CCC+ waiver
What is the CCC+ Waiver?
The Commonwealth Coordinated Care Plus (CCC+) Waiver is a state program designed to provide comprehensive, person-centered services to individuals who require long-term care and support. Its primary goal is to help eligible participants live safely and independently in their own homes and communities, rather than in nursing facilities or other institutional settings.
CCC+ Waiver services encompass a wide range of essential supports that address both medical and daily living needs. These services include assistance with activities of daily living (ADLs) such as bathing, dressing, eating, and mobility, as well as instrumental activities of daily living (IADLs), which involve tasks like managing finances, preparing meals, and using transportation. By offering this vital assistance, the waiver empowers individuals of all ages—whether young or elderly—to maintain their independence, dignity, and quality of life within their familiar surroundings.
Through CCC+, participants gain access to tailored care plans that are developed in collaboration with healthcare providers, caregivers, and case managers, ensuring that each person’s unique needs and preferences are met. This holistic approach not only supports the individual’s well-being but also helps reduce hospitalizations and delays or prevents the need for institutional care.
Coordination of Care
The Commonwealth Coordinated Care Plus (CCC+) Waiver emphasizes a holistic and integrated approach to care for members with complex health needs. This program ensures that all aspects of a participant’s health—both medical and behavioral—are seamlessly coordinated to provide comprehensive, person-centered support.
By bringing together physical health services, mental health care, and long-term supports, the CCC+ Waiver helps to create a unified care plan that addresses the whole individual. This coordination reduces gaps in care, prevents duplication of services, and improves health outcomes by fostering effective communication among healthcare providers, behavioral health specialists, caregivers, and the individual themselves.
Through this integrated model, members receive timely access to the appropriate care and resources they need, promoting stability, enhancing their quality of life, and supporting their ability to live safely and independently in the community.
Access to Services & Support in Services
Eligible participants have access to a wide range of services through the waiver, designed to support independent living within their homes and communities instead of institutional care settings. These services may include personal care assistance, respite care for family caregivers, transportation, and various other supports tailored to meet each individual’s unique needs and preferences.
To receive the CCC+ Waiver, the individual must:
- Be eligible for Medicaid
- Develop a cost-effective Plan of Care that includes a backup plan.
- Not reside in a nursing facility/assisted living facility that serves 5 or more people.
- Have exhausted community resources to meet the individual’s needs.
- Ensure health and safety are maintained in the home environment.
Financial Eligibility
Individuals usually need to meet specific financial criteria to qualify. Only the income and assets of the person applying for Medicaid are taken into account. For the purposes of the CCC+ Waiver financial assessment, children are considered a household of one. Approval requires meeting eligibility standards for both financial need and functional limitations.
Functional Eligibility
To qualify for the waiver, individuals must meet specific functional criteria related to their health needs. This is determined through a screening process conducted by their local Health Department, which assesses their ability to perform daily living activities. Approval requires meeting both financial eligibility and functional dependency standards to ensure that support is provided to those who truly need it.
Managed Care Model
The Commonwealth Coordinated Care Plus (CCC+) Waiver functions within a managed care system, where eligible members are enrolled in Managed Care Organizations (MCOs)—also commonly known as health insurance companies. These organizations play a central role in coordinating and managing the participant’s healthcare services, ensuring that all medical, behavioral, and long-term care needs are addressed in a seamless and efficient manner. By working closely with healthcare providers, specialists, and service facilitators, MCOs help develop personalized care plans that promote continuity of care and improve health outcomes. This managed care approach helps simplify access to services, reduces duplication, and provides members with the support they need to live as independently and safely as possible in their communities.
Adults: Contact your local Department of Social Services (DSS) to request a screening for Long Term Care and the CCC+ Waiver. You can find your local DSS office HERE.
Children: Contact your local Department of Health to request a screening for the CCC+ Waiver. Find your local Health Department HERE.
The screening will be conducted by a nurse from your local Health Department. A representative from your local DSS will then contact you to schedule the screening appointment.
- The screening will take place in the person’s home.
- The person being screened MUST be present.
- The nurse and DSS representative will be looking for a documented disability, functional capacity, medical/nursing needs, and risk of facility placement.
Waiver services are funded through Medicaid. Both adults and children must apply for Medicaid at the same time they begin the screening process for waiver services.
Instructions for completing the Medicaid application:
- Print and complete the Medicaid application form.
- Include only information about the person applying for
- Medicaid—do not include household information, even if requested.
- If you are completing the application for someone else, answer all questions on their behalf, not your own.
- Write “CCC+ Long Term Care Screening Request” clearly at the top and bottom of the form.
Additionally, print and complete the financial section of the Medicaid application, called Appendix D.
- Only the income and assets of the individual applying for Medicaid should be included—household income and assets are not considered.
- Once the individual receives a disability determination, they are considered a household of one for eligibility purposes.
- If completing this for someone else, answer on their behalf only.