SOURCE is the Georgia Medicaid waiver that puts an older adult's doctor and their home-care services under one coordinated care team instead of two disconnected systems. Short for Service Options Using Resources in a Community Environment, it differs from the Community Care Services Program (CCSP), where the participant keeps their own primary care doctor and gets HCBS separately. SOURCE participants instead enroll with a SOURCE site (a physician group, community health center, or community-based organization) that coordinates both their medical care and their long-term services together.

SOURCE is built on a hybrid federal authority, a Section 1915(c) HCBS waiver for the long-term services and a Section 1915(b) managed care waiver for the integrated primary care. It is administered by the Georgia Department of Community Health (DCH) and accessed through Empowerline, the same statewide front door used for CCSP and PACE. This guide explains how SOURCE works in practice, who qualifies, how to choose a SOURCE site, what services are covered, how the waitlist compares to CCSP, how cost share is calculated, how Structured Family Caregiving fits in, and how to decide whether CCSP or SOURCE is the right path for you.

Federal and Georgia Authority

SOURCE is unusual among HCBS waivers because of its hybrid 1915(c) plus 1915(b) structure.

Federal Authority

  • Section 1915(c) of the Social Security Act (HCBS waivers; provides the HCBS service authority)
  • Section 1915(b) of the Social Security Act (managed care waivers; provides the primary care coordination authority)
  • CMS HCBS waiver regulations under 42 CFR Part 441
  • CMS managed-care regulations under 42 CFR Part 438 (applicable to the 1915(b) portion)
  • 300 percent SSI Federal Benefit Rate Special Income Limit for institutional LTC eligibility
  • Federal Miller Trust authority (income-only trust permitting LTC eligibility above the income standard)
  • Federal spousal impoverishment protections (community-spouse income and resource allowances)

Georgia Authority

  • O.C.G.A. Title 49 Chapter 4 (Public Assistance, including Medicaid administration)
  • SOURCE Section 1915(c) Waiver Application (HCBS service authority)
  • SOURCE Section 1915(b) Waiver Application (primary care coordination authority)
  • DCH SOURCE Provider Manual (operational procedures for SOURCE sites and HCBS providers)
  • Georgia AAA Provider Manual (local AAA operational procedures for SOURCE intake)

Eligibility

SOURCE eligibility is essentially identical to CCSP eligibility, with one additional operational requirement (enrollment with a SOURCE site).

Functional Eligibility (NF Level of Care)

The AAA care coordinator conducts a functional assessment using the DCH standardized assessment instrument. NF LOC generally requires:

  • Significant impairment in at least two ADLs (bathing, dressing, toileting, transferring, eating, mobility), OR
  • Significant cognitive impairment requiring supervision, OR
  • A combination of physical and cognitive impairments that would otherwise require nursing facility placement

Financial Eligibility

  • Income: Gross monthly income at or below the annually-indexed Special Income Limit (300 percent of the SSI Federal Benefit Rate), or routed through a Miller Trust if above. For the current dollar amount, see the CMS Spousal Impoverishment Standards page and the SSA SSI Federal Benefit Rate page.
  • Assets: The standard Medicaid LTC asset limit for a single applicant and a slightly higher limit for a married applicant with both applying; full spousal impoverishment for a married applicant with a community spouse (community-spouse resource allowance is annually indexed).
  • Lookback: The federal Medicaid transfer-penalty lookback applies. Confirm the current operative window with DCH and the CMS Estate Recovery and Transfer of Assets guidance.
  • Home equity: The federal Medicaid home-equity cap applies. The home is not counted as long as a community spouse or qualifying dependent lives in the home. Confirm the current cap with DCH.

SOURCE Site Enrollment

SOURCE participants must enroll with an approved SOURCE site that operates in their geographic area. The SOURCE site agrees to be the participant's primary care medical home and the lead care coordinator for both medical and HCBS services. If no SOURCE site operates in the participant's county, CCSP is generally the alternative.

What Is a SOURCE Site?

A SOURCE site is the operational hub of the SOURCE program. It is an approved physician group, community health center, or community-based organization that has contracted with DCH to deliver coordinated primary care plus HCBS care coordination for SOURCE participants.

What a SOURCE Site Does

  • Primary care. A SOURCE primary care physician (PCP) serves as the medical home for the participant. The PCP provides routine medical care, manages chronic conditions, prescribes medications, refers to specialists, and admits to the hospital when needed.
  • HCBS care coordination. A SOURCE care coordinator (often a nurse or social worker) develops and manages the HCBS care plan, supervises home care providers, conducts monthly contacts and quarterly home visits, and responds to changes in condition.
  • Integrated care. Because the PCP and the care coordinator work on the same team, medical and HCBS decisions are coordinated. This reduces redundant assessments, conflicting care plans, and care fragmentation.
  • Capitation payment. DCH pays the SOURCE site a monthly capitation rate for primary care coordination, separate from the fee-for-service or HCBS waiver payments for individual services.

Types of SOURCE Sites

  • Physician groups (geriatric medicine practices, primary care groups specializing in older adults)
  • Federally Qualified Health Centers (FQHCs) with SOURCE certification
  • Community health centers with SOURCE certification
  • Hospital-based outpatient practices with SOURCE certification
  • Community-based organizations that have a contracted SOURCE PCP relationship

How SOURCE Sites Differ Across the State

  • Atlanta metro has the most SOURCE sites, often with multiple options per county
  • Mid-size cities (Augusta, Macon, Savannah, Columbus) typically have at least one SOURCE site
  • Rural counties may have no SOURCE site; in those areas CCSP is the practical alternative
  • Empowerline maintains the current SOURCE site directory; ask for the list when you call

What SOURCE Covers

SOURCE covers the same HCBS services as CCSP, plus the coordinated primary care layer through the SOURCE site.

HCBS Services

  • Adult Day Health (ADH): Center-based program providing daytime supervision, social activities, meals, personal care, nursing oversight, and rehabilitation
  • Alternative Living Services (ALS): Small group home, typically a personal care home, where the participant lives with other residents and receives 24-hour personal care
  • Emergency Response System (ERS): Wearable or in-home button connecting to a 24-hour monitoring center
  • Home-Delivered Meals: Nutritionally balanced meals delivered to the participant's home
  • Out-of-Home Respite: Short-term placement in a nursing facility or other approved setting to give the family caregiver a break
  • Personal Support Services (PSS): Hands-on personal care in the home (bathing, dressing, toileting, transferring, eating, light housekeeping, meal preparation, medication reminders)
  • Skilled Nursing: Periodic skilled nursing services in the home
  • Structured Family Caregiving (SFC): Family caregiver paid through an approved SFC provider organization

Coordinated Primary Care

  • Routine office visits with the SOURCE PCP
  • Chronic disease management
  • Medication management
  • Specialist referrals and coordination
  • Hospital admission and discharge planning
  • Care coordination meetings with the care coordinator and HCBS providers
  • Annual comprehensive assessment

What SOURCE Does NOT Cover

  • Services Medicare or other primary insurance covers (the SOURCE site coordinates with Medicare, which remains the primary payer for acute care for dual-eligible participants)
  • Nursing facility long-term care (NF placement is a separate Medicaid pathway, though out-of-home respite within an NF setting is covered under SOURCE)
  • Specialty services not in the care plan
  • Items paid through the maintenance allowance (rent, utilities, food, personal items)

How to Apply

Step 1: Call Empowerline

Empowerline is the statewide front door for SOURCE, CCSP, and PACE intake. Contact Empowerline (see the resource section below for the current phone number).

The intake specialist asks screening questions and routes you to the local AAA. The same intake call covers CCSP, SOURCE, and PACE assessment.

Step 2: AAA Initial Assessment

The local AAA conducts an initial assessment to verify potential eligibility and identify the best-fit program. If SOURCE is a viable option (NF LOC, SOURCE sites operate in your county, no conflict with existing care arrangements), the AAA discusses SOURCE site options.

Step 3: SOURCE Site Selection

The applicant chooses a SOURCE site from the approved providers in their geographic area. Factors to consider:

  • Geographic accessibility (can you get to the SOURCE office for in-person visits?)
  • PCP fit (does the SOURCE PCP have experience with your conditions; do you feel comfortable with the practice style?)
  • Care coordinator availability (some SOURCE sites are easier to reach than others)
  • HCBS provider relationships (which home care agencies and adult day health centers does the site work with?)
  • Existing relationship (if you already see one of the SOURCE PCPs, that practice may be the natural choice)

The AAA care coordinator and Empowerline can help you compare sites.

Step 4: Medicaid Application

If not already a Medicaid recipient, apply for LTC Medicaid through DFCS using the LTC application and supplement. Apply online at Georgia Gateway, by phone, or in person at your local DFCS office. See our Georgia Medicaid Application guide for operational details.

Step 5: SOURCE Site Enrollment

Once Medicaid eligibility is approved, the SOURCE site formally enrolls you. You meet your SOURCE PCP for an initial comprehensive visit. The care coordinator visits your home to conduct the in-home assessment and develop the care plan.

Step 6: Care Plan Implementation

The care plan is submitted to DCH for review and approval. Services begin. The care coordinator schedules monthly contacts, quarterly home visits, and annual reassessment.

Waitlist Comparison: SOURCE vs. CCSP

The biggest practical difference between CCSP and SOURCE is often the waitlist.

Why SOURCE Has Shorter Waits

  • SOURCE operates within existing managed-care capacity (SOURCE sites already have provider networks, primary care infrastructure, and care coordination teams in place)
  • The 1915(b) managed-care authority gives DCH more flexibility on enrollment timing than the 1915(c) HCBS-only authority
  • SOURCE sites have economic incentives to enroll participants quickly (capitation revenue)

Typical Waitlist Snapshot

  • CCSP urban metro: Substantial wait for standard priority
  • SOURCE urban metro: Minimal or no wait at most sites
  • CCSP suburban: Meaningful wait
  • SOURCE suburban: Minimal or no wait
  • CCSP rural: Variable, generally shorter than urban
  • SOURCE rural: Depends on whether a SOURCE site operates in the county

This is illustrative; verify current status with Empowerline and the specific SOURCE site.

Cost Share

SOURCE 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 a modest monthly cost share comparable to CCSP. The maintenance allowance for community living is calculated to leave the participant with enough income to pay for rent or mortgage, utilities, food, and other community living expenses.

Structured Family Caregiving Under SOURCE

SFC is available under SOURCE on the same basis as CCSP. The main operational difference is that the SOURCE site, in addition to the SFC provider organization, may be involved in the SFC care coordination.

Who Can Be Paid

  • Adult children (18+)
  • Grandchildren
  • Siblings
  • Other relatives by blood or marriage
  • Friends (some SFC providers, with home assessment)
  • Spouses are generally excluded (narrow exceptions via fair hearing)

How SFC Works Under SOURCE

  1. Participant enrolls in SOURCE through the AAA and SOURCE site
  2. SFC is added as a service in the care plan
  3. Participant and family member select an approved SFC provider organization
  4. SFC provider conducts a home assessment, trains the caregiver, and pays the monthly stipend
  5. SOURCE care coordinator and SFC provider jointly oversee care
  6. SOURCE PCP integrates SFC into the medical care plan

Stipend Amount

  • The SFC provider organization pays the caregiver a monthly stipend based on the care recipient's assessed acuity level. For the current operative stipend rates, verify with the SFC provider organization or Empowerline.
  • The stipend is reported as taxable income to the caregiver, typically on a 1099 or W-2 from the SFC provider. Foster-care-style payments made to caregivers living with the care recipient may be excludable from federal income tax under current IRS guidance; consult a tax professional.

How to Choose Between CCSP and SOURCE

Choose CCSP If

  • You want to keep your existing primary care doctor (not a SOURCE PCP)
  • No SOURCE site operates in your county
  • You prefer separation between medical care and HCBS coordination
  • Your existing PCP and care arrangements are working well
  • You are willing to wait for CCSP capacity

Choose SOURCE If

  • You want integrated medical and HCBS coordination through one team
  • A SOURCE site operates in your area with capacity
  • You do not have an existing PCP relationship you need to keep
  • You prefer shorter waitlist
  • You value the SOURCE PCP relationship for medication management and care planning

Either Way

  • Eligibility is the same
  • Services are the same (HCBS)
  • Cost share is similar
  • SFC is available

You can also switch between CCSP and SOURCE during open enrollment or with good cause.

Worked Examples

Example 1: Mrs. Henderson, 75, Wants Integrated Care

Facts: Mrs. Henderson lives in Fulton County. Her income is modest Social Security and her assets are below the LTC limit. She has diabetes, high blood pressure, and early-stage dementia. She does not have an established PCP relationship.

Decision: SOURCE is a good fit because:

  • A SOURCE site (a geriatric medicine practice in midtown Atlanta) is convenient to her home
  • The SOURCE PCP specializes in older adults with chronic conditions
  • She benefits from integrated medication management and HCBS coordination
  • No CCSP wait
  • She has no existing PCP to keep

Care plan:

  • SOURCE PCP visits monthly initially, then quarterly
  • PSS several hours per day, multiple days per week
  • Adult day health a couple of days per week (cognitive stimulation)
  • Home-delivered meals: weekday lunches
  • Emergency response system
  • Care coordinator monthly contact

Cost share: Calculated by DCH based on the cost-share formula.

Example 2: Mr. Carter, 80, Wants to Keep His PCP

Facts: Mr. Carter lives in Gwinnett County on modest fixed income with assets below the LTC limit. He has chronic kidney disease and has seen the same nephrologist and PCP for many years. The PCP is not a SOURCE site.

Decision: CCSP is a better fit because:

  • Mr. Carter wants to keep his established medical team
  • His specialist care for kidney disease is at a tertiary medical center, not coordinated through any SOURCE site
  • A meaningful CCSP wait is acceptable given his current home situation

Care plan:

  • His own PCP and nephrologist continue
  • CCSP PSS several hours per day for assistance with personal care
  • Home-delivered meals
  • Skilled nursing weekly for medication management and kidney disease monitoring

Cost share: Calculated by DCH based on the cost-share formula.

Example 3: Mr. Tucker, 68, Rural County, No SOURCE Site

Facts: Mr. Tucker lives in a small rural county where no SOURCE site operates. Income and assets are below the LTC thresholds. He has Parkinson's disease and needs help with daily living.

Decision: CCSP is the only HCBS option (other than ICWP, which is for younger adults with TBI or severe physical disability and does not match Parkinson's). CCSP rural waits are generally shorter than urban metro waits, so he should be able to start services relatively soon.

Care plan:

  • CCSP PSS several hours per day
  • Home-delivered meals
  • Skilled nursing weekly
  • Emergency response system

Cost share: Calculated by DCH based on the cost-share formula.

How to Verify the Numbers

  • SOURCE Provider Manual and waiver applications: dch.georgia.gov
  • SOURCE site directory: Empowerline or your local AAA
  • Special Income Limit and asset limits: DCH Medicaid Policy Manuals
  • SFC provider directory: request from your local AAA or Empowerline
  • CCSP vs. SOURCE comparison: empowerline.org

For free legal help with a SOURCE eligibility case or appeal, contact Georgia Legal Services Program, Atlanta Legal Aid, or the Georgia Senior Legal Hotline. For more on how SOURCE compares with CCSP and other LTC pathways see brevy.com's guides at /medicaid/georgia/ccsp-waiver and /medicaid/georgia/long-term-care.

Frequently Asked Questions

Neither is universally better. SOURCE adds integrated primary care coordination and generally has shorter waits. CCSP gives you more flexibility on your existing PCP relationships. The right choice depends on your existing medical care, geographic access to SOURCE sites, waitlist status, and your preference for integrated vs. separated care coordination.

Yes. SOURCE requires that your primary care be delivered through the SOURCE site's PCP. If your existing primary care relationship is important and your current PCP is not part of a SOURCE site, CCSP is the better path. You can keep specialists outside the SOURCE site, but they must coordinate with the SOURCE PCP.

Yes, during open enrollment periods or with good cause. Good cause includes a SOURCE site closing in your area, dissatisfaction with the SOURCE PCP, or geographic relocation. Work with your AAA care coordinator and Empowerline to navigate the switch.

DCH pays the SOURCE site a monthly capitation rate for primary care coordination, in addition to the regular fee-for-service or HCBS payments for individual services. The capitation creates an economic incentive for the SOURCE site to coordinate care well, manage chronic conditions, and prevent hospitalizations.

Yes. Many SOURCE participants are dually eligible (Medicare + Medicaid). Medicare remains the primary payer for acute medical services; Medicaid (through SOURCE) pays for the HCBS services and the primary care coordination. The SOURCE PCP coordinates with Medicare and Medicare Advantage plans.

DCH or your AAA will notify you. You will be helped to select another SOURCE site or to switch to CCSP. Services continue during the transition under continuity-of-care protections.

The SFC service is essentially the same: a live-in family caregiver paid through an approved SFC provider organization. Under SOURCE, the SOURCE site and care coordinator are additionally involved in SFC oversight, alongside the SFC provider organization. Under CCSP, only the SFC provider organization and the AAA care coordinator are involved.

DCH calculates cost share for each participant based on gross monthly income, the cost of the care plan, the maintenance allowance for community living expenses, health insurance premiums, and any family allowance. Most participants pay a modest monthly cost share.

Request a State Hearing through the Office of State Administrative Hearings (OSAH) within the timeframe stated on your denial notice. If you file early enough you can request aid pending for terminations or reductions of existing services. Free legal help is available through Georgia Legal Services Program and Atlanta Legal Aid. Verify the current appeal deadlines with the OSAH or the notice you received.

Call Empowerline and ask for the SOURCE site directory for your county. Empowerline maintains the current list of operational SOURCE sites and can tell you which are accepting new participants.

Key Phone Numbers and Resources

  • Empowerline. Statewide front door for SOURCE, CCSP, and PACE intake; provider directory of operational SOURCE sites.
  • Georgia DCH Member Services. General Medicaid questions.
  • DFCS Application Hotline. LTC Medicaid applications.
  • Office of State Administrative Hearings (OSAH). Appeals from Medicaid eligibility or service denials.
  • Georgia Long-Term Care Ombudsman. Advocacy for residents and beneficiaries.
  • Adult Protective Services. Reports of suspected abuse, neglect, or exploitation.
  • Georgia Legal Services Program and Atlanta Legal Aid. Free legal help for income-eligible older adults.
  • State Bar of Georgia Lawyer Referral and NAELA Georgia Chapter. Elder-law attorney referrals.
  • GeorgiaCares / SHIP. Medicare counseling.
  • Georgia DBHDD. Information on NOW and COMP, for comparison.

Learn More

Find personalized help comparing CCSP and SOURCE and choosing a SOURCE site 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.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.