Waivers

NOW / COMP
Overview

The New Options Waiver (NOW) and the Comprehensive Supports Waiver Program (COMP) offer home- and community-based services for people with a developmental or intellectual disability. A diagnosis of developmental disability includes mental retardation or other closely-related conditions such as cerebral palsy, epilepsy, autism or neurological problems. These are developmental disabilities that require a level of care provided in an intermediate care facility for people who have mental retardation. There are a little over 12,000 people with developmental disabilities served by the NOW/COMP programs in Georgia.

Purpose of the NOW/COMP Waiver Programs

The NOW waiver program enables individuals with less intense and urgent needs than out-of-home residential treatment or extensive waiver services to live independently in the community. Goals for participants in the NOW program include:

  • Increasing the independence and quality of life for people with developmental disabilities
  • Supporting families in caring for relatives with developmental disabilities
  • Increasing the flexibility of service planning and delivery to meet an individual’s needs
  • Avoiding the need for more intensive services

The COMP waiver program is for individuals who need comprehensive and intensive services to live in the community. Individuals eligible for the COMP waiver program need out-of home residential support and supervision or intensive in-home services to remain in the community.

Eligibility

People who are considering nursing institutional care such as Intermediate Care Facilities for people with mental retardation (ICF-MR) may be eligible for home- and community-based services as an alternative through Georgia’s Medicaid waiver programs.

In order to qualify for the waiver programs, the individual must first meet the criteria for Medicaid payment in an institution and certain other criteria. The person is then offered the choice between community-based services or institutional care.

The NOW/COMP Waiver Programs offer the following services, unless otherwise indicated:

  • Adult Occupational Therapy Services
  • Adult Physical Therapy Services
  • Adult Speech and Language Therapy Services
  • Behavioral Supports Consultation Services
  • Community Access Services
  • Community Guide Services
  • Community Living Support Services
  • Community Residential Alternative Services(COMP only)
  • Environmental Accessibility Adaptation Services
  • Financial Support Services
  • Individual Directed Goods and Services
  • Natural Support Training Services
  • Pre-vocational Services
  • Respite Services
  • Specialized Medical Equipment Services
  • Specialized Medical Supplies Services
  • Support Coordination Services
  • Supported Employment Services
  • Transportation Services
  • Vehicle Adaption Services

TEFRA / Katie Beckett Program
TEFRA / Katie Beckett Program

Applications for Katie Beckett may be filed online or with the Centralized Katie Beckett Medicaid Team:

Right From the Start Medicaid Project
Centralized TEFRA/Katie Beckett Medicaid Team
5815 Live Oak Parkway
Suite D-2
Norcross, GA 30093-1700
678-248-7449 (phone)
678-248-7459 (fax)
Overview

The Department of Community Health (DCH) provides Medicaid benefits to eligible children through the TEFRA / Katie Beckett Medicaid program under §134 of the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 (P.L. 97-248). States are allowed, at their option, to make these Medicaid benefits available to children age 18 or younger (living at home) who qualify as disabled individuals under §1614(a) of the Social Security Act as long as certain conditions are met, even though these children would not ordinarily be eligible for Supplemental Security Income (SSI) benefits because of parental income or resources. The specific statutory provisions establishing this option are contained in §1902(e) of the Social Security Act.

Who Is Eligible?

For Medicaid eligibility to be established under the TEFRA / Katie Beckett Program, it must be determined that the child:
kate-beckett-img-1

  • Is 18 years old or younger, AND
  • Meets federal criteria for disability, AND
  • Is financially ineligible for SSI benefits, AND
  • Requires a level of care provided in a hospital, skilled-nursing facility or intermediate-care facility (including an intermediate-care facility for people with intellectual disabilities); AND
  • Can appropriately be cared for at home, AND
  • Has an estimated cost of care outside of the institution that will not exceed the estimated cost of treating him/her within the institution
How Are Level of Care and Eligibility Determined?
  • Treating physicians, parents and others (school guidance counselors, therapists, etc.) complete the required clinical documents. The parents or legal guardians complete the Medicaid application.
  • The Katie Beckett Medicaid Team (the Team) receives the Medicaid application and required clinical documents.
  • The Team submits the clinical documents to Georgia Medical Care Foundation (GMCF) for determination of level of care and disability (if appropriate).
  • GMCF, under the direction of a pediatrician, pediatric neurologist and nurse, performs the clinical review of the required documents for level of care determination and disability determination (if appropriate).
  • If level of care, disability and all other eligibility criteria are met, the Team certifies Medicaid eligibility for the recipient.
Resources
  • The Georgia Pediatric Program (GAPP) provides specialized medical services to Medicaid-eligible members who are medically fragile and under age 21 based on a medical necessity determination.
  • The Champions for Children Program increases awareness throughout Georgia about non-profit services available to children who are medically fragile and children with special needs, increases access to health care and support services, and helps families continue to care at home for children with disabilities. For more information, visit its website.
  • Babies Can’t Wait (BCW) is Georgia’s statewide interagency service delivery system for families of infants and toddlers with developmental delays or disabilities. The Georgia Department of Public Health (DPH) is the lead agency for the Babies Can’t Wait Program. For more information about BCW, visit the web page.
  • The Children’s Medical Services (CMS) Program provides a comprehensive system of health care for children and youth with eligible chronic medical conditions from birth to 21 years of age. Its program is intended to ensure specialty health care services to these children in Georgia who live in low-income households. The CMS program works to provide improved health outcomes for children with special health care needs by coordinating their access to affordable quality specialty health care in communities and by using resources in a responsible manner. For more information about the CMS program, visit the web page.
For More Information

To learn more about TEFRA/Katie Beckett, visit the DCH website.