Family Resource
The Parent's Complete Guide to GAPP
From the first phone call to your child’s 21st birthday, this guide walks you through every stage of in-home nursing in plain language, with links to deeper reading along the way.
Enrolled GAPP Provider
College Park, Georgia
0-21
Ages GAPP covers
01 / Stage 1
Before You Apply
The Georgia Pediatric Program (GAPP) is a Georgia Medicaid program, administered by the Georgia Department of Community Health (DCH), that provides in-home skilled nursing and personal care support for medically fragile children ages 0-21. Our full GAPP guide explains the program in depth, so here we focus on what parents actually do.
Start with three simple questions. Is your child Medicaid eligible, either directly or through the Katie Beckett pathway? Does your child’s doctor agree that nursing or hands on support at home is medically necessary? And do you have recent records that show your child’s daily needs? If you are unsure about any of these, that is normal. A short call can sort it out.
02 / Stages 2 and 3
Applying and Waiting for Approval
Families do not apply to the state alone. All GAPP services need prior authorization, requested through an enrolled GAPP agency such as SLB. Here is how the path usually looks.
01
First Call and Intake
In the first week we talk through your child’s needs, your schedule and your insurance, and explain each next step.
02
Records and Physician Orders
Over roughly the next two weeks we gather physician orders and medical records. Our required documents list shows what to collect.
03
Packet Submitted
We prepare and submit the prior authorization packet, then track it so you are not chasing updates yourself.
04
State Review
The state makes the final decision. Review usually takes up to about 30 days after a complete packet. If hours are denied or reduced, we help you with the appeal.
05
Care Begins
Most families start care about 30 to 60 days after the first call. No date can be promised, because the state review sets the pace.
03 / Stage 4
Your First Week of Care
The first shifts are about getting to know each other. Your nurse will learn your child’s routines, equipment, cues and comfort habits. Expect plenty of questions, and ask your own. You helped choose this nurse, and if the match does not feel right, you can request a different one.
Before day one, clear a work area near your child’s bed, keep supplies in labeled bins, and post emergency numbers where anyone can see them. For any emergency, call 911 first.
- Walk the nurse through a typical day, start to finish
- Show where supplies, backup equipment and medication lists live
- Agree on how shift handoffs will work
- Share what calms your child and what upsets them
04 / Stage 5
Living With Home Nursing
After a few weeks, nursing becomes part of family life. A little structure keeps it comfortable for everyone in the house.
01
House Rules
Decide early on things like shoes, parking, phone use, food, pets and which rooms are private. Clear rules prevent awkward moments later.
02
Working With Nurses
Treat your nurse as a partner. Share updates from doctor visits, give feedback kindly and directly, and tell our office if something is not working.
03
Communication Log
Keep one notebook or shared log for vitals, feeds, meds, seizures and notes between shifts, so every caregiver sees the same picture.
04
Privacy
Nurses follow privacy rules for your child’s health information. You decide who else in the home sees records. Our HIPAA notice explains your rights.
Caring for Yourself and Your Other Children
Parents of medically fragile children often run on very little sleep for months. Home nursing gives you room to breathe, and it is fine to use it that way. Sleep during an overnight shift, take a walk, cook a real meal, or spend focused time with your other children. Siblings notice when a nurse joins the household, so explain in simple words who the nurse is and why they are there, and let siblings ask questions.
Keep a short list of people who can help in a pinch, such as relatives, neighbors or members of your faith community, and share it with your care team. If you feel overwhelmed, anxious or low for more than a few days, tell your own doctor. Looking after your health is part of looking after your child.
05 / Stage 6
When Needs Change
Children grow, and medical needs shift. Approved hours are reviewed and re-authorized periodically, which means updated physician orders and records. Keep an eye on renewal dates and start gathering updated paperwork early, so renewal does not become a last minute scramble.
You do not have to wait for a scheduled review. If your child has a new diagnosis, new equipment or a decline, talk to your child’s doctor, then call us so we can request an update based on the new needs.
Hospital stays pause home shifts. Let our office know when your child is admitted and when discharge is planned. Ask the hospital team for updated orders and discharge notes before you leave, since new instructions often change the care plan at home.
06 / Stage 7
School, Daycare and Travel
Home nursing does not have to keep your child at home. With planning, care can often continue in other settings.
01
School and Daycare
Care can often continue at school or daycare. Share your child’s care plan with staff and ask us early how shifts can be coordinated with the school day.
02
Trips and Vacations
Tell us about travel well ahead of time. Pack extra supplies, carry a current medication list, and confirm the nearest hospital at your destination.
03
Working Parents
Many parents use approved hours to keep working. Planning shifts around your job is part of the scheduling conversation.
07 / Stage 8
Planning for Turning 21
GAPP ends when a child ages out of the program, so the move to adult care deserves early planning, ideally a few years ahead. Georgia has adult programs that may support young adults with ongoing medical needs, but each has its own rules and timelines.
Talk with your child’s case manager and doctors well before the 21st birthday about which adult options fit. Gather current records and keep a clear summary of daily care, since adult programs will ask for the same kind of detail.
This is also a good time to think about decision making as your child becomes a legal adult. Some families explore supported decision making or guardianship, and others simply update consent forms and medical contacts. The right choice depends on your child’s abilities and wishes, so ask your child’s doctors and, where needed, a qualified attorney for guidance. Starting these conversations early gives your young adult a voice and keeps care from stopping on the birthday itself.
Sources And Official Information
- Georgia DCH: Georgia Pediatric Program (GAPP) overview
- Georgia DFCS Medicaid Policy Manual, section 2933: Georgia Pediatric Program
Last reviewed October 2026. This page is general information, not medical or legal advice. Talk to your child’s doctor about clinical decisions.
FAQ
Parent Questions About GAPP
Does GAPP cost our family anything?
There is no out-of-pocket cost for approved hours when approved by Georgia Medicaid. Ask us about anything outside your approved hours before care starts.
My child has private insurance. Can we still apply?
Yes. Children with private insurance can still apply, and Medicaid can act as secondary coverage. Read how insurance affects GAPP.
Do I have to stay home while the nurse is working?
That depends on your child’s care plan and approved hours. Discuss expectations with our team during intake so everyone knows who is responsible when.
What if we do not get along with our nurse?
Tell our office early and be specific about what is not working. Small issues, like communication style or shift handoffs, can often be fixed with a direct conversation before a change is needed.
Can we switch agencies later?
Yes. Families choose their GAPP provider and may move to another enrolled agency. See our guide to switching GAPP providers.
Who do I call outside office hours?
For emergencies, call 911. Our office is open Monday to Friday 7am to 7pm and Saturday to Sunday 11am to 5pm, and we offer 24/7 online support through our contact form.
What is the difference between nursing and personal care?
Skilled nursing from RNs and LPNs covers things like trach, vent, G-tube and medication care. Personal care support covers bathing, feeding help, mobility and supervision. Learn more about skilled vs non-skilled care.
Take The First Step
Ready to Take the First Step?
Check whether your child may qualify, then let our team handle the paperwork with you.