As of November 2011, the Division of Developmental Disabilities reports the following numbers of people IN the community waiting for home and community based services. The Short Term list reflects the number of individuals who need services in a short time frame (90 days to 6 months), and the Long Term list reflects individuals who need comprehensive or residential services to meet their long term needs.
Active NOW waivers as of November, 2011: 4989
Active COMP waivers as of November, 2011: 6150
Short Term Wiating List as of November, 2011: 2879
Long Term Waiting List as of November, 2011: 3208
Total Planning List November, 2011 : 6087
The waiting list figures have fluctuated quite a bit in the past year. In April, 2010, the Division of Developmental Disabilities was reporting a total of about 4600 on the short term and long term lists combined previously. In October, 2009, they were reporting figures as high as 6300. According to the Division, the list reduction was due to removal of duplications and a concerted effort to verify the individuals who were still waiting for services. For example, if a family put their son or daughter on the short term list prior to graduation from high school for immediate support services such as supported employment or personal support, and also put them on the long term list in anticipation of needing residential services in the future, then their name appears on each list and is duplicative. The individual's name is left on the list that more accurately reflects their immediate need, and removed from the other list. In addition, in scrutinizing the lists, Regional Staff removed names of individuals they could not locate after numerous attempts. Their files remain open at the Regional Offices, but their names are removed from the planning list count.
However, we want to express caution at interpreting this information. We know based on national statistics and the population size and demographic characteristics of Georgia that the waiting list numbers should be much higher than even the 6,000 reported in October. Currently, Georgia has about 12,000 individuals in services. Louisiana, for example, has over 30,000 people in services, and it is a much smaller state population-wise than Georgia. Georgia is the sixth fastest growing state in the country, and has one of the top ten fastest growing aging populations in the country. Both of these statistics point to many more people potentially needing services than have approached the state for assistance. We estimate that over 17,000 individuals with developmental disabilities live with caregivers over the age of 64. Every one of these individuals is vulnerable if their caregivers become disabled themselves, or pass away, making the need for community placement an emergency.
The Settlement Agreement for the USvGA case mandates 100 NOW/COMP waivers for individuals in the community who are waiting for services each year for the next 4 years. This will provide services for a fraction of the individuals needing these more substantial supports. The Unlock the Waiting Lists! campaign will continue to advocate for more Medicaid waiver services for individuals on the community waiting lists.
Independent Care Waiver Program - ICWP
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 also are available for persons with traumatic brain injuries (TBI). The program operates under a Home and Community Based Waiver (1915(c)) granted by the Centers for Medicare and Medicaid Services.
Eligibility Criteria
Independent Care 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:
• 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
• Medically stable but at risk of placement in a hospital or nursing facility because community-based support services are not available
• Are able to be safely placed in a home and community setting
Other factors also help determine whether eligible applicants can receive waiver services. Those factors may include: 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. In order to qualify for the waiver programs, the individual must meet the criteria for Medicaid payment in an institution and certain other criteria as outlined above. The person is 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.
How to Apply for ICWP
To apply for ICWP, contact the Georgia Health Partnership (GHP) at 678-527-3619 or 800-982-0411, ext. 3619. GHP will ask potential recipients questions over the phone, have them submit an application and schedule an in-person assessment. Based on the information provided, people may be eligible for ICWP and approved to receive services as funding becomes available.
Current ICWP Figures:
Active as of November, 2011: 1090
Waiting list as of November, 2011: 130
• The DCH proposed budget allows for only 135 people to receive funding for ICWP under Money Follows Person (MFP) slots from prior years.
Community Care Service Program - CCSP
The waiting list for
this program is described as Medicaid and Non-Medicaid. The waiting list for
Medicaid-funded services was significantly decreased after the legislature, in
response to federal CMS policy changes, instituted estate recovery. For
individuals who utilize Medicaid services and then pass away, Medicaid has the
right to recover some of the costs of care that the Medicaid-eligible person
received. For this reason, many seniors dropped off the Medicaid home and
community-based services list, and went on the non-Medicaid waiting list. The
non-Medicaid list is funded entirely with state dollars. As of November, 2009,
the waiting list for these two types of funding is as follows:
Active as of November, 2011: 9460
Waiting list as of November 2011: 1536
What Does
This Mean?
Three conclusions
could de drawn from these statistics.
• The need for home and community-based supports for individuals with
disabilities and those who are aging is greater than we know and than what is
officially documented.
• In order to build community capacity, we need a strategic, multi-year program
and funding plan to develop the home and community-based infrastructure that
will cross disability populations, and enable people to age in place with
personal supports, accessible housing and transportation, specialized equipment
and services, AND there needs to be adequate reimbursement for services
provided.
• In order to fund the services and supports mentioned above, the state needs
more revenue. There are a variety of suggestions being floated from supporting a
Tax Expenditures Report bill (SB 206) that catalogues tax credits and exemptions
and weighs them against their proposed benefit, to raising the cigarette tax, to
aggressive tax collections, etc. The sixth fastest growing state needs fuel!
Follow on Facebook