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Medicaid - Independent Care Waiver Program

Contact Person:
Address:	Dept of Medical Assistance
Address 2:	2 Peachtree Street 37th Floor
City:	Atlanta
State:	GA
Zip:	30303
Phone:	404-657-9321; 800-39
TDD/TYY:
Fax:	404-656-4913
Web Site:	http://www.communityhealth.state.ga.us

Age Groups Served (please check all that apply:)
	Infants and Toddlers (birth - 2 years)
	Pre-school
	Working
	All Ages
	Other Ages (specify):
Geographic Areas Served:
	Coastal Georgia
	Middle Georgia
	North Georgia / Atlanta
	South Georgia
	Statewide - all of Georgia
	National
	Other Geographic Details (specify):
Serves People with the Following Disabilities (please check all that apply):
	Communication limitations
	Learning limitations
	Motor limitations
	Personal care limitations (dressing, toileting, eating, etc.)
	Sensory limitations (vision, hearning)
	Other Demographics (specify): 0
Financial Eligibility (please check all that apply):
	Source will pay for some portion of AT devices / services
	Scholarships available
	Source accepts private insurance
	Source accepts Medicaid
	Source accepts Medicare
	Other Financial Eligibility details (specify):
Does the organization provide AT services?
	Information about vendors / devices
	Device demonstration
	Help choosing right device / system
	Help using current device appropriately
	Device training
	Fabricates special devices or adaptations
	Repairs devices
	Loans devices
	Device rental
	Financial help for device purchase
	Help with insurance, Medicaid, or Medicare claim appeals
	Technical assistance
	Service coordination
	Program advocacy
	AT workshops
	Other AT Services (specify) :
Does the organization provide AT Funding?
	If yes, please indicate what services are provided; check all that apply)
	Source sells devices
	Source leases devices
	Source loans device or money
	Source gives device free of charge
	Source pays for at least part of device cost
	Other Funding Details (specify):
Please indicate what types of AT devices the organization provides or provides services for:  (check all that apply)
	Adapted toys
	Communication
	Computer access
	Daily living devices
	Educational aids
	Environmental units
	Hearing aids
	Home modifications
	Job Accommodations
	Medical devices / supplies
	Prosthetics / orthotics
	Recreational aids
	Seating / positioning
	Vehicle modifications
	Vision aids
	Wheeled mobility
	All AT devices
Comments (any other information you would like us to include about your organization):
	Must be Medicaid recipient with severe disability 21 years old or older and at risk of residing in an institution. Offers services to assist a limited number of adult Medicaid receipients with physical disabilities to live in their own homes or in the community instead of in institutional settings. Services available are case management personal care home maker services home modifications skilled nursing services transportation specialized medical equipment and supplies occupational therapy counseling and personal emergency response services. Contact local case managers in your area. Applicant must be a Medicaid recipient.