the-arc

Why Georgia Medicaid Falls Short for Patients with IDD Seeking OB/GYN Services

Thu, 21 Aug 2025 21:08:55 GMT

Written by: Lindsey Grater, MS4 at the Medical College of Georgia

Key Takeaways

While most individuals with intellectual and developmental disabilities (IDD) in Georgia qualify for Medicaid, OB/GYN access remains limited. Gaps stem not from a lack of coverage, but from structural issues in how services are prioritized, coordinated, and delivered, especially through Georgia’s 1915(c) waiver programs and EPSDT. These systemic failures leave many patients with IDD without routine reproductive healthcare.

Introduction

Accessing quality health care is already challenging for many Georgians, but for individuals with intellectual and developmental disabilities (IDD), those challenges are even greater. While most people with IDD in Georgia qualify for Medicaid, basic reproductive and OB/GYN services often remain out of reach—not because coverage doesn’t exist, but because the system isn’t built to prioritize or coordinate this kind of care. As a result, too many individuals with IDD are left without the preventive screenings, menstrual health management, or reproductive care that others may take for granted.

This article takes a closer look at how Georgia’s Medicaid waivers and EPSDT policies impact access to OB/GYN care, where the biggest barriers exist, and what providers, caregivers, and advocates can do to close the gap.

Medicaid Waivers in Georgia: Coverage vs. Access

Georgia operates two major 1915(c) Medicaid waivers for individuals with IDD:
– NOW (New Options Waiver)
– COMP (Comprehensive Supports Waiver)

These waivers provide essential nonmedical supports like personal care assistance, supported employment, and respite care. However, they do not include OB/GYN services in their goals or required offerings. Each participant works with a support coordinator to create an annual service plan focused on daily living, behavior, and employment goals, not preventive or reproductive healthcare.

Impact: While OB/GYN services are technically covered under standard Medicaid, they are rarely addressed in waiver service plans. Because of this, there is no built-in structure to ensure these services are scheduled and accessed.

Georgia Department of Community Health: NOW/COMP Waiver Policies

EPSDT: Underused for Reproductive Health in Adolescents with IDD

EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) is a federal requirement for all Medicaid enrollees under 21. It mandates coverage of preventive services, including gynecologic screening and STI testing when medically necessary.

You can view Georgia’s EPSDT policy here.

In Georgia:
– EPSDT is inconsistently applied:

– In 2019, fewer than 30,000 of Georgia’s 1.4 million EPSDT-eligible children received referrals for care, placing Georgia among the lowest-performing states in follow-up action (1).

– Caregivers often lack guidance on using EPSDT for reproductive care.
– OB/GYN providers may have limited training or experience in caring for youth with disabilities.

Impact: Reproductive health concerns like menstrual management or contraceptive counseling are often neglected entirely in adolescents with IDD.

Georgia-Specific Barriers and Initiatives

A . Guardianship Laws

In Georgia, full legal guardianship grants broad authority over medical decision-making, including reproductive care. This can limit the autonomy of individuals with IDD, particularly when guardians are not aware of, or do not prioritize, reproductive health needs.
Link: O.C.G.A. § 29-4-21

B . Provider Training Gaps

Georgia does not require disability-specific CME, and most OB/GYNs receive no formal training in IDD care.

-Nationally, only 17.2% of OB/GYNs report any training in caring for women with disabilities, and fewer than 20% feel prepared to manage their reproductive care (2).

-Georgia DPH’s reproductive health resources do not address disability (DPH).

C . Reproductive Health Initiatives by Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD)

-In 2024, DBHDD launched a Reproductive System Management Healthcare Plan as part of its Health and Wellness Initiative.

-The plan provides optional tools for identifying reproductive health needs, recommending screenings, and promoting preventive OB/GYN care for individuals receiving NOW/COMP waiver services.

-However, participation is not required, and access to these resources remains limited across Georgia.

Link to DBHDD: Improving Health Outcomes Initiative

What Can We Do?

For OB/GYNs and Primary Care Providers:

– Initiate the conversation. Ask about menstrual health, sexual health, and contraception needs. Ask about guardianship status early.
– Use disability-informed approaches. Adapt consent forms, exams for sensory needs, allow extra time, and use communication aids.
– Seek training opportunities:
• Baylor CME: Adapting Primary Care visits for Youth and Adults with IDD

-Not OB/GYN-specific, but Baylor has previously offered gynecologic health modules for patients with IDD.

• ACOG Committee Opinion: Health Care for Women with Disabilities(practical guide for OB/GYN providers).
• IDD Toolkit: tips on communication, preventive screening, and reproductive care.

For Waiver Support Coordinators:

– Add reproductive health to service plans.
– Assist with logistics: schedule appointments, provide pre-visit education.

For Caregivers and Guardians:

– Support reproductive autonomy and preventive care.
– Know what’s covered under Medicaid and EPSDT.

Georgia Medicaid Programs Overview

Conclusion

Reproductive health is an essential part of overall well-being, yet for far too many Georgians with IDD, it remains overlooked. The gaps in Medicaid coordination, provider training, and waiver support create unnecessary barriers that impact both quality of life and long-term health outcomes.

At The Arc Macon, we believe equitable access to care is a matter of dignity and human rights. We are committed to raising awareness, supporting families, and partnering with providers to ensure that individuals with IDD have the same opportunities for preventive and reproductive health care as anyone else.

Together, we can create a system that not only covers reproductive health, but makes sure it is truly accessible.

References

(1) Miller A. Bottlenecks in Medicaid: Kids Get Screenings — but Not Always the Referrals for Care. Georgia Health News. July 21, 2021. Accessed August 5, 2025. https://www.georgiahealthnews.com/2021/07/bottlenecks-medicaid-kids-referrals-care/

(2) Access to obstetric and gynecologic care for patients with disabilities. Committee Statement No. 18. American College of Obstetricians and Gynecologists. Obstet Gynecol 2025;145:553–563.

Charles H. Jones Family Foundation Awards $200,000 Grant to The Arc Macon for Accessibility Renovation

Fri, 01 Aug 2025 21:10:01 GMT

Written by: Lindsey Grater, Medical College of Georgia Student Intern

The Arc Macon has been awarded a $200,000 grant from the Charles H. Jones Family Foundation to support its “Access for All” Front Entrance Renovation Project. This transformational gift will significantly improve safety and accessibility for individuals with intellectual and developmental disabilities (IDD), their families, and the broader community in middle Georgia.

The grant will fund a complete redesign of the building’s front entrance, including the installation of an ADA-compliant ramp, new concrete steps and handrails, repaving of the entrance-area parking lot, and construction of a freestanding canopy for weather protection. The renovation also includes enhanced lighting, sidewalks, and updated safety infrastructure.

This generous support from the Charles H. Jones Family Foundation reflects a shared commitment to dignity and inclusion. More than 200 individuals access services at The Arc Macon each year, and over 80% of adult participants use the front entrance weekly—many relying on wheelchairs, walkers, or other mobility aids. The renovation will directly address existing safety hazards and outdated infrastructure, ensuring that everyone can enter the building safely and with confidence.

Construction will begin in Fall 2025, led by Sheridan Construction and designed by Dunwody/Beeland Architects, two local firms with expertise in accessible nonprofit facilities. The project is expected to be completed by May 2026 and, once finished, will support more than 12,000 participant hours annually across day programs, student coaching, employment support, and family services.

This investment also marks one of the largest private gifts in the organization’s recent history. We are deeply grateful to the Charles H. Jones Family Foundation for advancing equitable access. Mr. Jones previously served as Board Chairman in the 1960s, helping shape The Arc in its early years. This project honors his legacy and marks a critical milestone in our mission to create a community where every person is valued, supported, and empowered.

To learn more about the Charles H. Jones Family Foundation and its community impact, visit www.thejonesfamilyfoundation.org .

To learn more about The Arc Macon’s programs and capital initiatives, visit www.thearcmacon.org .

GCDD and Partners to Celebrate Grand Opening of “Embracing Possibility” Exhibit at Harriet Tubman Museum in Macon, Georgia

Mon, 12 May 2025 21:11:00 GMT

The Georgia Council on Developmental Disabilities (GCDD) has announced the opening of the Embracing Possibility: Georgia’s Disability Justice Journey exhibit at the Tubman African American Museum Sunday, May 18, from 3:00 p.m. to 5:00 p.m. in Macon, Georgia.

The Arc Macon is among GCDD’s partners throughout the state of Georgia who are sponsoring an exhibit that celebrates Georgia’s disability community. The Arc supports the remembrance of these historical moments as poignant reminders of the ongoing fight for equitable services for all, furthering their mission as a community provider advocating for inclusion and access for disabled individuals.

The museum is located at 310 Cherry Street, Macon, GA 31201. The grand opening of The Embracing Possibility Exhibit is a free event, but registration is required.

To register for this event, click the following link:

https://embracingpossibilityexhibit.eventbrite.com

For more information about the Embracing Possibility Exhibit, visit www.gcdd.org.

Brighter Together

Wed, 07 May 2025 13:46:34 GMT

Artspace Macon and The Arc Macon welcomes visitors to the opening of its newest creative exhibit, Brighter Together, The Arc Artist Showcase. Open from May 9 to June 7 at the Artspace Macon, there will be a variety of artistic mediums on display to include paintings, drawings, ceramics, and jewelry available for purchase.

The Arc Macon builds up the lives of intellectually and developmentally disabled individuals, in part by supporting and encouraging community involvement throughout their lifetimes. Over the past year, artists of The Arc Macon have been participating in ongoing art classes to create the pieces on display at the Brighter Together showcase. Using a variety of techniques with the help of many artistic instructors, they have been focusing on the creative process and are eager to share their works with the Macon community.

Some pieces on display were made in collaboration with local artists. For instance, the background of the showcase invitation, seen above, is a mixed media collage that The Arc’s artists completed with artist Lindsey Hopkins during The Arc Arts’ programming. With accessibility and creative expression in mind, several professional artists taught The Arc’s artists about their mediums and helped them design their own works of art.

The Opening Reception will be held during the showcase’s second weekend – Friday, May 16, from 3:00 p.m. to 7:00 p.m. – during which attendees can participate in a silent auction for select pieces. No prior registration is required.

For the duration of the showcase, all pieces will be available for purchase through Artspace Macon. All proceeds of individual art sold will go directly to the artist. Proceeds from the sale of collaborative art will go back to The Arc Macon to be reinvested into the program.

Any ceramics or jewelry purchased may be taken home the day of the event, but all other artworks will remain on display until the close of the showcase on June 7th and can be picked up afterwards.

The Arc Macon will also be launching a fundraiser for their new artist fellowship program, “Sponsor an Artist”. The fellowship program aims to support 5 artists at The Arc Macon as they work with various local artists to create displays for rotating exhibits. With monthly fees for each artist at $175 each month, they aim to sponsor all 5 art fellows for a full year at a goal of $10,500. Donations will be accepted during the Brighter Together showcase and online at The Arc Macon’s website.

Artspace Macon is located at 2378 Ingleside Avenue, Macon, GA 31204. The Brighter Together Artistic Showcase is a free event with no registration required.

For more information about Artspace Macon and The Arc Arts Program, visit https://www.artspacemacon.com/thearcarts .

To donate electronically to “Sponsor an Artist”, visit https://www.thearcmacon.org

Written by: Madeline Hamby, Mercer University School of Medicine Student Intern