The NOW and COMP Waivers:
The Long Game of Special Needs Funding
If you have a child with a developmental disability in Georgia, you have probably heard the terms "NOW" and "COMP" thrown around in support groups or IEP meetings. Usually, it's followed by a heavy sigh and a comment about a waitlist that takes years.
Because the process is long and intimidating, many parents put off applying. But as someone who has dug through the red tape, I am telling you right now: Do not wait. Apply as soon as your child receives a qualifying diagnosis.
Here is exactly what these waivers are, why they are the holy grail of long-term support, and how to navigate the waitlist reality.
What are the NOW and COMP Waivers?
The New Options Waiver (NOW) and Comprehensive Supports Waiver Program (COMP) are Medicaid programs designed specifically for individuals with Intellectual and Developmental Disabilities (I/DD).
Historically, if an individual with severe disabilities needed round-the-clock care, the only option the government would pay for was an institution or a nursing facility. These waivers were created to change that. They "waive" traditional Medicaid rules to funnel that funding directly into the community, allowing your loved one to receive high-level care while living at home with you, or eventually, in an independent supported living environment.
NOW vs. COMP: What is the Difference?
While they both provide incredible funding, they are designed for different levels of need:
The NOW Waiver: Best for individuals with less intensive, daily support needs. The primary goal is to promote independence and prevent institutionalization for those who can live with their family or independently.
The COMP Waiver: Best for individuals with more intensive, round-the-clock needs. This waiver provides funding for high-level in-home care or residential support to ensure absolute safety.
Why Do We Want It?
These waivers cover the heavy-hitting expenses that private insurance and standard Medicaid sometimes won’t cover. Once approved, you get a designated budget and a support coordinator to help you manage it.
Funding can be used for:
Respite Care: Paying a qualified caregiver to watch your child so you can get a physical and mental break.
Home & Vehicle Modifications: Ramps, widened doorways, bathroom adaptations, or accessible vans.
Specialized Medical Equipment: High-end safety beds (like the Cubby Bed), specialized strollers, and communication devices.
Behavioral Support: High-level interventions for severe behaviors or elopement risks.
Community Access: Day programs, supported employment, and job coaches when your child ages out of the school system.
Participant-Direction: You can often hire your own caregivers—sometimes even family members or trusted friends—and pay them using waiver funds!
The Qualifications: Who is Eligible?
To qualify for either waiver in Georgia, the applicant must meet strict medical and financial criteria:
Medicaid Eligibility: The individual must be eligible for Medicaid. (Advocate Tip: If your child qualifies for the Katie Beckett waiver, they already meet this financial requirement!)
The Diagnosis: They must have an intellectual disability diagnosed before age 18, OR a related developmental disability (like Autism, Cerebral Palsy, or Epilepsy) diagnosed before age 22.
Level of Care: They must require the level of care typically provided in an Intermediate Care Facility (ICF-I/DD).
Significant Limitations: They must show significant limitations in adaptive functioning, such as daily living skills, communication, and self-care.
The Elephant in the Room: The Waitlist
This is the hardest part of the NOW/COMP conversation. In Georgia, there are currently over 7,000 people on the DBHDD "Planning List" (waitlist) for these waivers.
Because there is far more need than state funding, you are not simply given a number and told to wait your turn in line. The waitlist is not first-come, first-served.
Instead, Georgia organizes the waitlist into a 3-Tier System based entirely on the urgency of need:
Tier 1 (Immediate Need): Individuals in absolute crisis (e.g., at risk of homelessness, aging out of the foster system, or a caregiver who is severely ill and can no longer physically support them).
Tier 2 (Near-Term Need): Individuals whose needs will change significantly within the next 1 to 5 years (like a teenager transitioning out of the school system).
Tier 3 (Future Need): Individuals who are currently stable but will need services further down the road.
This tiered system is exactly why your paperwork and advocacy matter so much. You cannot just apply and sit back. You have to actively communicate with your DBHDD regional office to ensure they understand exactly how critical your child's needs are, so you are placed in the correct tier.
How to Apply
The application process goes through the Department of Behavioral Health and Developmental Disabilities (DBHDD), not your local DFCS office.
Gather your Master Medical Binder: You will need psychological evaluations, IEPs, proof of citizenship, and any medical records detailing their adaptive limitations.
Apply Online or In-Person: You can apply online through the Georgia Collaborative ASO portal (which is often processed faster), or download the forms and submit them to your local DBHDD Regional Field Office.
The Assessment: A DBHDD team will review your application and schedule a screening assessment (often including a psychologist's review) within 14 business days to determine pre-eligibility.
The Planning List: If deemed eligible, your child is placed on the planning list based on their tier of need until funding becomes available.
Advocate Tip: Get on the list now. Even if your child is young and you don't need intense residential care today, their needs will evolve as they get older, bigger, and stronger. Get the clock started, get into the system, and start building your paper trail so that when the urgent need arises, you are already established.