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Georgia - Homemaker Service — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

The Georgia Department of Community Health (DCH) licenses Homemaker services under the Private Home Care Provider (PHCP) classification, which authorizes agencies to deliver home management and housekeeping tasks to Medicaid waiver participants. Agencies delivering these services operate under DCH Healthcare Facility Regulation Rules Chapter 111-8-65 and are funded through Medicaid Home and Community-Based Services (HCBS) waivers such as the Comprehensive Supports Waiver Program (COMP).

Approval requires securing a provisional PHCP license from DCH before an agency can submit a Medicaid enrollment application through the GAMMIS portal. Applicants must clear fingerprint-based criminal background checks under Chapter 111-8-12 and secure a surety bond if any employee will have unlimited access to a client's personal funds for shopping or bill paying.

1. Service Definition and Scope

Georgia defines Homemaker services within the Private Home Care Provider regulations as encompassing two distinct categories: home management and housekeeping tasks. These services are designed to maintain a safe and clean environment for individuals who cannot perform these activities independently.

The scope of allowable tasks is strictly limited to household support and does not include personal care or skilled nursing, which require different PHCP service authorizations.

2. Regulatory and Oversight Agencies

Oversight of Homemaker services in Georgia is divided between the licensing authority and the Medicaid operating agencies. DCH handles facility licensure and Medicaid reimbursement, while DBHDD manages specific waiver operations.

Providers must interact with multiple state portals depending on the waiver program they intend to serve.

3. Gatekeeping Prerequisites: Who Can Even Apply

Georgia operates a continuous, open enrollment process for willing and qualified HCBS waiver providers, meaning there are no closed networks or Request for Proposal (RFP) procurement mandates blocking new applicants for Homemaker services.

However, structural prerequisites exist before Medicaid enrollment can begin. The applicant must first obtain a Private Home Care Provider license, which requires passing a stringent criminal background check process.

4. Licensure and Certification Requirements

Agencies must apply for a Private Home Care Provider license through DCH. New applicants are initially granted a provisional license to allow them time to demonstrate operational compliance.

For providers contracting with DBHDD for waiver services, additional certification is required if receiving funding under $25,000 per year, while those receiving $250,000 or more must obtain accreditation from an approved accrediting body.

5. Medicaid Provider Enrollment

Once licensed, providers must enroll in the Georgia Medicaid program using the GAMMIS Enrollment Wizard. For DBHDD waivers like COMP, providers must submit dual applications: one to DBHDD for screening and one to DCH for Medicaid enrollment.

Federal regulations require an application fee for institutional providers unless they qualify for a hardship exception or have already paid the fee to Medicare or another state.

6. Staffing, Training and Background Checks

Georgia mandates strict background checks and training standards for all PHCP personnel. Administrators and direct care staff must be vetted before providing services.

Falsifying qualifications or failing to maintain current background clearances are grounds for immediate license limitation or revocation.

7. Documentation, Policies and Records

PHCP rules require agencies to maintain a separate, comprehensive file for each client. This file must track the specific homemaker tasks performed and authorize any financial interactions.

Agencies must establish written policies for the retention and confidentiality of these records.

8. Billing, Rates and Claims

Medicaid reimbursement for Homemaker services is managed through the GAMMIS system. All waiver services require prior approval (PA) before claims can be paid.

The MMIS system uses programmed edits to enforce limits on the amount, frequency, and duration of services based on the participant's approved care plan.

9. Approval Sequence and Timeline

Becoming a Homemaker provider involves a sequential process starting with business formation and ending with Medicaid credentialing. The timeline depends heavily on the speed of background check processing and site visit scheduling.

Providers cannot bill for services provided prior to the official Medicaid enrollment effective date.

10. Common Denials and Survey Findings

DCH inspections frequently cite providers for administrative and documentation failures. Provisional licenses may be revoked if the agency fails to demonstrate compliance during the initial operational period.

Medicaid enrollment applications are often rejected if the mandatory application fee is not paid within 30 days of submission.

11. Key Contacts and Resources

Providers must utilize official state portals for applications, fee schedules, and policy manuals. The GAMMIS system serves as the primary hub for Medicaid billing and enrollment.

For waiver-specific requirements, DBHDD provides continuous updates and provider manuals.

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