HB 1238: 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

Currently, Georgia families caring at home for children under 21 with complex behavioral health conditions who are at risk of being placed in residential treatment or out-of-home care often cannot get Medicaid to pay caregivers for respite care, temporary relief care that lets a primary caregiver rest. This bill adds 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 allowing these caregivers to qualify for Medicaid reimbursement. The department must submit this waiver request by December 31, 2026. If the federal government approves the waiver, the department must then take the steps needed to actually start paying for this respite care and related services using Medicaid funds, in the least restrictive, most family-like setting that meets the child's needs. The bill also repeals any conflicting laws.

• Adds a new Georgia Medicaid law (O.C.G.A. § 49-4-142.6) requiring the Department of Community Health to request a federal waiver for caregiver Medicaid reimbursement.
• Sets a deadline of December 31, 2026 for the department to submit the waiver request to the federal Centers for Medicare and Medicaid Services.
• Targets the waiver at 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.
• Requires that, if the waiver is approved, the department take all necessary steps to begin paying for respite care and related services with Medicaid funds.
• Directs that such care be provided in the least restrictive, most family-like setting possible to meet the child's needs.

Families and caregivers of children under 21 on Medicaid who have complex behavioral health conditions and risk being placed in residential treatment, the Department of Community Health, which must apply for and implement the waiver, and the federal Centers for Medicare and Medicaid Services, which must approve it.

If the federal waiver is approved, families caring for children with serious behavioral health needs could get paid through Medicaid for respite care, potentially making it easier to keep children at home rather than in residential treatment or foster-style placements.

• Section 1 adds new Code section 49-4-142.6 to Article 7 of Chapter 4 of Title 49, Georgia's medical assistance law.
• Subsection (a) requires the department to submit a Medicaid waiver request to CMS by December 31, 2026, covering caregivers of recipients under 21 at risk of out-of-home or residential placement.
• Subsection (a) specifies the goal is respite care and related services delivered in the least restrictive, most family-like setting possible.
• Subsection (b) requires the department, once the waiver is approved, to take all necessary steps to pay for such care with Medicaid funds.
• Section 2 repeals any conflicting laws.

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

• Katie Dempsey (R, HD-013)Patrocinador principal
• 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. AprobadaVotación: Cámara de Representantes4 de marzo de 2026

   167 a favor, 2 en contra (3 sin votar, 5 ausentes)

   Passage: House Vote #626

2. AprobadaVotación: Senado31 de marzo de 2026

   46 a favor, 0 en contra (2 sin votar, 6 ausentes)

   Passage By Substitute: Senate Vote #893

3. AprobadaVotación: Cámara de Representantes2 de abril de 2026

   165 a favor, 2 en contra (5 sin votar, 4 ausentes)

   Agree To Senate Sub As Am: House Vote #852

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