Where Policy Meets Practice | Q2 2026
A Quarterly Update from DeAnna Julian
CEO, Frazer Center | Board President, SPADD
From Frazer Center:
Advocacy is part of our mission.
In addition to leading Frazer Center, CEO DeAnna Julian serves as Board President of SPADD (Service Providers for Developmental Disabilities), a statewide association representing organizations across Georgia. She also serves on the Georgia Behavioral Health Reform and Innovation Commission.
Each quarter, DeAnna shares an inside look at the policy conversations shaping services, funding, and opportunity for individuals with developmental disabilities.
Advocacy Requires Vigilance
By DeAnna Julian
Last quarter, I shared that while Georgia’s legislative session appeared quiet on the surface, important structural work was happening behind the scenes.
That remains true.
But as we move deeper into 2026, the policy landscape is becoming more complex. State priorities remain urgent, while new federal questions are creating additional uncertainty for providers, families, and individuals with developmental disabilities.
This is a time to stay informed, engaged, and focused on what matters most.
The Waitlist Remains Georgia’s Most Urgent Challenge
The most pressing issue continues to be Georgia’s Medicaid waiver waitlist, which still includes more than 7,000 Georgians with disabilities.
These are individuals who qualify for services but remain waiting for access to the support they need to live, work, and thrive in their communities.
This year, SPADD, the Georgia Council on Developmental Disabilities, and legislative champions worked together to advocate for a major investment in additional NOW and COMP waivers. Our goal was to secure funding that would significantly reduce the waitlist and provide meaningful relief to families across Georgia.
We advocated strongly for approximately 1,200 new waivers, including support for a proposed $21 million investment in the state budget.
While the Georgia Senate included that funding in its budget proposal, it was ultimately not approved in the final budget. Instead, only 100 annualized waivers were funded.
That outcome was disappointing, but it does not change the need.
The waitlist remains too large. Families continue to carry immense responsibility without adequate support. And our advocacy must continue.
Progress in this work requires persistence.
Federal Policy Is Bringing New Questions
In addition to state-level advocacy, providers across Georgia are closely monitoring federal policy changes that could affect Medicaid and disability services.
One of the most significant areas of focus involves proposed work and school requirements tied to Medicaid eligibility.
For individuals with developmental disabilities, this raises important concerns.
Many individuals have lifelong diagnoses and ongoing support needs. They should not face unnecessary administrative burdens or repeated documentation requirements simply to maintain access to essential services.
The concern is not only policy design. It is implementation.
States are being asked to move quickly, with guidance expected this summer and implementation timelines following shortly after. That creates challenges for agencies, providers, and families trying to understand and navigate new requirements.
We are watching these developments carefully and advocating for thoughtful implementation that protects individuals with developmental disabilities.
Accountability Matters, But So Does Balance
There is also increased federal attention on waste, fraud, and abuse across healthcare and Medicaid systems.
Accountability is important. Strong oversight protects both public resources and the individuals served.
At the same time, it is critical that disability services are not unintentionally harmed by broad policy actions designed to address issues elsewhere.
Georgia has historically maintained strong oversight and accountability measures. Even so, providers are preparing for the possibility of increased compliance and quality assurance expectations.
The goal should be better systems, not unnecessary barriers.
We must be careful not to create unintended consequences that disrupt essential services for the people who rely on them.
Workforce Stability Remains Essential
No policy conversation is complete without addressing workforce sustainability.
Direct Support Professionals remain the backbone of community-based services. They provide critical day-to-day support that makes independence, inclusion, and quality of life possible for thousands of Georgians.
Yet workforce challenges remain significant.
A major focus moving forward is advocating for a new rate study to evaluate Medicaid reimbursement rates for developmental disability services.
Georgia saw no reimbursement increase between 2010 and 2022. The most recent rate study took nearly three years to complete, was finalized in 2022, and was not fully implemented until 2024. These studies are intended to occur every four years, which means planning for the next study must begin now.
This matters because reimbursement rates directly affect provider sustainability and staff wages.
According to the 2024 National Core Indicators, a living wage in Georgia is $23.94 per hour.
Direct Support Professionals do difficult, highly skilled work. If we want to recruit and retain a strong workforce, compensation must reflect the value and complexity of that work.
Supporting the workforce is not separate from supporting people with disabilities. It is foundational to access, quality, and long-term sustainability.
Inclusion Must Remain the Goal
Even amid policy complexity, our focus at Frazer Center remains clear.
We continue to prioritize meaningful inclusion and employment opportunities for people with developmental disabilities.
That includes ongoing collaboration with the Georgia Vocational Rehabilitation Agency and participation in DBHDD’s technical assistance program to strengthen meaningful inclusion services.
This work centers on what are often called braided supports, services that work together to help individuals build meaningful lives in their communities. That includes supported employment, community integration, and day supports.
Policy matters because it shapes systems.
But the goal of those systems is always the same: helping people live connected, meaningful lives.
Looking Ahead
As Georgia moves toward a major election cycle, advocacy will remain essential.
SPADD is preparing to engage candidates in important conversations around developmental disabilities, workforce challenges, and meaningful inclusion.
The priorities remain clear:
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Reducing the Medicaid waiver waitlist
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Strengthening provider sustainability
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Supporting and retaining the workforce
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Protecting access to services
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Expanding meaningful employment and community integration
The work continues.
And in times of uncertainty, staying informed and engaged matters more than ever.