HB1238: HB1238 Community Health, Department of; submit a waiver request to the federal Centers for Medicare and Medicaid Services to authorize the qualification of certain caregivers for Medicaid reimbursement

Right now, family members caring for children under 21 who have serious behavioral health conditions and are at risk of being placed outside the home cannot get paid through Medicaid for providing respite care in the home. This bill would add a new section to Georgia's Medicaid law (O.C.G.A. § 49-4-142.6) directing the Department of Community Health to ask the federal Centers for Medicare and Medicaid Services for a waiver, a special permission to change normal program rules, by December 31, 2026. The waiver would let caregivers of Medicaid recipients under 21 who are at risk of out-of-home placement or residential treatment because of complex behavioral health conditions qualify for Medicaid payment when they provide respite care and related services in a family-like setting. If the federal government approves the waiver, the department would then have to take the steps needed to actually pay for that care with Medicaid funds.

• Requires the Department of Community Health to submit a federal Medicaid waiver request by December 31, 2026, covering caregiver reimbursement for respite care.
• Targets the waiver at caregivers of Medicaid recipients under age 21 who face risk of out-of-home placement or residential treatment due to complex behavioral health conditions.
• Directs that the care be provided in the least restrictive, most family-like setting possible to meet the child's needs.
• Requires the department to take all necessary steps to pay for the care and services with Medicaid funds once the federal waiver is approved.
• Repeals any existing Georgia laws that conflict with this new requirement.

Families and caregivers of children under 21 with complex behavioral health conditions who are at risk of being placed outside the home, the Department of Community Health, and the federal Centers for Medicare and Medicaid Services, which must approve the waiver before payments can begin.

If the federal waiver is approved, family caregivers could get paid through Medicaid for respite care they currently provide unpaid, potentially helping children with serious behavioral health needs stay in family settings rather than move into residential treatment or out-of-home placement.

• Section 1 adds new Code section 49-4-142.6, requiring the Department of Community Health to submit the waiver request no later than December 31, 2026.
• The waiver applies specifically to caregivers of Medicaid recipients under age 21 who are at risk of out-of-home placement or residential treatment due to complex behavioral health conditions.
• Care and services covered must be delivered in the least restrictive, most family-like setting possible.
• Subsection (b) requires the department to act to enable Medicaid payment for the care once the federal waiver is approved, but only after that approval.
• Section 2 repeals any conflicting laws.

1. 2026-04-02House Agreed Senate Amend or Sub As Amended (House)
2. 2026-03-31Senate Passed/Adopted By Substitute (Senate)
3. 2026-03-31Senate Third Read (Senate)
4. 2026-03-19Senate Read Second Time (Senate)
5. 2026-03-18Senate Committee Favorably Reported By Substitute (Senate)
6. 2026-03-06Senate Read and Referred (Senate)
7. 2026-03-04House Passed/Adopted (House)
8. 2026-03-04House Third Readers (House)

• Katie Dempsey (R, HD-013)Primary sponsor
• Lee Hawkins (R, HD-027)
• Mike Cameron (R, HD-001)
• Omari Crawford (D, HD-089)
• Sharon Cooper (R, HD-045)
• Bo Hatchett (R, SD-050)

1. PassedHouse voteMarch 4, 2026

   167 yea, 2 nay (3 not voting, 5 absent)

   Passage: House Vote #626

2. PassedSenate voteMarch 31, 2026

   46 yea, 0 nay (2 not voting, 6 absent)

   Passage By Substitute: Senate Vote #893

3. PassedHouse voteApril 2, 2026

   165 yea, 2 nay (5 not voting, 4 absent)

   Agree To Senate Sub As Am: House Vote #852

• Medicaid
• respite care
• behavioral health
• caregivers
• Department of Community Health