Where Policy Meets Practice | Q3 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.
Your Voice Is Part of Advocacy
This fall, much of my attention has turned toward the election and what it could mean for the issues we have been working on throughout the year.
I have attended several candidate forums in recent months, including conversations focused on developmental disabilities and early childhood education. These forums offer an important opportunity to hear directly from candidates about the issues that affect people with disabilities, families, providers, educators, and communities across Georgia.
As voters, we have that opportunity too.
Advocacy takes many forms. It happens when we meet with legislators, serve on commissions, share our experiences, and speak up about policies that affect the people we serve. It also happens when we learn about the candidates seeking office and make informed choices at the ballot box.
If disability services, early childhood education, access to childcare, Medicaid, or other issues affecting individuals and families matter to you, I encourage you to learn where your candidates stand.
The people elected this November will inherit many of the policy questions we have been working on for years.
The Waiver Waitlist Is Still a Priority
One of those issues is Georgia's Medicaid waiver waitlist.
More than 7,000 Georgians with intellectual and developmental disabilities are waiting for Medicaid waivers that can provide access to home- and community-based services. These supports can help people live more independently, participate in their communities, find and maintain employment, and receive needed assistance outside of institutional settings.
Earlier this year, SPADD and the Georgia Council on Developmental Disabilities advocated for 1,200 additional waivers. The final state budget funded 100 annualized waivers.
Those 100 waivers matter deeply to the people who will receive them. But thousands of Georgians remain on the waitlist.
Increasing the number of waivers continues to be one of our priorities, and it will remain an important issue for the leaders who take office next year.
Preparing for the Next Rate Study
We are also continuing to advocate for a new Medicaid rate study.
Medicaid reimbursement rates determine how much providers receive for delivering many developmental disability services. Those rates affect an organization's ability to hire and retain Direct Support Professionals, maintain programs, and provide consistent, high-quality services.
Georgia has made some adjustments to reimbursement rates over the years, but the state went more than two decades without implementing a comprehensive rate-setting process. The most recent rate study took nearly three years to complete and was fully implemented in 2024. Even with those changes, gaps in funding remain for some services.
Rate studies are intended to take place every four years. Because the process itself takes time, we believe planning for the next study needs to begin now.
This is not simply a provider issue. When reimbursement rates fail to keep pace with the actual cost of delivering services, the effects eventually reach the people who depend on those services.
BHRIC's Work Is Moving Toward Recommendations
Another important piece of work is approaching a milestone.
The Intellectual and Developmental Disabilities Subcommittee of the Georgia Behavioral Health Reform and Innovation Commission is scheduled to wrap up its current work in November.
As a member of the subcommittee, I have been part of conversations about several issues affecting Georgians with developmental disabilities, including housing, transportation, reimbursement rates, person-centered practices, employment, and greater flexibility in how waiver supports can be used.
Some of these conversations are still developing, so I don't want to get ahead of recommendations that have not been finalized. What I can say is that there has been substantial work around identifying barriers and considering ways Georgia can better support people with developmental disabilities in living, working, and participating in their communities.
I look forward to sharing more as that work moves forward.
Keeping an Eye on Federal Policy
We are also continuing to monitor changes at the federal level that could affect Medicaid, IDEA, and other programs and services important to people with disabilities and their families.
There is still uncertainty around how some federal changes will be implemented and what their effects will be in Georgia. For now, our focus is on staying informed, participating in conversations as details become clearer, and making sure the needs of people with developmental disabilities remain part of those discussions.
The Work Continues After Election Day
Elections can change the people sitting at the table, but the issues facing people with developmental disabilities do not disappear when an administration or legislative session ends.
The waiver waitlist will still need attention. Providers will still need sustainable reimbursement rates. Georgia will still need a strong Direct Support Professional workforce. Families will still need access to services, childcare, transportation, housing, and employment opportunities.
That is why this election matters.
Whatever your political views, I encourage you to learn about the candidates on your ballot. Ask what they know about the issues affecting people with disabilities and their families. Pay attention to what they say about Medicaid, education, childcare, employment, and community-based services.
Then use your voice. Advocacy does not end at the ballot box, but voting is one important part of it.