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Home and Community Based Services

Medicaid Waiver

The Medicaid Waiver Home and Community-Based Case program is designed to provide services for elderly seniors and disabled individuals to allow them to live well in their own homes and communities they love rather than having their needs met in a nursing home. Person-centered case management, personal care, homemaker and other services are provided at no cost to the individual or their family.

NARCOG currently serves over 600 individuals in Cullman, Lawrence, and Morgan County.

NARCOG has been awarded Case Management for Long-Term Services and Supports Accreditation by the National Committee for Quality Assurance (NCQA).  NCQA is a private, non-profit organization dedicated to improving health care quality.


Medical Guideline

As determined by a doctor to be at a level of disability that would otherwise require nursing facility level care.

Financial Guideline

To be eligible, applicants must be receiving full Medicaid benefits or may become eligible through Medicaid deeming. Individuals may be deemed eligible for Medicaid if their incomes do not exceed 300% of the federal poverty level and they have limited assets. If you do not have full Medicaid benefits, additional financial information and a Medicaid application will be required.

The monthly limits are reviewed by Alabama Medicaid annually and is adjusted.

Estate Recovery

What is Estate Recovery?

Established under the federal law, this program requires the Alabama Medicaid Agency to recover the costs paid by the agency from the estates of the deceased Medicaid recipients, however, there are some exceptions.

Who is affected by Estate Recovery?

  • A person of any age permanently residing in a nursing facility, intermediate care facility for the intellectually disabled, or other medical institutions; and
  • A person 55 years of age or older who received medical assistance for any services covered under the Alabama Medicaid State Plan (this includes any individual receiving Home and Community based services.)

When does Estate Recovery occur?

Estate Recovery happens only after the death of a person receiving Medicaid benefits under the effected categories.

Medicaid Waiver Program Summaries

Elderly and Disabled (E&D) Waiver

The Elderly and Disabled Waiver program provides home and community-based services to the elderly and individuals with disabilities at risk for nursing facility placement. Case managers work alongside participants to develop individualized care plans. Participants in this program may receive personal care, homemaker, respite, adult day health, companion services, and home-delivered frozen meals.

Personal Choices

Personal Choices provides self-directed home and community-based services. It is designed to offer older adults and individuals with disabilities more choices and flexibility in the type of care they receive. Participants enrolled in the program may use their allotted budgets to receive the care they need. Participants can also appoint family or friends to provide their care. They can also save for other items that support and enhance their health.

To participate in Personal Choices, the individual must be enrolled in the Elderly and Disabled (E&D) Waiver program or the Alabama Community Transition (ACT) Waiver program. A Personal Choices Counselor helps the participant with the application process and supports them and their workers as care is provided with an individualized budget.

Gateway to Community Transitions (GCL)

Gateway supports individuals who wish to transition from an institutional setting to community living. A transition coordinator works alongside the applicant to ensure a smooth transition. A variety of services is available to ensure a successful transition into the community and to provide ongoing care in the community based on the client’s medical needs.

Alabama Community Transition Waiver (ACT)

The Alabama Community Transition (ACT) Waiver provides services to individuals with disabilities or long-term illnesses who have transitioned from a nursing facility to a home or community setting. Many services are available to ensure a successful transition into the community and provide ongoing care based on the client’s medical needs.

Technology Assisted Waiver for Adults (TA) Waiver

The Technology Assisted (TA) Waiver provides services to individuals age 21 or older with complex skilled medical conditions, who are ventilator-dependent or have a tracheostomy, and who would otherwise require care in a long-term care setting to instead remain in the community. The plan of care and case management services are based on individual client needs. Services include private duty nursing, personal care/attendant service, medical supplies, assistive technology, and targeted nurse case management.

Hospital to Home Program

Hospital to Home helps individuals return home after a hospitalization. Ideal candidates for Hospital to Home are full Alabama Medicaid beneficiaries who are admitted from home to an acute-care facility and are at risk of permanent placement in a long-term care facility.