How to document your child’s daily care for GAPP, so nothing gets left out.

Prefer to do it on your phone? One Day of Care walks you through the same steps and prints a one-page summary.

Why the daily list matters

All GAPP services need a doctor's order. The doctor signs a plan of treatment that shows the nursing and personal care hours recommended. ^source Every GAPP service must be approved in advance. The reviewer is Alliant Health Solutions for regular Medicaid, or your child's Medicaid health plan (CMO). ^source

In practice, that means the people deciding never see your living room. They see paperwork. A doctor who sees your child for fifteen minutes every few months can only write down what they know about, so the more precisely you describe a real day, the more accurately the request reflects your child.

Once the application packet is complete, review can take up to 30 days. ^source Missing information is one of the things that keeps a packet from being complete.

What parents forget

Parents of medically complex kids are experts at their child’s care. That is exactly why things get left out: care that happens ten times a day stops feeling like care. The items most often missing from what parents tell doctors:

• Overnight care. Suctioning, pump checks, turning, alarms and changes between bedtime and morning.
• Short, frequent tasks. Two minutes of suctioning twelve times a day is 24 minutes of skilled care.
• Watching. Staying close because of seizures, airway risk or falls is part of the care, even when nothing happens.
• Prep and cleanup. Mixing feeds, cleaning trach supplies, setting up equipment.
• Getting out the door. Transfers, equipment and positioning for every appointment.

How to write it down

1. Pick a typical day, then note what a hard day adds.Don’t describe your best day. If some days are much harder, say how often those happen.
2. Go in order: morning, midday, evening, overnight.Walking through the clock is how you catch the tasks that hide in routine.
3. For every task, write how many times and about how long.“Suction, about 10 times, 2–3 minutes each” is far more useful than “frequent suctioning.”
4. Count night wake-ups on their own.How many times you get up, and about how long each time.
5. Name the equipment.Trach, ventilator, BiPAP, oxygen, feeding pump, pulse oximeter, suction machine, lift.

Skilled nursing or personal care?

GAPP covers skilled nursing and/or personal care support at home. DCH also lists a medical daycare setting. ^source As a rough guide, tasks like trach care, suctioning, tube feeds and medicines through a tube, and responding to seizures with rescue medicine are usually nurse-level. Bathing, dressing, feeding by mouth, toileting, turning and transfers are usually personal care. Your child’s doctor and GAPP decide what counts, so write everything down and let them sort it.

Parents and other legally responsible adults can be paid to provide GAPP personal care services, approved through December 31, 2029. ^source At Ava, parents do this as Family Caregivers.

What to bring to the doctor

• Your written day, or the Care Day Summary from One Day of Care.
• A list of equipment and supply companies.
• Recent hospital discharge papers.
• Your child’s Medicaid number, if you have one.

Then ask: “Can these tasks and how often they happen go into my child’s plan of treatment?” and “Which of these do you consider skilled nursing?”

No Medicaid because your income is too high? Georgia ignores the family's income for Katie Beckett. The child's own situation is what counts. ^source See Katie Beckett Medicaid for GAPP.

After approval: renewals

GAPP is renewed every year. The medical form is valid for one year and must be renewed 30 to 60 days before it expires, and the family re-signs program forms yearly. ^source Keep your list up to date. When your child’s needs change, the paperwork should change with them. You have the right to choose or change your GAPP agency. The current agency must keep serving at least 30 days during a change. ^source

Where Ava fits

Ava is a listed GAPP provider. Our GAPP application help means we collect records and prepare the packet with you, then staff approved hours with pediatric home nursing (RN and LPN) or pediatric personal care. Call (404) 905-7699, Mon–Fri 9am–5pm.

Official sources (checked 2026-09-27): Georgia Pediatric Program (GAPP) Presentation, GAMMIS (June 2023) · Community-Based Services, Georgia DCH · Reimbursements Approved for Legally Responsible Individuals Under GAPP, Georgia DCH (Nov 2024) · TEFRA/Katie Beckett, Georgia Medicaid