April 10, 2020

State of Georgia Announces Approval of Appendix K Emergency Preparedness Response Plans

The State of Georgia announced that the Centers for Medicare and Medicaid Services (CMS) approved Georgia’s Appendix K emergency preparedness response plans to combat COVID-19. To read the approval letter, click here.

Appendix K emergency preparedness plan update: withdrawal of request on Home and Community-Based Waivers. Download this pdf file. Read Georgia Appendix K update here.

This comprehensive set of amendments provides the State with a number of flexibilities for the care of Georgians served under the Community Care Services Program (CCSP), Service Options Using Resources in a Community Environment (SOURCE) program, as well as individuals with significant physical disabilities and/or traumatic brain injury under the Independent Care Waiver Program (ICWP). These waiver programs are operationally managed by the Georgia Department of Community Health (DCH) within the Elderly and Disabled Waiver Program serving 26,000 members. Read the full Appendix K: EDWP and ICWP.

CMS also approved flexibilities for providers and members receiving services through the Department of Behavioral Health and Developmental Disabilities (DBHDD).  These flexibilities augment provisions under the existing New Options Waiver Program (NOW) and the Comprehensive Supports Waiver Program (COMP) and provide temporary approval of telehealth services for a number of Intellectual and Developmental Disabilities (I/DD) services. Read the full Appendix K: COMP and NOW.

“The State of Georgia is grateful to CMS for quickly granting these critical amendments,” said Governor Brian Kemp. “Many of those impacted under these emergency preparedness response plans fall into the high-risk category for COVID-19. It was imperative that we acted swiftly and thoughtfully to help mitigate exposure to risks and provide alternative service delivery models for Georgia’s most vulnerable citizens. I’d like to thank our partners with DCH and DBHDD and our many providers who worked together to meticulously craft these measures.”

The Appendix K emergency preparedness response plans collectively include the following summarized temporary flexibilities:

  • Under the EDWP and ICWP, modification of service scope or coverage for Adult Day Health; Traditional Case Management; Enhanced Primary Care Case Management; Skilled Nursing Services – RN (ICWP); and Skilled Nursing Services Hourly – LPN (ICWP)
  • Under the COMP and NOW, modification of service scope or coverage for Community Living Support Services, Community Access, In-Home and Out-of-Home Respite Services, and Specialized Medical Supplies Services

  • Expansion of setting(s) where services may be provided to include alternate living services and out-of-home respite
  • Allows certain services to be provided in out-of-state settings
  • Permits payment for services rendered by family caregivers or legally responsible individuals if not already permitted – including those out of state
  • Modification of provider qualifications and training requirements as certain training requirements may be completed electronically or telephonically, and agency supervisory staff may manage, train and supervise staff using social distancing guidelines
  • Modification of processes for level of care evaluations or re-evaluations
  • Increase certain payment rates
  • Modification of person-centered service plan development process and individual(s) responsible for person-centered service plan development
  • Allows for payment of services for the purpose of supporting waiver participants in an acute care hospital or short-term institutional stay
  • Includes retainer payments to address services delivered in settings closed in response to the health crisis

Additionally, under the COMP and NOW Appendix K amendments, telehealth is now permitted for the following I/DD services:

  • Occupational Therapy
  • Physical Therapy
  • Speech and Language Therapy (some exceptions)
  • Nutrition Services
  • Behavior Supports Services
  • Registered Nursing Services
  • Intensive Support Coordination and Support Coordination
  • Supported Employment (limited scope)  

The approval of these temporary flexibilities is effective retroactively to March 1, 2020, and applies in all locations served by individual waivers for anyone impacted by COVID-19.