2132 New Option Waiver and Comprehensive Supports Waiver Program

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Georgia Division of Family and Children Services
Medicaid Policy Manual

Policy Title:

New Option Waiver and Comprehensive Supports Waiver Program

Effective Date:

July 2024

Chapter:

2100

Policy Number:

2132

Previous Policy Number(s):

MT 60

Updated or Reviewed in MT:

MT-72

Requirements

New Options Waiver (NOW) and Comprehensive Supports Waiver Program (COMP) are classes of assistance (COA) designed to provide in-home and community-based services to Medicaid eligible intellectually disabled and developmentally disabled individuals who do not receive Medicaid benefits under a cash assistance program.

Basic Considerations

To be eligible under the NOW/COMP COA, an A/R must meet the following conditions:

  • The A/R is assessed for waivered services by an DBHDD Regional Office.

  • The A/R is approved by the DCH Medical Management contractor, Alliant Healthcare Solutions, evidenced by a completed DMA-7.

  • The DMA-7 (only used for NOW/COMP) may be approved by the DBHDD Regional Office.

  • The A/R is placed in a NOW/COMP slot and is receiving NOW/COMP waivered services.

  • The A/R meets the Length of Stay (LOS) and Level of Care (LOC) basic eligibility criteria.

  • The A/R meets all other basic and financial eligibility criteria.

NOW/COMP Medicaid recipients receive certain waivered services.

The individual determined suitable through a level of care determination for NOW/COMP is placed under support coordination (case management).

The Support Coordinator arranges for the provision of waivered services to the recipient.

The beginning date of Support Coordination (case management) is the same as the enrollment date for an A/R leaving an institution, and the same as the date services begin for an A/R already residing in the community.

A/Rs who are coming out of an institution may receive Support Coordination for up to six months prior to placement in NOW/COMP and while they are still living in the facility.

Procedures

Follow the steps below to determine ABD Medicaid eligibility under the NOW/COMP COA.

Step 1

Accept the A/R’s application, the Form 1008, NOW/COMP Communicator, and approved LOC instrument

After April 1, 2003, DMA-6s will no longer be completed by GMCF/Alliant but by private vendors contracting with Mental Health. Instead of an actual DMA-6, it will be a mailer containing pertinent information. A new LOC instrument is required upon entry into NOW/COMP
Step 2

If the A/Rs income includes SSI, STOP, deny application. SSI NOW/COMP A/Rs' claims are directly billed to DCH through the NOW/COMP agency.
Step 3

If the A/R is institutionalized or resides in the community, and is ABD Medicaid eligible, schedule a review when information is received from the Support Coordinator or provider. Proceed to Step 6.
Step 4

If the A/R is institutionalized or resides in the community, and is not currently eligible for Medicaid, schedule an initial interview when information is received from the Support Coordinator or provider.
Step 5

Determine basic eligibility. Refer to Chapter 2200, Basic Eligibility Criteria.
Step 6

Determine financial eligibility.
Step 7

Determine if the Length of Stay criteria is met. Refer to 2235 Length of Stay for ABD Medicaid.
Step 8

The system will determine the A/R’s Cost Share for NOW/COMP services. Refer to 2559 Patient Liability / Cost Share Budgetinge. The PNA is the same amount as the Medicaid Cap.
Step 9

Approve if the A/R meets all eligibility criteria.

Do not approve Medicaid under the NOW/COMP COA for any month prior to the month of either the NOW/COMP Enrollment Date or Date Services Begin listed on Form 1008, NOW/COMP Communicator, or prior to 2/1/94, the effective date of the NOW, or 10/1/97, the effective date of the COMP amendment.
Step 10

Complete Section III of Form 1008, NOW/COMP Communicator. Enter the Medicaid number at the top of the form. Send to the originating I & E Team with a copy to the Regional Office (as noted on Form 1008). A list of Regional Office addresses and the counties they serve is found at the end of Section 2132. The I & E Team will complete the return address for the I & E Team and the Regional Office. File a copy in the case record.

The NOW/COMP Communicator is used to provide required information to the NOW/COMP agency. If the NOW/COMP agency is listed as AREP in Gateway to receive the required notices, it is not necessary for the DFCS case worker to also complete and return the NOW/COMP Communicator.
Step 11

Notify the A/R and any authorized representative of case disposition.

Annual Reviews and Specials

Effective March 1, 2002, all DMA-7 forms processed by the I & E Teams for continued LOC will be completed on or before the birth date of the recipient. It will be valid until the following birth date, but not for longer than 365 days.

A new LOC instrument will not be required at annual review unless the review month coincides with the recipient’s birth month. Otherwise, a LOC instrument received in the birth month of a recipient is to be treated as a special review.

Special Considerations

The NOW/COMP COA requires one specifically designated form, a Form 1008, NOW/COMP Communicator. The Communicator is maintained by DBHDD.

The NOW/COMP Communicator functions much like the Community Care Communicator (CCC). The form is initiated by the I & E Team completing the following sections:

  • The top section, with all identifying information except the Medicaid number, unless the A/R is already a Medicaid recipient.

  • Section I

  • Section II

  • Section IV

  • Section V should include the I & E Team’s address.

Division of Mental Health, Developmental Disabilities and Addictive Diseases

Contact Information for Division of Mental Health, Developmental Disabilities and Addictive Diseases can be found on the DBHDD website.

Entity Contact Information

General Information

dbhdd.georgia.gov/

Regional Field Offices

dbhdd.georgia.gov/regional-field-offices

Regional Hospitals

dbhdd.georgia.gov/be-caring

Georgia Crisis & Access Line at 1-800-715-4225