Georgia Medicaid Waivers for Children with Special Needs

Understanding Katie Beckett, TEFRA, GAPP, and other programs that help medically fragile children receive care at home

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What is the Katie Beckett Waiver (TEFRA)?

The Katie Beckett waiver, also known as TEFRA (Tax Equity and Fiscal Responsibility Act), is a Medicaid eligibility option for children with disabilities. It allows children who need an institutional level of care to qualify for Medicaid based on their own medical condition —not their family's income.

Key Point

Katie Beckett is an eligibility pathway to Medicaid. Once approved, your child can access Medicaid services including GAPP nursing care.

Who qualifies for Katie Beckett in Georgia?

  • Child is under 18 years old
  • Has a disability or chronic medical condition
  • Requires care that would normally be provided in a hospital or nursing facility
  • Can be appropriately cared for at home
  • Home care costs less than institutional care

Common conditions that may qualify:

Cerebral palsy
Muscular dystrophy
Spina bifida
Severe autism
Traumatic brain injury
Ventilator dependence
Tracheostomy care needs
Tube feeding requirements
Seizure disorders
Genetic conditions

What is GAPP (Georgia Pediatric Program)?

The Georgia Pediatric Program (GAPP) is a Medicaid waiver program that provides in-home nursing care and personal care services to medically fragile children. GAPP allows children to receive skilled medical care at home instead of in a hospital or nursing facility.

Services covered by GAPP:

Skilled Nursing (RN)

Registered nurses providing medical care including medication administration, ventilator management, tracheostomy care, and complex medical monitoring.

Licensed Practical Nursing (LPN)

LPNs providing nursing care under RN supervision, including medication administration, wound care, and medical monitoring.

Personal Care Services (PCS)

Help with daily activities including bathing, dressing, feeding, mobility, and other activities of daily living.

Learn more about how GAPP works

GAPP vs Katie Beckett: Key Differences

Katie Beckett (TEFRA)GAPP
What it isMedicaid eligibility pathwayService delivery program
PurposeQualify for Medicaid regardless of family incomeProvide in-home nursing and personal care
Income limitsNo family income limitMust have Medicaid (any pathway)
Age limitUnder 18Under 21
Services providedAccess to all Medicaid servicesRN, LPN, and PCS in-home care
Key requirementInstitutional level of care neededMedicaid + medical necessity
Choose provider?Depends on service typeYes - choose your GAPP provider

How they work together: Many families use Katie Beckett to qualify for Medicaid, then enroll in GAPP to receive nursing services at home. You can use both programs simultaneously.

Not sure which program is right for your child?

Take our quick screener to see if your child might qualify for GAPP services.

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How to Apply for Each Program

Applying for Katie Beckett (TEFRA)

  1. 1

    Gather medical documentation

    Medical records, diagnoses, treatment plans, and any assessments showing your child's level of care needs.

  2. 2

    Contact Georgia DFCS

    Call your local Department of Family and Children Services or visit dfcs.georgia.gov

  3. 3

    Complete the application

    Submit the Katie Beckett application with all required documentation.

  4. 4

    Medical evaluation

    Your child will be evaluated to confirm they need an institutional level of care.

Applying for GAPP

  1. 1

    Ensure Medicaid eligibility

    Your child must have Georgia Medicaid (through any pathway including Katie Beckett).

  2. 2

    Get a physician's order

    Your child's doctor must document the medical necessity for in-home nursing care.

  3. 3

    Request GAPP evaluation

    Contact Georgia's Department of Community Health or your care coordinator.

  4. 4

    Choose a provider

    Once approved, you can choose any enrolled GAPP provider. Use our directory to find one.

Browse GAPP providers in your county

Other Georgia Medicaid Waivers

Georgia offers several other waiver programs for individuals with disabilities:

NOW Waiver

New Options Waiver for individuals with intellectual and developmental disabilities. Provides community-based supports and services.

COMP Waiver

Comprehensive Supports Waiver for individuals with significant intellectual and developmental disabilities requiring more intensive support.

ICWP

Independent Care Waiver Program for adults with physical disabilities who need assistance with daily living activities.

CCSP

Community Care Services Program for elderly and disabled adults who need help staying in their homes.

Frequently Asked Questions

What is the difference between GAPP and Katie Beckett?
GAPP (Georgia Pediatric Program) provides in-home nursing and personal care services for medically fragile children. Katie Beckett (TEFRA) is a Medicaid eligibility pathway that allows children with disabilities to qualify for Medicaid based on their own condition, not family income. Many children use Katie Beckett to become eligible for Medicaid, then receive GAPP services.
Can my child be on both Katie Beckett and GAPP?
Yes! Katie Beckett is often the pathway to Medicaid eligibility, while GAPP is the program that provides the actual nursing services. A child can qualify for Medicaid through Katie Beckett and then receive home nursing through GAPP.
What is TEFRA and how does it relate to Katie Beckett?
TEFRA (Tax Equity and Fiscal Responsibility Act) is the federal law that created the Katie Beckett option. In Georgia, the Katie Beckett program is our state's implementation of TEFRA. These terms are often used interchangeably.
Does my family income matter for Katie Beckett?
No. Katie Beckett determines eligibility based on the child's disability and medical needs only, not family income. This is different from regular Medicaid, which has income limits.
How long does it take to get approved for Katie Beckett in Georgia?
The Katie Beckett application process typically takes 45-90 days in Georgia, though complex cases may take longer. Having complete medical documentation ready can help speed up the process.
What services does GAPP cover that regular Medicaid doesn't?
GAPP covers private duty nursing (RN and LPN) and personal care services (PCS) in the home. Regular Medicaid may cover some home health, but GAPP specifically provides ongoing, scheduled in-home care for medically fragile children.
What if my child is denied for Katie Beckett or GAPP?
You have the right to appeal any denial. Common reasons for denial include incomplete documentation or the child not meeting the "institutional level of care" requirement. Working with a patient advocate or requesting a fair hearing can help.
Are there other Medicaid waivers in Georgia for children?
Yes. Georgia has several waiver programs including NOW (New Options Waiver) and COMP (Comprehensive Supports Waiver) for developmental disabilities. Each program serves different needs and has different eligibility criteria.

Ready to Find a GAPP Provider?

Browse our directory of verified GAPP providers across Georgia.

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This directory is not affiliated with the State of Georgia or the official GAPP program. We help families find providers but are not a state agency.