GAPP Pediatric Nursing Services
The Georgia Pediatric Program (GAPP) is a Georgia Medicaid program that pays for skilled nurses to care for medically fragile children at home, at no cost to the family. Here is what GAPP nurses do, who qualifies, how hours are approved, and how to choose a nursing agency.
What GAPP Nurses Do
GAPP nursing is shift nursing: a nurse stays in your home for the hours your child is approved for. Two kinds of nurses are involved.
The Registered Nurse (RN) Leads the Care
- The first evaluation visit and the initial plan of treatment
- Case management and coordination with your child's physician
- Teaching parents and caregivers, with a competency checklist
- Regular supervisory visits for the LPNs and aides on your child's case
- Re-evaluating your child's needs when it is time to renew hours
RNs and LPNs Work the Shifts
Depending on your child's orders, shift care can include:
- Medications and treatments as the physician ordered
- Trach care, suctioning, and ventilator or oxygen monitoring
- G-tube feedings and medications
- Seizure monitoring and response
- Vital signs, assessments, and shift notes
- Calling the RN and the family when something changes
Care happens in your home. GAPP cannot pay for nursing in a hospital, a school, or a similar facility; nursing at school is arranged through the school.
Who Qualifies for GAPP Nursing
- Under 21
- Children age out of GAPP on their 21st birthday.
- Georgia Medicaid
- Your child must be enrolled in Georgia Medicaid. Many children with complex medical needs qualify through the Katie Beckett pathway, which looks at the child's needs instead of the parents' income.
- A skilled nursing need
- Since October 2026, every child in GAPP must need medically necessary skilled nursing. Personal care alone is no longer enough to enroll.
- Physician orders
- Your child's doctor signs the plan of treatment that lists the nursing your child needs.
Does your child have a trach or ventilator? See how GAPP works for children with a trach or ventilator.
How Nursing Hours Are Approved
Approved one child at a time
State reviewers set nursing hours from the physician's orders and medical records. There is no standard number of hours for a diagnosis.
A decision within seven days
Once the agency submits a complete packet, reviewers have seven days to decide. Services must start within 60 days of approval.
Renewed every three to six months
Renewals rely on the last three months of nursing notes, so careful shift documentation protects your child's hours.
You can ask for a reconsideration
If you disagree with a decision, you have 30 days from the date of the letter to request a reconsideration. The request must come from the family, not the agency.
Nursing and Personal Care Are Different
GAPP also covers personal care, such as bathing, dressing, and feeding, and its Family Caregiver Option can pay a parent who lives with the child for those approved tasks. Skilled nursing is never paid to a family member: it always comes from the agency's nurses.
Your Right to Choose a Nursing Agency
GAPP nursing is delivered by Medicaid-approved home nursing agencies, and the family decides which one.
You choose the agency
Families sign a Freedom of Choice form every year. You can pick any Medicaid-approved GAPP agency that can staff your child's care.
You can change agencies
You can transfer without any penalty from your current agency, and that agency must keep providing care for 30 days if you want it to while the move happens. Since July 2026, transfers are limited to one every three months.
Two agencies can share nursing hours
If one agency cannot staff every shift, a second agency can cover some of the nursing hours. Personal care hours cannot be split between agencies.
Questions to Ask Any Agency
- Do your nurses have experience with my child's specific equipment and conditions?
- Which shifts can you staff right now, and what happens when a nurse calls out?
- Who is the RN supervisor, and how do I reach a nurse after hours?
- Can you take a referral while my child is still in the hospital?
- Do you serve my county?
Who Provides the Care
This guide is run by Heart and Soul Healthcare, a Medicaid-approved GAPP nursing agency:
- A registered nurse oversees every child's care, with on-call support after hours
- Referrals accepted from families, physicians, and hospital discharge planners
- Help with the GAPP paperwork from the first referral through every renewal
Heart and Soul Healthcare currently serves Fulton, DeKalb, Cobb, Clayton, Henry, Gwinnett, Fayette, Douglas, Forsyth, Rockdale, Cherokee, Paulding, Bartow, Newton, Spalding, Coweta, Carroll, Barrow, Gilmer, and Pickens counties. If you live elsewhere in Georgia, reach out anyway and you will get an honest answer about whether your child's care can be staffed.
GAPP Nursing Questions
What are GAPP pediatric nursing services?
They are in-home shifts of skilled nursing for medically fragile Georgia children under 21, paid for by Georgia Medicaid through the Georgia Pediatric Program. A registered nurse plans and oversees the care, and RNs or LPNs work the approved shifts in your home.
Does GAPP nursing cost anything?
No. Approved GAPP services are covered by Georgia Medicaid at no cost to the family.
Will my child have an RN or an LPN?
Often both. A registered nurse must do the first evaluation, write the plan of treatment, manage the case, and supervise. Shifts can be worked by an RN or an LPN, depending on your child's orders and the agency's staffing. LPNs are supervised by an RN at least once a month.
Can a GAPP nurse go to school with my child?
Not under GAPP. GAPP services are provided in the home and cannot be billed in a school, hospital, or similar facility. Nursing at school is arranged and billed through the school instead.
Can I be paid to be my child's nurse?
No. The Family Caregiver Option lets a legally responsible family member who lives with the child be paid only for approved personal care, such as bathing and dressing. It never covers skilled nursing, and every child in GAPP must have skilled nursing from the agency.
How many nursing hours will my child get?
It depends on your child's medical needs. Reviewers decide hours from the physician's orders and records, renew them every three to six months, and can change them when your child's condition changes.
Who runs this website?
This site is an independent family guide operated by Heart and Soul Healthcare, a Medicaid-enrolled GAPP nursing agency. It is not a government website. For official program questions, contact the Georgia Department of Community Health at GAPP.Inquiries@dch.ga.gov.