How do I change a service provider or case management agency?

The short answer

Tell your case manager. Say which provider you want to change, and whether you already have one in mind. The case manager is obliged to tell you what providers are available in your geographic area and to let you choose among them, and then to coordinate the change so your care continues.

This applies to a service provider – the agency that sends the helper, delivers the meals, runs the day program – and it applies to the case management agency itself.

The rules behind it

Two provisions of Georgia’s waiver rules do the work here.

§1894 gives the member the right to choose their Traditional or Enhanced EDWP provider. It is a right held by the member, not a permission granted by an agency.

§1896 puts the corresponding duty on the case manager: to inform the member of the providers available in their geographic area, and to let the member choose. That duty is not discharged once at enrollment. A member who asks later is entitled to the same information.

There is a third rule worth knowing. §1834.13 means no provider may require a member to take all of their services from that provider or a company connected to it. Bundling is not allowed, and a member who is told otherwise should say so to their case manager.

Together these mean the choice is real and it stays open. Choosing an agency at enrollment does not lock a member in for as long as they are on the waiver.

What actually happens

The process is administrative and, done properly, unremarkable.

1. You say you want to change. In a call, a visit, a letter or a message. It does not have to be formal, and it does not require a reason.
2. You are told what is available. The providers in your geographic area that offer the service in question, presented as options rather than a recommendation.
3. You choose. Take time over it if you want. Ask questions of the agencies themselves.
4. The change is coordinated. Effective dates, records, and the plan of care are handled between the outgoing provider, the incoming provider and the case manager, with the aim that care does not stop.
5. The plan follows you. Eligibility, the level-of-care determination and the plan of care do not restart. There is usually an introductory visit and some paperwork with the new agency.

Changing the case management agency

Including this one.

If a member decides another case management agency suits them better, they are entitled to move, and the change is handled the same way. It is not treated as a complaint, it does not require a falling-out, and it does not put anything about their waiver eligibility at risk.

An agency that reacts to that request by making it difficult is telling you something about how it works. The right response is to give the member the information they are entitled to and to coordinate the change cleanly.

If the problem is a service, not the provider

Changing providers is not always the right tool. If the issue is that visits are being missed, the first step is usually faster and simpler: raise it with the provider, then with the case manager. Many staffing problems are fixable inside a week, and a change of agency is a slower fix than a change of schedule. See what to do if a service isn’t showing up.

If a member wants both – the service fixed and a formal record made – they can do both. Complaints and provider changes are separate routes, and using one does not close the other. The complaints page sets out the routes, including for complaints about this agency.