Georgia runs two Medicaid waivers for people with intellectual and developmental disabilities. The New Options Waiver (NOW) serves adults who do not need around-the-clock care, and the Comprehensive Supports Waiver (COMP) serves those who do. Both are capped, so eligible Georgians join a Planning List that held roughly 7,900 people in September 2025. This guide explains who qualifies, what each waiver covers, how the Planning List works and how DBHDD prioritizes it, and how to apply.

Who qualifies for the Georgia NOW Waiver and COMP Waiver

Both the New Options Waiver (NOW) and the Comprehensive Supports Waiver (COMP) use the same gateway. A person must have an intellectual disability, or a closely related developmental disability such as autism, cerebral palsy, or epilepsy, that substantially impairs intellectual or adaptive functioning. The disability must have originated during the developmental years: by age 18 for an intellectual disability, or by age 22 for a developmental disability. The person must meet an institutional level of care equivalent to an intermediate care facility for individuals with intellectual disabilities (ICF/IID) and be a Georgia resident.

Financial eligibility runs through the Medicaid Cap special income standard, which is 300% of the federal Supplemental Security Income (SSI) Federal Benefit Rate. In 2026 the SSI Federal Benefit Rate is $994 per month for one person, so the 300% special income standard is $2,982 per month. For an adult age 18 or older, only the applicant's own income and resources count; parental income is not counted. That is one reason waiver enrollment matters so much for adult children of higher-income families who would not qualify for ordinary Medicaid.,

The difference between the two waivers is the level of support, not the diagnosis:

Feature New Options Waiver (NOW) Comprehensive Supports Waiver (COMP)
Who it serves Adults with I/DD who do not need 24-hour care Adults with I/DD who need 24-hour care or higher-intensity supports
Typical living setting Family home or own apartment Family home, Host Home, or a Community Residential Alternative
Residential placement Not included Community Residential Alternatives and Host Home / Life Sharing
Eligibility gateway I/DD onset by 18/22, ICF/IID level of care, 300% SSI income standard Same gateway as NOW
Administering agency DBHDD DBHDD

What the Georgia NOW Waiver covers

The New Options Waiver funds community-based supports for adults who live with family or independently and do not need around-the-clock care. Services authorized in the person's Individual Service Plan (ISP) include:

  • Community Living Supports (CLS): personal care, supervision, and community engagement in home and community settings, authorized in hours based on individual need.
  • Respite: short-term, in-home or out-of-home relief for unpaid family caregivers.
  • Supported Employment: job development, on-site coaching, and follow-along support to obtain and keep competitive integrated employment.
  • Prevocational Services: skill-building toward competitive integrated employment.
  • Behavior Supports: assessment and behavior-support-plan development by qualified specialists.
  • Specialized Medical Equipment, Environmental Accessibility Adaptations (home modifications such as ramps and grab bars), and Vehicle Adaptations.
  • Support Coordination, Community Access, and Natural Support Training for unpaid family members.

NOW participants can choose Participant Direction, in which the individual or family hires and schedules workers while a financial management services entity handles payroll and tax withholding. Self-direction gives the participant employer authority over their workers and budget authority over an individualized service budget. Georgia does allow a relative to be hired, through NOW and COMP Family Hire, but never automatically: each hire is approved case by case with documented hardship, regional review, and annual renewal. A spouse, the parent of a minor recipient, a legal guardian, and a conservator are barred, and so is the person named as the participant's Representative for Participant-Directed Services. The parent of an adult recipient is allowed. Personal-support hours delivered under self-direction are subject to Electronic Visit Verification, so directly hired workers clock in and out the same way agency staff do.

What the Georgia COMP Waiver covers

The Comprehensive Supports Waiver covers everything NOW covers, plus the residential and high-intensity supports that adults who need 24-hour care require:

  • Community Residential Alternatives (CRA): small group homes serving two to four people with 24-hour staff support.
  • Host Home / Life Sharing: the person lives in the home of a paid host family that provides 24-hour support under DBHDD oversight.
  • Community Living Supports up to 24 hours a day for people who live in a family home or their own apartment with intensive supervision needs.
  • Supported Living: semi-independent living in the person's own apartment with scheduled staff visits and on-call support.
  • Intensive Behavior Supports, Transportation to and from waiver services, and Crisis Stabilization during behavioral or medical crises.

Under the federal Home and Community-Based Services (HCBS) Settings Rule, provider-controlled residential settings such as Community Residential Alternatives and Host Homes must give residents a legally enforceable lease or residency agreement, lockable doors, control over their own schedules and activities, access to food at any time, and the freedom to have visitors.

How the Georgia Planning List works

Because NOW and COMP are capped under federal Section 1915(c) waiver rules, Georgia cannot enroll everyone who is eligible at once. People who qualify are placed on the Planning List, the official waiting list the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) maintains. Roughly 7,900 individuals were on the Planning List in September 2025. About 3,000 of them (38%) were under age 22, and about 4,900 were age 22 or older; 43% of those adults (2,100 of 4,900) had been waiting at least six years, and nearly all of them were waiting for NOW services. On average, people on the list had been waiting nearly five years.

How people come off that list is the part families most often get wrong. Prioritization is based on need rather than the length of time on the Planning List. DBHDD typically prioritizes the individuals with the greatest unmet needs, and those with more urgent circumstances, as classified under DBHDD's own criteria, may receive services first. Georgia restructured its waiver waitlist in 2024 into three tiers: the Planning List, the Short-Term Planning List, and the Active Waitlist.

New waiver slots come from state appropriations: funding for new slots in fiscal year 2025 totaled about $4.68 million ($2.35 million appropriated in fiscal year 2025 plus an annualized $2.33 million in fiscal year 2026).

When the situation becomes urgent

Because DBHDD prioritizes by need, a change in circumstances is what moves a person up, not another year of waiting. If a caregiver dies or can no longer provide care, if housing becomes unstable, or if a behavioral or medical situation escalates, report it to the DBHDD Regional Field Office and document it. DBHDD classifies urgency under its own criteria, and it cannot weigh a change it does not know about. Ask the Regional Field Office what documentation it needs rather than assuming your situation will not count. Urgency is not a valve that can absorb the whole Planning List, though: the average wait on it is nearly five years.

What does a Support Coordinator do?

When a person enrolls in NOW or COMP, DBHDD assigns a Support Coordinator. To satisfy the federal conflict-free case-management rule, the Support Coordinator is independent and is not employed by any waiver service provider. The Support Coordinator conducts person-centered planning, writes and updates the Individual Service Plan (ISP), monitors the services and providers the plan authorizes, reviews the ISP at least annually, and connects the person to non-waiver resources such as SSI, Vocational Rehabilitation, and ABLE accounts. For most families, the Support Coordinator is the primary contact within the waiver system, and the annual ISP review is the main opportunity to adjust hours, add providers, and document changing needs.

Who pays for that coordination depends on where you sit in the system. For someone enrolled in NOW or COMP, the Support Coordinator's work is funded as a Section 1915(c) waiver service. For someone still on the Planning List, the same functions may be available as standalone Targeted Case Management under Section 1915(g), a State Plan benefit that needs no waiver slot. The work is largely the same and the coordinator may be the same person; only the billing authority differs, because DBHDD-contracted support coordination agencies deliver both. Alongside the ISP, that work covers assessment of intellectual and adaptive functioning, coordination with direct support professionals, day programs and residential providers, behavioral and therapy coordination, family and respite support, and transition planning across life stages.

What federal law governs NOW and COMP?

Both waivers operate under Section 1915(c) of the Social Security Act (42 U.S.C. 1396n(c)), which lets a state cover home and community-based services for people who would otherwise need institutional care. Every 1915(c) waiver rests on three federal tests: cost neutrality (the average per-person waiver cost cannot exceed what institutional care would have cost), an individual level-of-care determination reassessed at least annually, and a federally permitted cap on the number of people served. That cap is what creates the Planning List.

Georgia's emphasis on community placement traces to Olmstead v. L.C., the 1999 U.S. Supreme Court decision brought by two Georgia plaintiffs, which held that Title II of the Americans with Disabilities Act (ADA) requires states to serve people with disabilities in the most integrated setting appropriate to their needs. After a federal investigation, the United States and Georgia entered a 2010 settlement agreement that required the state to expand NOW and COMP enrollment, build 24/7 mobile crisis services, and grow supported employment. That agreement remains a central driver of Georgia's I/DD policy.

How to apply for a Georgia I/DD waiver

For families just beginning, the application steps are straightforward, even if the wait that follows is not:

1
Step 1

Apply online through the Individual IDD Connects portal

Applications for NOW and COMP are submitted through the Georgia Collaborative Administrative Services Organization (ASO). The DBHDD Regional Field Office helps families who need assistance with the application.

2
Step 2

Complete the eligibility evaluation

DBHDD confirms the I/DD diagnosis with developmental-years onset and the institutional (ICF/IID) level of care, and verifies Medicaid financial eligibility under the 300% SSI income standard.

3
Step 3

Join the Planning List

Individuals found pre-eligible are placed on the I/DD Planning List for NOW and COMP, and DBHDD prioritizes from it by assessed need rather than by time waiting.

4
Step 4

Tell DBHDD when the situation changes

If a caregiver dies or can no longer provide care, or another urgent change arises, report it to the Regional Field Office with documentation: those with more urgent circumstances under DBHDD's criteria may receive services first.

5
Step 5

Work with your Support Coordinator once a slot opens

When a waiver slot becomes available, the Support Coordinator builds your Individual Service Plan and connects you to providers.

Apply as soon as you are eligible, but be clear about what that buys you. Time on the Planning List is not what moves a person up; DBHDD prioritizes based on need rather than length of time waiting. What an early application does is get the person found pre-eligible and onto the list, so they are already in the system when circumstances change. Keep the Regional Field Office informed as needs shift.

A few things families commonly miss

  • The Planning List does not provide services. It places you in the queue for future enrollment. State Plan Medicaid services such as medical care, prescriptions, and standalone Targeted Case Management remain available, but waiver-specific services do not start until a slot opens.
  • Katie Beckett is a separate pathway for children. Children under 18 with significant disability may qualify for Georgia's Katie Beckett (TEFRA) pathway, which also does not count parental income; many children transition to NOW or COMP at adulthood.
  • ABLE accounts protect savings. A Georgia STABLE account, the State of Georgia ABLE Plan, lets an eligible person save without losing means-tested benefits, with a base contribution limit of $20,000 in 2026 and balances up to $100,000 excluded from the SSI resource limit.
  • Some relatives can be paid caregivers, but never a spouse. Georgia Medicaid does not pay a spouse on any self-direction route; only VA programs and private pay can. Other relatives, including the parent of an adult recipient, can be hired under NOW and COMP Family Hire, approved case by case with documented hardship, regional review, and annual renewal.
  • 988 connects to crisis help. For a behavioral-health crisis, 988 in Georgia is answered 24/7 by the Georgia Crisis and Access Line (GCAL), which can dispatch mobile crisis teams.

Worked examples

These examples are hypothetical and illustrative; they show how the rules apply, not the experience of specific individuals. Each draws on the same NOW and COMP service menu and eligibility gateway described above.,

Example #1: NOW Waiver and supported employment

A 24-year-old adult with autism lives with a parent and finished high school through an IEP-supported transition plan. The family applied for the New Options Waiver at age 19 and joined the Planning List, and because the adult was stable at home the assessed need was not urgent. After several years, a NOW slot opened, and the Support Coordinator built an ISP with Community Living Supports during the parent's work hours, Supported Employment at a local grocery store, and Behavior Supports. The family chose self-direction and hired a special-education student as the primary worker.

Example #2: COMP Waiver after a caregiver dies

A 32-year-old with cerebral palsy and intellectual disability lived with a parent who was the primary caregiver. The family had been on the Planning List for COMP for years when the parent died suddenly. With no one able to provide the 24-hour care the person needed, a relative reported the change to the DBHDD Regional Field Office with documentation of the caregiver's death and the person's medical needs. DBHDD treated the situation as urgent under its own criteria, and the person moved into a Host Home with a trained host family.

Example #3: COMP Waiver for an aging-out young adult

A 19-year-old who was in foster care has an intellectual disability and needs supports for the transition to adulthood. As foster care ended, the child-welfare agency and DBHDD coordinated an expedited COMP enrollment on the strength of the urgency of the situation. The Individual Service Plan placed the young adult in a Community Residential Alternative with two other residents and 24-hour staff, continued Supported Employment from high school transition planning, and added Community Living Supports oriented toward independent-living skills.

Example #4: NOW Waiver as parents plan ahead

A 28-year-old with Down syndrome works in food service and lives with parents in their early sixties. The family applied for NOW anticipating future transition needs and, after two years on the Planning List, a slot opened. The ISP added on-the-job coaching, after-work Community Living Supports, and Behavior Supports. The family opened a Georgia STABLE account to save for the future and is exploring a Host Home transition over the next several years as the parents age.

Frequently Asked Questions

What is the difference between Georgia's NOW and COMP waivers?

NOW (New Options Waiver) funds lower-intensity supports for adults with I/DD who do not need 24-hour care and typically live with family or independently. COMP (Comprehensive Supports Waiver) funds higher-intensity supports for adults who need 24-hour care, including residential placements such as Host Homes and Community Residential Alternatives. The eligibility gateway is the same for both.

Who is eligible for NOW or COMP?

Both waivers require an intellectual or developmental disability that began during the developmental years (by age 18 for an intellectual disability, or age 22 for a developmental disability), an institutional (ICF/IID) level of care, Georgia residency, and Medicaid financial eligibility under the 300% SSI special income standard, which is $2,982 per month for one person in 2026. For adults 18 and older, parental income does not count.,

How do I apply for a Georgia I/DD waiver?

Applications are submitted online through the Georgia Collaborative Administrative Services Organization (ASO) Individual IDD Connects portal. If you need help applying, contact your DBHDD Regional Field Office, which assists families through intake and eligibility evaluation.

How long is the Georgia Planning List?

About 7,900 Georgians were on the NOW/COMP Planning List in September 2025. Of the roughly 4,900 who were age 22 or older, 43% (2,100 people) had been waiting at least six years, and the average wait across the whole list was nearly five years.

How does DBHDD decide who comes off the Planning List?

By need, not by seniority. DBHDD says prioritization is based on need rather than the length of time on the Planning List: it typically prioritizes the individuals with the greatest unmet needs, and those with more urgent circumstances, as classified under DBHDD's criteria, may receive services first. That is why reporting a change in circumstances to your Regional Field Office matters more than waiting quietly.

Can a family member be paid to provide care?

Under Participant Direction, the individual or family can hire and manage workers while a financial management services entity handles payroll and taxes. A spouse cannot be paid through Georgia Medicaid on any route. Other relatives, including the parent of an adult recipient, can be hired under NOW and COMP Family Hire, approved case by case with documented hardship, regional review, and annual renewal. Self-directed personal-support hours are subject to Electronic Visit Verification.

NOW and COMP contacts

Use these contacts to apply, navigate the Planning List, report a change in circumstances, or reach crisis help.,

DBHDD Regional Field Office Help with NOW and COMP applications and with reporting a change in need. dbhdd.georgia.gov
Individual IDD Connects portal (Georgia Collaborative ASO) The online application pathway for NOW and COMP. dbhdd.georgia.gov/be-dbhdd/be-compassionate/how-do-i-apply-dd-services
Georgia Crisis and Access Line (GCAL) / 988 24/7 behavioral-health crisis response, including mobile crisis teams. 1-800-715-4225 (or dial 988)
Georgia Department of Community Health (DCH) Medicaid Member Services General Georgia Medicaid questions and eligibility status. 1-866-211-0950https://www.gabar.org/about-the-bar/contact-us dch.georgia.gov
Georgia Council on Developmental Disabilities (GCDD) Policy advocacy and family support for people with I/DD. 1-404-657-2126
Parent to Parent of Georgia Peer support and navigation help for families. 1-770-451-5484

Learn More

MedicaidGeorgia Medicaid HCBS WaiversGeorgia's four Medicaid HCBS waivers in 2026: who EDWP (CCSP and SOURCE), ICWP, NOW, and COMP serve, the 300% SSI limit, the planning list, and how to apply. MedicaidGeorgia ICWP WaiverGeorgia's Independent Care Waiver Program (ICWP) funds home care for adults 21-64 with severe physical disabilities or TBI. Eligibility, services, how to apply. MedicaidGeorgia Katie Beckett (TEFRA) PathwayGeorgia's Katie Beckett Deeming Waiver (TEFRA) covers a child with a significant disability on the child's own income, through the month the child turns 19. MedicaidGeorgia Medicaid Self-Directed Services and Section 1915(j)Georgia's Medicaid program inventory lists no standalone Section 1915(j) program. Here are the self-direction and family-caregiver-payment paths that do exist. MedicaidGeorgia Medicaid: How to ApplyHow to apply for Georgia Medicaid in 2026: Georgia Gateway, your local DFCS office, Form 700, the documents you need, processing timelines, and how to appeal. MedicaidGeorgia Medicaid Targeted Case ManagementGeorgia Medicaid Targeted Case Management (TCM) under Section 1915(g): who qualifies (SMI, SED, I/DD, HIV/AIDS, CSHCN), who delivers it, and how to get it.

Find personalized help navigating Georgia's NOW and COMP Waivers at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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