Independent Care Waiver Program
Who should apply: Person age 21-64 years of age who has severe physical disabilities and/or traumatic brain injury and requires a level of care that is typically provided in a hospital or nursing home. You can apply while residing in a facility or if you are at risk of being institutionalized if you do not obtain the appropriate care in your home or community.
What is provided: Case Management, Companion Services, Counseling, Emergency Response System, Environmental Modifications, Homemaker Services, Occupational Therapy, Personal Care Services, Skilled Nursing, Specialized Medical Equipment and Supplies
How to Apply:
Contact the following two agencies but be sure to also send a letter in writing confirming that you applied even if they tell you not to do so. See the sample letter.
Georgia Department of Community Health
Division of Medical Assistance
2 Peachtree Street, N.W.
Atlanta, GA 30303-3159
(404) 657-5465
Director, Independent Care Waiver Program
57 Executive Park South, N.E., Suite 200
(404) 982-0411
To Appeal a Denial of Your Application:
Department of Human Resources
Legal Services Office
2 Peachtree Street, N.W., 29th Floor
Atlanta, Georgia 30303-3159
Advocacy Tips:
ICWP Cost Cap. The State has told the federal government that it will consider costs on an aggregate basis, meaning the total cost of serving everyone on the ICWP waiver cannot be greater than the total cost of serving everyone on the ICWP waiver in the appropriate institutional setting. Advocates believe Georgia is not to apply an individual cap. However, in practice, people are denied because they “cost too much.” If this is the reason for a person's denial, have him contact one of the legal resources to discuss possible next steps.
Low Score Because of No Informal Support. The current ICWP assessment process relies heavily on whether a person has family members or other non-paid help to provide some of the care. For some people, this is not possible. If a person faces this issue, have her contact one of the legal resources to discuss possible next steps.
Inadequate ICWP Assessment. The ICWP assessment usually involves a person interviewing the applicant to get information about how many hours of supports she will need each day in the community. Sometimes the applicant does not know what is possible and may quickly respond that he or she needs 24 hours of supports, which will often lead to a denial. If a person needs more creative planning, it may be possible to request a re-assessment. There are people who know more about creative planning and may be of assistance.
Independent Care Waiver Coordinator
Georgia Medical Care Foundation, Suite 200
57 Executive Park South, N.E.
Atlanta, Georgia 30329
RE: Jane Doe's Independent Care Waiver Program Application
Dear Independent Care Waiver Program Coordinator:
Please consider this an application for the Independent Care Waiver Program services for Jane Doe. Ms. Doe is currently a resident of Rosebud Nursing Facility and can be contacted for her preliminary telephone screening at ( ) 777-7777. (You can add the name of an advocate or friend to also be contacted if that is Ms. Doe's wish)
Ms. Doe's address is: Rosebud Nursing Facility
555 Institution Way
Atlanta, GA 00000
Ms. Doe is 35 years old and has muscular dystrophy. She is medically stable and needs assistance with some activities of daily living. She has lived in the nursing home since 1992. She desperately wants to live in the community because she feels that being confined in the nursing home does not allow her to enjoy life as she would like to. She has different interests and desires from most of the residents at the nursing home and is also considerably younger than most of the residents. Ms. Doe would like to be considered for any services the ICWP offers.
Please provide me and Ms. Doe with a list of the criteria for the program and an explanation of how these criteria are used to score applicants in writing.
In keeping with section 702.3 (B) of the ICWP Policies and Procedures manual, please conduct a face-to-face assessment with Ms. Doe within 30 days of the telephone screening. Also, could you please let me know the status of Ms. Doe's application after the telephone screening and after the assessment? I have enclosed a Release of Information form signed by Ms. Doe authorizing this.
Thank you very much for your kind assistance in this matter. Please do not hesitate to contact me if you have any questions.
Sincerely,
Amy Advocate
Enclosure
cc: Ms. Bessie Barnes, Division of Medical Assistance, Department of Community Health,
2 Peachtree Street, N.W., Atlanta, GA 30303
Jane Doe (for her records) – Very Important to Keep a Copy of All Correspondence
Independent Care Waiver Coordinator
Georgia Medical Care Foundation
Suite 200
57 Executive Park South, N.E.
Atlanta, Georgia 30329
Bessie Barnes
Division of Medicaid
Department of Community Health
2 Peachtree Street, N.W.
Atlanta, GA 30303
RE: Status of Jane Doe's Independent Care Waiver Program Application
Dear Independent Care Waiver Coordinator and Ms. Barnes:
Ms. Doe first applied for the Independent Waiver Program on (date) and was placed on the waiting list to receive services. See attached letter notify Ms. Doe that she was placed on the waiting list.
I am writing to obtain the status of Ms. Doe's placement on the waiting list. Please notify both Ms. Doe and me as to where Ms. Doe is on the list, the criteria used to score her application, and expected date for receipt of services.
I am also enclosing a Release of Information authorizing me to obtain a copy of Ms. Doe's waiver application file, including assessments, criteria used to place Ms. Doe on the waiting list, and other documents related to her current and previous waiver applications.
Thank you very much for your kind assistance in this matter. Please do not hesitate to contact me if you have any questions.
Sincerely,
Amy Advocate Even better to send the letter from Ms. Doe, rather than an advocate.
Enclosure
cc: Jane Doe (for her records)