Sick child care in Georgia: what to do when daycare isn't an option

Your child needs more medical attention than a daycare can provide. Here's how Georgia families get in-home nursing coverage through Medicaid.

Why regular daycare doesn't work for medically complex kids

You called five daycares. Two said no immediately. Three said they'd "look into it" and never called back. That's the reality for parents of children with trachs, vents, feeding tubes, or seizure disorders in Georgia. Standard childcare centers don't have nurses on staff, and they're not equipped for the medical tasks your child needs throughout the day.

Medically fragile daycare programs do exist, but Georgia has very few of them. They're concentrated in metro Atlanta, they have waitlists, and they may not match your child's specific needs or your work schedule.

For most Georgia families, the answer is GAPP: in-home nursing paid for by Medicaid. Instead of dropping your child off somewhere, a nurse comes to your house.

How GAPP home nursing works as childcare

GAPP (Georgia Pediatric Program) sends licensed nurses to your home to care for your child while you're at work, sleeping, or handling other responsibilities. It's not labeled as "childcare," but for families with medically complex kids, it solves the same problem.

RN nursing

For kids who need tracheostomy care, ventilator management, IV medications, or other complex medical procedures. The RN handles everything medical while you're away.

LPN nursing

For medication administration, G-tube feedings, wound care, and basic skilled nursing. An LPN works under RN supervision and costs Medicaid less per hour, so you may get more hours approved.

Personal care services (PCS)

For children who need help with bathing, feeding, mobility, and daily routines but don't need a nurse. PCS aides can cover the hours when your child needs supervision and physical help but not medical procedures.

Read more about each service type in our GAPP services guide.

Does your child qualify?

GAPP is for children under 21 with medical conditions that require skilled care at home. Your child needs active Georgia Medicaid and a doctor who will write an order for home nursing.

Common conditions that qualify:

  • Tracheostomy or ventilator dependence
  • Seizure disorders requiring monitoring
  • Feeding tubes (G-tube, NG-tube)
  • Cerebral palsy with daily care needs
  • Spina bifida or spinal cord conditions
  • Chronic respiratory conditions (oxygen dependence, frequent suctioning)
  • Post-surgical recovery requiring skilled nursing

If your family earns too much for regular Medicaid, your child may still qualify through Katie Beckett, which looks at the child's disability instead of family income.

Not sure if your child qualifies? Take our 2-minute eligibility screener to find out.

How to get GAPP nursing for your child

Four steps from "I need help" to having a nurse in your home.

1

Get Medicaid active

Your child needs Georgia Medicaid before anything else. Apply through Georgia Gateway or your local DFCS office. Regular Medicaid takes 30-45 days. Katie Beckett takes 45-90 days. Read our approval timeline guide for details.

2

Get a physician order

Your child's doctor writes an order specifying what nursing care is needed and how many hours per day. The more specific the documentation, the better your chances of getting the hours you actually need.

3

Pick a GAPP provider agency

Search by your county in our provider directory. Call 2-3 agencies. Ask if they have nurses available for the shifts you need. The agency handles the prior authorization paperwork with Medicaid.

4

Nursing starts

Once Medicaid approves the prior auth (usually 2-6 weeks), your agency assigns a nurse. The first visit includes a home assessment and care plan review. After that, your nurse shows up on schedule.

Other childcare options for sick kids in Georgia

GAPP home nursing is the main path for medically complex children, but there are a few other options depending on your situation:

Paid family caregiver through GAPP

In some cases, a family member can get paid to provide care through GAPP. This works well when a parent or relative is already the primary caregiver. Read how it works.

School-based nursing

If your child attends school, the school district may provide a nurse during school hours. For before/after school and weekends, GAPP covers the gap.

Respite care

If you already have GAPP nursing during the week but need weekend or evening coverage, respite hours give you scheduled breaks with a backup nurse.

Long-term care coordination

For children with chronic conditions that will need ongoing support, long-term care options in Georgia include therapy services, durable medical equipment, and transition planning.

Sick child care FAQs

Can a medically fragile child go to regular daycare in Georgia?
Most regular daycares can't take kids who need medical care during the day. If your child has a trach, feeding tube, or needs medications that require a nurse, standard childcare centers aren't set up for that. GAPP provides in-home nursing so your child gets care at home instead.
What is medically fragile daycare?
A medically fragile daycare is a licensed childcare facility with nurses on staff who can handle complex medical needs. Georgia has very few of these. Most families use GAPP home nursing as the alternative, where an RN or LPN comes to your house during the hours you need coverage.
Does Medicaid pay for childcare for sick children in Georgia?
Medicaid doesn't pay for daycare directly. But if your child qualifies for GAPP, Medicaid pays for a nurse to come to your home. That nurse handles all medical care while you work, sleep, or take care of other things. It's not daycare, but it solves the same problem.
What do I do if my child is too sick for daycare but I have to work?
Apply for GAPP through your child's doctor. If approved, a nurse comes to your home during the hours you need. Some families also use a paid family caregiver arrangement through GAPP while they work. Start with our eligibility screener to see if your child qualifies.
How is GAPP different from hiring a babysitter for a sick child?
A babysitter can't administer medications, manage a ventilator, or handle medical emergencies the way a licensed nurse can. GAPP sends RNs and LPNs trained in pediatric care. And Medicaid covers the cost, so you don't pay out of pocket.
Can I get GAPP nursing while my child attends school?
Yes. Some children have a GAPP nurse at school if the school can't meet their medical needs. Others use GAPP hours before and after school. Talk to your agency about scheduling nursing hours around your child's school day.

Ready to find a GAPP provider?

Search verified agencies accepting new patients in your county.

This directory is not affiliated with the State of Georgia or the official GAPP program. We help families find providers but are not a state agency.