Georgia IDD Waiver Services: HCBS, Self-Directed, and Day Programs

What IDD Waiver Services Are (and Are Not)

Georgia's home and community-based services (HCBS) waivers — the New Options Waiver (NOW) and Comprehensive Supports Waiver (COMP) — fund supports that keep adults with intellectual and developmental disabilities living in the community instead of institutions. Both waivers are administered by the Department of Behavioral Health and Developmental Disabilities (DBHDD) and funded through Medicaid under Section 1915(c).

The critical thing to understand: these waivers pay for services, not for a single program slot. Once you have an active waiver, you assemble a package of services tailored to the individual's needs and goals. The two waivers share most service categories but differ in intensity — COMP covers 24-hour residential care while NOW serves individuals who need less intensive support.

Core Service Categories

Both NOW and COMP waivers fund the following service types. Your DBHDD support coordinator helps you build a service plan that draws from these categories based on an individual needs assessment.

Community Living Supports. Staff assist with daily living activities — personal care, meal preparation, household management, community navigation, and social skills. This is the backbone service for most waiver participants.

Day Services and Prevocational Training. Structured programs during business hours that build skills for employment and community participation. Georgia operates both facility-based day programs and community-integrated options. Facility-based programs provide group activities in a center setting; community-integrated programs take participants into actual workplaces and community settings for hands-on learning.

Supported Employment. Job coaching and on-the-job support for competitive, integrated employment. A job coach helps the individual learn their work duties, navigate workplace social dynamics, and maintain their position over time. Supported employment can also include job development — identifying and negotiating job opportunities that match the individual's strengths.

Respite Care. Temporary relief for primary caregivers. Both waivers fund planned respite (scheduled breaks) and crisis respite (emergency situations). Respite can be provided in the family home or in an approved respite facility.

Specialized Medical Equipment and Supplies. Items not covered by the standard Medicaid State Plan — adaptive equipment, vehicle modifications, environmental accessibility modifications, and other assistive technology.

Community Access. Transportation and activity supports that help the individual participate in community life — recreation, shopping, volunteering, worship, and social events.

Self-Directed Services: You Control the Budget

Georgia's self-directed option puts the waiver participant (or their representative) in charge of hiring, training, scheduling, and managing their own support staff. Instead of receiving services through a provider agency, the individual gets an approved budget and makes their own staffing decisions.

Self-direction is often the only practical option in rural Georgia, where provider agencies are scarce. Even in metro Atlanta, families choose self-direction because it gives them control over who works with their family member and when.

Under self-direction, a fiscal intermediary handles payroll, tax withholding, and worker's compensation insurance. The participant or representative selects workers, sets schedules, and determines how budget hours are allocated across service categories. DBHDD provides a support broker to help with administrative tasks and service coordination.

The trade-off is real: self-direction requires significant administrative work from the family. You become an employer. You handle hiring, scheduling conflicts, backup staffing when workers call out, and ongoing documentation. For families with the capacity to manage this, the control and flexibility are worth it. For others, an agency-based model with an established staff roster is a better fit.

NOW vs. COMP: Which Waiver Covers What

Both waivers require Medicaid eligibility (individual income under the $2,982 monthly Medicaid cap for 2026) and an Intermediate Care Facility (ICF/IID) level of care determination.

NOW Waiver is designed for individuals who live with family or in their own home and need periodic support — not 24-hour supervision. NOW funds community living supports, day services, supported employment, respite, and specialized equipment. It does not fund residential placements.

COMP Waiver covers everything NOW does plus intensive residential services — host homes, group homes, and 24-hour supervised settings. COMP is for individuals whose needs exceed what family caregivers and part-time supports can handle.

Both waivers are capped programs with a shared Planning List. As of late 2025, approximately 7,900 Georgians were on the combined NOW/COMP Planning List, and 43% of adults had been waiting six or more years.

Getting on the Planning List Is Not Getting Services

Being found pre-eligible and placed on the DBHDD Planning List does not activate any waiver services. The Planning List is a triage queue, not a first-come-first-served waitlist. DBHDD prioritizes individuals based on immediate need:

• Short-term (within 90 days): Immediate crisis — caregiver death, homelessness risk, abuse
• Medium-term (within 6 months): Significant needs with stressed but stable caregivers
• Long-term (1+ year): Stable family supports with anticipated future need

To improve your priority, you must submit updated documentation to your DBHDD Regional Field Office whenever circumstances change — a caregiver health crisis, a change in living situation, escalating behavioral needs. Ask your regional office: "What is our specific priority categorization, and what documentation would demonstrate that our needs require a higher priority?"

The Georgia SSI at 18 & Adult Disability Benefits Guide includes a DBHDD application walkthrough, a Waiver Application Checklist, and an Agency Communication Log designed for tracking every contact with your regional field office — so nothing gets lost in the years-long wait.

See more Georgia guides →