The 2024 Georgia legislative session is over, but GHF is not finished!
We’ve made it to the end of the legislative session and through Sine Die (the last day of legislative session).
In this week’s update we review which notable health bills passed and which bills didn’t quite make it across the finish line, as well as the major health changes and investments in the state budget.
You can find a full list of this year’s health care-related legislation at GHF’s legislative tracker. In May, we’ll provide one final update about the Governor’s bill signings, vetoes, or budget changes.
Did you enjoy these weekly updates from the legislative session or find them useful to your work and advocacy? Great! We enjoy putting them together for you. We hope you will consider supporting this time-intensive, detailed, and expert-driven work with a donation to GHF! Please give here(and consider making it a monthly gift because advocacy is year-round!). Thank you for your generous support.
Legislative finalizes FY25 budget
The Senate passed its version of the FY2025 budget last Tuesday. Because the vote came so late in session, House and Senate budget leaders had already begun working out the differences in their budget drafts during the prior weekend. Their negotiations continued well into Sine Die. The final budget landed on legislators’ desks after 8 pm on Thursday, after which the House and Senate approved it. The FY2025 budget sets the state’s spending for July 1, 2024 to June 30, 2025, and it now goes to the Governor for his signature. The Governor cannot add anything new to the budget, but he can remove items or instruct state agencies to “disregard” certain funds (e.g. act as if the money has not been allocated to them).
You can read our previous overviews of the Governor’s FY25 budget proposal here and the changes the House made here.
One of the most meaningful investments in the FY2025 budget is $283 million to provide a 4% cost-of-living pay increase for state employees. This is incredibly important for retaining the state employees who run the programs and implement the policies that Georgians rely on, like eligibility workers for Medicaid and SNAP, state and county public health nurses and other staff, housing program managers, and insurance regulators.
Department of of Behavioral Health and Developmental Disabilities
Governor’s Budget:
$79M to increase pay to the providers and workers who deliver support and health services to people with IDD. This is one of GHF’s priorities!
$9.4M to make permanent 500 NOW and COMP waivers, plus $2.3M for 100 new waiver slots
$9.4M for a new crisis center in DBHDD Region 1 (in north Georgia)
$6.6M to annualize the costs of crisis centers in Fulton County, Dublin, and Augusta
House added $500K to increase funds for Hepatitis C screening services at core behavioral health sites
Senate reduced this funding to $250K
House added $3.2M for the Macon Crisis Stabilization Diagnostic Center for individuals with IDD
House added $108K for adult autism services
House added $300k to support staffing of the 988 hotline
House added $2M to expand Apex – the DBHDD funded school-based behavioral health program
Senate lowered this to $1M and specified that the addition would support the provision of telehealth
House added $2.5M to increase funds for the Georgia Housing Voucher Program
Senate removed the House’s addition with a note that they wanted to wait on any further funding increases until Georgia receives an update from the U.S. Dept. of Justice regarding the state’s progress towards compliance with the Olmstead Settlement Agreement. (This agreement requires Georgia to invest and build community-based infrastructure, services, and supports so that people with mental illness or developmental disabilities can live healthfully in communities rather than institutions.)
An increase in GVHP funding is one of GHF’s priorities!
Conference Committee:
Met in the middle with $375K for Hepatitis C screening services at core behavioral health sites
Agreed to the Senate’s allocation of $1M to the Apex Program
Department of Community Health
Governor’s Budget:
The federal government will pay Georgia slightly more for our Medicaid expenses. The Federal Medical Assistance Percentage (FMAP) will increase from 65.89% to 66.04%. These changes are reflected throughout DCH’s budget, as well as other state health agencies.
Reduction of $104M in Low-Income Medicaid to reflect lower enrollment and use of services because of the Medicaid unwinding.
To better oversee the performance of Georgia’s Medicaid insurers (usually called Care Management Organizations or CMOs), the budget calls for $1.5M to fund 20 new positions for employees who will monitor, evaluate, and support improvements in their performance.
$1.49M increase to the Georgia Board of Health Care Workforce for 79 new residency slots in primary care medicine. This is an important step for reducing the shortage of doctors in areas that lack primary care.
An enhanced rate for emergency service (ambulance) providers for a program called “treatment without transport.” This helps to provide health care to people with certain urgent health needs who do not need to go to the emergency room (which is one of the most expensive places to receive care).
House & Senate:
House added $750,000 to expand primary care and mental health at Federally Qualified Health Centers (FQHCs) in Union and Cobb counties respectively, and dental services at FQHCs in several other counties
House added $2M for rural hospital stabilization grants.
Senate removed this funding
House added $2.8M for continuous glucose monitors (per SB 35 from the 2024 session)
Senate removed this funding
House & Senate added funds to increase reimbursement rates for certain Medicaid-covered health services and providers:
Speech-language pathology, audiology, physical therapy, and occupational therapy: House added $7.5M and Senate added an additional $7.5M (Total: $15M)
Primary care and OB/GYN services: House added $8.4M and Senate matched that increase (Total: $16.8M)
Dental services for people with disabilities and other Medicaid members: House added $9.6M
Dental services for people with disabilities and other Medicaid members: House added $9.6M
House added $284K for biomarker testing
House added $22.8M to account for increased enrollment and utilization of services by PeachCare for Kids members
Senate added budget instructions requiring DCH to update Georgia’s Medicaid plan so that it covers long-acting injectable medications that are typically used to treat people with schizophrenia. These drugs make it easier for Medicaid members who have schizophrenia to stay consistently medicated compared to taking a daily pill, which improves their chances of staying healthy and lowers the risk of hospitalization.
House added $500,000 to the Governor’s $1.49M (total: $2M) increase the number of primary care residency slots to 105 (up from 79)
Conference Committee:
Added $200K to support the Comprehensive Health Coverage Commission established by HB 1339
Lowered the funds to increase reimbursement rates for certain Medicaid providers and Medicaid-covered health services:
Speech-language pathology, audiology, physical therapy, and occupational therapy: $5.6M
Primary care and OB/GYN services: $12.7M
Funding to increase reimbursement rates for dentists and Medicaid-covered dental services for people with disabilities and other Medicaid members increased to $10.5M
$1M (down from the House’s $1.5M) in new training programs, residencies, fellowships, and rotations for health care providers in rural, maternal, and related areas of practice. This funding includes $56,000 for a rural public health preventative medicine rotation to train future doctors.
Department of Human Services
Beginning April 1, 2023, DHS and DCH began to assess the eligibility of 2.7 million Medicaid members, including PeachCare for Kids. For many members, this is the first time they’ve gone through the “redetermination” process, because it has been paused since the start of the pandemic in March 2020. The state’s 14-month window to complete redeterminations, disenrollment, and appeals will end around May 2024.
Governor Budget:
$3.24M for 300 additional Medicaid eligibility caseworkers for redeterminations. This is one of GHF’s priorities!
House & Senate:
House added $1.5M to increase funds for child advocacy centers to expand mental health services and forensic interviewing for children who have experienced abuse, neglect, exploitation, and trafficking, and an additional $100,000 for a psychiatric nurse to support these survivors.
House added $1.1M for independent living services for people with vision impairments
Senate increased funding to $2M
House added $500,000 for non-Medicaid covered home and community based services for senior
Conference Committee:
Agreed to $1M for child advocacy centers to expand mental health services and forensic interviewing for children who have experienced abuse, neglect, exploitation, and trafficking.
$1.5M for independent living services for people with vision impairments
Department of Insurance
Governor Budget:
Added $20M to the reinsurance program to lower health insurance premiums. (In AYF24, $134M was added to for the state reinsurance program to lower insurance premiums on the health insurance exchange, and $16.4M was added to implement the new Georgia Access health insurance marketplace.)
Conference Committee: No notable changes made
Department of Public Health
Governor Budget:
Because of the way Georgia structures its public health system, 4300 county public health employees will receive the 4% pay increase slated for all state employees. This is incredibly important for employee retention in county PH departments that are often thinly staffed. This is one of GHF’s priorities!
$14K to increase funds (to $1M total) to expand the pilot to provide home visiting in at-risk and underserved rural communities during pregnancy and early childhood to improve birth outcomes.
$150K to add one case manager position to help pregnant women (and those who have recently delivered) who have tested positive for congenital syphilis and/or HIV to connect with testing and treatment resources.
House & Senate:
House increased funds to $2.3M total to expand the home visiting pilot program to improve birth outcomes
Senate lowered the total funding for the program to $1.7M
House added $2.5M of new funding to initiate a multi-year plan to stabilize the trauma network.
Senate increased the funding to $6M
House added $796,000 for outreach and breast cancer screening services
Senate added $4M to implement SB 515, which requires DPH to purchase 4 ambulances, two of which will service DPH Regions 2 and 8 respectively
Conference Committee:
Agreed to the Senate’s $1.7M total for the home-visiting pilot program to improve birth outcomes. This is one of GHF’s priorities!
$4M to stabilize the trauma network
$2M for SB 515’s new ambulances
Final legislative action for 2024
HB 404: Quality housing for Georgia renters | PASSED | This is one of GHF’s priorities!
HB 404, introduced by Rep. Kasey Carpenter, would provide protections for tenants by ensuring:
Residential rental properties are fit for human habitation;
Cooling as a utility cannot be shut off after an order for eviction has been issued by the court;
Allows a tenant three (3) business days following a written eviction notice to pay money that is due prior to a lawsuit seeking to evict them may be filed with the court; and
Limiting landlords from requiring a security deposit that exceeds two months’ rent
Awaiting Governor’s signature.
Thank you to everyone who advocated for this bill!
HB 793: Streamlining licensing for the behavioral health workforce | DID NOT PASS
HB 793, sponsored by Rep. Matt Barton, would have authorized the professional licensure board for Counselors, Social Workers, and Marriage & Family Therapists to waive all or a portion of the usual in-state experience requirements for providers who are already licensed in another state, and have maintained full licensure in good standing for a minimum of two years. This would have sped up licensing for BH providers who are moving to Georgia from another state, and was a priority for the Department of Behavioral Health and Developmental Disabilities.
This bill passed the House, but was not heard by the Senate Regulated Industries and Utilities Committee.
HB 873: Creation of new Juvenile Treatment Court | PASSED
HB 873, sponsored by Rep. Stan Gunter, would provide alternative ways of handling juvenile delinquency and truancy cases with the creation of new Juvenile Treatment Court divisions within the juvenile court system.
These new court divisions aim to reduce family disruption or removal to an alternative placement and increase juvenile rehabilitation and treat their mental and behavioral health needs.
Awaiting Governor’s signature
HB 924: Prohibiting discrimination against certain healthcare facilities and providers | DID NOT PASS
HB 924, introduced by Rep. Mandi Ballinger, would prohibit insurers from discriminating against certain healthcare facilities and providers in connection with the administration of provider administered drugs. Provider administered drugs are medicines that cannot be self-administered by the patient or a caregiver. They are typically infused or injected by a health care provider in a physician’s office, clinic, infusion center, or hospital. Examples include some clotting factors for bleeding disorders and immunosuppresants used by transplant patients, among others.
This bill aimed to ensure insurers will not be able to exclude coverage for a provider administered drug if not given out by a pharmacy selected by the health benefit plan. Some physicians purchase these drugs directly from the manufacturer or other source.
This bill passed the House, but was not heard by the Senate Insurance and Labor Committee.
HB 991: Hospital Medicaid Financing Program | PASSED
HB 991, introduced by Rep. Shaw Blackmon, would extend the Hospital Medicaid Financing Program through June 30, 2030. This program requires hospitals to pay a fee (based on their net revenues) to the Department of Community Health. These funds make up part of the state’s matching dollars for federal Medicaid funding. Without this program, Georgia would have to use more public tax dollars to fund Medicaid. The program is currently set to expire in 2025, so this bill simply extends that into 2030.
Awaiting Governor’s signature.
HB 1010: Parental Leave increase | PASSED
HB 1010, introduced by Rep. Jan Jones, would increase state employees’ paid parental leave from three weeks to six weeks. The American College of Obstetricians and Gynecologists endorses paid leave for at least eight weeks, as paid parental leave has recognized benefits including decreased infant mortality, decreased rehospitalization rates, decreased post-partum depression and intimate partner violence.
Awaiting Governor’s signature.
HB 1046: Georgia Commission on Infant and Maternal Health | PASSED as a different bill
HB 1037 was originally introduced by Rep. Lauren Daniel to create the Georgia Commission on Maternal and Infant Health. This commission was vetted and passed through the House. During the last weeks of session, HB 1037’s language was amended into HB 1046and approved by both the House and Senate. The commission will be made up of 14 members and tasked with gathering different perspectives about the state of perinatal health care in Georgia to inform policy and programs that improve perinatal care in Georgia.
Awaiting Governor’s signature.
HB 1077: Increases in behavioral health residency training and development of loan repayment program | DID NOT PASS
In its original form, HB 1077 was introduced by Rep. Sharon Cooper and would have created a grant program administered by the Georgia Board of Health Care Workforce that would fund more mental health and addiction recovery workforce training. It would also have established a student loan repayment program for mental health and addiction recovery providers. A similar student loan repayment program was approved in SB 480 (scroll down for more details).
HB 1077 was amended by the Senate Regulated Industries Committee to propose closing Georgia’s coverage gap. To close the gap, Georgia adults with low-incomes would qualify for no-cost private health insurance (similar to the health coverage on healthcare.gov and GeorgiaAccess.gov). This is a GHF priority!
The amended version of HB 1077 was not approved by the Senate committee.
HB 1125: Eliminating subminimum wage for workers with disabilities | DID NOT PASS | This is one of GHF’s priorities!
Under current law, people with disabilities can be paid less than the state-mandated minimum wage. The federal Fair Labor Standards Act allows employers who receive a special certificate from the Department of Labor to pay wages less than the federal minimum wage to workers who have disabilities. HB 1125, introduced by Rep. Sharon Cooper, would prohibit Georgia employers from using this loop-hole after July 1, 2026.
This bill passed the House and its Senate committee, but did not receive a vote by the full Senate.
HB 1170: Banning essential medical care for transgender youth | DID NOT PASS
The Senate Health & Human Services committee took a good public health bill, HB 1170, aimed at requiring opioid agonists in government and university buildings, and added new, harmful language to it. The new version of the bill would ban providers from prescribing medicines that temporarily pause puberty to Georgians under the age of 18. This form of puberty-delaying medicine helps give young people more time to mature and understand their gender so they can make important decisions about their health care.
Every major U.S. medical and mental health organization–including the American Medical Association, American Academy of Pediatrics and American Psychological Association–supports access to gender-affirming care (including puberty-delaying medicines) for transgender young people and adults.
This bill passed the Senate, but did not receive a final “agree” from the House.
Thank you to everyone who advocated against this bill!
HB 1182: Low Income Housing Tax Credits | DID NOT PASS
HB 1182, introduced by Rep. Clint Crowe, would make changes to Georgia’s Low Income Housing Tax Credit (LIHTC) program. HB 1182 would have limited the state credits to 50-80% (the percent changed several times between the House and Senate) of any federal LIHTC awarded, except for developments in “targeted communities” — which it defined as housing projects located in rural counties or near “stable and high-frequency transportation;” complexes for seniors or people with disabilities; renovation projects; or those owned by public housing authorities. Critics worried the bill’s passage would deal a serious blow to much-needed affordable housing production.
Tabled by the Senate. Later a LITHC cut (from 100% to 80%) was added into SB 349. SB 349 passed the House but did not receive a final “agree” from the Senate.
Thank you to everyone who advocated against cuts to Georgia’s LIHTC! This was a GHF priority to help protect this important investment in low-income housing for Georgians.
HB 1190: Streamlining licensing for the behavioral health workforce | DID NOT PASS
HB 1190, introduced by Rep. J Collins, hoped to streamline the licensure process that providers have to go through. In this bill, if a provider applicant (including social workers, counselors, and marriage & family therapists) has met all licensure requirements, this bill would allow the division director of the licensure board to issue the license, even when the professional licensure board has not been able to act. This would help address the lengthy amount of time it can take for behavioral health and other professionals in the state to become licensed, or move to the state with a license so that they can practice.
This bill passed the House and its Senate committee, but did not receive a vote by the full Senate.
HB 1339: Hospital Regulations and the Comprehensive Health Coverage Commission | PASSED | This is a GHF priority!
While HB 1339 primarily focused on the state’s regulation of hospitals, it also included a provision that would establish a Comprehensive Health Coverage Commission to explore closing Georgia’s coverage gap.
If the Governor signs this bill into law, the Comprehensive Health Coverage Commission will likely convene this summer for its first meeting. We will keep you updated about the Commission, its activities, and opportunities to engage in its study of Georgia’s coverage gap.
Awaits Governor’s signature.
Thank you to everyone who advocated for changes to this bill, in an effort to close the coverage gap this year!
HB 1344: Streamlining licensing for the behavioral health workforce | PASSED
Sponsored by Rep. Katie Dempsey, HB 1344 also authorizes the professional licensure board for Counselors, Social Workers, and Marriage & Family Therapists to waive all or a portion of the usual in-state experience requirements for providers who are already licensed in another state, and have maintained full licensure in good standing for a minimum of two years. This would speed up licensing for BH providers who are moving to Georgia from another state. Additionally, it allows delegates to the Behavioral Health Coordinating Council for purposes of voting. This bill was a priority for the Georgia Department of Behavioral Health & Developmental Disabilities.
Awaiting Governor’s signature.
SB 198: Georgians with Intellectual and Developmental Disabilities Innovation Commission | PASSED as a different bill
Sponsored by Sen. Sally Harrell, SB 198 in its original form would have created the Georgians with Intellectual and Developmental Disabilities Innovation Commission. The commission would explore issues and solutions facing Georgians with intellectual and developmental disabilities (IDD) including housing, employment, waiver waiting list management, and workforce wages and incentives.
In the last two weeks of session, House members stripped SB 198 of its original language and new bill language was added. The new bill sets the minimum amount that a pharmacy benefit manager must pay independent pharmacies to dispense prescriptions to consumers. The minimum amount is equal to the average reimbursement rate that the PBM pays chain retail pharmacies (like CVS or Walgreens) for the same drug. This law only applies to PBMs used by the State Health Benefit Plan, and other plans covering public school teachers and employees.
No other bill was amended to save the proposal for a Georgians with Intellectual and Developmental Disabilities Innovation Commission, which means this Commission will not be established this year.
Awaits Governor’s signature
SB 293: Approval processes for new public health leadership | PASSED
Sponsored by Sen. Ben Watson, SB 293 aims to address some of the state’s public health workforce shortages. This bill would allow a professional with a Master’s degree in Public Health (MPH)–instead of a doctor (MD)–to serve as the director of a public health district. If the district health director (DHD) is not a doctor, they must employ a physician to be Chief Medical Director for the district. DHDs are approved by a vote of the county Boards of Health within their district.
The Commissioner at the Georgia Department of Public Health would be allowed to appoint an interim DHD until a permanent replacement is approved by the county boards of health.
SB 377, introduced by Sen. Blake Tillery, updates the definition and oversight of “qualified residential treatment programs (QRTPs).” Children and adolescents with serious emotional and mental conditions receive in-patient treatment through these programs. This bill closely aligns with other licensing requirements around the country and seeks to ensure quality services are available to young Georgians in need.
Awaits Governor’s signature.
SB 395: Naloxone availability | PASSED | This is one of GHF’s priorities!
SB 395 became the vehicle for all three naloxone availability bills ahead of Sine Die. The bill makes naloxone, which can save a person’s life during an opioid overdose, available in three different locations:
Schools–the bill allows students, staff, and visitors at school and school events to carry naloxone. It will require that all school systems – both public and private – acquire and have naloxone available.
Remote automated medication systems (like vending machines)–to increase the availability of naloxone in communities
Government buildings and courthouses–these buildings must maintain a supply of at least three unit doses of opioid antagonists
The bill also holds harmless Georgians, schools, and governments who are acting in good faith to supply and administer naloxone to people at risk or experiencing overdose.
Awaits the Governor’s signature.
SB 456: Preventing harm to people in need of care | PASSED
SB 456, introduced by Sen. Brian Strickland, allows Georgia’s Central Caregiver Registry to be used to screen people who are applying to be caregivers of people with disabilities. The Registry was originally created so that family members or guardians of elderly Georgians could see if potential caregiver workers had criminal backgrounds or other safety concerns that might put their loved one in danger.
Awaits Governor’s signature.
SB 480: Student loan repayment for behavioral health professionals | PASSED
SB 480, introduced by Sen. Mike Hodges, establishes a student loan repayment for mental health and substance use professionals, including physiatrists, psychologists, social workers, and other mental health professionals. (This bill is similar to HB 1077 before it was amended). Qualifying providers could receive repayment assistance for up to five years. The bill does not specify how much assistance providers might be eligible for, so the Georgia Board of Healthcare Workforce will likely make that determination as it oversees the program and is based on any funding allocated to the program by the Georgia General Assembly.
In order to be eligible for student loan repayment assistance, providers must see underserved Georgia youth or practice in unserved geographic areas of Georgia that are “disproportionately impacted by social determinants of health,” as determined by the workforce board.
Awaits Governor’s signature.
SB 505: Requiring hospitals and related institution to publish certain financial documents on their website | PASSED
Sponsored by Sen. Blake Tillery, SB 505 tightens and standardizes hospital and health system reporting standards. The law should make it easier for Georgians and our state leaders to find and compare hospitals’ financial and other public records. It also requires that hospital authorities (which oversee most nonprofit hospitals in Georgia) include a board member from the local city or county in which the hospital authority is based. This is meant to give hospital authorities more independent oversight of the hospitals that they govern.
Awaits Governor’s signature.
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