Georgia proposes new waiver waitlist tiers

Georgia’s Department of Behavioral Health and Developmental Disabilities (DBHDD) has proposed a major restructuring of the state’s Medicaid Home and Community Based Services (HCBS) waiver waiting list. The change would replace the current single waiting list with a three-tier prioritization system intended to better match access to services with the urgency of need. DBHDD’s proposal would shift the primary basis for prioritization away from how long someone has waited and toward current and anticipated support needs. The department says the approach is designed to improve fairness and transparency, while aligning Georgia’s waiver access practices with how other states manage entry to waiver services.

What would change under the proposal

Under the proposal, individuals on the planning list would be grouped into three categories:

• Individuals with immediate and urgent needs 

• Individuals expected to need services within one to five years

• Individuals likely to need services further in the future

This structure is intended to create clearer prioritization than a single list based primarily on time. DBHDD has framed the change as a way to better align services with need, particularly for people whose circumstances require more urgent supports.

Why the waiting list remains a focus

As of March, more than 7,800 individuals were reported to be on Georgia’s waiver waiting list. The size of the list has been a longstanding concern among families, advocates, and policymakers. While many advocates support the concept of prioritization, they have emphasized that careful implementation and adequate funding will be essential. Without those elements, stakeholders have cautioned that changes in how the list is organized may not translate into meaningful improvements in access to care.

DBHDD’s proposed restructuring is expected to take effect in 2026, pending approval and implementation planning.