Overview

The Independent Care Waiver Program (ICWP) offers services that help a limited number of adult Medicaid recipients 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 under a Home- and Community-Based Waiver (1915c) granted by the Centers for Medicare and Medicaid Services.

Eligibility Criteria

The Independent Care Waiver is for eligible Medicaid recipients who have severe physical disabilities, are between the ages of 21 and 64 when they apply, and meet the criteria below. They must:

• Be capable of directing 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;
• Be medically stable but at risk of placement in a hospital or nursing facility because community-based support services are not available; and
• Be able to be safely placed in a home and community setting.

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).
People 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. People 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.

Services Provided

• As appropriate to their asessed needs, members are offered service coordination, personal support, home health, emergency response, respite, specialized medical equipment and supplies, counseling and/or home modification.
• Families/clients and their case manager work together as a team to establish a plan of care. The plan assesses individuals’ present circumstances, strengths, needs, goals, services required, available providers and projected budget. Funds must be available for the plan to be approved by the state Medicaid agency.