Decatur County Day Program Builds Friendships, Fuels Medicaid Waiver Debate

Rodneshia Stewart has been walking through the doors of the Georgia Pines Decatur Seminole Service Center since 2011, and what she found there was not just programming but people. "I have friends here. They do share with me and they do help me out a lot. And I like them and I do honestly like them and I do appreciate them. And I do love them. I love them a lot," Stewart said.

Stewart is one of many adults with intellectual and developmental disabilities who rely on the center for life skills training, social engagement, and daily structure. Fellow participant Deshawn Breedlove has described the program as a vital, consistent part of his routine, one that provides connection and support that he does not find elsewhere.

The program that anchors their days sits at the center of a high-stakes legislative fight in Atlanta. The Georgia Senate is considering a proposal that would fund more than 1,200 new Medicaid waiver slots specifically for adults with intellectual and developmental disabilities. The two programs at the heart of the debate, Georgia's NOW (New Options Waiver) and COMP (Comprehensive Supports Waiver Program), cover exactly the kind of services Stewart and Breedlove use: day programs, respite care, and community-based support staff.

Demand far outpaces what the state currently funds. As of early 2025, approximately 7,800 to 7,900 Georgians with intellectual and developmental disabilities were waiting for NOW/COMP waiver services, and advocates say that figure likely undercounts the true need because many families never apply, knowing they face years-long waits. Across the South, more than half a million people with intellectual and developmental disabilities are on similar waiting lists for Medicaid home and community-based services.

The gap between need and action has been widening for years. In 2022, a Georgia Senate Study Committee created through Senate Resolution 770, sponsored by Sen. Sally Harrell of District 40, recommended funding 2,400 new waiver slots in the FY 2024 budget with the goal of eliminating the waiting list entirely within three years. The state has fallen well short: Georgia added 513 slots for FY 2023 and only 100 for FY 2025.

Katie Bailey, Director of Project and Operational Strategy at Sangha Unity Network, a nonprofit supporting people with intellectual and developmental disabilities, framed the waivers' significance directly. "[The waivers] open the door for people to have the option to access their community and live in a home of their choosing rather than an institution or nursing facility," Bailey said.

D'Arcy Robb, executive director of the Georgia Council on Developmental Disabilities, expressed cautious optimism about recent restructuring proposals but stressed that successful implementation will require "an ongoing commitment from the state" and meaningful input from people with disabilities and their families.

That commitment now faces pressure from two directions. Lawmakers could scale back the current 1,200-slot proposal before it passes. At the federal level, advocates have warned that proposed Medicaid budget cuts tied to legislation referred to as the "big, beautiful bill" could shrink funding for optional services like home and community-based care, which are typically among the first cut when states face budget shortfalls. The Georgia Council on Developmental Disabilities has warned the roughly 7,900 Georgians already on the waiting list could face further delays if federal funding contracts.

Decatur County is served by DBHDD Region 4, a South Georgia structure that also covers Seminole County and more than 20 surrounding counties. For Stewart, fourteen years of friendships make the policy debate anything but abstract.