Georgia DBHDD Group Home Licensing: Experience & Exception Rules

Under DBHDD Policy 02-701 Attachment A (Version 10/31/2024), new Developmental Disability (DD) provider agencies must demonstrate that the agency itself has delivered similar community-based services such as I/DD or other Home and Community-Based Services for at least one year before applying to DBHDD.

This proof usually includes a prior contract with a state, Medicaid authority, or authorized contracting entity showing at least 12 months of verified service delivery, claims history, and performance documentation.

In short: DBHDD wants to see that you or your agency already know how to operate in a regulated, person-centered care environment.

Regional Experience Review: The Exception Path

If your agency doesn’t yet have a year of operating history, DBHDD allows a regional approval of individual experience for leadership in place of agency experience.

Here’s what that means in practice:

1. Who qualifies for review:

   • The Director, Developmental Disabilities Professional (DDP), and Clinical Services Supervisor (CSS)must each meet the individual experience standards under Policy 02-701.

   • The Medicaid billing lead must show at least one year of billing experience for a similar agency or service.

2. What happens next:

   • DBHDD’s regional office reviews resumes, references, and background information for these individuals.

   • A regional interview follows, where applicants discuss their business plan and operational readiness.

   • DBHDD may approve the application if it determines that the leadership team, collectively, provides adequate experience and competency.

This process functions as DBHDD’s version of an “exception,” though officially termed regional approval in lieu of agency experience.

Converting from Individual to Agency Provider

DBHDD also provides a pathway for individual providers with at least two years of enrollment to become an agency. To qualify, the provider must be in good standing, show strong Qlarant review scores, and have no billing irregularities.

This route recognizes proven service history as equivalent to agency experience, streamlining the transition for established providers.

Preparing a Compliant Application

To meet DBHDD’s expectations:

✅ Gather contracts, service records, or claims showing at least one year of similar work.

✅ Ensure the Director, DDP, and CSS resumes clearly show qualifying experience.

✅ Include references with direct contact information.

✅ Organize documentation in the order outlined by DBHDD Policy 02-701 Attachment A.

✅ Be prepared for an interview with your regional field office.

Common Pitfalls

• Submitting an incomplete Letter of Intent (LOI) or missing evidence of prior service.

• Listing staff without verifiable experience or unclear roles.

• Failing to provide proof of billing experience for administrative leads.

Remember: DBHDD may deny applications if leadership or agency qualifications don’t meet Policy 02-701 or if investigative checks raise concerns.

FAQ

1. Does DBHDD allow new agencies with no service history? Yes, but only if DBHDD’s regional office approves the individual experience of the leadership team as a substitute for agency experience.

2. How long must experience be?At least one year of verified community-based service delivery—or comparable individual experience that DBHDD deems equivalent.

3. Who should I contact for clarification? Reach out to your DBHDD Regional Field Office or the Georgia Collaborative ASO Credentialing team at GAEnrollment@Carelon.com for current enrollment cycle details.

Sources

• Georgia DBHDD Policy 02-701: Attachment A – New Provider: Agency Applicant (Version 10/31/2024)

• Georgia Collaborative ASO, Provider Enrollment Guidance

• Georgia Department of Community Health, Medicaid Facility Enrollment

Next Step:Magnate Consulting helps Georgia providers prepare DBHDD applications that meet every policy requirement. From verifying experience to drafting your regional exception packet, our consultants walk you through each step.