Georgia’s programs for children with disabilities do different jobs, so most families need more than one. Katie Beckett gets a child Medicaid when the family’s income is too high. GAPP pays for nursing and personal support at home. Medicaid’s autism program pays for autism therapy. NOW and COMP fund long-term supports for intellectual and developmental disabilities, from a planning list. The Elderly and Disabled Waiver, home of Structured Family Caregiving, serves frail elderly and disabled Georgians who need nursing home level care.
Parents are often handed these names in a rush, by a discharge planner or a therapist, with no explanation of how they fit together. This page lays them side by side.
At a glance
| Program | Who it is for | What it pays for |
|---|---|---|
| GAPP | Children under 21 with full Georgia Medicaid whose medically necessary needs include nursing, personal support or a behavioral support aide | Skilled nursing, personal support and behavioral support aide services at home |
| Katie Beckett | Children 18 and under with a disability who need an institutional level of care, when family income is too high for Medicaid | Georgia Medicaid coverage, the same as other Medicaid members |
| Medicaid autism services | Medicaid members under 21 with a documented autism diagnosis | Autism assessment and treatment by board certified behavior analysts |
| NOW and COMP waivers | People with intellectual or developmental disabilities, including autism, cerebral palsy and epilepsy, who meet an ICF-ID level of care | Long-term supports at home and in the community, including respite, behavioral supports, equipment and home adaptations. COMP adds residential care |
| Elderly and Disabled Waiver (CCSP and SOURCE) | Frail elderly and disabled Georgians who need a nursing facility level of care | In-home and community services, including personal care, respite and Structured Family Caregiving |
Where to apply, and whether a parent can be paid
| Program | Apply through | Can a parent be paid? |
|---|---|---|
| GAPP | A GAPP-approved nursing agency | Yes, for approved personal support hours only, through the Family Caregiver Option |
| Katie Beckett | The Centralized Katie Beckett Medicaid Team, a DFCS office, or gateway.ga.gov | No. It provides Medicaid, not caregiver pay |
| Medicaid autism services | A Medicaid benefit, through enrolled providers | No. It pays for therapy |
| NOW and COMP | DBHDD, online through IDD Connects or a Regional Field Office | Ask DBHDD. Participants can choose to direct their own services |
| Elderly and Disabled Waiver | Georgia’s Aging and Disability Resource Connection, 1-866-552-4464, option 2 | Structured Family Caregiving pays family caregivers within this program |
GAPP
GAPP, the Georgia Pediatric Program, pays for care at home for medically fragile children under 21: skilled nursing by a licensed nurse, personal support with daily care, and behavioral support aide services. Your child needs full Georgia Medicaid; PeachCare for Kids is not eligible. You apply through a GAPP-approved agency, the state’s reviewer has 30 days to decide a complete request, and care must start within 60 days of approval. A parent who lives with the child can be paid for approved personal support hours, never for nursing. GAPP does not cover respite care. Everything else is in our GAPP guide.
Katie Beckett
Katie Beckett, also called TEFRA, is a route into Medicaid for children 18 and under with a disability who live at home. It ignores family income and looks at the level of care the child needs: hospital, nursing facility, or a facility for people with intellectual disabilities. Care at home must cost Medicaid no more than that institution would. It does not provide care on its own. It gives your child Medicaid, which then opens the door to GAPP and the autism program. Our Katie Beckett guide and checklist cover every form.
Medicaid autism services
Since January 1, 2018, Georgia Medicaid has covered autism assessment and treatment for members under 21 with a documented diagnosis from a licensed physician, psychologist or other licensed professional. The treatment, called adaptive behavior services, is delivered by board certified behavior analysts according to medical necessity. The GAPP manual directs members with autism to this program. Our article on getting paid to care for an autistic child explains where GAPP fits and where it does not.
NOW and COMP
NOW and COMP are Medicaid waivers for people with an intellectual disability or a closely related condition, such as autism, cerebral palsy or epilepsy, who meet the level of care of an intermediate care facility for people with intellectual disabilities. The disability must have begun by age 18 for an intellectual disability or by 22 for a developmental disability.
- NOW offers services that help a person keep living in their own or their family’s home.
- COMP serves people with more intensive needs. It primarily provides residential care, or intensive services at home, to avoid institutional placement.
Services across the two include community living support, respite, behavioral supports, natural support training, specialized medical equipment and supplies, home and vehicle adaptations, support coordination and transportation, and participants can choose to direct their own services. You apply through DBHDD. People found pre-eligible go onto a planning list, and DBHDD prioritizes it by need, not by how long someone has waited, so it is worth applying early.
The Elderly and Disabled Waiver and Structured Family Caregiving
The Elderly and Disabled Waiver Program, which includes CCSP and SOURCE, serves frail elderly and disabled Georgians who need a nursing facility level of care, with services such as personal care, adult day care, home-delivered meals and respite for family caregivers. Structured Family Caregiving, the program behind most “get paid to care for a family member” ads, is part of it. You apply through Georgia’s Aging and Disability Resource Connection, 1-866-552-4464, option 2. It is a different program from GAPP, with its own rules, and it is not paid to spouses or to parents of minor children; see does Medicaid pay family caregivers in Georgia?.
When your child turns 21
GAPP ends on the 21st birthday. Before then, the state assesses whether the young adult meets the criteria for the Independent Care Waiver Program (ICWP), Georgia’s adult program, and ICWP services cannot begin before the 21st birthday. Start planning six months to a year ahead.
Where to start
- Your child needs nursing or hands-on care at home: GAPP, once your child has full Medicaid.
- Your income is too high for Medicaid: Katie Beckett first.
- Your child is autistic and needs therapy: Medicaid’s autism services, through Medicaid or Katie Beckett.
- Your child has an intellectual or developmental disability and will need long-term supports, respite or adaptations: apply to DBHDD for NOW and COMP now.
- You want to be paid to care for your child: GAPP’s Family Caregiver Option covers approved personal support. See our Village Care page.
In short
- Katie Beckett is a door into Medicaid; GAPP, autism services and the waivers are what happens inside.
- GAPP is the program for nursing and hands-on care at home, and the only one here that pays a parent for a child’s personal support.
- NOW and COMP have a planning list prioritized by need, so apply early.
- Structured Family Caregiving belongs to the Elderly and Disabled Waiver, not GAPP.
Not sure where your child fits? Tell us about your child. If GAPP is not the right program, we will tell you which one to call.
Common questions
What is the difference between GAPP and Katie Beckett?
Katie Beckett is a way for a child with a disability to get Georgia Medicaid without counting the parents' income. GAPP is a Medicaid program that pays for skilled nursing and personal support at home. Many families need Katie Beckett first, then apply for GAPP through an agency.
What is the difference between the NOW and COMP waivers?
Both serve people with intellectual or developmental disabilities who meet an ICF-ID level of care. NOW supports people to keep living in their own or their family's home. COMP serves people with more intensive needs and primarily provides residential care, or intensive in-home services.
Which Georgia program pays a parent to care for a child with a disability?
GAPP's Family Caregiver Option pays a parent or other legally responsible adult who lives with the child for approved personal support hours, as an employee of the GAPP agency. It does not cover skilled nursing. Structured Family Caregiving belongs to the Elderly and Disabled Waiver, a different program.
Does any Georgia program cover respite care for a child?
GAPP does not cover respite care. The NOW and COMP waivers list respite services, and DBHDD places eligible applicants on a planning list prioritized by need.
How do I apply for the NOW or COMP waiver?
Through the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD), online through its IDD Connects system or with help from a DBHDD Regional Field Office. People found pre-eligible are placed on a planning list.
Sources
- Georgia Department of Community Health, Part II Policies and Procedures for Georgia Pediatric Program (GAPP) In-Home Nursing, July 1, 2025 edition, published on GAMMIS under Provider Manuals.
- Georgia Department of Community Health, Georgia Pediatric Program (GAPP) provider presentation, June 2023, published on the Georgia Medicaid Management Information System portal.
- Georgia Medicaid, Waiver Programs.
- Georgia Department of Community Health, Community Based Services.
- Georgia Medicaid, TEFRA/Katie Beckett.
- Georgia Medicaid, Autism Spectrum Disorder.
- Georgia Medicaid, New Options Waiver (NOW) and Comprehensive Supports Waiver (COMP).
- Georgia Department of Behavioral Health and Developmental Disabilities, Apply for DD Services.
- Georgia Division of Aging Services, Aging and Disability Resource Connection FAQs.
Please read. This article is general information about a public program, not medical, legal or financial advice, and it is not a decision about your child. Program rules change. Confirm anything that matters with the Georgia Department of Community Health or with a GAPP participating agency before you rely on it.