.
The Georgia Department of Community Health (DCH) oversees the Elderly and Disabled Waiver Program by providing administrative oversight and working through the Area Agencies on Aging (AAAs). The AAAs operationally administer the waiver. Area Agencies on Aging, created under the Older Americans Act, are designed to help older people and their families plan for long-term care needs.
To qualify for the EDW, you must meet the following criteria:
There is no minimum nor maximum age for waiver enrollment. The key factor is that recipients served by this waiver program must meet a nursing home level of care. Assessments are completed by a contracted external review organization, with DCH making the final determination and authorization of the level of care.
Note: Those who are dual-eligible for Medicare and Medicaid may be able to receive services under this waiver.
The waiver program provides a list of services to help recipients live independently in their homes or community as an alternative to institutional care. These services are personalized to meet specific needs identified through a thorough assessment and care plan.
Available services include:
Developing the care plan involves collaborating with the applicant and/or representative to determine the specific type, duration, and frequency of services required to meet the individual's needs.
To apply for the Elderly and Disabled Waiver, contact your local Area Agency on Aging (AAA) or call the toll-free, state-wide number at 866-552-4464 to undergo a phone screening about your situation.
You can also fill out this form, and Givers will refer you to the appropriate case management agency.
You'll be contacted by case management to schedule an in-home assessment to determine the level of care needed. The nurse or care coordinator will work with the recipient and their family to develop a personalized care plan as part of the assessment.
Once your assessment is complete, your application will be sent to DCH for final determination and authorization of level of care. Once approved, you'll start receiving services.
The initial assessment is completed by a nurse to determine a recipient's level of care. The assessment includes physical, cognitive, social, emotional, and environmental status, and it's done using the MDS-HC instrument. Reevaluation for level of care determination is conducted annually or more often if there's a significant change in condition.
The State's Medical Management Review Organization reviews the assessments. Then, the Department of Community Health makes the final determination and authorization of the level of care.
A service plan is developed during the initial visit between an RN and the recipient, family, or representative. Participation in the waiver program is based on choice, and participants have the right to help develop their service plan and choose others to be involved. Participants have the right and responsibility to participate in developing the service plan and selecting service providers.
The service plan is reviewed with the consumer or representative at least every three months or more frequently if needed. Georgia uses a person-centered planning approach to honor the member's wishes during the initial assessment and all reassessments.
One of the services offered under EDW is Structured Family Caregiving (SFC), which allows participants more control over their care through a participant-direction option.
The goals of SFC include:
Structured Family Caregiving offers support, training, and oversight for caregivers who live with the individuals they care for. The living situations vary and may involve a family member living with the care recipient, or vice versa, where an older or disabled adult moves in with a relative who provides full-time care.
The waiver participant and caregiver must be related by blood or marriage. The caregiver cannot be a legally responsible adult like parents of minor children or spouses. Caregivers are paid a tax-free daily stipend for the care they provide through a licensed Structured Family Caregiving provider agency, like Givers.
There is no age limit to this service, but individuals under the age of 21 must receive their personal care through EPSDT.
We believe that families should have the support and resources they need to care for their loved ones at home. The Elderly and Disabled Waiver Program offers critical services that empower individuals to stay independent while providing caregivers the tools they need to succeed. If you're considering Structured Family Caregiving, Givers is here to guide and support you every step of the way.
