Understanding the Difference Between NOW and COMP Waivers in Georgia

If you're a parent, sibling, or caregiver of someone with an intellectual or developmental disability (I/DD) in Georgia, you've probably heard the names "NOW" and "COMP" more than once. These two Medicaid waiver programs are the backbone of Georgia's home and community-based support system for people with I/DD — but many families aren't sure how they differ or which one applies to their situation.

This guide breaks it down clearly, so you can advocate more effectively for your loved one.

What Are NOW and COMP Waivers?

Both the New Options Waiver (NOW) and the Comprehensive Supports Waiver (COMP) are Georgia Medicaid waiver programs administered by the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD). They fund home and community-based services that help individuals with I/DD live as independently as possible — in their own home, with family, or in a community residential setting — rather than in an institution.

The word "waiver" refers to the federal flexibility that allows states to waive certain standard Medicaid requirements in order to provide a broader range of community-based services. Georgia's full waiver program information is available through Georgia Medicaid's programs page.

Both programs are part of the broader family of Georgia's home care options alongside GAPP, ICWP, and EDWP.

The Core Difference: Level of Support

The single most important distinction between NOW and COMP is the intensity of support the individual requires.

• COMP (Comprehensive Supports Waiver) is designed for individuals who have higher support needs — people who require more hands-on assistance, more hours of care, or more complex service coordination throughout the day. COMP generally provides a larger annual budget and access to a more comprehensive array of services.

• NOW (New Options Waiver) is designed for individuals who have moderate or lower support needs — people who can live with greater independence and require fewer direct support hours, though still benefit meaningfully from structured community-based services.

Think of it this way: both programs serve the same population (individuals with I/DD), but COMP is built for those who need a higher "floor" of daily support, while NOW is better suited for individuals who are working toward greater independence.

Neither program is "better" — the right fit depends entirely on your loved one's assessed needs. A DBHDD support coordinator will help determine which waiver is appropriate based on a thorough functional assessment.

Who Is Eligible?

To qualify for either NOW or COMP, an individual must:

• Be a Georgia resident enrolled in Georgia Medicaid
• Have a documented diagnosis of intellectual disability, developmental disability, or related condition (such as autism spectrum disorder)
• Be determined to require an intermediate care facility (ICF/IID) level of care — meaning that without these services, institutional placement would be necessary
• Be at least 3 years old (there is no upper age limit)

A diagnosis alone is not enough. Georgia uses a functional assessment process through DBHDD to evaluate daily living skills, behavioral support needs, and medical requirements. This assessment drives both waiver eligibility and service planning.

What Services Are Available?

Both waivers cover a wide range of services, though COMP typically authorizes more hours and supports for individuals with higher needs.

Services Available Under Both NOW and COMP

• Community Living Supports (CLS) — assistance with daily living, personal care, and skill building in the home
• Community Access — structured outings and activities to support community participation
• Supported Employment — job coaching and workplace supports
• Behavioral Support Services — assessment and intervention for challenging behaviors
• Respite Care — temporary relief for primary caregivers
• Transportation — to and from waiver-funded services
• Natural Support Training — education and training for family members providing care
• Occupational, Physical, and Speech Therapy (when medically indicated)

Services More Commonly Associated With COMP

• In-home supports at higher intensity — more daily hours of direct care and assistance
• Residential supports in community settings — host home and supported living arrangements
• Crisis and emergency supports — more robust crisis response planning and services

The Waitlist Reality

One of the hardest parts of the NOW and COMP system is the waitlist. Demand for both programs significantly outpaces the number of available slots, and families often wait years before their loved one is enrolled.

Here's what you need to know:

• Get on the waitlist early. Even if your loved one is a child, you can apply to be placed on the DBHDD Interest List. Time on the list can count toward eventual enrollment, so earlier is always better.
• Waitlist placement is separate from eligibility determination. Being on the waitlist does not mean you've been approved — you'll still go through the full assessment process when a slot becomes available.
• Check your status regularly. DBHDD allows families to monitor Interest List status through their support coordinator or by contacting DBHDD directly at 1-800-436-7442.
• Interim services may be available. While waiting, some individuals may qualify for other Georgia programs like GAPP (for children with medical needs) or Medicaid State Plan services that don't require a waiver slot.

The wait can feel discouraging, but families who stay engaged with DBHDD and work with a support coordinator are better positioned to navigate transitions and move through the process when opportunities arise.

How to Apply

Applying for NOW or COMP involves several steps:

1. Enroll in Georgia Medicaid — Medicaid is the foundation for both waivers. If you're not already enrolled, visit the Georgia Gateway portal or call 1-800-282-4536.
2. Request placement on the DBHDD Interest List — Contact your regional DBHDD office or call 1-800-436-7442 to request placement on the I/DD Interest List.
3. Complete a functional assessment — When a slot becomes available, DBHDD will conduct a comprehensive assessment to determine eligibility and level of need.
4. Work with a support coordinator — Once enrolled, a support coordinator will help develop your Individual Service Plan (ISP), select service providers, and monitor ongoing supports.

For more on how Georgia's waiver programs fit together, see our guide to navigating Georgia's Medicaid waiver programs.

How Heart and Soul Healthcare Fits In

Once your loved one is enrolled in NOW or COMP, Heart and Soul Healthcare is here to deliver the direct support services outlined in their Individual Service Plan. Our team provides community living supports, personal care, and other approved waiver services — always with the goal of helping individuals thrive in the setting they call home.

If you're still navigating eligibility, waitlist placement, or service planning, we can connect you with resources and help you understand your next steps. You don't have to figure out this system alone.