A major state program designed to help Georgians with intellectual and developmental disabilities receive in-home care and supports could see significant changes in 2026, as state officials consider proposals aimed at reshaping how applicants are prioritized for services.

Officials with the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) presented recommendations during a December board meeting that would restructure the current waiting list for Medicaid waivers that help keep people out of institutional settings. Those waiver services can include items such as medical supplies, personal care assistants, and emergency alert systems.

Georgia had more than 7,800 people on the waiver waiting list as of March, though the agency notes not everyone on the list has an urgent need. Advocates say better identifying urgency is a key first step so the most critical cases can be addressed sooner, while state leaders continue debating long-term funding needed to expand access and potentially reduce or eliminate the wait list.

One proposal would create a three-tiered system separating applicants into categories based on urgency and expected timeframe of need, including those who need help immediately, those likely to need services within one to five years, and those who may need services later. Recommendations also include developing a new waiver option for people who don’t currently qualify under existing programs and using an updated assessment tool to improve data collection and decision-making.

Supporters say the plan could make the process more transparent and aligned with best practices used in other states, but they also stress that implementation will be critical and should include ongoing input from people with disabilities, their families, and advocacy organizations. Concerns were also raised about the potential impact of federal Medicaid funding cuts, which could force states into difficult budget choices.

The proposals are currently recommendations, and a specific timeline for moving forward has not yet been announced.

The Georgia Recorder contributed to this report.