Participant Directed Waiver Services


Participant Directed Waiver Services


Important Notice – Family Hire

The temporary provisions for Family Hire provided through Appendix-K will end on November 11, 2023. The established Family Hire Provisions in Chapter 1200, PART II Policies and Procedures COMP and NOW Waiver Program Manual will be reinstated on November 12, 2023. Family members who have extenuating circumstances as defined in Chapter 1200 will need to apply no later than July 31, 2023 to continue being paid caregivers after November 11, 2023. Participant Direction Representatives should submit Family Hire applications with supporting documentation via email to no later than July 31, 2023. Please include your Region# in the subject line of your email when you submit your family hire application.

See the links below for more information.  Please reach out to us via email at if you have any questions or concerns.

Unwinding PD Family Hire from Appendix K – Memo

Unwinding PD Family Hire Presentation – Powerpoint

Unwinding PD Family Hire from Appendix K Presentation – PDF

Family Hire Application

DBHDD Participant Direction Coordinators

DBHDD Regional Map


Behavior Support Service Providers

Check out the list of current providers (July 2023) of Behavior Supports.
DBHDD Waiver BCBA Approved Behavior Support Service Providers


Participant Direction promotes independence by allowing individuals or their representatives to make decisions about the services and supports they receive from Medicaid Home and Community-Based Waivers. Georgia allows Participant Direction in the NOW/COMP waiver. Download the Participant Direction Handbook

Cover of the Participant Direction Handbook showing young woman in pool with direct support staff

Participant Direction is a Service Delivery Option

Service Delivery refers to the method that is used to obtain the services. Individuals can choose to receive services using the Traditional Provider Model or by Participant Direction.

Traditional Model: Services are provided by a Medicaid approved company that is responsible for providing the necessary supports and services including hiring and paying employees. The company charges a fee for their services (usually a percentage of the cost of the services) which is taken from the budgeted allocation of the waiver. The company will pay for your services and bill Medicaid for reimbursement.

Participant Direction: You are the employer and are responsible for recruiting, hiring and training employees. You determine how much you will pay for services and which vendors you will use for supplies and other goods and services. You are responsible for managing your budget and submitting invoices and/or timesheets for services to a fiscal intermediary. The fiscal intermediary pays for your services and then bills Medicaid for reimbursement.

Who can Participant Direct?

In Georgia, Participant Direction is an option for individuals receiving the NOW/COMP waiver and who live in their own home or in the home of a family member. Participant Direction is not available to individuals who live in a residential facility, host home or a personal care home.

In addition to the individual with the waiver, a legal representative of the participant or anyone that the individual chooses (if the individual is over 21) can direct the services.

It is important that whoever directs the services be able to understand and perform the tasks required to manage and supervise employees. In addition, he/she should be able to complete all required timesheets and invoices and manage the budget.

Getting Started

The first step to getting started with Participation Direction is to contact your NOW/COMP Waiver Support Coordinator who will assist you with the following steps:

  • Contact a fiscal agent to manage your waiver funds;
  • Complete enrollment forms for processing and approval;
  • Recruit, hire and train staff;
  • Select vendors for other services.

Support Coordination

Support Coordination is a required service for all NOW/Comp waiver participants. Support Coordinators identify, coordinate, and oversee the delivery of services. Learn more about Support Coordination and the NOW/COMP Waiver. There are currently seven support coordination agencies with ten locations in Georgia.

Check out these Additional Resources

Download the P2P/DBHDD Participant Direction Fact Sheet

Are you interested in connecting, learning and supporting other individuals and families that Participant Direct? Check out this Facebook Group:

Georgia Participant Direction – Support/Information