Service Options Using Resources in a Community Environment (SOURCE)

Overview

Service Options Using Resources in a Community Environment (SOURCE) -- SOURCE operates under authority of the Elderly and Disabled 1915-c Home and Community Based Services Medicaid Waiver approved by the Centers for Medicare and Medicaid Services. Individuals eligible for enrollment in SOURCE must be fully covered by Medicaid and meet other eligibility requirements.

SOURCE is an enhanced primary care case management program that serves frail elderly and disabled beneficiaries. The program works to improve the health outcomes of persons with chronic health conditions, by linking primary medical care with home and community-based services through case management agencies. The Georgia Department of Community Health’s (DCH) Aging and Special Populations Unit administers SOURCE to approximately 19,000 elderly and disabled beneficiaries statewide.

SOURCE Offices - Updated 03/14/14

SOURCE Fact Sheet - Updated 09/18/13


Purpose

SOURCE integrates primary medical care with supportive services through case managers who work with the member and their primary care physicians (PCP). Beneficiaries who meet eligibility criteria enroll with a SOURCE site as their primary care provider who coordinates all medical and social services. The program was established to:

  • Integrate primary care, specialty care and home-based care to eliminate fragmentation;
  • Reduce emergency room use, hospital and nursing home admissions caused by preventable medical complications;
  • Stabilize social and lifestyle factors that affect compliance, health status and quality of life;
  • Insure that current gaps in Medicaid benefits for medical and supported living services are addressed so they do not negatively affect health outcomes and cost; and
  • Reduce the need for long-term institutional placement.
Care coordination

Upon enrollment, the case manager completes an assessment during a home visit and prior to the appointment with their disciplinary team. The case manager works closely with the member’s PCP and his/her medical director to coordinate care. The assessment provides more extensive information to the physician about the beneficiary’s social history, home environment and functional status than would be obtained during an initial visit. Case managers contact participants at least once a month and make home visits at least once every quarter. Care path protocols are completed at each quarterly home visit.

Care paths are sets of standardized outcomes for each level of care, with customized plans for each person to achieve those outcomes. Replacing traditional HCBS care plans, care paths provide a case management structure that regularly measures the achievement of targeted key outcomes for individuals enrolled. Based on functional ability not diagnosis, care paths cover areas such as: keeping medical appointments, service provider performance, skin care, medication compliance, transfers, informal supports, nutrition/weight, key clinical indicators, Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs) and problem behavior.

Based on assessment information, participants are assigned levels of care that meet the state’s nursing home level of care criteria. Level one includes members who require skilled nursing services daily and need assistance with the activities of daily living. Level two includes members with substantial cognitive loss and/or physical impairments that affect their ability to complete activities of daily living. To address risk factors related to functional capacity and the progression of chronic conditions, care paths have been developed and implemented for each level.

Provider enrollment

SOURCE contractors receive a flat per member per month case management fee billed on the CMS 1500.

If you are interested in information about becoming a service provider, review the SOURCE and CCSP manuals located at www.mmis.georgia.gov. Completed applications may be mailed to The Georgia Department of Community Health, Aging and Special Populations Unit, 2 Peachtree Street NW, 37th Floor, Atlanta GA 30303: Attention SOURCE specialist.

For additional information call (404) 463-6570 or 404-653-8365.