Georgia - Housing Stabilization — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

Georgia does not offer a standalone Medicaid State Plan benefit explicitly named Housing Stabilization Services; instead, tenancy support, housing search, and retention functions are embedded within Community Living Support (CLS) and residential services under the New Options Waiver (NOW) and Comprehensive Supports Waiver Program (COMP). The Department of Behavioral Health and Developmental Disabilities (DBHDD) manages these waivers and dictates the provider network capacity, meaning prospective agencies cannot simply enroll in Medicaid but must first pass DBHDD's rigorous network enrollment process.

To deliver these housing-related supports, an agency must submit a Letter of Intent (LOI) to DBHDD during an open enrollment window or targeted procurement period, demonstrating prior operating history and compliance with state standards. Only after DBHDD approves the agency as a qualified NOW/COMP provider can the entity submit a formal Medicaid enrollment application to the Department of Community Health (DCH) through the Georgia Medicaid Management Information System (GAMMIS) portal.

1. Service Definition and Scope

Because Georgia lacks a distinct Housing Stabilization service code, providers deliver housing search, landlord mediation, and retention planning as components of Community Living Support (CLS) or residential services under the NOW and COMP waivers. These services are designed to assist individuals with intellectual and developmental disabilities in acquiring, retaining, or improving skills necessary to live successfully in the community.

The scope of these embedded services includes assisting members with finding affordable housing, understanding lease obligations, and developing community integration plans. Direct payment of rent or security deposits is strictly prohibited under these Medicaid waiver service definitions.

• Service Classification: Embedded within Community Living Support (CLS) and residential services under NOW/COMP waivers
• Target Population: Individuals with intellectual and/or developmental disabilities meeting institutional level of care
• Covered Activities: Housing search assistance, lease negotiation support, independent living skill development, and tenancy retention planning
• Excluded Activities: Direct payment of rent, room and board costs, utility deposits, and property modifications
• Service Setting: Member's own home, family home, or integrated community settings

2. Regulatory and Oversight Agencies

The Department of Behavioral Health and Developmental Disabilities (DBHDD) serves as the primary operating agency for the NOW and COMP waivers, handling provider qualification, network management, and quality oversight. DBHDD utilizes third-party contractors to conduct site visits and review provider applications.

The Department of Community Health (DCH) is the single state Medicaid agency responsible for final provider enrollment, claims processing, and federal compliance. DCH's Healthcare Facility Regulation Division (HFRD) licenses any residential facilities, such as Community Living Arrangements (CLAs), if the provider operates facility-based services.

• Operating Agency: Department of Behavioral Health and Developmental Disabilities (DBHDD) (https://dbhdd.georgia.gov)
• Medicaid Agency: Department of Community Health (DCH) (https://dch.georgia.gov)
• Licensing Authority: DCH Healthcare Facility Regulation Division (HFRD) (https://dch.georgia.gov/divisionsoffices/hfrd)
• Enrollment Portal: Georgia Medicaid Management Information System (GAMMIS) (https://www.mmis.georgia.gov)
• Quality Oversight: Georgia Collaborative ASO (https://www.georgiacollaborative.com)

3. Gatekeeping Prerequisites: Who Can Even Apply

Entry into the NOW and COMP provider network is strictly gated by DBHDD's Letter of Intent (LOI) and application process. DBHDD does not maintain an open, rolling enrollment for all services at all times; applications are often subject to regional network needs, meaning a provider cannot apply if DBHDD determines there is adequate capacity in a specific region.

Furthermore, Georgia HCBS waiver programs typically require a minimum operating history before an agency can apply to become a Medicaid provider. For example, related waiver programs like CCSP require an agency to have been in business providing the specific service for a minimum of 12 consecutive months prior to making an application.

• Network Access: DBHDD Letter of Intent (LOI) approval required before any Medicaid application is accepted
• Operating History: Minimum of 12 consecutive months of business operation in Georgia required prior to application
• Business Authorization: Must possess a current local business license and proof of legal authorization to operate in Georgia
• Training Prerequisite: Mandatory attendance at DBHDD/DCH Provider Pre-Enrollment and New Provider Training
• Financial Solvency: Must demonstrate financial stability and capacity to operate without Medicaid reimbursement during the initial credentialing phase

4. Licensure and Certification Requirements

If a provider is strictly delivering non-facility-based Community Living Support (CLS) in a member's own home, a specific HFRD facility license is not required, but DBHDD certification as a waiver provider is mandatory. DBHDD evaluates the agency's policies, procedures, and staff qualifications during the initial site visit and desk review.

Providers that expand their housing support into operating residential facilities, such as Community Living Arrangements (CLAs) or Personal Care Homes (PCHs), must obtain the corresponding license from HFRD pursuant to Code 111-8-62. Additionally, DBHDD requires providers delivering services exceeding $250,000 annually to obtain national accreditation.

• Waiver Certification: DBHDD approval as a NOW/COMP provider
• Facility Licensure: HFRD license required only if operating a Community Living Arrangement (CLA) or Personal Care Home (PCH)
• National Accreditation: Required for DBHDD providers billing over $250,000 annually (e.g., CARF, CQL, or Joint Commission)
• Site Visit: Satisfactory pre-enrollment site visit conducted by DBHDD or its third-party contractor
• Policy Review: Submission and approval of agency operational policies, including critical incident reporting and person-centered planning

5. Medicaid Provider Enrollment

Once DBHDD issues an approval letter, the agency must complete the formal Medicaid enrollment process through the GAMMIS web portal. The applicant uses the Provider Enrollment/Enrollment Wizard to submit their data and receives an Application Tracking Number (ATN) to monitor their status.

The DCH enrollment process requires the submission of specific financial and tax documents to establish a payee record. The effective date of Medicaid enrollment is typically the first day of the month in which the application is received by DCH or the date of DBHDD licensure/approval, whichever is later.

• Enrollment Portal: GAMMIS Provider Enrollment Wizard
• Tracking Mechanism: Application Tracking Number (ATN) assigned upon initial portal submission
• Tax Documentation: IRS confirmation (Form 147-C, CP575-A, or Tax Coupon) and Form W-9 required
• Payment Setup: Electronic Funds Transfer (EFT) Agreement with a voided check or bank letter
• Ownership Disclosure: Mandatory disclosure of anyone with 5% or greater ownership and all managing employees per 42 CFR 1002.3

6. Staffing, Training and Background Checks

Agencies providing CLS and housing-related supports under NOW/COMP must ensure all direct support professionals (DSPs) meet DBHDD's stringent qualification standards. This includes comprehensive criminal background checks processed through the Georgia Applicant Processing Service (GAPS).

Staff must complete mandatory training prior to delivering services independently. This training covers person-centered planning, crisis intervention, and recognizing signs of abuse, neglect, and exploitation.

• Background Checks: Fingerprint-based criminal history checks via GAPS required for all direct care staff
• Basic Qualifications: High school diploma or GED, valid driver's license, and clean driving record for staff transporting members
• Certifications: Current CPR and First Aid certification required prior to independent client contact
• Initial Training: DBHDD-mandated orientation covering waiver policies, incident reporting, and member rights
• Ongoing Training: Annual continuing education hours required as specified in the DBHDD provider manual

7. Documentation, Policies and Records

Providers must maintain comprehensive records that align with the member's Individual Service Plan (ISP) developed by their support coordinator. Every housing search activity, landlord mediation session, or skill-building intervention must be documented with specific start and stop times, the exact nature of the intervention, and the member's response.

Agencies are strictly monitored for compliance with the HCBS Settings Rule, ensuring members have lease protections, privacy, and community access. Providers must also utilize the DBHDD HCBS Incident Reporting System for any critical incidents.

• Service Notes: Daily documentation requiring date, start/stop times, specific interventions, and staff signature
• Care Plan Alignment: All billed activities must directly tie to goals outlined in the member's DBHDD-approved ISP
• Settings Rule Compliance: Documentation proving the member has a legally enforceable lease or residency agreement
• Incident Reporting: Mandatory use of the DBHDD HCBS Incident Reporting System for critical events
• Record Retention: Financial and programmatic records must be retained for a minimum of six years

8. Billing, Rates and Claims

Because housing stabilization is not a standalone code, providers bill for the time spent delivering these supports using the authorized CLS or residential service procedure codes (e.g., T2017 for CLS 15-minute increments) as specified in the member's prior authorization. Claims are submitted electronically through the GAMMIS portal.

Rates are established by DCH in coordination with DBHDD and are published in the NOW/COMP waiver rate schedules. Providers cannot bill for housing search activities if the member is not present or actively engaged in the service, unless specific collateral contact is authorized in the ISP.

• Billing System: Electronic claims submission via the GAMMIS portal
• Procedure Codes: Billed under Community Living Support (CLS) codes (e.g., T2017) as authorized
• Prior Authorization: Services strictly require an active prior authorization generated from the approved ISP
• Rate Schedule: Fixed fee-for-service rates published by DCH/DBHDD; providers cannot balance bill members
• Claim Timeliness: Claims must generally be submitted within 6 months of the date of service

9. Approval Sequence and Timeline

The path to becoming a billing provider is lengthy, often taking 6 to 12 months from initial intent to active Medicaid enrollment. The process begins with monitoring DBHDD for open enrollment windows and submitting the Letter of Intent (LOI).

If the LOI is accepted, the provider submits the full DBHDD application, undergoes a site visit, and awaits DBHDD approval. Only after receiving the DBHDD approval letter does the provider submit the DCH Medicaid application via GAMMIS, which undergoes its own credentialing review.

• Step 1: Verify 12-month operating history and monitor DBHDD for network needs or open LOI windows
• Step 2: Submit Letter of Intent (LOI) to DBHDD
• Step 3: Complete full DBHDD provider application and pass pre-enrollment site visit
• Step 4: Receive DBHDD approval letter and waiver certification
• Step 5: Submit Medicaid enrollment application via GAMMIS Provider Enrollment Wizard
• Step 6: Receive DCH Welcome Letter with active Provider ID and effective date

10. Common Denials and Survey Findings

Applications are frequently rejected at the DBHDD LOI stage if the agency fails to demonstrate the required 12 months of prior operating history or if DBHDD determines there is no network need in the requested region. DCH Medicaid applications are often suspended or denied due to mismatched tax information or missing EFT documentation.

During post-enrollment surveys, the most common citations involve inadequate documentation of service delivery. Auditors frequently recoup funds if service notes lack specific start/stop times, fail to describe the actual intervention provided, or do not align with the goals in the member's ISP.

• LOI Rejection: Failure to prove 12 months of continuous business operation in the requested service type
• Network Saturation: DBHDD denial due to adequate existing provider capacity in the target region
• Application Suspension: Mismatch between the legal business name on the IRS Form 147-C and the GAMMIS application
• Audit Recoupment: Service notes lacking specific start/stop times or staff signatures
• Compliance Failure: Failure to obtain national accreditation once annual billing exceeds $250,000

11. Key Contacts and Resources

Prospective providers must navigate multiple state portals to access current manuals, rate sheets, and application wizards. The DBHDD website is the primary resource for waiver policies, LOI announcements, and provider network requirements.

The GAMMIS portal is essential for the final Medicaid enrollment steps, tracking application status, and accessing DCH provider manuals. Providers should regularly check the Georgia Collaborative ASO site for quality standards and IDD Connects portal updates.

• DBHDD Provider Network: https://dbhdd.georgia.gov/becoming-provider
• DCH Medicaid Enrollment Portal (GAMMIS): https://www.mmis.georgia.gov
• Healthcare Facility Regulation Division (HFRD): https://dch.georgia.gov/divisionsoffices/hfrd
• Georgia Collaborative ASO: https://www.georgiacollaborative.com
• DCH Waiver Programs Info: https://medicaid.georgia.gov/programs/all-programs/waiver-programs

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