Georgia · waiver service
NOW & COMP Waivers — Participant Direction in Georgia
The NOW and COMP waivers, run by Georgia's Department of Behavioral Health and Developmental Disabilities (DBHDD), serve people with intellectual and developmental disabilities. With participant direction, the person or their representative hires their own staff. A family member who is not legally responsible can be paid with DBHDD approval; spouses, parents of minors and legal guardians cannot.
Also called: NOW waiver · COMP waiver · New Options Waiver · Comprehensive Supports Waiver · DBHDD participant direction · family hire Georgia
Who do you care for?
Quick facts
- Pay
- up to the provider rate
- Adult children & other relatives
- Sometimes
- Spouse
- Not right now
- Parent of a minor child
- Not right now
- Waitlist
- long
Who qualifies for NOW & COMP Waivers — Participant Direction
- Has an intellectual or developmental disability and needs ICF/IID level of care.
- Medicaid eligible.
- Has been offered a NOW or COMP slot from DBHDD's planning list (crisis cases can move faster).
- Services are listed in the Individual Service Plan (ISP).
Who can be paid as the caregiver
- Adult children & other relatives Sometimes
- an adult relative by blood or marriage (within the third degree) can be paid if DBHDD approves a family hire request showing extenuating circumstances, such as no qualified workers in the area.
- Spouse Not right now
- since November 11, 2023, the waiver manual strictly prohibits paying a spouse.
- Parent of a minor child Not right now
- parents of minor participants cannot be paid.
- Living together
- not required for participant-directed staff.
Who employs the caregiver: Either. Services can come from agencies or be participant-directed, where the person or representative is the employer and a Financial Support Services provider handles payroll and taxes.
Spouse rules differ by program — see spouse pay in Georgia.
How much NOW & COMP Waivers — Participant Direction pays
up to the provider rate. The participant sets the wage, but it cannot exceed what a traditional provider bills Medicaid for the same service under the DBHDD fee schedule.
Hours and budget: The support coordinator and planning team set services and units in the ISP; the participant-directed budget comes from those authorized services.
Compare with other Georgia programs on the Georgia caregiver pay page, or across states in pay rates by state.
Is there a waitlist?
DBHDD keeps a multi-year planning list for NOW and COMP. Slots are given by need, with crisis exceptions.
How to apply for NOW & COMP Waivers — Participant Direction
- Contact your DBHDD regional field office to apply and be placed on the planning list.
- When a slot is offered, work with a support coordinator to write the ISP.
- Choose participant direction and enroll with a Financial Support Services provider.
- To hire a relative, the support coordinator submits a family hire request to DBHDD's Participant Direction team (participant.direction@dbhdd.ga.gov); do not start paid work until it is approved.
- DBHDD Participant Direction · not published · official site
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NOW & COMP Waivers — Participant Direction questions
Can a parent be paid under the NOW or COMP waiver?
Not for a minor child. Parents of adult participants who are not their legal guardians may be paid with an approved family hire request.
Can a spouse be paid under NOW or COMP?
No. Since November 11, 2023, spouses, parents of minors and legal guardians are barred from being paid caregivers.
What is a family hire request?
A form the support coordinator sends to DBHDD showing at least two extenuating circumstances, such as a lack of qualified staff. DBHDD must approve it before the relative can be paid.
How long is the NOW/COMP planning list?
It can be several years. People in crisis can be prioritized.
How much can a family worker be paid?
No more than what a traditional provider would bill Medicaid for the same service.
Sources: dbhdd.georgia.gov · dbhdd.georgia.gov · p2pga.org · p2pga.org · pplfirst.com · Updated 2026-10-08. Program rules change — always confirm with the program.
Where most Georgia caregivers are
Counties with the most residents aged 65 and older. The rules are the same everywhere in Georgia — pick yours for the local picture.
Across the line
States that border Georgia
Each state writes its own rules, and they differ more than people expect — a spouse who can be paid on one side of the line often cannot be on the other.