1. Atlanta Regional Commission ADRC Andrew Parker 11/08/2017

2. Connected – there is “no wrong door.”
Connections to the right services at the right time in the right place.

3. Providing…
Information and assistance counseling for older adults, persons with disabilities and caregivers.
Intake and Screening for the Community Care Services Program.
MDSQ Options counseling.
Money Follows the Person.
Nursing Home Transition (Non-Medicaid).
Care Consultation.

4. Advanced web-based telephone technology including:
Telephonic information and assistance counseling for older adults, persons with disabilities and caregivers.
Options counseling to support individuals in the process of accessing supports and services according to their preferences and values (person-centered).
Advanced web-based telephone technology including:
Call back feature.
Chat feature.
Language line translation services.
Texting services.
TTY, Sign-language and other interpretive services.
24 hour overnight support from United Way.

5. Who is eligible for Community Care Services?
The eligibility criteria for CCSP include the following:
Functional impairment caused by physical limitations which includes Alzheimer’s, dementia and some neurological conditions*.
Unmet need for care.
Approval of care plan by applicant’s physician.
Services fall within the average annual cost of Medicaid reimbursed care provided in a nursing facility.
Approval of an intermediate level of care certification for nursing home placement.
*not an intellectual disability or behavioral health diagnosis.

6. What are the financial eligibility requirements?
Supplemental Security Income
Persons who receive Supplemental Security Income (SSI) and are eligible for medical assistance automatically meet financial eligibility for CCSP SSI limits are $735/month for an individual and $1,103/month for a couple.

7. What are the financial eligibility requirements?
Cost Share
A person’s monthly income determines how much they will pay towards the cost of services each month.
The amount may be as high as all of the income over $735 per month for a single individual.
However, the cost share amount could be different for a married couple as the CCSP Medicaid-eligible person may potentially be able to divert some of his or her income to a legal spouse who is neither in CCSP nor in an institution.
The Department of Family and Children Services will determine the exact monthly cost share.

8. What are the financial eligibility requirements?
Resource Limit
A single person may have up to $2,000 in resources and in addition may have up to $10,000 more if designated for burial (life insurance will count towards the burial amount).
For a married couple, if a CCSP client has a spouse who is neither in CCSP nor an institution, the total combined assets of the individual and the spouse must be $121,220 or less.
The CCSP client must transfer the assets in his or her name in excess of $2,000 to the community spouse within one year from the month Medicaid eligibility begins.
If both persons in a couple are enrolled in CCSP and/or an institution, they may have only up to $4,000 in combined resources.

9. Medicaid Estate Recovery
Medicaid Estate Recovery applies for individuals enrolled in CCSP who own their own home. Please call the intake unit at for more information or the Medicaid Estate Recovery office at

10. BRI - Care Consultation
Personalized Care Advice and Quality Information
“I was struggling with my work schedule and caring for my Mom at the same time. The Care Consultant worked with my family to come up with a solution. Now my family is helping more, and I don’t feel stressed out.”
- Family Caregiver

11. What is BRI-Care Consultation?
BRI-Care Consultation is a FREE telephone-based information and support service for adults, with health challenges and their family or friend caregivers. BRI-Care Consultation provides ongoing help to find practical solutions to concerns about health and care. You don’t have to leave your home to use Care Consultation. All communication is done by phone.

12. Who participates in BRI-Care Consultation?
BRI-Care Consultation serves individuals with memory impairment and their caregivers who assist them with their daily activities, tasks or health-related disabilities.
BRI-Care Consultation is sponsored by the Atlanta Regional Commission, Area Agency on Aging; the Rosalynn Carter Institute for Caregiving; the Benjamin Rose Institute on Aging; and the Georgia Department of Human Services, Division of Aging Services.

13. Talk to a Care Consultant about:
Personal and household care
Medicare, Medicaid and other insurance
Home safety
Legal and financial issues
Family communication
Medication use
Balancing caregiving with other responsibilities
Planning for future care
Other care-related concerns

14. Types of Assistance Awareness and Use of community services
Determine services you need, how to get and use them and what to expect
Improve communication with doctors and other services providers
Healthcare-Related Information
Get tips on where to look for information on diseases, caregiving and more
Receive helpful information by mail or

15. Types of Assistance Coaching and Support Family and Friend Involvement
Strengthen support from family and friends
Involve family and friends who do not currently help but are willing to assist
Coaching and Support
Use practical solutions to address concerns about care
Receive follow-up calls to ensure recommended tasks have been helpful

16. BRI - Care Consultation
To find out more about:
BRI-Care Consultation
call: Monica Gilbert

17. Nursing Home Options Counseling
Face to face counseling for clients in nursing home setting seeking information about service options in the community.
Referrals must be received more than 14 days before impending NH discharge. Client will be referred to the ADRC if they are no longer in the Nursing Home.
No specific eligibility criteria required for referrals.
Referrals can be received from any source.
Submit the MDSQ Referral form
Options Counselors can complete CCSP initial screenings for placement on the CCSP WL.
The OCs can also complete screenings for MFP and NHT.

18. Options Counseling
Interactive decision‐support process whereby consumers, family members and/or significant others are supported in their deliberations to determine appropriate long‐term support choices in the context of the consumer’s needs, preferences, values, and individual circumstances.
Information Giving
Education
Decision Support

19. Options Counseling Referral Form

20. Nursing Home Transitions

21. Money Follows the Person
Program under the Department of Community Health
90 Consecutive Days from Hospital to Nursing Home Stay.
Client must have Nursing Home Medicaid.
Medicaid eligibility in the community.
Partner with Waiver Program.
Priority on waiver waiting list.
No age requirement for eligibility.
ALS/PCH providers must be licensed for 4 beds or fewer.

22. MFP Transition Coordination
Transition Coordination Support:
Pre-transition planning in the Nursing Home.
Transition coordination into the community.
Post-transition support and assistance.
Transition planning meeting:
Coordinates with Nursing Home Social Worker.
Waiver case manager.
Circle of support.
365 day access to transition support.
Monthly transition coordinator contacts.
365 days of access to budget balances.
Coordinate with waiver case manager.

23. Money Follows the Person
MFP Taxonomy Budgets Includes:
Home accessibility modifications.
Equipment and Supplies.
Peer Support.
Deposits, First Month Rent, Past Due Utilities.
Life Skills Coaching.
Home Care Ombudsmen.
Home furnishings.
Moving supports.
Temporary transitional in-home care assistance.
Transition day transportation.

24. Non-Medicaid Nursing Home Transition Program
Program under the Division of Aging Services.
Legislatively funded.
30 Day minimum consecutive between Hospital and Rehab/Nursing Home.
Nursing home Medicaid NOT required.
Not required to transition with waiver.
No priority with waiver.
Not required to maintain Medicaid in the community.
Must be 55 and older.
Monthly income not greater than $6k monthly.
Can transition into any housing or ALS/PCH.

25. Non-Medicaid Nursing Home Transition Program
Transition Coordination Support:
Pre-transition planning in the Nursing Home.
Transition coordination into the community.
Post-transition support and assistance.
365 day access to transition support.
Monthly transition coordinator contacts.
365 days of access to budget balances.

26. Our role is to give people the tools they need to choose the right path for themselves

27. Atlanta Regional Commission
Aging and Disability Resource Connection
229 Peachtree Street, NE