For referring professionals

What this agency is

Apple Community Health Services is a case management agency approved by the Georgia Department of Community Health for Traditional (TCM) and Enhanced (ECM) EDWP case management. It arranges, coordinates and monitors Elderly and Disabled Waiver Program services. It is not a home care agency, not a SOURCE site and not a provider of personal support.

The practical consequence for a referrer: sending someone here does not schedule a shift. It opens a waiver case. If your member needs hands-on help within days, a waiver referral is the wrong tool on its own and should be paired with something that can start sooner.

Who is eligible

Two independent tests, both of which must be met:

• Level of care. The person must need the level of care Georgia would require for nursing-home admission. Assessed with the DON-R; the DMA-6 carries the medical picture. Under General Services §602.11 the plan of care and the level-of-care attestation may be signed by the member’s own physician or by the case management agency’s medical director. ACHS has a medical director on staff.
• Financial. Medicaid income and asset rules. These differ between CCSP and SOURCE – SOURCE applies tighter SSI-level income rules with no spousal protections, so a married household that fails one route sometimes clears the other.

Nothing said at referral or intake is an eligibility determination. Only the assessment and Medicaid’s own review decide that.

What to send

Enough to identify the person, reach a decision-maker, and understand the clinical picture. In descending order of usefulness: identifiers and Medicaid status, current functional deficits, the DMA-6 or equivalent clinical summary, discharge or transition context, and who has authority to speak for the member. The full checklist, with what each item is for and what its absence costs, is on the documentation page in this section.

A referral can be opened with partial information. Send it incomplete rather than holding it while you chase a form – gaps are worked after intake, not before it.

What happens after you send it

1. Intake logs the referral and confirms receipt to the referring party.
2. A screening contact with the member or their representative establishes waiver fit, Medicaid status and whether the Area Agency on Aging has already been involved.
3. Where the person has not been screened, they are routed through the Area Agency on Aging / ADRC – in metro Atlanta the Atlanta Regional Commission, whose public service is Empowerline. That step is not optional and it is not something a provider can bypass.
4. Level-of-care assessment, plan of care, and financial determination proceed, commonly in parallel.
5. On authorization, service providers are arranged and the case moves onto the waiver’s monitoring schedule.

Realistic time from first contact to services starting is two to six months, and there is often a waiting list because the waiver has a limited number of funded slots. Referral sources who tell families otherwise create a problem that lands back on them.

How you find out what happened

Referrers are contacted at receipt and again once the case has a direction – accepted and moving, routed elsewhere, or closed. Where the referrer is the member’s clinician or facility and consent allows, status can be shared directly. Where it does not, ACHS will confirm that the referral was received and worked without disclosing clinical detail.

Provider choice

Medicaid members choose their case management agency and may change it. Present ACHS as one option among those serving the region, not as the destination. That is both §1894 and the honest answer.