Health home for children with medically complex conditions

The Centers for Medicare and Medicaid Services awarded the Georgia Department of Community Health $100,000 on August 1, 2026, under a Project Grant for planning activities related to development of a Medicaid State Plan Amendment to establish a Health Home model for children with medically complex conditions pursuant to Section 1945A of the Social Security Act.

The award funds Georgia's submission to develop and plan a health home model that coordinates and integrates care for Medicaid-eligible children under age 21 with medically complex conditions, including those in the foster care system and others at risk of government intervention. Georgia's approach draws on resources across the Department of Community Health and the Department of Human Services to designate health home providers and teams that deliver whole-person care addressing clinical and non-clinical needs.

The project establishes four main goals: improve health outcomes for Georgia foster children with complex medical conditions through stabilizing supports to increase home-based placements; evaluate Medicaid data systems and healthcare interoperability; understand the target population and barriers to care; and inform construction of an effective State Plan Amendment. Work is performed in Georgia with a period of performance through July 31, 2029.

Abstract

Summary the georgia department of community health's (DCH's) submission for the home for children with medically complex conditions (hcmcc) planning grant for activities related to the development of a state plan amendment (SPA) pursuant to section 1945A of the social security act (the act) directed to children with medically complex conditions to plan and develop this health home model. Taking a unifying approach across two agencies and drawing on resources in the DCH and department of human services (DHS), georgia's submission meets CMS' direction to "ensure that certain medicaid beneficiaries' care is better integrated and coordinated, thereby helping to ensure that these beneficiaries can receive whole person care that addresses both clinical and non-clinical needs." embedded in principles articulated in 42 U.S.C. 1396W-4A to select a "designated provider, a team of health care professionals operating with such a provider, or a health team as the child's health home for purposes of providing the child with health home services" for medicaid-eligible children under age 21, georgia's plan incorporates improving outcomes for children with medically complex conditions in the foster care system and those identified as meeting the hhcmcc definition, that otherwise are at risk of government intervention, including removal from their homes. Georgia's proposal provides four main goals designed to understand and define the population, perspectives, barriers, electronic health record completeness, interoperability of data systems, and treatments or services needed to effectively construct an effective medicaid state plan amendment (SPA): 1. Goal 1: improve health outcomes for georgia foster children with complex medical conditions through stabilizing supports to increase the number of appropriate home-based placements. 2. Goal 2: evaluate medicaid (gammis) and other healthcare data, relevant child welfare data (shines), and related resources to study and inform the processes, supports, and treatment models that may increase home-based care for defined CMC. 3. Goal 3: increase stakeholder engagement to inform care and treatments to reduce non-home-based placements that may be necessitated by specialty care requirements and may contribute to increased placement velocity ("disruption"). 4. Goal 4: increase integration of state systems, including those responsible for child-welfare connected youth, to inform and aggregate documented health or health-related attributes as a complete health record. The total budget for the project is $150,600 based on the allowable federal funding and state match requirement of current fmap for georgia. Funds will be used to engage the project director to ensure the goal tasks are executed and engage the collaborative team. Funds will also be used for consulting services to define estimates and forecasts by DCH's actuary based on the planning grant collaborative cross-agency team recommendations for review and consideration of a defined population, suggested treatments, services and supports both in georgia foster care and those at-risk of government intervention. Funds will be expended to advance understanding and balance fiscal and operational considerations in support of a subsequent submission of a state plan amendment on or about spring 2027.