Potential CCSP Provider Information
Provider agency must have been in business for which application is being made a
minimum of 12 consecutive months. There is a $25.00 registration fee for the Pre-Enrollment Technical Assistance Training.
CCSP does not guarantee client referrals. Clients have choice of providers.
Community Care Services Program(DHR/DASCCSP)
CCSP Information
Select Publications, CCSP Publications to access Annual Report and Pre-Enrollment Technical Assistance Packet
ORSState License or Permit Information
*Nursing homes wishing to enroll in CCSP, ADH or RC will need to obtain a waiver from ORS before pursing enroll process with CCSP.
- Personal Care Homes404-657-4076
- Long-Term Care Section404-657-5850
Questions about ORS Personal Care Home (PCH): ALS-F/ ALS-G
General Information 404-657-4076
Dorothy Rosser 404-657-4074
Kris Adams 404-657-1511
Questions about ORS Private Home Care Providers(PHC) or Home Health: PSS/ HDS
General Information 404-657-5550
Shunda Dennison 404-657-1509
ORS Complaint Intake:
800-878-6442 or 404-657-5726 and 5728
Georgia Health Partnership (DCH/DMAMedicaid)
Medicaid Provider Manuals
Select Provider Information tab, go toMedicaid Provider Manuals box and select ‘View Full List’. Access manuals: Part I Policies and Procedures for Medicaid/Peachcare for Kids; CCSP General Manual; and, CCSP service specific manual(s)
DCH Application for Medicaid
Select Provider Information tab, go to Documents & Forms box and select ‘View Full List’. Download ‘Provider Enrollment Application Package’ and ‘Disclosure of Ownership and Control Interest Statement’, complete, and submit to CCSP
Questions about DCH CCSP Medicaid(aged and disabled waiver) contact
Alexis Teitelbaum 404-657-7211
DCH/ SOURCEQuestions
Contact 404-657- 5463: Alexis Teitelbaum, Program Manager, DCH
e-mail address:ateitelbaum.dch.ga.gov
DCH Other Waiver Phone Contacts
ICWP (waiver for physical disabilities)Bessie Barnes contact 404-657-9321
MRWP/CHSS (waiver for developmentally disabled)contact 404-463-8037
General DCH/Medicaid Questions:
404-651-9976
Pre-Enrollment Technical Assistance Packet
Pre-Enrollment Registration Form must be returned to attend training. Mail the Pre-Enrollment CCSP Technical Assistance Registration Form, attachments, and a check or money order of $25.00 (per person) made payable to the DAS General Training Trust Fund to:
GeorgiaDepartment of Human Resources
Division of Aging Services/CCSP
Two Peachtree Street, NW, Suite 9.405
Atlanta, Georgia 30303-3142
CCSP PSS/ HDS/ALS-Gapplicant agency must also submit a current, non-restricted permit issued by ORS. ERS applicant must submit a Low Voltage Contractor License issued by Secretary of State.
TheCCSP Medicaid application is distributed at the training. The CCSP Provider Enrollment Application and the DCH Medicaid Application are distributed at the CCSP Pre-Enrollment Training.
CCSPStateProvider Specialists:
Ruth Davis 404-657-5309CSRA, Heart, Middle GA, Lower Chatt.
Norma Ivey 404-657-5320 Coastal GA, SE GA, SWGA.
James Woodruff 404-657-5305ARC, GA Mountains, NE GA.
Nancy Dubas404-657-5303NWGA., Southern Crescent
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Rev. 04/02/2008, 06/03/2008, 01/12/2009