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