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Georgia - Day Habilitation Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

The Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) funds structured daytime programming under the New Options Waiver (NOW) and Comprehensive Supports Waiver Program (COMP) through a service officially designated as Community Access Group (CAG). This service is designed to help individuals acquire, retain, or improve self-help, socialization, and adaptive skills in non-residential settings.

Prospective providers cannot submit a Medicaid enrollment application directly to the Department of Community Health (DCH); they must first register for a New Provider Enrollment Forum, submit a Letter of Intent (LOI) to the Georgia Collaborative ASO during a designated open enrollment window, secure an invitation to apply, and pass a DBHDD site visit before DCH will accept their enrollment.

1. Service Definition and Scope

In Georgia, Day Habilitation is delivered under the service name Community Access Group (CAG) or Community Access Individual (CAI). These services provide structured daytime activities outside the individual's residence to promote community integration and skill development.

CAG is typically provided in a facility-based setting or in community groups, focusing on activities that build adaptive skills, socialization, and daily living capabilities.

2. Regulatory and Oversight Agencies

The Department of Behavioral Health and Developmental Disabilities (DBHDD) serves as the operating agency for the NOW and COMP waivers, managing provider network entry and daily operations. The Department of Community Health (DCH) acts as the State Medicaid Agency, holding ultimate authority over Medicaid enrollment and claims.

Facility-based services are licensed by DCH's Healthcare Facility Regulation Division (HFRD), while the Georgia Collaborative ASO administers the initial provider enrollment phases on behalf of DBHDD.

3. Gatekeeping Prerequisites: Who Can Even Apply

Georgia strictly controls entry into the NOW/COMP provider network through designated open enrollment periods. Providers cannot apply at will; they must wait for DBHDD to announce an open window for I/DD services.

Before accessing the application, an agency must attend a mandatory forum and submit a Letter of Intent (LOI). Only applicants whose LOIs are approved receive an invitation to submit the DBHDD New Provider Application.

4. Licensure and Certification Requirements

If Community Access Group services are provided in a facility owned or leased by the provider, the site must be licensed as an Adult Day Center by the DCH Healthcare Facility Regulation Division (HFRD).

In addition to facility licensure, providers must pass a DBHDD certification review that evaluates compliance with the DBHDD Core Requirements for Providers and the federal HCBS Settings Rule.

5. Medicaid Provider Enrollment

Medicaid enrollment in Georgia is a two-phase process. Phase 1 involves the DBHDD application and site visit managed by the Georgia Collaborative ASO. Phase 2 is the formal Medicaid enrollment through DCH.

Once DBHDD approves the Phase 1 application, the provider is notified to complete the online DCH application via the Georgia Medicaid Management Information System (GAMMIS) portal.

6. Staffing, Training and Background Checks

Agencies must employ qualified Direct Support Professionals (DSPs) and designate a Developmental Disability Professional (DDP) to oversee service delivery and person-centered planning.

All staff must clear rigorous background checks through the state system and complete DBHDD-mandated training prior to providing direct care.

7. Documentation, Policies and Records

Providers are required to maintain comprehensive records that align with the individual's Individual Service Plan (ISP). Daily progress notes must reflect specific goals and community integration activities.

DBHDD enforces strict incident reporting protocols and requires quarterly reporting on subcontractor performance and service delivery.

8. Billing, Rates and Claims

Claims for NOW and COMP waiver services are billed directly to DCH through the GAMMIS portal. Reimbursement is strictly tied to prior authorizations entered into the MMIS by DBHDD.

Rates for Community Access Group are established by DCH and published in the NOW/COMP Part III manual. Edits in the system prevent billing beyond the authorized amount, frequency, and duration.

9. Approval Sequence and Timeline

The approval sequence is lengthy due to the gated enrollment windows and dual-agency review. It begins with the mandatory forum and LOI submission during an open window.

Following LOI approval, the agency submits the DBHDD application, undergoes a Regional Field Office site visit, and finally applies to DCH for Medicaid billing privileges.

10. Common Denials and Survey Findings

Many prospective providers fail at the initial gate by attempting to submit applications outside of the published open enrollment windows or failing to attend the mandatory forum.

During site visits, common citations include failure to meet HCBS Settings Rule requirements, such as facilities exhibiting institutional characteristics, or incomplete policy manuals.

11. Key Contacts and Resources

The primary resources for prospective Day Habilitation providers in Georgia are the DBHDD provider enrollment pages and the GAMMIS portal, which houses the official NOW/COMP manuals.

The Georgia Collaborative ASO serves as the main point of contact for Phase 1 enrollment inquiries and LOI submissions.

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