Bill would create licensure and Medicaid waiver to expand affordable assisted living for low-income seniors

Representative Taylor and an industry witness urged lawmakers to create a new licensure category and waiver to expand affordable assisted-living options for Medicaid-eligible seniors.

Harmony Harrington, vice president of government relations for Silver Birch Living, told the House Committee on Community Health that House Bill 1430 would authorize the Department of Community Health to license Supportive Senior Housing Communities, or SSHCs, and apply for a 1915(c) Medicaid home- and community-based-services waiver. She said the bill targets Georgia residents age 65 or older who are clinically assessed at a nursing-facility level of care but do not require the intensity of institutional nursing home services.

Harrington said assisted-living alternatives would provide services such as medication assistance, meals, wellness monitoring, transportation and structured care plans in an apartment-style setting. She argued that shifting eligible seniors from nursing facilities to SSHCs could reduce Medicaid spending; in testimony she cited a per-person daily saving of about $95 in states that have similar waivers. "House Bill 1430 helps address this gap by creating a framework for affordable assisted living through licensed SSHCs," Harrington said.

Committee members asked procedural and design questions. Representative Oliver asked whether the department’s rule-making would automatically trigger a state appropriation; sponsors and witnesses said design work and rule development would proceed first and any state payment changes would come later through an appropriation process. Members also probed whether the proposal would serve private-pay residents or be limited to Medicaid beneficiaries; witnesses and the sponsor clarified the draft is narrowly tailored to Medicaid-eligible residents though some states allow a mixed private-pay/Medicaid start-up ratio.

The bill was presented for committee discussion but was not voted on at this hearing. Sponsors said they plan to work with the Department of Community Health and stakeholders over the summer to refine licensure standards, eligibility criteria and the waiver request before returning to the legislature.