GAPP Program Guide
What Is GAPP? Georgia Pediatric Program Guide
A plain language guide to the GAPP program for Georgia parents of medically fragile children: who qualifies, what it covers, how hours work, and how to apply.
Enrolled GAPP Provider
College Park, Georgia
0-21
Ages GAPP covers
GAPP, the Georgia Pediatric Program
A Georgia Medicaid (DCH) program for in home skilled nursing and personal care, ages 0-21.
Definition
What Is the GAPP Program?
In everyday terms, GAPP lets a child who needs ongoing medical care stay at home with family instead of in a hospital or facility. A licensed nurse or trained aide comes to the home on an approved schedule and handles the care the child’s doctor has ordered, so parents can sleep, work, look after siblings and simply be parents again.
GAPP is a Medicaid program, not a waiver. Families sometimes hear the two terms mixed together because many children reach Medicaid through the Katie Beckett pathway first. The difference matters when you fill out paperwork or talk to a caseworker, so it helps to use the right name.
Because GAPP is part of Medicaid, it follows state rules about eligibility, prior authorization and periodic review. Those rules are explained below in the order most families meet them, from the first eligibility questions to choosing a nurse.
Care happens in your home, on a schedule built around your child
Services are delivered by an enrolled GAPP agency that you choose
Every service is tied to orders from your child's physician
Eligibility
Who Qualifies for GAPP
A child generally needs to meet all four of the conditions below. The state makes the final decision on each application, so treat this as a starting point rather than a promise.
Many families are unsure whether their child is “sick enough” to apply. The question the state asks is not about a label but about the level of care your child needs each day and whether a physician has written that down clearly.
Georgia Resident
01
The child must live in Georgia. Care is provided in the family home, wherever that is in the state.
Age 0 to 21
02
Infants coming home from the NICU, school age children and young adults up to their 21st birthday can all be considered.
Medicaid Eligible
03
The child must qualify for Georgia Medicaid, either directly through household income or through the Katie Beckett pathway, which looks at the child’s own income and resources instead of the parents’.
Documented Medical Need
04
The child’s physician must document medical necessity: the diagnoses, the daily care involved and why that care calls for a nurse or aide at home.
Your GAPP Folder
6 groups
What to Gather
Documents Families Usually Gather
Copies or phone photos are fine for most items. If something is missing, bring what you have and we will help fill the gaps.
Coverage and ID
Your child’s Medicaid ID card or Katie Beckett application status, any private insurance cards, front and back, and a photo ID for the parent or legal guardian.
Diagnosis Information
A list of your child’s diagnoses as written by the doctor, plus any recent letters or medical reports that describe each of those conditions.
Physician Contacts
Name, practice, phone and fax for your child’s primary care doctor and for each pediatric specialist who currently follows and manages your child’s care.
Current Medications
Every medication with its dose, route and schedule, including as needed medicines and feeding formulas, written out together in one clear list.
Hospital Notes
Recent hospital discharge summaries plus the latest notes from specialist visits, such as pulmonology or neurology, kept together in one place.
Equipment List
Each device your child uses at home with its current settings, such as ventilator settings, feeding pump rate, oxygen flow, suction and monitors.
Two Service Types
Skilled Nursing vs Personal Care
GAPP has two service types. Your child’s doctor and the state’s review decide which one fits, and some children need both at different times of day.
Skilled Nursing
Personal Care Support
Skilled Nursing:
Licensed registered nurses (RNs) and licensed practical nurses (LPNs)
Who provides it
Personal Care Support:
Trained personal care aides
Skilled Nursing:
Trach care and suctioning, ventilator monitoring, G tube feeds, medications, seizure monitoring, ongoing assessments
Typical tasks
Personal Care Support:
Bathing, feeding help, mobility and transfers, toileting, dressing, general supervision
Skilled Nursing:
Children whose care needs clinical judgment or medical equipment management
Best fit for
Personal Care Support:
Children whose daily living tasks are hard for the family to manage alone
Skilled Nursing:
Physician orders showing nursing level needs
What drives approval
Personal Care Support:
Physician orders showing hands on help with daily activities
Clinical decisions about your child’s care belong to your child’s doctor. In an emergency, call 911.
Hours and Reviews
How GAPP Hours Are Approved and Reauthorized
Every GAPP service requires prior authorization. Your enrolled agency submits a packet that includes physician orders, recent medical records and a care plan. The state reviews that packet and approves a number of hours based on your child’s documented need. There is no fixed number that every child receives.
Approved hours are reviewed and reauthorized periodically. Before each review, the agency gathers updated orders and notes so the state sees an accurate picture of your child today. If your child’s needs change between reviews, for example after a surgery, a new device or a hospital stay, you can ask for an update rather than waiting for the next cycle.
If a request is denied or hours come back lower than expected, families have the right to appeal. SLB helps families understand the decision and prepare the paperwork for an appeal.
Keep a review log
Track hospital visits, equipment, medication changes and hard nights to share at reviews.
Application
How to Apply for GAPP, Step by Step
30 to 60 days
Most families start care about 30 to 60 days after their first call. No agency can promise a start date.
01
Confirm Medicaid
Make sure your child has Georgia Medicaid, or apply through Katie Beckett if household income is too high.
02
Choose an Enrolled Agency
Contact a GAPP provider. With SLB, the first call and intake happen in the first week.
03
Gather Physician Orders
Your agency collects orders, records and a care plan from your child’s doctor over about two weeks.
04
Submit Prior Authorization
The agency sends a complete packet to the state, which usually reviews it within about 30 days.
05
Meet Your Nurse, Begin Care
Once hours are approved, the agency matches a nurse or aide with your family and sets the schedule.
Other Options
GAPP vs Other Georgia Options
Families often compare GAPP with private insurance home health and with the Katie Beckett pathway. Katie Beckett is not a separate care service: it is one way a child becomes Medicaid eligible, which can then open the door to GAPP.
GAPP
What it is
Georgia Medicaid program for in home nursing and personal care
Provides nursing itself?
Yes, through an enrolled agency
Cost to family
No out of pocket cost for approved hours when approved by Georgia Medicaid
Hours
Set by the state based on documented need
Provider choice
Family chooses any enrolled GAPP agency
Private Insurance Home Health
What it is
Home health benefit under your own health plan
Provides nursing itself?
Depends on the plan
Cost to family
Copays, deductibles and plan limits may apply
Hours
Set by plan rules and limits
Provider choice
Usually limited to the plan’s network
Katie Beckett
What it is
Medicaid eligibility pathway based on the child’s own income and resources
Provides nursing itself?
No, it qualifies the child for Medicaid services such as GAPP
Cost to family
Not a care service; it opens Medicaid eligibility
Hours
Not applicable
Provider choice
Not applicable
Children with private insurance can still apply for GAPP; Medicaid can act as secondary coverage. Program rules change, so confirm details with the official sources below.
Agency Support
What Your GAPP Agency Handles for You
The GAPP paperwork can feel heavy when you are already managing appointments, equipment and medications. A good enrolled agency carries most of that load. Here is what SLB takes on for families, from the first conversation through every review that follows.
01
Intake and Planning
We listen to how your days and nights actually look, note the care your child needs, and explain which GAPP service type is likely to fit before any forms are filed.
02
Physician Coordination
We contact your child’s doctor for the orders and records the state expects, and follow up on missing pieces so you are not chasing signatures on your own.
03
Prior Authorization Packet
We prepare and submit the complete packet, then track it through the state’s review and let you know when a decision comes back.
04
Appeal Paperwork
If hours are denied or reduced, we help you gather stronger documentation from your child’s care team for the next step.
05
Pediatric Staffing
We staff licensed RNs and LPNs with a pediatric focus, plus personal care aides for personal care services.
06
Scheduling and Respite
We coordinate day, evening and overnight shifts, including respite shifts, and adjust the schedule when school, therapy or travel plans change.
Enrolled GAPP Provider
College Park, Georgia
Provider Choice
Choosing and Switching Your GAPP Provider
Your Right to Choose
Families choose their GAPP provider and may switch agencies if shifts go unfilled or communication breaks down. The new agency explains the transfer and state paperwork.
Questions to Ask
Ask how an agency staffs overnight shifts, matches nurses with families and helps with reauthorizations and appeals. At SLB, families help choose their nurse.
Serving Your County
SLB In-Home Care serves Fulton, Clayton, DeKalb and Fayette counties and families statewide. Open Monday to Friday 7am to 7pm, weekends 11am to 5pm, with 24/7 online support.
Common Questions
GAPP Program Questions
Does GAPP cost anything for my family?
For approved hours, there is no out of pocket cost when the care is approved by Georgia Medicaid. Hours that are not approved, or services outside the approved plan, are not covered by GAPP.
Is GAPP a waiver program?
No. GAPP is a Georgia Medicaid program. Katie Beckett is the waiver style pathway some children use to become Medicaid eligible, and that eligibility can then be used to apply for GAPP.
What diagnoses does GAPP cover?
GAPP looks at care needs rather than a list of diagnoses. Children with tracheostomies, ventilators, feeding tubes, seizure disorders, cerebral palsy and other complex conditions often apply, but approval depends on what the physician documents.
Can GAPP nurses go to school or daycare with my child?
In many cases care can continue at school or daycare and around travel, depending on the approved plan. Ask your agency how this works for your child’s schedule.
Can I get overnight nursing through GAPP?
Yes, overnight shifts can be part of an approved schedule when the documented need supports it. Many families use overnight hours so parents can sleep.
Can parents be paid as the GAPP caregiver?
GAPP services are delivered by staff of an enrolled agency. Rules about family members are set by the state, so ask your agency and check the official policy manual for current guidance.
What happens when my child turns 21?
GAPP covers children ages 0-21. Planning for adult services should start well before that birthday; talk with your agency and your child’s care team about next steps.
What should I do if my child has a medical emergency during a shift?
Call 911 first. A GAPP nurse follows the emergency plan in your child’s physician orders, but GAPP is not an emergency service. After the emergency, tell your agency and your child’s doctor so the care plan and orders can be updated if needed.
Do I need a referral to start GAPP?
You do not need a special referral form to contact an agency. What the state requires is documentation from your child’s physician, so it helps to tell your child’s doctor early that you are applying. Your agency can explain which documents are needed.
How do I get started with SLB?
Call or text 404-905-8332, email admin@slbinhomecare.org, or use our eligibility check. We start intake and coordinate with your child’s doctor from there.
Get Started Today
Find Out if GAPP Fits Your Child
Answer a few questions and our team will walk you through the next step.