Bill would create licensed supportive senior housing and seek Medicaid waiver to avoid costly nursing‑home placements

Chairlady Cooper opened the committee hearing and Representative Taylor introduced House Bill 1430, a proposal to create a licensure category for Supportive Senior Housing Communities and to allow the Department of Community Health to apply for a 1915(c) home‑and‑community‑based services waiver to cover assisted‑living‑style supports for Medicaid‑eligible seniors.

The bill targets seniors "who are already medically qualified to enter a nursing home today" but who do not require the intensity of institutional care, Representative Taylor said. Harmony Harrington, vice president of government relations at Silver Birch Living, described SSHCs as residential communities with planned care that can include medication assistance, meals, daily‑living support, wellness monitoring and transportation. "These are designed specifically for residents who require greater levels of support than home health but do not need institutional nursing home care," she said.

Why it matters: Witnesses told the committee that placing Medicaid‑eligible seniors in nursing homes because no affordable assisted‑living option exists raises costs to the state and reduces seniors' ability to age in place. Harrington said nursing facility care can "often exceed $100,000 per year, while assisted living typically costs substantially less," and she gave a figure in committee that Georgia could save about "$95 per day per person" by shifting some seniors to SSHCs instead of skilled nursing, while also citing other states that use 1915(c) waivers to support assisted‑living settings.

Key details: Under the framework presented, SSHC residents would need to be Georgia residents age 65 or older, eligible for Medicaid and clinically determined to meet a nursing‑facility level of care. The Department of Community Health would write rules and oversee licensing and implementation. Harrington and others said states vary on how they structure eligibility and mixing of private‑pay slots during start‑up; Silver Birch said its communities operate largely for Medicaid residents (85–90 percent in their model), though some states permit a 50 percent Medicaid threshold to allow mixed payor occupancy during early years.

Discussion and next steps: Committee members pressed on funding and implementation. Representative Oliver asked whether DCH rule‑making would require a separate appropriation; Representative Taylor said appropriations would be required after regulations and an operational plan are completed. The chair emphasized the committee would not vote on the measure that day and that sponsors and staff will work through the summer to develop details such as startup ratios and how private‑pay and Medicaid slots would be balanced.

The hearing included examples of demand: Harrington cited an Ohio community with a 65‑person waitlist for a 120‑unit SSHC and described states that have attracted private investment after creating supportive policy frameworks. Committee members asked staff and sponsors to return with more operational clarifications and cost estimates.

The committee took no formal action on HB 1430 during this session; sponsors said further drafting and data work will continue over the summer.