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Which Georgia Medicaid waiver is my family member in?

Draft — not approved for publication. This page is excluded from the sitemap and set to noindex. Every page needs a named approver before it goes live — DCH General Services §605.1.28 makes each published version a retained advertising record.

Georgia runs several Medicaid home and community based waivers, each for a different group. EDWP serves older adults and adults with disabilities who need a nursing-home level of care. ICWP serves adults with severe physical disabilities. NOW and COMP serve people with intellectual and developmental disabilities. GAPP serves medically fragile children.

Why there is more than one waiver

Georgia does not run a single home care program. It runs several Medicaid waivers, each written for a different group of people, each with its own eligibility rules, its own front door and its own agencies. That is why two families in the same neighborhood, both getting help at home paid for by Medicaid, can be in completely different programs with different rules.

The names get used loosely, so it is common for a family to say they are ‘on the waiver’ without knowing which one. Below is the plain version of who each one is for.

The main Georgia waivers at a glance

ProgramWho it is generally forNotes
EDWP – Elderly and Disabled Waiver ProgramOlder adults, and adults with disabilities, who meet a nursing-home level of careDelivered two ways: CCSP and SOURCE. This is the waiver this site is about.
ICWP – Independent Care Waiver ProgramAdults with severe physical disabilities, including traumatic brain injury, who would otherwise need hospital or nursing facility careBuilt around independent living in the community
NOW and COMP – New Options Waiver and Comprehensive Supports Waiver ProgramPeople with intellectual and developmental disabilitiesAdministered through the Department of Behavioral Health and Developmental Disabilities. COMP is for more intensive support needs than NOW.
GAPP – Georgia Pediatric ProgramMedically fragile children who need skilled nursing care at homeA children’s program, so age limits apply

This table is a signpost, not an eligibility determination. Each program has detailed rules about age, level of care, diagnosis and finances, and those rules change. Nobody should conclude from a table that their family member does or does not qualify for anything.

How to tell which one you are looking at

Three questions usually settle it.

How old is the person, and what is the underlying need? A medically fragile child is a GAPP question. An adult with an intellectual or developmental disability is a NOW or COMP question. An older adult who is becoming unsafe at home is an EDWP question.

Would they otherwise need institutional care, and what kind? Waivers exist because they cost the state less than the institution they replace. Which institution the program is measured against – a nursing facility, a hospital, an intermediate care facility – is a large part of what separates one waiver from another.

Which agency is coordinating? If the paperwork says CCSP, SOURCE, or names a case management agency, that is EDWP. If it names a support coordinator through the Department of Behavioral Health and Developmental Disabilities, that is NOW or COMP.

Where to ask if you still do not know

For older adults and adults with disabilities, the front door is the Area Agency on Aging, which runs the Aging and Disability Resource Connection. They do the intake, they do the level-of-care screening, and they can tell you whether EDWP is the right program to be pursuing. In metro Atlanta the Area Agency on Aging is the Atlanta Regional Commission, and its service is called Empowerline.

For intellectual and developmental disability services, the route is through the Department of Behavioral Health and Developmental Disabilities regional office rather than the Area Agency on Aging.

If your family member is already receiving services and you simply cannot work out from the paperwork which program it is, ask whoever writes the care plan. It is a reasonable question, and the answer changes what you should be asking for next.

Questions people ask about this

How do I find out which waiver my mother is already on?

Her case manager or care coordinator can tell you, and so can the paperwork from her most recent care plan or annual review. If she has neither to hand, the Area Agency on Aging or ADRC that handled the intake can point you to who is holding her case.

Can a person be on two Georgia waivers at once?

No. A person is enrolled in one home and community based waiver at a time. If someone appears to fit more than one, the question is which program matches their needs and their eligibility, not which two they can combine.

What happens to a waiver when a child turns eighteen or twenty-one?

Programs built for children have age limits, so a young person can age out of one and need to move to an adult program. That transition takes planning and it should be started well before the birthday, not after it.

Is a Medicaid waiver the same as Medicaid?

No. Medicaid is the health coverage. A waiver is a separate program that uses Medicaid funds to pay for long-term care at home for people who would otherwise need care in an institution. A person generally needs Medicaid eligibility to use a waiver.

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