Georgia CCSP Waiver 2026: Community Care Services Program

The Community Care Services Program, known statewide as CCSP, is Georgia's largest Medicaid Home- and Community-Based Services waiver. It is the front door for older adults and adults with physical disabilities who meet a nursing facility level of care but want to remain in their own home, a family member's home, or a small community-based residential setting rather than enter a nursing facility. CCSP is authorized under Section 1915(c) of the Social Security Act at 42 USC 1396n(c), administered jointly by the Department of Community Health (DCH) and the Department of Human Services Division of Aging Services, and accessed through the network of twelve Area Agencies on Aging via Empowerline at 1-404-463-3333.

This guide explains who qualifies, what services are covered, how to apply step by step, what to expect from the functional assessment and care plan development, how the waitlist works and how crisis priority can move you to the top, how cost share is calculated, how Structured Family Caregiving lets a family member be paid as a live-in caregiver, and how to appeal a denial through the Office of State Administrative Hearings.

Federal and Georgia Authority

CCSP exists because of Section 1915(c) and is implemented through state regulations and the DCH provider manual.

Federal Authority

• 42 USC 1396n(c) (Section 1915(c) HCBS waivers; the primary CCSP statutory authority)
• 42 CFR Part 441 Subpart G (HCBS waiver regulations, including assurances about cost neutrality, level of care, person-centered planning, and quality)
• 42 USC 1396a(a)(10)(A)(ii)(VI) (300 percent SSI Special Income Limit for LTC, which CCSP uses)
• 42 USC 1396p(d)(4)(B) (Miller Trust, which integrates with CCSP for over-SIL applicants)
• 42 USC 1396r-5 (spousal impoverishment, which applies to CCSP)

Georgia Authority

• O.C.G.A. Title 49 Chapter 4 (Public Assistance, including Medicaid administration)
• CCSP Section 1915(c) Waiver Application (approved by CMS; current cycle through 2027)
• DCH CCSP Provider Manual (operational procedures for providers and AAA care coordinators)
• DHS Division of Aging Services policies (case management and Empowerline operations)
• Georgia AAA Provider Manual (local AAA operational procedures)

Eligibility

Functional Eligibility (NF Level of Care)

CCSP requires the participant to meet Nursing Facility Level of Care. The AAA care coordinator conducts a functional assessment using the standardized DCH assessment instrument, which evaluates:

• Activities of Daily Living (ADLs): bathing, dressing, toileting, transferring, eating, mobility
• Instrumental Activities of Daily Living (IADLs): meal preparation, housekeeping, medication management, transportation, shopping, telephone use, finances
• Cognitive status: orientation, memory, judgment
• Medical complexity: chronic conditions, medication regimen, recent hospitalizations
• Behavioral status: agitation, depression, anxiety

NF LOC generally requires:

• Significant impairment in at least two ADLs, OR
• Significant cognitive impairment requiring supervision, OR
• A combination of physical and cognitive impairments that would otherwise require nursing facility placement

Financial Eligibility

CCSP uses the LTC pathway:

• Income: Gross monthly income at or below approximately $2,982 (2026 SIL) directly, or routed through a Miller Trust if above
• Assets: $2,000 for a single applicant; $3,000 for a married applicant with both applying; full spousal impoverishment for a married applicant with a community spouse (CSRA $32,532 to $162,660 in 2026)
• Lookback: 60-month transfer-penalty lookback under 42 USC 1396p(c)
• Home equity: $752,000 in 2026; not counted while community spouse or dependent lives in home

Other Eligibility

• Georgia residency
• U.S. citizenship or qualified non-citizen status
• No active criminal warrants (background check policy varies by AAA)

What CCSP Covers

CCSP services are delivered in the participant's home, in an alternative living service setting, in an adult day health center, or in the home of a Structured Family Caregiver.

Adult Day Health (ADH)

A center-based program providing daytime supervision, social activities, meals, personal care, nursing oversight, and rehabilitation. Typically 4 to 8 hours per day, up to 5 days per week. ADH is appropriate for participants whose caregiver works during the day, who need socialization, or who benefit from professional oversight during daytime hours.

Alternative Living Services (ALS)

A small group home, typically a personal care home or community residential setting, where the participant lives alongside other residents and receives 24-hour personal care. ALS is appropriate when home-based care is no longer feasible but nursing facility placement is premature.

Emergency Response System (ERS)

A wearable or in-home button that connects the participant to a 24-hour monitoring center. Appropriate for participants living alone who could fall, have a medical emergency, or need emergency assistance.

Home Delivered Meals

Nutritionally balanced meals delivered to the participant's home, typically Monday through Friday. Appropriate for participants who cannot safely prepare meals themselves.

Out-of-Home Respite

Short-term placement in a nursing facility or other approved setting to give the family caregiver a break. Typically up to 30 days per calendar year, though longer respite can be approved through care plan exceptions.

Personal Support Services (PSS)

Hands-on personal care delivered in the home: bathing, dressing, toileting, transferring, eating assistance, light housekeeping, meal preparation, medication reminders. Provided by a personal support aide from an approved CCSP provider agency. Typically 1 to 6 hours per day depending on care plan.

Skilled Nursing

Periodic skilled nursing services in the home for medication administration, wound care, complex chronic disease management, or assessment. Provided by an RN or LPN.

Structured Family Caregiving (SFC)

A live-in family caregiver receives a daily stipend through an approved SFC provider organization. The family caregiver provides 24-hour care, including personal care, meal preparation, medication reminders, supervision, and companionship. The SFC provider organization provides training, care coordination, oversight, and emergency backup support.

How to Apply

Step 1: Call Empowerline

Empowerline: 1-404-463-3333

Empowerline is the statewide front door for CCSP, SOURCE, and PACE. The intake specialist asks basic screening questions to identify which program is appropriate and routes you to the right Area Agency on Aging.

Step 2: AAA Initial Assessment

The local AAA conducts an initial assessment, either by phone, in-home, or in the AAA office, to:

• Verify potential eligibility (age, residency, basic functional status)
• Identify whether CCSP, SOURCE, PACE, or another program is the best fit
• Provide guidance on the Medicaid application process
• Place the applicant on the waitlist if appropriate

Step 3: Medicaid Application

If not already a Medicaid recipient, the applicant must apply for LTC Medicaid through DFCS. The application can be filed:

• Online at gateway.ga.gov
• By phone at 1-877-423-4746
• In person or by mail at the local DFCS office using Form 700 (and Form 700-A for LTC supplement)

For the operational details see our Georgia Medicaid Application guide.

Step 4: AAA Functional Assessment

A CCSP care coordinator from the AAA conducts an in-home functional assessment using the DCH assessment instrument. This visit typically takes 2 to 3 hours and includes:

• Review of medical history
• ADL and IADL assessment
• Cognitive screening
• Caregiver interview (if applicable)
• Home environment assessment
• Initial care plan discussion

Step 5: Care Plan Development

The care coordinator develops a person-centered care plan that specifies:

• Services authorized (ADH, PSS hours per day, SFC, etc.)
• Provider preferences
• Goals and outcomes
• Backup plan if a service is interrupted

The care plan is submitted to DCH for review and approval.

Step 6: Eligibility Determination

DCH and DFCS jointly review:

• Functional eligibility (NF LOC determination)
• Financial eligibility (LTC pathway)
• Cost neutrality (CCSP cost cannot exceed NF cost)

Once approved, services begin. The care coordinator schedules monthly contact, quarterly home visits, and annual reassessment.

The Waitlist

CCSP has a waitlist in 2026 because slot capacity is limited by the federal HCBS waiver agreement with CMS.

How the Waitlist Works

• Applicants are placed on the waitlist after the initial AAA assessment
• Order is determined by date of application plus category of need
• Categories of need:
  • Crisis priority: imminent risk of NF placement, recent hospital discharge with no caregiver, caregiver collapse, abuse or neglect
  • High priority: caregiver overwhelmed but functional, multiple unmet care needs
  • Standard priority: care needs that are not immediately critical

Wait Times in 2026

• Urban metro counties (Fulton, DeKalb, Cobb, Gwinnett, Clayton): waitlists are longest for standard priority
• Suburban counties: moderate wait times
• Rural counties: generally shorter waits than metro areas

These are illustrative; verify current waitlist status with your local AAA.

How to Get Crisis Priority

Document the urgency of the care need:

• Recent hospital discharge with no safe discharge plan
• Caregiver hospitalization or death
• Adult Protective Services involvement
• Risk-of-self-harm assessment
• Physician letter documenting imminent NF placement risk

Submit documentation to the AAA care coordinator with a written request for crisis-priority review.

Cost Share

CCSP cost share is calculated for each participant based on:

• Gross monthly income
• Care plan cost
• Maintenance allowance for community living expenses
• Health insurance premiums
• Family allowance (if applicable)

Most participants pay $0 to $50 per month. High-income participants (close to the SIL) may pay more. The cost share is much smaller than the patient liability for NF Medicaid because CCSP participants need to retain enough income to pay for rent or mortgage, utilities, food, and other community living expenses.

Structured Family Caregiving in Detail

SFC is one of the most valuable CCSP services because it allows family members to provide care without leaving the workforce or going unpaid. It is also just one of several ways to get paid as a family caregiver in Georgia, alongside SOURCE participant direction, the ICWP and NOW/COMP waivers, and the VA programs that do pay spouses.

Who Can Be an SFC

• Adult children (18+)
• Grandchildren
• Siblings
• Aunts, uncles, cousins
• Other relatives by blood or marriage
• Friends (under some SFC provider policies, with home assessment)
• Spouses are generally excluded under DCH policy (the principle being that spouses are expected to provide care anyway, though some narrow exceptions apply via fair hearing)

How SFC Works

1. Participant enrolls in CCSP through the AAA
2. SFC is added as a service in the care plan
3. Participant and family member select an approved SFC provider organization
4. The SFC provider conducts a home assessment
5. SFC provider trains and credentials the family caregiver
6. SFC provider pays a daily or monthly stipend to the caregiver
7. SFC provider provides ongoing care coordination, training, emergency backup

Stipend Amount

• Daily rate: approximately $80/day depending on care needs
• Monthly: approximately $1,987 to $2,400/month
• Stipend is taxable income to the caregiver (reported on 1099 or W-2 from the SFC provider)
• Stipend amount varies by SFC provider organization, geographic area, and care plan intensity

SFC Caregiver Responsibilities

• Provide 24-hour care including personal care, meal preparation, medication reminders, supervision, companionship
• Attend training provided by the SFC provider
• Submit daily care logs
• Report changes in the participant's condition
• Coordinate with the SFC provider for emergencies

SFC Limitations

• The caregiver must live with the participant
• Only one SFC caregiver per participant
• The caregiver cannot have other significant employment outside the home (varies by SFC provider)
• The home must meet basic safety standards

Worked Examples

Example 1: Mrs. Johnson, 78, Single, Lives Alone

Facts: Mrs. Johnson lives alone in DeKalb County. Income: $1,400/month Social Security. Assets: $1,800. Needs help with bathing, dressing, meal preparation, and medication.

Eligibility:

• Functional: significant ADL and IADL impairment, meets NF LOC
• Financial: income below SIL (~$2,982), assets below limit ($2,000)
• Standard priority on waitlist

Care plan:

• PSS: 3 hours/day, 5 days/week
• Home-delivered meals: weekday lunches
• Emergency response system
• Care coordination monthly

Cost share: $0

Example 2: Mr. Lee, 82, Married, Adult Daughter Lives With Him

Facts: Mr. Lee lives with his daughter Sarah in Cobb County. Mr. Lee's income: $3,200/month (Social Security $1,600 + pension $1,600). Assets: $1,500. Mrs. Lee lives at home with her own income $1,800. Mr. Lee has dementia, needs 24-hour supervision.

Eligibility:

• Functional: dementia with safety risks, meets NF LOC
• Financial: $3,200 over SIL → Miller Trust required; assets below limit; spousal impoverishment for Mrs. Lee
• Standard priority; possible high priority due to caregiver burnout risk

Care plan:

• SFC with Sarah as live-in caregiver (Sarah resigns from her job)
• Adult day health 2 days/week to give Sarah respite
• Care coordination monthly

Cost share: ~$30/month after Miller Trust mechanics SFC stipend to Sarah: ~$2,800/month

Example 3: Ms. Walker, 65, Recent Stroke, Crisis Priority

Facts: Ms. Walker had a stroke six weeks ago. She is being discharged from a Fulton County hospital. She lives alone and her family lives in another state. No caregiver available. Income: $2,100/month. Assets: $1,200.

Eligibility:

• Functional: severe ADL impairment post-stroke, meets NF LOC
• Financial: income below SIL, assets below limit
• Crisis priority due to imminent NF placement risk at discharge

Outcome:

• AAA fast-tracks the application
• Care plan: PSS 6 hours/day, ADH 3 days/week, home-delivered meals, emergency response system
• Services begin within 2 weeks of application

How to Verify the Numbers

• CCSP Waiver Application and Provider Manual: Georgia DCH Waiver Programs
• Empowerline and AAA Network: empowerline.org
• DCH Cost Neutrality and Waiver Renewals: CMS Section 1915(c) waiver public records
• Special Income Limit and Asset Limits: DCH Medicaid Policy Manuals
• SFC Provider Directory: request from your local AAA or Empowerline

For free legal help with a CCSP eligibility case or appeal, contact Georgia Legal Services Program at 1-833-457-7529, Atlanta Legal Aid at 1-404-524-5811, or the Georgia Senior Legal Hotline at 1-888-257-9519. For more on how CCSP fits in the GA LTC framework see brevy.com's guides at /medicaid/georgia/long-term-care and /medicaid/georgia/source-waiver.

Learn More

• Georgia Medicaid Programs Overview
• Georgia Medicaid Eligibility & Income Limits
• Georgia Medicaid Long-Term Care
• Georgia SOURCE Waiver
• Georgia Medicaid Community First Choice
• Georgia Medicaid Covered Services
• How to Apply for Georgia Medicaid

Find personalized help navigating CCSP eligibility at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.