INFO/HELP
Below is various information that maybe helpful to you in navigating the disability world.
If you should need additional individual assistance, please feel free to contact Heidi to discuss her consulting services for your family.
1. Katie Beckett / Deeming Waiver Information
2. Very Important Information for Katie Beckett/Deeming Waiver Families
3. Other Home and Community Based Disability Waiver Information (NOW/COMP/ICWP/GAPP/SOURCE,etc.)
4. Other Things You Should Know
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Education
6. Various Helpful Websites
Katie Beckett / Deeming Waiver Application Information
Below is information that may help you when submitting your Katie Beckett / Deeming Waiver information. This in no way will guarantee that you will be approved but will help you in organizing the application for your child.
If you should want additional help regarding preparing your Katie Beckett / Deeming Waiver application, please contact Heidi for additional consulting information.
The first step in the process is to determine ineligibility for Supplemental Security Income (SSI). Most of the time, the county DFCS office can make this determination, but occasionally this is not possible. If they cannot, they will refer you to the Social Security office to apply for SSI for your child.
The new eligibility guidelines for the Katie Beckett waiver are on the web. Go to the website below, click on "Medicaid", and then click on "New Information on TEFRA/Katie Beckett & Required Forms". This is where you will find letters from DCH, the New DMA-6A form, instructions, Level of Care Criteria (this means new eligibility requirements), the Care Plan and Instructions. http://dch.georgia.gov/00/channel_title/0,2094,31446711_133613701,00.html
| All applications after 11/15/04 have the following new forms: |
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– Pediatric DMA6(A) (please note that DFCS offices use various dated versions of these forms) |
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– Care Plan (DMA 706). |
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– Cost-Effectiveness Form (DMA 704- which replaced the Deeming Waiver Physicians Referral Form). |
YOU still need to go through your local DFCS office to get your counties specific KB waiver application (which will probably include the above forms and others) but at least the above forms give you an idea of what you need to fill out. Please do not contact your DFCS office until you are ready to fill out the forms. Some DFCS offices are limiting the amount of time you have on submitting your application!
Find your local DFCS office here
If you are denied the Katie Beckett Waiver, you may want to consider contacting the Champions for Children with Exceptional Needs Initiative (formally the Katie Beckett Waiver foundation) for possible funding for your child:
http://www.championsforchildrenga.org/
Very Important Information for Katie Beckett/Deeming Waiver Families
On Tuesday October 7, 2008, Georgia Advocacy Office and Atlanta Legal Aid and Georgia Legal Services had a wonderful informational training session for parents who are faced with Katie Beckett hearings for Medicaid denials of eligibility for children with disabilities. Over 30 families attended this training.
If you were unable to participate in this very important meeting, please go to the following website to watch the video and/or download the presentations distributed.
http://www.georgiaadvocates.org/calendar/event.214858-Katie_Beckett_Medicaid_Update
Thanks again to the Georgia Advocacy Office and Atlanta Legal Aid and Georgia Legal Services for making this training possible.
In addition, please view the following for more information regarding Katie Beckett / Deeming Waiver - Fair Hearing Legal Information
Other Home and Community Based Disability Waiver Information
Below is additional information regarding different disability waivers available in Georgia (which include the following: NOW, COMP, ICWP, CHSS, GAPP, Source, etc). Please note that the State of Georgia is currently going through a transition period over to different home and community based service waivers. To find out the most recent information, please go to the Department of Human Resources website at http://www.dhr.georgia.gov/portal/site/DHR/.
Please note that effective 7/1/09, the new Department of Behavioral Health and Developmental Disabilities formed. Dr. Olivia Garland will lead the new disabilities department as Deputy Commissioner for Developmental Disabilities.
Read more about this here
Home and Community Based Service Waivers
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Section 1915c of the Social Security Act allows the federal government to “waive” (ignore) certain Medicaid rules to enable states to cover home and community-based services as an alternative to institutionalization. |
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These are called Home and Community Based Service Waivers. |
Service Waivers
“Waive” Medicaid policies that require institutionalization of an individual before non-medical services can be provided.
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This allows states to offer programs that provide additional services to Medicaid eligible individuals in their home and/or community. |
Georgia’s Home and Community Based Service Waiver Programs
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Comprehensive Supports Waiver (COMP) formally called the Community Habilitation Supports Services (CHSS). |
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ICWP (Independent Care Waiver Program) |
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New Options Waiver (NOW) formally called the Mental Retardation Waiver Program (MRWP) |
* Please note that all the waivers above have waiting lists for services!
Community Care Services
Program
The Community Care Services Waiver (CCSP) is for the elderly with disabling conditions and people with severe physical disabilities who need in-home support services.
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To apply: |
CCSP Intake Unit (Atlanta Regional Commission)
(404) 463-3244
www.agewiseconnection.com |
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Eligibility: |
Must have a functional impairment, require nursing home level of care, Medicaid eligible, any age, may include cost share which is determined by individual’s monthly income Resource limit. Individual may have up to $2,000 in resources. |
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Provides: |
Adult Day Health • Personal Support Services • Out of Home respite care • Home delivered meals • Home delivered services, e.g. nursing, Physical therapy, Occupational therapy, Speech therapy • Alternative Living Services • Emergency response services |
Independent Care Waiver Program
The ICWP is for adults between ages 21 and 64, with physical disabilities or traumatic brain injury.
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Individuals must be able to direct their own care. Must be at risk of nursing home or hospital placement. |
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Services include: case management, companion services, including homemaker services, personal support services, environmental modification, skilled nursing, specialized medical equipment and supplies, personal emergency response systems, counseling, occupational therapy, adult day services, respite care, physical therapy, and speech therapy. |
More information from Dept. of Community Health on ICWP: http://dch.georgia.gov/vgn/images/portal/cit_1210/33/22/75995826IWCP12009.pdf
New Options Waiver (NOW) and Comprehensive Supports Waiver (COMP):
The NOW and COMP provides a wide array of community based services to individuals with developmental disabilities.
To be eligible for the NOW and COMP, an individual must:
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Be Medicaid eligible |
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Have mental retardation or another developmental disability which requires services similar to those needed by people with mental retardation |
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Be at risk for going into an institution for people with mental retardation if unable to get the services you need in the community. |
The NOW and COMP are available to all ages. (including children)
Support Coordination - Required
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Support coordination is a separate State contract - it does not use an individual's waiver money. |
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Support Coordination is for those on the Short Term Planning List and for those enrolled in the program. |
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The regional office contracts for support coordination. |
NOW and COMP Disability Waiver
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The largest service waiver program in Georgia. |
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The largest waiting list for services (over 6,000+ people statewide). To find out more information go to www.unlockthewaitinglists.com |
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Georgia has had this waiver since 1989. |
DBHDD Regional Offices Contact Information for Disability Waivers
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Region 1: |
(706) 802-5272 or toll-free 1-800-646-7221. |
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Region 2: |
(706) 792-7733 or toll-free 1-866-380-4835. |
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Region 3: |
(770) 414-3052. Clayton, Cherokee, Cobb, DeKalb, Douglas, Fayette, Fulton, Gwinnett, Henry and Rockdale |
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Region 4: |
(229) 225-5099. |
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Region 5: |
(912) 303-1670 or toll-free 1-800-348-3503. |
NOW and COMP Waiver – Possible Services effective November 2008
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Behavioral Support Consultation (max $2,450/yr) |
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Community Access Services (rate max $29/hr individual (YR: $10,454), $12/hr group (YR: $17,510) |
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Community Living Support Services formally personal support (max $22,921/yr NOW or $44,384/yr COMP and rate cap of $15/hr or daily rate of $138/day-COMP only) |
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Environmental Accessibility Adaptations formally environ. modifications (up to $ 10,400 lifetime) |
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Financial Support Services (Self direct fiscal agent – Acumen $75/month required.) |
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Specialized Medical Supplies (max $1,734/yr- NOW, max. $1868/yr -COMP). |
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Supported Employment Services (rate max $29/hr individual (YR: $10,454), $7.20/hr group (YR: $6,912) |
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Specialized Medical Equipment (max annual $5,200yr up to lifetime max. of $13,474) |
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Support Coordination ($149/mn) |
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Transportation Services (max 13.78/hr up to $2,797/yr) |
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Vehicle adaptation (max $ 6,240 lifetime cap) |
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Professional therapeutic services up to $ 1,800/yr (Adult ONLY) |
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Prevocational Services (rate max $12/hr up to max. $17,500/yr) |
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Dental services (not approved in Georgia yet for $500/yr) |
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Community Guide services (up to $ 2000 max a year) |
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Respite Services (rate max of $12/hr or overnight of $96/day)- NOW only. |
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Individual Directed Goods and Services (max $1,500/yr) – NOW only. |
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Natural Support Training (rate max $83/hr up to max of $ 1,787/yr) – NOW only. |
To find out more information regarding caps/rates and maximum limitations for each service listed above, please refer to the COMP/NOW Program Part II and III Policies and Procedures Manual at www.ghp.georgia.gov for most recent information.
If you are interested in the new rates starting November 1, 2008, view the COMP and NOW waivers
If you are interested in the Medicaid limitation on services for the NOW/COMP Waiver, view limitations on services
If you are interested in the "Crosswalk" to services for NOW/COMP Waiver, view Crosswalk to services
More information regarding families who are self directed in services (under the NOW/COMP) and utilize Acumen as the fiscal agent will be available soon.
Self Direction – Acumen (Fiscal Agent for the NOW/COMP Waivers)
View the September 2009 presentation that Acumen gave families, providers, support coordinators, etc at their Town Hall Meetings:.
Medicaid Covered Services
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GAPP (Georgia Pediatric Program):
The Georgia Pediatric Program (GAPP) was implemented in August 2002. This Children’s program is designed to serve eligible members based on medical necessity determination(s) under the age of 21 years. Eligible members age out of the GAPP program on their 21st birthday. Members must be medically fragile with multiple systems diagnoses and require continuous skilled nursing care in order to be considered for services in the Georgia Pediatric Program. GAPP services provide approved services to medically fragile children in their homes and communities and in a ‘medical’ daycare setting as an alternative to placing children in a nursing care facility. A DMA-6A is required for pre-admission approval for all GAPP services. Members served by the GAPP are required to meet the same level of care for admission to a hospital or nursing facility and must be Medicaid eligible.
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SOURCE (Service Options Using Resources in Community Environments)
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The GAPP and SOURCE are services (not waivers) covered under Medicaid.
Other Things You Should Know
Below is additional information that you might find helpful in the disability world.
People First Language
Always remember to use People First Language. For more information regarding People First Language, please go to Kathie Snow’s website: http://www.disabilityisnatural.com/
Only through continuing to educate and communicate in a positive way, is the community in which we live going to see the true potential of our children.
Get involved and monitor your child’s Medicaid card.
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www.ghp.georgia.gov and request a password from GA Health Partnership to be able to track Medicaid charges to your child’s account. |
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This is very important in order to verify and report problems. You can report a complaint via the website as well. |
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Only through education, accountability and communication are we going to be able to make a difference in the process. |
Health Insurance Premium Payment (HIPP) program:
HIPP (Health Insurance Premium Payment program) is a Medicaid program that may pay for the cost of your private health insurance premiums, when it is found to be cost effective. You must be Medicaid eligible to apply. Please call the HIPP program to ask for an application and additional information at 678-564-1162.
General Things to Know….
For those who already have a waiver
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Individuals who have a Medicaid waiver are entitled to ALL the necessary services provided in that waiver program. |
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Waivers can be used anywhere in the state of Georgia but cannot be transferred out-of-state. |
For those who are waiting for a waiver.
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Parents and family members need to advocate for services. |
Education
School Accommodations and Modfications flyer from FAPE (Families and Advocates Partnership for Education).
Helpful Websites
How to find your legislators?
www.vote-smart.org
Medicaid Waivers overview by DHR on NOW/COMP waivers
http://www.unlockthewaitinglists.com/MedicaidWaiverManual.pdf
Guide for DD services in Georgia
http://mhddad.dhr.georgia.gov/DHR-MHDDAD/DHR-MHDDAD_CommonFiles/15933684Guide_to_ServicesChg04.pdf
DOE Annual Report for Exceptional Children
follow this link
Training at DHR
http://mhddad.dhr.georgia.gov/training
Champions for Children with Exceptional Needs Initiative (KB Waiver foundation)
http://www.championsforchildrenga.org/
Summary of GA Medicaid waivers
http://www.unlockthewaitinglists.com/pdf/summaryofwaivers.pdf
A Guide to Disability Rights Laws - Federal CFR Codes
http://www.access.gpo.gov/nara/cfr/cfr-table-search.html
Georgia’s Council on Developmental Disabilities
http://web.me.com/gcdd/GCDD/Home.html
Atlanta Alliance on Developmental Disabilities
http://www.aadd.org/
Unlock the Waiting Lists
http://www.unlockthewaitinglists.com/facts.html
Families of Children Under Stress
http://focus-ga.org/
North Metro Miracle League. Adaptive sports program and inclusive social activities for children and adults with disabilities
http://www.nmml.net
Parent to Parent of Georgia
http://www.parenttoparentofga.org/
Kirk Advocacy and Consulting, Inc.
http://www.disabilitiesissuesandanswers.com/
Georgia Advocacy Office
http://www.thegao.org/
Dept. of Community Health
http://dch.georgia.gov/00/channel_title/0,2094,31446711_31944826,00.html
Dept. of Human Resources and the new Dept. of Behavioral Health and Developmental Disabilities (effective 7-1-09)
follow this link
Dept. of Education – Exceptional Children
http://www.doe.k12.ga.us/ci_exceptional.aspx
President Obama’s agenda for Disabilities in the White House
http://www.whitehouse.gov/agenda/disabilities/
The attached guide includes community services and resources identified for Gwinnett, Rockdale and Newton Counties and was prepared by Children 1st. View guide
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