SB 186: Hospitals and Related Institutions; assisted living communities and personal care homes to enroll as Medicaid providers; permit

Under current Georgia law, assisted living communities are barred from enrolling as Medicaid providers or receiving federal Medicaid funds under Title XIX of the Social Security Act. This bill removes that ban and instead allows assisted living communities and personal care homes to enroll as Medicaid providers, so they can be paid for home and community based services, though not for room and board. The bill directs the Department of Community Health to bring together stakeholders and design a model for how facilities would enroll and get paid, then submit any needed Medicaid state plan amendment or waiver request to the federal government by December 31, 2026. The stated goal is to let Georgians who need this level of care but lack the money for it age in place instead of moving into a skilled nursing facility.

• Repeals the current ban on assisted living communities enrolling as Medicaid providers or receiving Title XIX funds, replacing that subsection with 'Reserved.'
• Adds a new Code section allowing both assisted living communities and personal care homes to enroll as Medicaid providers for home and community based services, excluding room and board.
• Requires the Department of Community Health to convene stakeholders and build an implementation model for the new enrollment process.
• Sets a deadline of December 31, 2026 for the department to submit a Medicaid state plan amendment or waiver request to federal health officials if needed.
• States the General Assembly's intent to give people who have exhausted their resources for licensed assisted living a way to keep receiving care without moving to a nursing home.

Assisted living communities and personal care homes across Georgia, residents of those facilities who need help paying for care, people living independently or in subsidized housing who need a higher level of home care, and the Department of Community Health, which must design and roll out the new enrollment program.

Residents who run out of money to pay privately for assisted living or a personal care home could keep receiving services there instead of moving to a nursing facility, if their facility chooses to enroll as a Medicaid provider. The change depends on the department building a workable model and getting any necessary federal approval.

• Section 1 states the General Assembly's intent to help Georgians who need assisted living or personal care but lack resources, and to expand access to home and community based Medicaid services.
• Section 2 revises O.C.G.A. § 31-7-12.2(i) to remove the existing prohibition on assisted living communities enrolling as Medicaid providers, marking the subsection 'Reserved.'
• Section 3 adds new Code Section 31-7-12.9, permitting assisted living communities and personal care homes to enroll as Medicaid providers for home and community based services, unless federal law or regulation prohibits it.
• Section 3(b) requires the Department of Community Health to convene stakeholders and develop an implementation model for enrollment.
• Section 3(c) requires the department to submit a Medicaid state plan amendment, waiver request, or waiver amendment to federal health officials by December 31, 2026, if necessary.
• Section 4 repeals conflicting laws.

1. 2025-02-19Senate Read and Referred (Senate)
2. 2025-02-18Senate Hopper (Senate)

• Jason Esteves (D, SD-035)Primary sponsor
• Harold Jones (D, SD-022)
• Elena Parent (D, SD-044)
• Nabilah Islam Parkes (D, SD-007)
• RaShaun Kemp (D, SD-038)
• Kenya Wicks (D, SD-034)
• Donzella James (D, SD-028)
• Gail Davenport (D, SD-017)
• Sally Harrell (D, SD-040)
• Nan Orrock (D, SD-036)
• Nikki Merritt (D, SD-009)
• Tonya Anderson (D, SD-043)
• Michael Rhett (D, SD-033)
• Ed Harbison (D, SD-015)
• Josh McLaurin (D, SD-014)

• Medicaid
• assisted living
• personal care homes
• aging in place
• long-term care