DD Provider FAQs

Please note: This FAQ page will be updated continuously as new questions are received that could be useful to all providers.  Please check this page periodically to see updates.

For all Medicaid billing questions, DBHDD encourages providers to contact their Gainwell Representative. From the Georgia Medicaid Management Information System (GAMMIS) website, hover over “Contact Information” and select “Contact Us” from the drop-down menu. Once on the contact form, select “Customer Service” from the menu options when completing the “How can we help you?” section. They can also be reached by phone at the Provider Services Contact Center at 800-766-4456, which is available from 7:00 am to 7:00 pm EST Monday through Friday.

  • Are any of the following covered under the NOW/COMP?
    • Dental –Waiver Supplemental services can be used as available and needed for qualifying dental services
    • Long term planning, guardianship, special needs trusts, wills – Not Covered
    • Van modification – Yes, under vehicle adaptation
    • Bathroom adaptation – Yes, under environmental modification
    • Assistive technology – Not covered at this time
    • Please give an example something covered under Goods and Services.
    • Incontinent supplies are one example of something covered under Goods and Services. Please refer to the waiver manuals for more details.
  • Can the waiver ever be lost?

    The NOW and COMP waivers are available to individuals who maintain Medicaid and clinical eligibility and abide by participant responsibilities as outlined in the waiver manuals.

  • Can a family member be paid to be direct support staff?

    There is a family hire exception in policy for participant-direction. It is approved on a very limited basis and is reviewed on a case by case basis. There are strict restrictions found in Chapter 1200 of the NOW and COMP Part II policy manual.

  • Are therapy services considered a part of waiver services or are they separate? Is there a monthly cap on the amount of therapy services that someone can receive?

    Yes, adult speech, adult occupational, adult physical therapies are available waiver services for individuals with clinically assessed need. Yes, there is a cap in the amount of therapy an individual can receive, which can be found in the NOW and COMP waiver manuals.

  • What is Employment Express and how do you access it?

    Employment Express is actually employment express funding. This is a funding stream using state dollars to support individuals who are on the planning list and wanting to pursue supported employment. Job development and procurement is funded through the Georgia Vocational Rehabilitation Agency (GVRA) and Employment Express funding is used to provide support to an individual while on the job (working) once their case is closed with GVRA.

  • Do employers receive incentives for hiring individuals with IDD?

    No.

  • Does employment affect SSI?

    Each case is different. GVRA offers benefits counseling to help people see which earnings are affected and how they could impact benefits. Payroll earning must be reported to Social Security.

  • Does competitive employment affect a waiver?

    No, but income can affect Medicaid eligibility.

  • Can individuals on the planning list receive supported employment before receiving a waiver? How do families access Supported Employment services if they don’t have a waiver?

    Yes, individuals on the planning list can contact the Regional Field Office to request a referral to GVRA to begin the supported employment service.

  • 6. If Vocational Rehab deems an individual unemployable, what are other options?

    DBHDD needs to be made aware of this occurrence as DBHDD does not consider anyone who desires to work to be unable to seek and achieve employment.

  • If an individual with I/DD wants to pursue self-employment, are there resources to help?

    DBHDD is working to find resources and tools for self-employment.

  • How does someone apply for a waiver?

    Contact the Regional Field Office or  Download this pdf file. print a paper application . 

  • Is there an age that an individual should apply for waivers?

    There is no age restriction on when a person can apply for NOW and COMP waiver services.

  • What determines most-in-need? How do individuals receive waivers?

    DBHDD utilizes an objective, validated needs assessment tool and most-in-need questionnaire to determine who moves into waiver services. The planning list is not based on when you apply for service. The tool is updated at least annually. DBHDD encourages families to contact their DBHDD Regional Field Office at any time during the year if there is a change in condition or circumstance so the assessment tool can be updated.

  • Do the new autism services from DCH impact the ability for an individual to be on the planning list and/or receive services?

    The services available through the Autism State Plan do not affect the ability of an individual to be on the planning list. However, because the waiver is the payor of last resort, individuals who should be receiving services through the Autism State Plan will not be eligible to receive those services through the waiver.

  • If there is no longer a waiting list for NOW and COMP waivers, do those of us on the previous waiting list have to reapply when our kids graduate and leave high school?

    DBHDD maintains a Planning List for individuals with IDD who have applied for waiver services and have been determined pre-eligible. Annually, the regional field office contacts the individual to update the needs assessment. People come off the planning list and move into services based on the needs assessment and most-in-need criteria. If the individual has a change of circumstance at any time during the year, they must contact the Regional Field Office to have the needs assessment updated by a Planning List Navigator (specific staff person who manages this work).

  • Who do we contact when we need to re-activate our application or reapply?

    Contact the Regional Field Office.

  • What is intensive support coordination and how does it specifically serve the individual?

    Intensive support coordination is provided to individuals who demonstrate significant behavioral/medical needs based on assessment tools. An intensive support coordinator provides more in-depth oversight, more frequent visits, and works with a clinical supervisor to address more intensive clinical needs.

  • If a family is not pleased with the level of service from the support coordinator, who should they contact? Can families change support coordination agencies?

    If an individual is unhappy with their support coordinator, they should first contact the leadership of the support coordination agency and express their concerns. If they feel that their concerns are not being addressed, they can contact the Regional Field Office to communicate their concerns. An individual is offered choice and can move to another support coordination agency if they so choose. If that is desired, they will need to contact the Regional Field Office to let them know of the desire to change and which agency they would like to change to. There are 7 support coordination agencies to choose from in Georgia, but not all of the 7 agencies cover all areas of the state.

  • Please discuss the new ISP template. Can families review prior to the ISP meeting?

    IDD Connects will not enable an individual or their family members to review the ISP prior to scheduling and completion of the ISP meeting being held. Authorized representatives will have access to the ISP prior to signing it and once it has been approved.

  • Are providers being trained in autism, especially triggers and de-escalation?

    Yes, DBHDD is providing some training through START (Systemic, Therapeutic, Assessment, Resources, and Treatment) is a tertiary care research-based model of services and supports. While providing training, assessment, and crisis intervention services, START services are implemented in the context of a comprehensive, systems-linkage approach to improve capacity in the system as a whole.

    The Center for START Services, developed in 2009, is a national initiative based at the University of New Hampshire Institute on Disability/UCED and provides educational and capacity-building services, promotes and evaluates evidence-informed practices and approaches, and facilitates START model program implementation across the United States with the aim of improving the lives of individuals with IDD and behavioral health needs.

  • Are there autism specific crisis respite homes for individuals over 17?

    Individuals over 17 who require the services of a crisis respite home would be placed in a regular crisis home for individuals with I/DD.

  • What are the steps to change to the participant direction service delivery model?

    Contact your support coordinator and inform them of your interest. Sign-up and complete the six-hour mandatory training provided by DBHDD Participant Direction staff. Provide the support coordinator the copy of the certificate of completion then select and enroll with the one of the three fiscal intermediaries within 90 days of completion of the training. You will also need to read and understand the NOW and COMP Medicaid policy for participant direction.

  • Is there a participant direction handbook or manual for families?

    Yes, it is posted on the DBHDD website with other helpful resources on participant direction at: https://dbhdd.georgia.gov/be-compassionate/home-services/participant-direction

  • If a family chooses to go self-direct, does the family also choose the support coordination agency?

    Yes, all individuals can choose their support coordination agency.

  • Does the mobile crisis unit avoid the needs for emergency room admission? 1013?

    Yes, the purpose of the mobile crisis team is to deescalate crisis situations I the community. For more information on accessing crisis services, go to: https://www.georgiacollaborative.com/providers/georgia-crisis-and-access-line-gcal/

  • Does GA have crisis care for children/adults with I/DD and MH – inpatient, out of home?

    Yes, DBHDD has in-home and out-of-home crisis options that are accessible through GCAL (1-800-715-4225) with an expected response time of 60 minutes.