Georgia Medicaid Waivers

This info is from the Georgia Home and Community Based Waivers guide on the UNLOCK site.

If you have been referred for nursing home or other institutional care, but could stay in your home or in the community with special services, you may be eligible for home and community-based services (HCBS) through Georgia’s Medicaid program.

Many of these services are called waiver programs, because the Centers for Medicare & Medicaid Services (CMS) allows states to “waive” certain Medicaid requirements and pay for home and community-based services as an alternative to institutions, such as nursing homes or hospitals for people with disabilities. Essentially, the law provides you a choice.
Georgia has several home and community-based waivers. Some of the waiver program services include assistance with daily living activities (bathing, dressing, meals and some household chores), help with arranging medical or support services, and services to relieve family caregivers. This guide describes HCBS programs for people who are elderly, physically disabled, have a developmental or intellectual disability, or are medically fragile children.

Although different waiver programs offer differentservices, they have some things in common. Each program is designed to help people who qualify for institutional care remain in the community or return to the community from nursing homes, hospitals or other long-term institutions. Each program also requires that people be eligible for Medicaid. To qualify for a waiver program, you can have higher income and resources than permitted in the regular Medicaid program.

In addition to the waiver programs, Georgia offers other services through the regular Medicaid program designed to support people in their homes and communities. Some of those are described in this guide and include the Georgia Pediatric Program’s (GAPP) in-home services for medically fragile children and behavioral or mental health services.
Download the Guide to Medicaid Waiver Programs in Georgia

This info is from the Medicaid Waivers page on the UNLOCK site.

States must include nursing facility care for Medicaid recipients in their Medicaid programs, but home and community-based services (HCBS) are available at a state’s option. This bias toward institutionalization, as well as a growing understanding that institutional care is generally more costly than HCBS for individuals with the same level of need, led to the creation of federal Medicaid rules that allow states to establish Medicaid HCBS waiver programs.

Generally, the waivers provide a package of medically necessary services and supports to people with disabilities and chronic conditions whose medical and support needs are high enough to require an “institutional level of care,” but who do not want to live in a nursing home or institution and could live in the wider community with appropriate services and supports.

States can develop these HCBS waiver programs very narrowly or broadly in terms of the ages and functional ability levels of the eligible p population, the number of waiver slots available, their geographic distribution in the state, having an annual cost cap, and other kinds of income or asset conditions that waiver recipients must meet.

Medicaid Eligibility
Medicaid is a medical assistance program that provides health coverage for children under 19 years of age, pregnant women, families with dependent children under 19 years of age, and people who are aged, blind and/or disabled and whose income is insufficient to meet the cost of necessary medical services. This fact sheet provides the basics of Medicaid eligibility in Georgia. Medicaid is funded by federal and state governments. In Georgia, the Department of Community Health (DCH) and the Department of Human Services (DHS) work together to process applications and make Medicaid eligibility determinations.
Download the Medicaid Eligibility Fact Sheet

Georgia Medicaid Long-Term Services and Supports

Medicaid Long-Term Services and Supports programs enable eligible Georgians to live in the setting most appropriate for their needs – nursing facilities, their own home, or a caregiver’s home. To be eligible for long-term care assistance, applicants must meet both income and resource limits, which may be higher than the limits for other Medicaid programs. Other criteria considered are functional status, age (in the Independent Care Waiver Program {ICWP} only), citizenship and Georgia residency. Waiver recipients must also qualify for the level of care provided in a nursing facility or other qualified institution.
Download the CCSP Fact Sheet

The Community Care Services Program (CCSP)
The CCSP waiver provides home- and community-based services to elderly and/or functionally impaired or disabled members. The program includes case management, adult day health care, alternative living services, personal care, home-delivered meals and services, extended home health, respite care and emergency response services.
Download the CCSP Fact Sheet

Independent Care Waiver Program (ICWP)
ICWP offers services to a limited number of adult members with physical disabilities, including persons with traumatic brain injuries (TBI). This program is available for eligible Medicaid members who are severely physically disabled and between the ages of 21 and 64 when they apply. ICWP services include personal support, home health, emergency response services, specialized medical equipment and supplies, counseling and home modifications.
Download the ICWP Fact Sheet

New Options Waiver Program/Comprehensive Supports Waiver Program (NOW/COMP)
NOW and COMP offer home or community-based services for people with developmental disabilities or intellectual disabilities. Six regional offices under the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) determine eligibility and coordinate service delivery for these programs. The programs cover supported employment, residential services, personal care and respite services, specialized medical equipment and supplies, vehicle adaptations, home modifications, and behavioral support services.
Download the NOW/COMP Fact Sheet

TEFRA/Katie Beckett Medicaid Program
The Katie Beckett Program, also know as the Deeming Waiver, is not a waiver program for Home and Community-based services. Rather, it waives standard Medicaid eligibility criteria to permit the state to ignore family income and only consider the child’s income when the child meets an institutional level of care. Qualifi cation is not based on medical diagnosis; it is based on the institutional level of care the child requires. Title 42 Code of Federal Regulations outlines the criteria used to determine eligibility. If approved under Katie Beckett, the child is granted Medicaid eligibility to access all Medicaid state plan services, such as physician and hospital services.
Download the TEFRA/Katie Beckett Fact Sheet

Service Options Using Resources in a Community Environment (SOURCE)
SOURCE serves frail, elderly and disabled Georgians who are eligible for Supplemental Security Income/ Medicaid. The SOURCE program uses primary care physicians on the case management team. In addition to core services of monitoring and assistance with functional tasks, SOURCE recipients can have Assisted Living Services (ALS), extended home health, personal care, home-delivered meals, adult day health care, emergency response services, and 24-hour medical access to a case manager and primary care physician.
Download the SOURCE Fact Sheet

Home Health Services
Home Health Services include skilled nursing, home health aide, and physical, speech and occupational therapy services. Services are provided in the member’s home and require physician orders. Because they are meant to be short term in nature, there is an annual limit on the number of home health visits that can be reimbursed.

Nursing Facility
Nursing Facility services include skilled nursing care, rehabilitation services and health-related care in an institutional setting. People in nursing facilities need around-the-clock nursing oversight. These services also include Intermediate Care Facilities-Intellectual Disability/Developmental Disability (ICF-ID/DD) and swing-bed services.

Hospice includes palliative medical care and services for terminally ill persons and their families. Hospice offers nursing care, medical social services, counseling, medications, medical appliances and supplies, and hospice-aide. Care may be provided in the member’s home or in an inpatient facility, including nursing facilities.

Georgia Pediatric Program (GAPP)
The Georgia Pediatric Program Nursing Program is designed to serve eligible members with nursing services based on medical necessity determination(s) under the age of 21. Members must be medically fragile with multiple systems diagnoses and require skilled nursing and personal care to be considered for services in the GAPP Program.
Applications to the Georgia Pediatric Program are completed by the individual Medicaid providers enrolled to offer services through the program. To view current a list of providers please: visit, select Provider Information, select Provider Manuals and select GAPP specific manual of interest.
GAPP applications must to be submitted to the Alliant Georgia Medical Care Foundation’s (GMCF) Medical Review Team at least thirty (30) days prior to the start of GAPP service.

Community Mental Health Services
Community Mental Health Services are provided to persons 4 years of age and older who have mental illness or issues with substance use or addiction. Services are provided in the community, in outpatient facilities, clinics or inpatient facilities. Services include:

  • Diagnostic assessments
  • Crisis intervention
  • Psychiatric treatment
  • Nursing assessment and care
  • Individual, group and family outpatient therapies
  • Medication administration
  • Behavioral health rehabilitation services
  • Substance abuse and detoxification services
  • Short-term, in-patient care for severely emotionally disturbed youth

For More Information
Visit the DCH website at