Georgia - Prevocational Services — Licensing, Medicaid Enrollment and Startup Requirements

Last reviewed: 2026-09-09

The Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) and the Department of Community Health (DCH) jointly approve Prevocational Services under the New Options Waiver (NOW) and Comprehensive Supports Waiver Program (COMP). DBHDD strictly controls new provider enrollment based on regional network capacity, meaning agencies can only apply during specific open enrollment windows or targeted solicitations published by the state.

Prospective providers must first pass DBHDD's programmatic review and physical site inspection to obtain a recommendation for approval. Only after DBHDD forwards this recommendation will DCH process the application through the Georgia Medicaid Management Information System (GAMMIS) to issue a Medicaid provider number.

1. Service Definition and Scope

Prevocational Services in Georgia prepare individuals with intellectual and developmental disabilities for paid or unpaid employment. The service focuses on teaching general work skills rather than job-specific tasks and cannot occur concurrently with Community Access or Supported Employment services.

Services are designed to be time-limited and must be directly tied to goals established in the individual's approved service plan.

• Target Population: NOW and COMP waiver participants not expected to obtain paid employment within the next year
• Covered Activities: teaching rule compliance, attendance, task completion, problem solving, and workplace safety
• Delivery Settings: facility-based training sites or mobile crews operating in the community
• Exclusions: cannot take place in the individual's own home, family home, or any residential site
• Transportation: travel to and from the facility site is included in the service definition

2. Regulatory and Oversight Agencies

Dual oversight governs this service in Georgia. DBHDD manages the programmatic certification, site inspections, and waiver operations, while DCH acts as the State Medicaid Agency handling final enrollment and claims.

Providers must interact with both agencies' systems to maintain compliance and receive reimbursement.

• Operating Agency: [Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD)](https://dbhdd.georgia.gov/) manages waiver day-to-day operations and provider certification
• Medicaid Agency: [Georgia Department of Community Health (DCH)](https://dch.georgia.gov/) oversees the waiver and reimburses providers
• Claims Portal: [Georgia Medicaid Management Information System (GAMMIS)](https://www.mmis.georgia.gov/) processes all prior authorizations and billing
• Licensing Division: [Healthcare Facility Regulation Division (HFRD)](https://dch.georgia.gov/divisionsoffices/healthcare-facility-regulation) issues facility permits if applicable to the provider's broader service array

3. Gatekeeping Prerequisites: Who Can Even Apply

DBHDD strictly controls the provider network size for NOW and COMP waiver services. Applications are not accepted on a rolling basis for all services in all regions.

Agencies must wait for DBHDD to declare a need for Prevocational Services in a specific county before an application will even be reviewed.

• Network Capacity Moratoria: DBHDD monitors regional need and suspends solicitations for new providers when capacity is met
• Open Enrollment Cycles: applications are only accepted during DBHDD-published enrollment windows or targeted Requests for Proposals
• Business Registration: must provide evidence of business recorded with the Georgia Secretary of State matching the application's legal name
• Experience Requirement: DBHDD requires evidence of delivering behavioral health or IDD services for at least one year prior to application
• Good Standing: applicants must have no deficiencies within the past three years from any licensing or regulatory entity associated with Medicaid

4. Licensure and Certification Requirements

Georgia does not issue a standalone Prevocational Services License. Instead, agencies must obtain DBHDD Provider Certification by meeting the standards in the DBHDD Provider Manual for NOW/COMP waivers.

This certification process functions as the primary regulatory gate, requiring a comprehensive review of the agency's policies, physical plant, and administrative structure.

• Primary Authority: DBHDD Provider Certification replaces a traditional facility license for this specific waiver service
• Core Requirements: applicants must pass a review against the DBHDD Core Requirements for Providers
• Site Visit: DBHDD conducts an initial screening and physical site visit of the facility before recommending approval
• Local Zoning: facility-based sites must secure local commercial zoning and fire marshal approvals prior to the DBHDD site visit
• Service Area Expansion: expanding to new counties requires a formal request and approval process limited to twice per calendar year

5. Medicaid Provider Enrollment

Enrollment is a sequential two-step process. An agency cannot obtain a Medicaid provider number from DCH without a prior approval recommendation from DBHDD.

Even with DBHDD's recommendation, DCH retains final authority over issuing the Medicaid billing number.

• Step One: submit the DBHDD Provider Application during an open enrollment cycle
• Step Two: submit the DCH Medicaid application via the [GAMMIS Portal](https://www.mmis.georgia.gov/)
• Approval Dependency: DBHDD recommendation does not guarantee DCH approval or dictate the DCH processing timeframe
• New Provider Training: mandatory attendance at a DCH/DBHDD training session is required prior to receiving a Medicaid number
• Location Enrollment: multiple copies of the location section are required as each service location must be individually identified and enrolled

6. Staffing, Training and Background Checks

Direct support professionals delivering Prevocational Services must meet DBHDD's stringent training and background check mandates before working with waiver participants.

Agencies must maintain detailed personnel files proving compliance with these standards for every employee.

• Background Checks: mandatory fingerprint-based criminal history checks through the Georgia Applicant Processing Service (GAPS)
• Basic Qualifications: staff must possess a high school diploma or GED and a valid driver's license
• Initial Training: CPR, First Aid, and DBHDD-approved crisis intervention training required before independent client contact
• Ongoing Training: annual continuing education hours as specified in the NOW/COMP community provider manual
• OIG Exclusion: agencies must verify staff are not on the federal or state Medicaid exclusion lists

7. Documentation, Policies and Records

Providers must maintain comprehensive records that align with the participant's Individual Service Plan (ISP) approved by the DBHDD Regional Office.

Documentation must clearly demonstrate that the service is teaching work-readiness skills and not simply providing day care or job-specific vocational training.

• Service Plans: services must be explicitly tied to a prevocational goal in the DBHDD-approved ISP
• Daily Notes: documentation must reflect specific activities like task completion, endurance training, and rule compliance
• Business Hours: agencies must document operating hours, including potential evening or weekend availability to accommodate consumers
• Policy Manual: must maintain a comprehensive policy and procedure manual available for DBHDD site reviews
• Annual Review: prevocational goals must be reviewed annually to ensure the individual is progressing toward employment

8. Billing, Rates and Claims

Reimbursement is strictly controlled by Prior Authorizations (PA) entered into GAMMIS. Providers cannot bill beyond the authorized units or outside the approved dates of service.

Rates are standardized by DCH and published in the NOW/COMP fee schedule.

• System: all claims are submitted through [GAMMIS](https://www.mmis.georgia.gov/)
• Prior Authorization: all waiver participant services require PA from DBHDD before service delivery begins
• Rate Setting: DCH establishes the fee schedule for NOW and COMP waiver services
• Billing Edits: GAMMIS is programmed with hard edits to control the amount and frequency of reimbursed services
• Concurrent Billing: claims will deny if billed at the same time of day as Community Access or Supported Employment services

9. Approval Sequence and Timeline

The end-to-end process requires navigating both DBHDD and DCH timelines, which typically takes several months from the initial letter of intent to final Medicaid enrollment.

Delays in site readiness or incomplete documentation will pause the timeline.

• Phase 1: submit Letter of Intent and initial application during a DBHDD open enrollment window
• Phase 2: DBHDD conducts programmatic application review and physical site inspection
• Phase 3: DBHDD forwards the formal approval recommendation to DCH
• Phase 4: DCH processes the Medicaid enrollment application through GAMMIS
• Phase 5: DCH issues the Medicaid provider number and loads rates into the system

10. Common Denials and Survey Findings

Applications are frequently rejected for administrative omissions, applying outside of approved windows, or failing to demonstrate the required operating experience.

During site visits, physical plant issues are the most common cause for delayed certification.

• Out of Cycle: submitting applications outside of DBHDD's published open enrollment windows results in immediate withdrawal
• Incomplete Data: failing to match the legal business name exactly with the Secretary of State records
• Site Deficiencies: failing the DBHDD physical site inspection due to safety, zoning, or accessibility issues
• Missing Experience: inability to prove one year of prior behavioral health or IDD service delivery
• Policy Gaps: submitting generic policy manuals that do not address DBHDD-specific Core Requirements

11. Key Contacts and Resources

Providers must regularly consult DBHDD and DCH resources for policy updates, fee schedule changes, and enrollment schedules.

The DBHDD Provider Manual is the definitive source for service standards and must be reviewed frequently.

• Operating Agency: [DBHDD Provider Information](https://dbhdd.georgia.gov/be-connected/applications-new-existing-providers)
• Medicaid Agency: [DCH Provider Enrollment](https://dch.georgia.gov/providers/provider-enrollment)
• Claims Portal: [GAMMIS](https://www.mmis.georgia.gov/)
• Policy Manuals: [DBHDD Community Provider Manuals](https://dbhdd.georgia.gov/be-connected/community-provider-manuals)
• Licensing: [Healthcare Facility Regulation Division](https://dch.georgia.gov/divisionsoffices/healthcare-facility-regulation)

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