Georgia NOW vs COMP Waiver Comparison: Which Waiver Fits Your Child

Two Waivers, Two Levels of Support

Georgia's Department of Behavioral Health and Developmental Disabilities (DBHDD) operates two Medicaid Home and Community-Based Services waivers for individuals with intellectual and developmental disabilities: the New Options Waiver (NOW) and the Comprehensive Supports Waiver Program (COMP). Both keep people in their communities rather than institutions, but they serve very different levels of need.

NOW is designed for individuals who can live with family members or independently with moderate community supports. It funds services like community access, behavioral support, respite care, and supported employment — but under a lower annual funding cap.

COMP is reserved for individuals with higher-intensity medical or behavioral needs. It covers everything NOW covers, plus intensive residential options like Host Homes and Community Residential Alternatives for individuals who cannot safely live with family.

Both share the same clinical eligibility criteria. The difference is the intensity and cost of services the individual needs.

Eligibility: The Same Threshold for Both

Clinical eligibility for both NOW and COMP requires:

• A documented intellectual disability with onset prior to age 18, or a developmental disability (autism, cerebral palsy, epilepsy, or similar) with onset prior to age 22
• Significant limitations in functional adaptive behavior across multiple domains
• A demonstrated need for an Intermediate Care Facility (ICF/IID) level of care

The determination is made through the IDD Connects portal, operated by the Georgia Collaborative ASO. Families submit psychological evaluations, adaptive behavior assessments, and school records to establish eligibility. Being found eligible places the individual on the planning list — it does not start services.

The Planning List Is Not a Queue

This is the most misunderstood part of Georgia's waiver system. The DBHDD planning list is not first-come, first-served. In late 2025, approximately 7,900 individuals were on the NOW/COMP planning list, with roughly 2,100 adults waiting six or more years.

DBHDD allocates waiver slots based on clinical urgency using an objective needs assessment tool and a "most-in-need" questionnaire. Priority goes to individuals facing acute crises: homelessness, abuse, neglect, or the loss of an aging primary caregiver. A student aging out of school at 22 does not automatically move to the front.

This means the application timeline matters enormously. Submitting the IDD Connects application during high school — ideally by tenth grade — establishes the individual on the list and begins documenting their needs history. Families must then report any change in caregiver health, housing stability, or the individual's behavioral needs to their Regional Field Office immediately, because those changes can trigger a re-evaluation and shift their priority ranking.

Key Differences Between NOW and COMP

Residential supports. NOW funds community living supports that help individuals live with family or in their own homes. COMP funds more intensive residential placements — Host Homes (where a trained provider shares their home with the individual), Community Residential Alternatives (group homes), and other out-of-home options.

Funding cap. NOW operates under a lower annual funding ceiling. COMP has a higher ceiling to accommodate intensive 24/7 residential and behavioral supports. The exact amounts are set annually by DBHDD.

Service array. Both waivers cover community access, supported employment, respite, behavioral supports, and specialized medical equipment. COMP adds intensive residential services that NOW doesn't include.

Participant Direction. Both waivers allow Participant Direction, which gives the individual or their family employer authority and budget authority. Under Participant Direction, families can hire their own support staff — including family members in some cases — manage schedules, and direct how services are delivered. This is a powerful option for families who want to maintain control over who provides care and how their budget is allocated.

Which One to Apply For

You don't have to choose one waiver at the application stage. The IDD Connects application establishes eligibility for both, and the specific waiver is determined when a slot becomes available based on the individual's assessed level of need.

That said, understanding the distinction helps with long-term planning:

• If your adult child can live safely at home with moderate daily support, community access, and employment assistance, NOW is likely the match.
• If your adult child needs 24/7 supervision, intensive behavioral intervention, or residential placement outside the family home, COMP is the appropriate level.
• If you're unsure, apply early and keep the needs assessment current. The individual's placement on NOW vs. COMP is determined by DBHDD based on the documented level of need — not by the family's preference.

Don't Wait for Age 22

A dangerous misconception, repeated in some local transition timelines, is that waiver funding "typically starts when the student turns 22" or that aging out of school triggers waiver activation. Neither is true. DBHDD allocates slots based on clinical urgency, not school exit dates. A student can wait on the planning list for years after leaving school.

The counter-strategy is early application and aggressive documentation. Apply through IDD Connects during high school, report every change in circumstances to the Regional Field Office, and treat the annual needs assessment as an opportunity to make sure DBHDD's records reflect your child's actual situation.

The Georgia IEP Transition to Adulthood Guide includes the full IDD Connects application walkthrough, a comparison of NOW and COMP services and funding structures, and a documentation strategy for maximizing planning list priority during the school-to-adult transition.

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