Less expensive coverage comes with more risks “The administration’s rule change is dangerous for Georgia consumers,’’ said Laura Colbert of Georgians for a Healthy Future
Blog (December 2017)
Earlier this week, GHF provided a summary of the recommendations from several Senate study committees and how their findings may affect the health care system and consumers in the state. The Georgia House of Representatives also convened study committees to examine issues directly related to health care, and two of these committees recently released their final recommendations.
The House Study Committee on Georgians’ Barriers to Access to Adequate Health Care (HR 240) examined a broad array of health care issues with a focus on the burden of chronic disease in Georgia. The committee, chaired by Representative Sharon Cooper, issued an exhaustive final report that included several legislative recommendations that could impact consumers. The most pertinent recommendations include:
Increasing access to immunizations: Allow schools to require the second dose of the meningitis vaccination in 12th grade; require hospitals and nursing homes to offer shingles and flu vaccinations; allocate an additional $1 million to the Department of Public Health for additional staff and screenings for the viral hepatitis program; require the Department of Juvenile Justice to check vaccination records and offer vaccinations for juveniles in their care.
Improving testing and treatment for HIV/AIDS: Rewrite state laws to focus criminalization on intention to transmit HIV, as opposed to knowledge of HIV infection; ensure access to HIV treatment regimens for sexual assault victims; increase funding to the Department of Public Health to expand their ability to test for HIV; encourage state-funded health care programs such as Medicaid to expand their outreach for HIV testing.
Facilitating continued enrollment in Medicaid: Engender a policy shift that would allow for the suspension of Medicaid benefits, as opposed to outright termination, for people entering incarceration in the state.
Addressing respiratory diseases: Build upon the existing state asthma plan, which expires in 2018, to include a broader scope of chronic respiratory diseases; expand the screening process for people at risk of COPD to help confirm additional diagnoses.
Expanding access to mental health services: Expand funding for the Department of Behavioral Health and Development Disability’s community service boards; allocate funding for psychiatric residents who specialize in mental health treatment; encourage the use of e-prescriptions for opioid medications in an effort to curb opioid abuse.
You can read the full committee report here.
The House Rural Development Council (HR 389) closely examined a variety of issues that impact rural communities in Georgia and a recurring theme across the state was a need for increased access to quality health care. After 18 meetings in all parts of rural Georgia, the council released several recommendations that could have a significant impact on rural health care consumers.
One of the most noteworthy recommendations encouraged the Department of Community Health to apply for an 1115 Medicaid waiver that would allow participating hospitals and community providers to form a closed network in order to provide care to a set number of uninsured community residents. This waiver would allow Georgia to pull down additional federal funds to provide health care to some of the state’s uninsured population and to test out new ways to deliver high quality care at a lower cost. Unfortunately this idea falls far short of expanding Medicaid, which would provide health coverage to low-income, uninsured Georgians statewide and is the most significant step our state could take in improving access to care for rural Georgians. (Note: the council report refers to this capitated, value-based delivery model as a “block grant,” but this waiver would differ from a block grant in some nuanced, but important ways.)
Like the Senate Study Committee on Barriers to Georgians’ Access to Adequate Healthcare, the council heard a significant amount of testimony on the dearth of practicing medical professionals in rural counties and, as a result, their final recommendations mirror those of the Senate committee. They suggest expanding the scope of practice for mid-level practitioners to allow them to perform certain medial services not currently allowed and implementing a preceptor tax credit program to incentivize medical practitioners to train future healthcare professionals in rural areas.
Finally, the council recommended establishing a Rural Center for Health Care Innovation and Sustainability, which will be responsible for promoting a curriculum of best practices for rural health care. The center will also be used to provide mandatory training for the executive leadership and boards of rural hospitals.
You can read the full committee report here.
As always, you count on GHF to keep you up-to-date on how these recommendations may turn into legislative action when the General Assembly convenes in January. Stay tuned!
As the year winds to an end, the General Assembly’s 2017 study committees have largely completed their work and are releasing final reports, complete with notable findings and recommendations for the legislature to consider when it convenes in January. GHF monitored the activities of several Senate study committees this year as they considered changes to Georgia’s health care system that may impact consumers. (We will issue a blog later this week to provide an overview of similar House committees.)
The Senate Study Committee on Barriers to Georgians’ Access to Adequate Healthcare (SR 188) chaired by Senator Renee Unterman focused heavily on provider shortages that impact Georgians’ ability to receive health care when and where they need it. These shortages are felt most heavily in rural areas of the state, including the 79 counties that have no practicing OB/GYN physicians, 63 counties with no pediatric physicians, and 9 counties with no practicing physicians at all. In its final report, the committee issued several specific recommendations to remedy the provider shortages and increase access to care. Most prominently, the committee recommended expanding the scope of practice for Advance Practice Registered Nurses (APRNs) in areas of the state with the worst health outcomes and largest provider shortages. The committee noted that Georgia has among the strictest practice environments for APRNs and expanding the scope of practice for these nurses would allow rural Georgians to access quality care despite a lack of physicians. The committee also recommended expanding the practice of telemedicine in the state by training more telemedicine presenters, loosening restrictive rules, and providing more funding to telemedicine initiatives. Lastly, the committee addressed the rash of rural hospital closures around the state, suggesting that the closures could be prevented by providing more specific training for hospital board members on healthcare finance and supporting ongoing education for hospital board members and executive staff. You can read the committee’s full report here.
Senator Unterman also chaired the Senate Study Committee on Homelessness (SR 352). The committee examined the integral link between mental health and housing stability, and discussed housing status as a social determinant of behavioral health. The committee recommended that the Department of Community Health identify ways in which the state could use Medicaid funds to support people who are at risk of becoming homeless, and they recommended increased funding to expand the Georgia Housing Voucher and Bridge Program to ensure that more people who live with behavioral health conditions are connected with supportive housing programs. During the committee’s proceedings, several health care providers testified about the health care needs of people experiencing homelessness, including the need to have health insurance coverage. The committee did not issue a recommendation about how to better provide health care services for the homeless population; however, data shows that expanding Medicaid would be a meaningful and significant step to ensuring access to care and treatment for this group of Georgians. You can read the committee’s full report here.
Finally, GHF has also been following the work of Lt. Governor Casey Cagle’s Health Care Reform Task Force, which has met throughout the year at locations across the state. The task force has held meetings about the best practices to combat the opioid crisis and treat addiction, expanding access to health care in rural areas, and strengthening preventative care across the state. The task force convened for their final meeting in October, and they will issue their formal recommendations to the state legislature in January.
It is unclear which of these recommendations will be acted on by the General Assembly during the 2018 legislative session. However, you can count on GHF to keep you updated on any resultant legislation and any other legislative decisions that will impact Georgia’s health care consumers.
GHF is proud to welcome Zach Nikonovich-Kahn to our staff. Zach will serve as GHF’s Communications & Special Projects Manager. In this role, he will manage GHF’s external communications, utilize communications strategies to mobilize Georgians in support of GHF’s mission, and provide research & policy support.
Zach Nikonovich-Kahn is a communications and community engagement professional, specializing in the nonprofit sector. Prior to joining Georgians for a Healthy Future, Zach worked as the Public Policy Advocate for Families First, where he was responsible for leading the agency’s government affairs and advocacy initiatives.
Zach is an extremely proud Atlanta native, and he lives in Midtown. He currently serves on the BeltLine Affordable Housing Advisory Board, as well as the Atlanta BeltLine Young Leaders Council. Zach has also served on the board of the Midtown Neighbors Association, the Board of Ambassadors at the Georgia Museum of Contemporary Art, and the board of the Atlanta chapter of the New Leaders Council.
Zach graduated from the Honors College at the University of Georgia with a B.A. in History, and he has a Master’s degree from Cambridge University.