I/DD Waivers in Georgia

All states: Medicaid disability services map

Georgia I/DD services at a glance

Last verified against state sources: 2026-10-28.

Who runs I/DD services in Georgia?

Two state agencies share the work. The Georgia Department of Community Health (DCH) is the state Medicaid agency and holds the federal waivers. The Department of Behavioral Health and Developmental Disabilities (DBHDD), through its Division of Intellectual and Developmental Disabilities, runs the two I/DD waivers day to day. Support coordination agencies help each person plan and arrange services.

• Department of Community Health (DCH): Georgia's Medicaid agency. It submits the waivers to the federal Centers for Medicare and Medicaid Services (CMS), enrolls providers in Medicaid and pays claims.
• DBHDD Division of Intellectual and Developmental Disabilities: operates the NOW and COMP waivers. DBHDD Regional Field Offices handle intake, run the planning list (Georgia's waiting list) and authorize services.
• Front door: people apply online through IDD Connects, a portal run by the Georgia Collaborative ASO (administrative services organization, a state contractor), or on paper through a DBHDD Regional Field Office.
• Case management: Support Coordination and Intensive Support Coordination agencies enrolled with DBHDD coordinate each person's services and visit at least once a quarter.

What Medicaid waivers serve people with I/DD in Georgia?

Georgia has two 1915(c) waivers for people with intellectual and developmental disabilities: the New Options Waiver (NOW) and the Comprehensive Supports Waiver Program (COMP). A 1915(c) waiver is a federal Medicaid option that lets a state pay for home and community services instead of institutional care. NOW serves people with less intensive needs who live at home. COMP serves people who need intensive supports, including residential care.

• New Options Waiver Program (NOW, 1915(c), control number GA.0175.R07.00): serves people with an intellectual disability or a closely related developmental disability who meet the level of care for an intermediate care facility and live in their own or a family home. Services include Community Living Support, Community Access (day habilitation), Prevocational Services, Supported Employment, Respite, Support Coordination, Behavioral Supports, adult therapies and dental care, Individual Directed Goods and Services, home and vehicle adaptations, Natural Support Training and transportation. NOW has a lower cost cap than COMP and no residential service. CMS approved the current renewal on June 9, 2023 for five years effective November 9, 2022, for up to 5,615 people in year 1 rising to 6,643 in year 5.
• Comprehensive Supports Waiver Program (COMP, 1915(c), control number GA.0323.R05.00): serves people with I/DD who meet the same level of care and need intensive or comprehensive supports, including out-of-home residential care and people leaving institutions. It offers everything NOW does plus Community Residential Alternative (group home, host home or life sharing, with intensive and specialized options), Additional Staffing, skilled nursing, Financial Support Services and transition services. CMS approved this version on July 14, 2022 for five years effective April 1, 2021. DCH has proposed a renewal starting April 1, 2026 (see the last section).

Georgia also has Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), the institutional level of care that NOW and COMP are an alternative to. Two other Georgia waivers, the Independent Care Waiver Program (ICWP) and the Elderly and Disabled Waiver, serve people with physical disabilities, brain injury or age-related needs and are not I/DD waivers.

Does Georgia pay for I/DD services through managed care?

No. NOW and COMP are paid fee-for-service, which means DCH pays enrolled providers directly for each service they bill. There are no health plans in between. DBHDD authorizes services, and support coordination agencies coordinate them.

• Who pays: DCH, as the Medicaid agency, pays NOW and COMP claims from enrolled providers.
• Who approves services: DBHDD Regional Field Offices authorize services in each person's plan.
• Who coordinates: Support Coordination and Intensive Support Coordination agencies enrolled with DBHDD.

Is there a waiting list for I/DD services in Georgia?

Yes. Georgia limits the number of NOW and COMP slots, and the state does not publish a current count of people waiting. People found pre-eligible go on DBHDD's planning list, with separate lists for NOW and COMP. Openings go to people with the greatest need, not to whoever has waited longest.

• How priority works: DBHDD's planning list page says it looks at health and safety and at the strength of the person's caregiver and support system, not time on the list.
• New slots for 2027: the state budget for fiscal year 2027 (HB 974) sought 900 new NOW and COMP slots. The Governor's signing instructions directed DBHDD to use $2,318,504 for 100 new slots and to hold back the remaining $9,274,016. The budget also fully funded 150 slots added earlier.

For a person's status on the planning list, families can call their DBHDD Regional Field Office or the DBHDD Division of Intellectual and Developmental Disabilities at (404) 232-1622.

How do people apply for NOW and COMP, and how are budgets set?

A person applies online through the Georgia Collaborative ASO's IDD Connects portal or on paper through a DBHDD Regional Field Office. DBHDD schedules a screening within 14 business days of a complete application. People found pre-eligible go on the planning list, and support levels are set with the Supports Intensity Scale (SIS).

• How to apply: the state's NOW and COMP application page and DBHDD's how to apply page explain the steps.
• Eligibility: Medicaid eligibility, plus an intellectual disability that began before age 18 or a closely related condition (such as autism, cerebral palsy or epilepsy) that began before age 22, significant intellectual or adaptive limits, and intermediate care facility level of care.
• Who decides: a DBHDD psychologist decides pre-eligibility. Alliant-Georgia Medical Care Foundation, a state contractor, makes the final level of care decision.
• Assessment: the Supports Intensity Scale (SIS), a standard interview about how much support a person needs, is given every 3 to 5 years and assigns an assessment level that feeds rate tiers. The Health Risk Screening Tool (HRST), which flags health risks, is done each year.

What day and residential services can I/DD providers offer in Georgia?

NOW and COMP both cover three day and employment services: Community Access, Prevocational Services and Supported Employment. Providers must be DBHDD standards compliant agencies with a DBHDD Letter of Agreement. Residential services (Community Residential Alternative) are offered only in COMP, and in-home Community Living Support is offered in both. The details below come from DCH's draft COMP renewal application (August 2025).

Day and employment services (NOW and COMP)

• Community Access (Group and Individual): day habilitation that builds skills and community participation. Group can be center-based or in the community, and Individual is one-to-one teaching and coaching. It cannot be delivered in the person's home or a residential setting. Ratios are 1:1 for Individual, up to 1:10 for center-based group and up to 1:5 for community-based group, with rates tiered by assessed need. Billed in 15-minute units. Providers need a DBHDD Letter of Agreement and DCH enrollment.
• Prevocational Services: teaches work skills in a facility or through small mobile work crews at community sites. It cannot be billed at the same time as Community Access or Supported Employment. Billed in 15-minute units. In COMP it shares an annual maximum of 6,000 units with Community Access Group. The research did not find a published ratio.
• Supported Employment (Individual and Group): job development and ongoing job supports for competitive work in the community, including self-employment. Group supported employment runs from 1:2 to 1:10, with rates that vary by group size. Providers can be standards compliant agencies or individual Employment Specialists who meet DBHDD qualifications. COMP's combined annual maximum is $21,686.40. We did not confirm the billing unit.

Residential and in-home services

• Community Residential Alternative (CRA), group home (COMP only): personal care, supervision and skill training in homes of four or fewer people (older five-person homes may continue until a vacancy opens). Billed on a 344-day year. COMP also offers CRA-Intensive and CRA-Specialized. Homes hold a Personal Care Home permit or a Community Living Arrangement license and must meet DBHDD standards.
• CRA host home or life sharing (COMP only): CRA delivered in a host family's home for two or fewer people, under DBHDD Host Home and Life Sharing Guidelines. A Child Placing Agency license is among the licenses listed for CRA providers.
• Community Living Support (NOW and COMP): personal care and habilitation in the person's own or family home. It can be provider-managed, self-directed or co-employer. Agencies need a Private Home Care Provider license. Billed in 15-minute units and subject to electronic visit verification (EVV).

How are I/DD provider rates set and how do agencies enroll in Georgia?

Georgia pays NOW and COMP providers from a fee schedule built on a 2022 to 2023 rate study by Burns and Associates (Health Management Associates). SIS assessment levels are grouped into rate categories. Agencies enroll first with DBHDD and then with DCH. EVV is required only for Community Living Support.

• Latest rate change: DCH announced on July 11, 2024 that CMS approved NOW and COMP amendments carrying the rate study increases, retroactive to July 1, 2024.
• Wage floor: providers must pay direct support staff at least $14 an hour for services whose rates were set in the rate study.
• Becoming a provider: according to DBHDD's provider enrollment page, new agencies attend a Georgia Collaborative ASO new provider enrollment forum, submit a letter of intent during an open enrollment period, complete the DBHDD application and any site visit, and then apply to DCH for Medicaid enrollment.
• EVV: Community Living Support in NOW and COMP, including self-directed and co-employer support, must use EVV. Residential, day, employment, respite and support coordination services are not subject to EVV. DCH's provider FAQ (March 2021) says the state EVV solution comes from Conduent with Netsmart (Tellus), and that agencies using another EVV system must integrate with it. DCH's current EVV page lists the NOW and COMP Community Living Support codes among EVV services.

What is changing next for I/DD services in Georgia?

The NOW waiver's current five-year approval took effect November 9, 2022, so it ends in November 2027 and a renewal is due. DBHDD is also developing a three-tier planning list, a new assessment tool and a new waiver. As of October 28, 2026, we did not find a NOW renewal notice or any state document with terms or dates for the other three changes.

• NOW renewal: watch DCH for a public notice and draft renewal ahead of November 2027.
• Planning list, assessment tool and new waiver: the DBHDD Board heard presentations on the planning list, an assessment tool and a new waiver at its December 18, 2025 meeting. These are plans in development, not final decisions.
• COMP renewal: DCH proposed renewing COMP for five years, April 1, 2026 through March 31, 2031, pending DCH Board and CMS approval, according to its renewal briefing document. The draft would raise capacity to 8,689 people in year 1 and 10,289 in year 5, offer both employer and budget authority for self-direction, convert several service limits to units, and merge Additional Staffing into one service with two rates. We did not find CMS approval of this renewal, so these terms may change.
• New slots: the fiscal year 2027 budget funds 100 new NOW and COMP slots, as described in the waiting list section.

For the status of any of these changes, ask DBHDD's Division of Intellectual and Developmental Disabilities or check DCH's waiver public notices.

Georgia I/DD sources

• DBHDD: Intellectual and Developmental Disabilities
• DBHDD: Planning list
• Georgia.gov: Apply for the NOW and COMP waiver programs
• DCH: CMS approval letter, NOW waiver renewal GA.0175.R07.00 (June 9, 2023)
• DCH: Draft COMP renewal application (August 2025)
• DCH: Provider rate study CMS approval press release (July 11, 2024)
• DBHDD: Provider enrollment
• Georgia Medicaid: Electronic Visit Verification (EVV)
• Georgia Medicaid: EVV provider frequently asked questions
• Office of the Governor: HB 974 (FY 2027 appropriations) signing document

Related reading

• Disability Services and Independent Living Guide
• Developmental Disabilities vs. Mental Health: Key Differences
• Essential Acronyms in Disability Services: A Quick Reference Guide
• Disability Services DayHab has a dilemma - how to solve it
• I/DD services in every state (map)
• Georgia EVV requirements

Page history

• October 28, 2026: Page rewritten and checked against state sources.

This page is a reference, not legal advice. State rules change, so confirm details with the state before you act on them.

Ankota provides software for I/DD provider agencies, including EVV, service documentation, goal tracking and billing. If you would like to talk through your program, contact Ankota or read more about Ankota's I/DD software.