---
title: SB 186. Hospitals and Related Institutions; assisted living communities and personal care homes to enroll as Medicaid providers; permit
collection: bills
id: 2025-2026/sb186
cite_as: SB 186, 2025-2026 Regular Session (Ga.)
canonical_url: https://georgiacommons.org/bills/2025-2026/sb186
md_url: https://georgiacommons.org/bills/2025-2026/sb186.md
text_url: https://georgiacommons.org/bills/2025-2026/sb186/text
source_url: https://www.legis.ga.gov/legislation/70397
date: 2025-02-19
status: introduced
corpus_version: bills-2026-09-13
license: Public record of the Georgia General Assembly, via LegiScan; see about.md
publisher: Georgia Commons, an independent project of Georgia Civic Data. Not the State of Georgia. Not legal advice.
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omitted: votes and history
omitted_chars: 95
omitted_url: https://georgiacommons.org/bills/2025-2026/sb186.md?full=1
bill_number: SB 186
session: 2025-2026 Regular Session
session_slug: 2025-2026
chamber: Senate
bill_type: bill
status_date: 2025-02-18
last_action: Senate Read and Referred
sponsors:
- Jason Esteves
- Harold Jones
- Elena Parent
- Nabilah Islam Parkes
- RaShaun Kemp
- Kenya Wicks
- Donzella James
- Gail Davenport
- Sally Harrell
- Nan Orrock
- Nikki Merritt
- Tonya Anderson
- Michael Rhett
- Ed Harbison
- Josh McLaurin
text_version: Introduced
has_text: true
legiscan_url: https://legiscan.com/GA/bill/SB186/2025
upstream_id: 1974305
summaries_model: claude-sonnet-5
topic_tags:
- Medicaid
- assisted living
- personal care homes
- aging in place
- long-term care
---
# SB 186. Hospitals and Related Institutions; assisted living communities and personal care homes to enroll as Medicaid providers; permit
## Text
Senate Bill 186
By: Senators Esteves of the 35th, Jones II of the 22nd, Parent of the 44th, Islam Parkes of the
7th, Kemp of the 38th and others
A BILL TO BE ENTITLED
AN ACT
To amend Article 1 of Chapter 7 of Title 31 of the Official Code of Georgia Annotated,
relating to regulation of hospitals and related institutions, so as to permit assisted living
communities and personal care homes to enroll as Medicaid providers; to provide for
development of a model for implementation; to provide for submission of a state plan
amendment or waiver, if necessary; to provide for legislative intent; to provide for related
matters; to repeal conflicting laws; and for other purposes.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
SECTION 1.
It is the intent of the General Assembly:
(1) To assist Georgians who need the services of assisted living communities and larger
personal care homes in order to age in place without moving to a skilled nursing facility,
but don't have the financial resources to do so;
(2) To allow home and community based services funded under the Medicaid program
to be accessible to Georgians, in some instances when such services have been previously
prohibited by state law and policy;
(3) To have the Department of Community Health initiate a program to allow such
persons to receive Medicaid home and community based services, but not room and
board, in assisted living communities, all personal care homes, and subsidized housing
when such facilities choose to be enrolled as Medicaid providers; and
(4) That such program enabled by this Act provide an opportunity for provider choice
to persons in need of home and community based services, such as residents in assisted
living communities who have exhausted the resources required for licensed assisted
living and persons living independently in their home or in subsidized housing who need
a higher level of care.
SECTION 2.
Article 1 of Chapter 7 of Title 31 of the Official Code of Georgia Annotated, relating to
regulation of hospitals and related institutions, is amended in Code Section 31-7-12.2,
relating to regulation and licensing of assisted living communities, by revising subsection (i)
as follows:
"(i) An assisted living community shall not be permitted to enroll as a provider of medical
assistance, as defined in paragraph (6) of Code Section 49-4-141, or receive any funds
authorized or paid pursuant to Title XIX of the Social Security Act. Reserved."
SECTION 3.
Said article is further amended by adding a new Code section to read as follows:
"31-7-12.9.
(a) Unless otherwise prohibited by federal law or regulation, assisted living communities
and personal care homes shall be permitted to enroll as providers of medical assistance, as
defined in paragraph (6) of Code Section 49-4-141, and receive any funds authorized or
paid pursuant to Title XIX of the Social Security Act.
(b) In order to implement the provisions of this Code section, the department shall convene
stakeholders and develop a model to allow assisted living communities and personal care
homes to enroll as providers of medical assistance, as defined in paragraph (6) of Code
Section 49-4-141, and receive any funds authorized or paid pursuant to Title XIX of the
Social Security Act.
(c) To implement the provisions of this Code section, the department shall submit a
Medicaid state plan amendment, waiver request, or amendment to an existing waiver to the
United States Department of Health and Human Services, as necessary, no later than
December 31, 2026."
SECTION 4.
All laws and parts of laws in conflict with this Act are repealed.
## Summaries written by Georgia Commons
The following was written by claude-sonnet-5 from the text above and is not part of the bill. Quote the text, not the summary.
Senate Bill 186 would let Georgia assisted living communities and larger personal care homes enroll as Medicaid providers, reversing a current ban and opening Medicaid-funded home care services to residents who cannot afford to pay privately.
### Plain-language summary
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.
### What it does
- 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.
### Who it affects
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.
### Why it matters
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.
### Key provisions
- 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. ยง 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.
## Status
- Status: Introduced (2025-02-18)
- Last action: Senate Read and Referred (2025-02-19)
- Sponsors: Jason Esteves, Harold Jones, Elena Parent, Nabilah Islam Parkes, RaShaun Kemp, Kenya Wicks, Donzella James, Gail Davenport, Sally Harrell, Nan Orrock, Nikki Merritt, Tonya Anderson, Michael Rhett, Ed Harbison, Josh McLaurin
- Official page: https://www.legis.ga.gov/legislation/70397
> The history, votes, and amendments (95 characters) are at https://georgiacommons.org/bills/2025-2026/sb186.md?full=1