A Program of the Georgia Department of Community Health 
A SNAPSHOT OF THE 
Katie Beckett Program 
 
Overview 
Established in 1982 under the Tax Equity and Fiscal Responsibility Act (P.L. 97-248), the Katie Beckett Medicaid Program (KB), permits the state to ignore family income for certain disabled children. It provides benefits to certain children 18 years of age or less who qualify as disabled individuals under 1614 of the Social Security Act and who live at home, rather than in an institution. These children must meet specific criteria to be covered. Qualification is not based on medical diagnosis; it is based on the institutional level of care the child requires. Title 42 Code of Federal Regulations outlines the criteria used to determine eligibility. 
Applying for the Katie Beckett Program 
Applications must be filed at the local county Department of Family and Children Services (DFCS). 
 
ENROLLMENT 
Enrollment dramatically increased over five years from 2,694 to 6,299. Up 250 percent. 
OTHER STATES 
 Other 20 States have opted to open the category 
 Only three other states in the Southeast have a KB program 
 
Has Katie Beckett eligibility criteria changed? 
To ensure that health care is delivered to the children who need services most, and to reduce abuse and fraud to the program, the Georgia Department of Community Health (DCH) began enforcing federal 
 
ELIGIBILITY 
 18 years old or younger  Meet federal criteria for 
childhood disability  Meet institutional level of care 
 
guidelines for the program in November 2004. Reasons behind the 
 
 Can safely be served at home 
 
current criteria are: 
 
 Cost does not exceed the 
 
 DCH received numerous reports of children in the program that were not eligible 
 
applicable institutional cost 
 
 The Centers for Medicaid and Medicare began auditing states' 
 
Medicaid and Medicare programs. Portions of the audit focus on whether the evidence supports 
 
compliance with regulations and eligibility determinations 
 
 Adult Activities of Daily Living (ADL) was being used to assess eligibility of children, rather than the 
 
child specific criteria 
 
 In November 2004, physician specialists, advocates and parents helped develop pediatric criteria 
 
How is level of care determined? 
STEP 1 Families apply for the KB Wavier with a DCFS case manager 
STEP 2 Treating physicians, parents and others (school guidance counselors, therapists, etc.) complete the required application packet 
STEP 3 GMCF under the direction of a pediatrician, pediatric neurologist and nurses, perform the clinical review of the packet 
STEP 4 If level of care is satisfied, DCFS does a cost neutrality assessment to determine whether the cost of home care is less than an institution 
 
2 Peachtree Street, Atlanta, Ga 30303 www.dch.georgia.gov 
 
February 2009 
 
 A Snapshot of Katie Beckett Program 
Is there an appeals process? Yes. An initial (administrative) appeal can be made directly to GMCF. A second appeal can be made by requesting a hearing directly with DCH. 
Alternatives to Katie Beckett  During the 2006 legislative session, the General Assembly directed the DHR to create a foundation to 
ease the transition of those children who are no longer eligible for the KB Wavier. The General Assembly appropriated $7.6 million in FY2006 Amended FY 2006 Budget to help these families. Contact DHR for more details about this foundation  Babies Can't Wait (BCW) program Individualized Family Service Plan  Local Education Agency Individualized Education Plans