Georgians for a Healthy future partnered with Step Up Savannah to host a health advocacy training on Tuesday, April 3rd.  Advocates learned how they could participate and lead health advocacy efforts in their own community and received information about pressing health advocacy issues in Georgia. Representatives from Healthy Savannah and the Chatham County Safety Net Planning Council were also in attendance to share local resources.

The significance of Medicaid was highlighted throughout the event. Participants learned that Medicaid primarily covers low-income children, people with disabilities, seniors, and pregnant women, including 40,000 of Chatham County residents. Alyssa Green, GHF’s Outreach & Education Manager, discussed Georgia’s opportunity close the coverage gap so that 240,000 more Georgians would have access to health insurance coverage. Alyssa shared the story of a Georgia woman who works part-time at DisabilityLINK but is stuck in the coverage gap and, as a result, has trouble managing her high blood pressure.

GHF’s Executive Director Laura Colbert introduced ways that people can advocate for the health care issues that matter most to them, like increased access to healthcare, bringing down health care costs, and protecting the Medicaid program. She explained how to build a relationship with legislator, communicate support or opposition for significant bills, and other forms of advocacy.

The training concluded with presentations from the Chatham County Safety Net Planning Council and Healthy Savannah. The two Savannah-based organizations provided participants with information and resources to promote and build a healthy local community.

If you are interested in hosting a training like this in your community, please contact Alyssa Green at agreen@healthyfuturega.org or 404-567-5016 x 2 for more information.

Every day four Georgians die from opioid overdose and recent data from the Centers for Disease Control and Prevention confirm that the epidemic shows no signs of slowing. Health care providers, public health professionals, community leaders, and families are all searching for effective strategies to slow and stop this growing public health crisis. Some initial steps have been taken by Georgia policy makers and others to increase access to life-saving drugs like naloxone, improve and expand the prescription drug monitoring program (PDMP) to prevent over-prescribing, and raise public awareness about the risks of opioids and other substances, but more is needed. Solutions must include evidence-based strategies that emphasize prevention and early intervention, as well as timely treatment and support for recovery.

An exciting development within Georgia’s Medicaid program gives health care providers an additional tool to aid in the fight against substance use disorders, especially among adolescents and young adults. Georgia’s Medicaid agency has activated the reimbursement codes for a tool called SBIRT, which stands for Screening, Brief Intervention and Referral to Treatment. SBIRT is a set of tools that identifies people who use alcohol or other drugs at harmful levels and guides follow-up counseling and referral to treatment before serious long-term consequences occur.

Ninety percent of adults who meet the medical criteria for addiction started smoking, drinking, or using other drugs before they were 18 years old. Because Medicaid and PeachCare for Kids cover half of all Georgia children, the activation of the Medicaid reimbursement codes for SBIRT is a powerful opportunity to identify youth substance use and intervene early. Studies show that simply asking young people about drugs and alcohol use can lead to positive behavior changes and that brief interventions reduce the frequency and amount of alcohol or other drug use by adolescents.

This policy change was the product of a sustained advocacy effort by Georgians for a Healthy Future (GHF) and the Georgia Council on Substance Abuse (GCSA). We anticipate it will lead to the screening of an estimated 145,000 Georgia youth annually and that 36,000 of those youth will present substance use behaviors that prompt a brief intervention with a health care provider. Initial data from Georgia’s Medicaid agency demonstrates that some providers are already making use of the SBIRT codes in their practices.

Notwithstanding these exciting results, we have committed to continue our efforts to improve access to screening, early intervention, and recovery services and supports for young people across Georgia. While the Medicaid reimbursement codes allow physicians, physician extenders, and advanced practice registered nurses to provide SBIRT services, we recognize that RNs, LPNs, licensed clinical social workers, and certified peer counselors can and should be able to provide SBIRT to youth and adults. Further, the codes allow SBIRT to be provided primarily in health care settings, but that excludes schools and other community-based settings where most young people spend their time.

We invite you to join our efforts to prevent substance use among young Georgians. Spread the word by giving our new fact sheet to the providers in your clinic, public health department, or hospital. If you are a health care provider, attend a training to develop the skills to implement SBIRT with the people that you care for. Join our on-going advocacy efforts to activate the reimbursement codes for more practitioner levels (including RNs and LPNs) and more settings by contacting us to let us know you are interested.

The opioid and substance use crisis that is sweeping Georgia and impacting communities nationwide will require a full spectrum of solutions that leverage the expertise of health care providers, public and private resources, and community and family supports. SBIRT is an evidence-based tool that can play a significant role in our collective efforts to reduce substance use and create a healthier Georgia for all of us.

To learn more, visit our Keeping Youth on a Healthy Path page.

For health care providers: download our new fact sheet here.

Appropriations Health Subcommittee heard bill to close the coverage gap

Last Tuesday, the House Appropriations Health Subcommittee met for a hearing about HB 669, a bill that would close Georgia’s coverage gap by extending health insurance to low-income Georgians as allowed by the Affordable Care Act. Minority Leader Bob Trammell presented the bill to the committee and outlined how it would bolster economic activity in rural Georgia, increase access to care for low-income Georgians, and be a smart investment of tax-payer dollars. Committee members asked questions about the bill’s impact on people with mental health conditions and the costs and savings of the bill, and all expressed a desire to find a common solution to Georgia’s high uninsured rate and barriers to health care. No vote was taken on HB 669, so the bill remains in the House Appropriations Health subcommittee.

For a more detailed account of the hearing and to encourage the committee members to continue the conversation, check our latest blog post by clicking here.

Surprise billing: where the bills stand and prospects for passage

Surprise billing legislation received a significant amount of attention from legislators early in this session. Several of these bills aligned with GHF’s policy priority of facilitating greater access to care and ensuring financial protections for consumers purchasing private insurance. HB 314 (formerly SB 359) is expected to be amended and get a vote today in the House. The legislation would prevent consumers from receiving balance bills when they unexpectedly receive care from providers that are not in their insurance plan networks during emergencies. Surprise out-of-network medical bills can be hundreds of thousands of dollars and it’t time to legislation in Georgia that protects consumers.

Call your State Representative today and urge them to vote “YES” on House Bill 314 because this legislation protects patients from surprise bills in emergency situations.

Education legislation impacting behavioral health needs of young students passed by the Senate

HB 740, which requires schools to provide a multi-tiered system of supports for a student in pre-school through third grade prior to expelling or suspending the student for five or more days was passed by the Senate last week. The bill must now return to the House for agreement before being sent to the Governor for his signature. The legislation provides increased opportunities for schools to screen students for a variety of academic and behavioral health needs, and connect them to the appropriate health and other services.

Rural health bill and Health Coordination & Innovation Council bill moving forward

The House agreed to Senate changes to HB 769, the rural health care bill, which allows the bill to move to the Governor’s desk for approval. The complementary bill, SB 357, creating the new Health Coordination & Innovation Council, passed the Senate and House and must now return to the Senate for agreement. Both bills included negotiated changes to better coordinate the two bills’ likely impacts.

Stay up to date on the status of bills these last few days of session and check out our full list of health care related legislation at GHF’s legislative tracker.

Changes in Health Care and Policy in the 2018 Georgia Legislative Session

Georgians for a Healthy Future and the Georgia Budget and Policy Institute will be presenting “Changes in Health Care and Policy in the 2018 Legislative Session” on Thursday, April 19th at 10:00 AM. Make sure to join GBPI and GHF to hear an overview of the bills, resolutions, and budgets that were passed and that will affect Georgia’s health care system and health care consumers. Tune in to this webinar to find out how this session’s legislation may affect your work, your health care, or your coverage.

Yesterday morning the House Appropriations Health Subcommittee met for a hearing about HB 669, a bill that would close Georgia’s coverage gap by extending health insurance to Georgians making less than $16,000 for an individual and $22,000 for a family of three (138% of the federal poverty line). Minority Leader Bob Trammell presented the bill to the committee and outlined the three goals of the legislation:

1. To bolster economic activity across Georgia, especially in rural communities
2. To move beyond a patchwork approach to health care by putting insurance cards in the wallets of more Georgians
3. To better leverage state dollars that are currently going to the federal government rather than providing coverage for hard-working Georgians.

Leader Trammell pointed out that the General Assembly consistently aims to run Georgia like a business by investing dollars smartly and efficiently. However, by refusing to extend health insurance to low-income Georgians, the state is missing out on $8 million per day ($3 billions dollars per year) that could be used to help treat and care for Georgians. Leader Trammell added that other states that have closed their coverage gap have seen drops in uncompensated care costs as large as 60%. Further benefits included support for rural economies by preventing future hospital closures and better treatment for those with substance use disorders.

Some members of the subcommittee expressed their support for closing the coverage gap, while others had questions about the costs of extending coverage to low-income Georgians. As GHF has previously reported, Georgia can afford the estimated annual costs and the investment would draw down $9 federal dollars for every $1 dollar spent by the state for expanded coverage. Representative Stephens brought up the possibility of raising the tobacco tax to raise additional revenue for Georgia’s health care needs. All members of the committee recognized the need to increase access to care for all Georgians and the need for bipartisanship in finding a Georgia-specific way to resolve the issue.

No vote was taken on HB 669, so the bill remains in the House Appropriations Health subcommittee.

We are grateful to the committee for considering Georgia’s opportunity to put an insurance card in the pockets of low-income Georgians and support continued conversation on the issue. You can help by thanking the members of the committee and asking them to ensure the conversation continues to move forward towards a solution. Send an email now!

Rep. Butch Parrish – Chairman

District 158

Email: butch.parrish@house.ga.gov

Rep. Lee Hawkins – Vice Chair

District 27

Email: lee.hawkins@house.ga.gov

Rep. Pat Gardner

District 57

Email: pat@patgardner.org

Rep. Carolyn Hugley

District 136

Email: carolyn.hugley@house.ga.gov

Rep. Ron Stephens

District 164

Email: ron.stephens@house.ga.gov

Rep. Darlene Taylor

District 173

Email: darlene.taylor@house.ga.gov

Health care bills re-appropriated for new purposes

Each year, as the end of the legislative session comes into view, legislators work to ensure that priority legislation can be successfully passed before the Sine Die deadline. Sine Die is the day that legislative session ends and is scheduled for March 29th this year. This often results in major changes to legislative language or the combination of related bills. These changes are evident in several notable health care bills, which we have detailed here.

• This week, the Senate HHS committee heard HB 161, which effectively decriminalizes needle exchange programs in Georgia. The bill passed out of committee but with major additions. The additions are largely taken from SB 352 which, among other things, establishes a Commission on Substance Abuse & Recovery headed by a Director (for a more detailed review of SB 352, read our previous coverage here). The bill now awaits approval by the Senate Rules Committee in order to receive a vote on the Senate floor.
• The House HHS committee this week voted to pass SB 325 which, in its original form, would have allowed Georgia to enter into the Interstate Medical Licensure Compact. However, all of the bill’s original language was removed and substituted with new legislative language that, among other provisions, limits step therapy and sets up a process for physicians to request exceptions (previously HB 519). Step therapy is a requirement by some insurers that patients try a series of lower-cost treatments before the insurer will cover the treatment prescribed by a patient’s physician. SB 325 will now go to the House Rules committee to be approved for a vote by the full House.
  

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Health Care Bills Favored By Legislative Leadership Passed

Rural health bill and Health Coordination & Innovation Council bill passed by respective chambers

Two bills named as priorities by legislative leaders passed their respective chambers this week. The rural health care bill, HB 769, passed the Senate and SB 357, legislation creating the new Health Coordination & Innovation Council, passed the House. Both bills included negotiated changes to better coordinate the two bills’ likely impacts. Because the bills passed with changes, they will each need to return to their chamber of origin for an “Agree” vote before they are eligible for the Governor’s signature.

Legislation Impacting Social Determinants of Health

Legislation concerning suspension of young students passed by Senate committee

HB 740, which requires schools to provide a multi-tiered system of supports for a student in pre-school through third grade prior to expelling or suspending the student for five or more days, was passed by the Senate Education & Youth Committee on Thursday. The legislation provides increased opportunities for schools to screen students for a variety of academic and behavioral health needs, and connect them to the appropriate health and other services. The bill will now need approval by the Senate Rules Committee to reach the floor for a vote by the full Senate.

Legislation to promote healthy housing fails; Resolution proposing study committee introduced

Housing, one of the most recognized social determinants of health, can influence a person’s physical and mental health, and access to economic opportunity and necessary social and health services. Earlier this session, Representative Scott Hilton introduced HB 954, which would have prohibited landlords from retaliating against tenants who complain about unhealthy or unsafe rental housing but the bill never received a hearing in the House Judiciary Committee. In order to lay the groundwork on this issue for future legislative sessions, Representative Sharon Cooper has sponsored HR 1431 establishing a study committee on healthy housing, which if passed would evaluate the scope of unhealthy housing problems in the state, its impact on Georgia families and the costs of unhealthy housing to the state and local communities, and would identify promising initiatives and policies in other states that address unhealthy housing.

Rural health care bill moves forward, does not include closing the coverage gap

The legislature began the final quarter of the 2018 session last week. Committees were especially busy as they began to consider the numerous bills that passed from the opposite chamber the previous week.

The Senate HHS committee this week considered HB 769, the result of the House Rural Development Council’s efforts to address barriers to health care in rural Georgia. The bill proposes a number of programs that incentivize health care providers to practice in rural areas, as well as establishes a Rural Health System Innovation Center within the State Office of Rural Health. It also increases the value of donations made to rural hospitals in an attempt to provide rural hospitals with additional funding. Senator Orrock correctly pointed out during the hearing that significant federal funding is available to help strengthen rural hospitals if state leaders would close Georgia’s coverage gap by providing health insurance to low-income Georgians. The Senate HHS committee passed HB 769 with no amendments to close the coverage gap, and the bill now proceeds to the Senate Rules committee.

Health Coordination & Innovation Council Bill Approved

Changes made to SB 357 to earn committee approval

On Tuesday, the House Health & Human Services Committee heard SB 357, which would establish a Health Coordination and Innovation Council to coordinate health care planning across state agencies and within the health care system. SB 357 will no longer include the creation of a Health System Innovation Center to support the work of the Council because it was seen as duplicative to HB 769’s Rural Health System Innovation Center. Changes were also made to enumerate who can be appointed to the Council; no consumer representation was included in the changes. The House HHS committee approved SB 357 on Friday, so the bill will move forward for consideration by the House Rules committee in order to receive a floor vote by the full House.

Correction: FY2019 Budget Passed By House This Week

House passes its version of the FY2019 budget

Last week’s legislative update incorrectly stated that the FY2019 state budget, which begins on July 1, 2018 and runs through June 30, 2019, had been passed by the House prior to Crossover Day. The House was still working on its version of the state budget through late last week and passed it on Friday, March 9th. The budget includes several new investments in children’s mental health and mostly maintains funding for other health care programs and priorities. For more information on the health care highlights in the proposed FY2019 budget, read the Community Health and Behavioral Health budget overviews from the Georgia Budget & Policy Institute.

Legislation Increases Screening Opportunities for Young Students

Bill would require schools to take certain steps before suspending students in preschool through 3rd grade

Education, in combination with the other social determinants of health, plays a major role in a person’s health and well-being. HB 740, sponsored by Representative Randy Nix, requires school systems to provide a multi-tiered system of supports for a student in pre-school through third grade prior to expelling or suspending the student for five or more days (unless the student possessed a weapon, drugs, or other dangerous instrument or the child’s behavior endangers the safety of others). While the legislation does not prescribe what types of supports must be provided, it is likely that schools will use the opportunity to screen students for a variety of academic and behavioral health needs, and connect them to the appropriate health services. Children with behavioral health conditions drop out of school at much higher rates than those without, so this opportunity to identify behavioral health and other health-related barriers to learning is a critical prevention strategy. HB 740 is expecting to be heard in the Senate Education & Youth Committee today.

GHF is excited to welcome Michelle Conde as the organization’s new Communications & Special Projects Manager. In this role, Michelle will manage GHF’S external communication channels (email, social media, earned media) and leverage social media for digital advocacy. She will also provide policy research support as needed and contribute to the organization’s policy analysis efforts.

Michelle is a graduate of Georgia State’s Andrew Young School of Public Policy, where she received her Master’s in Public Policy with a focus on nonprofit policy. She is a creative and highly motivated leader with familiarity in working with diverse communities and quickly finding resourceful solutions. Before joining GHF she served as a policy fellow at Voices for Georgia’s Children and as a volunteer at Hemophilia of Georgia for over a decade. She is also a founding member of Hemophilia of Georgia’s Advocacy Board where she participates in efforts to advocate and educate the public and legislators.

We are pleased that Michelle has joined our team! You can contact Michelle at mconde@healthyfuturega.org or 404-567-5016 x 3

Georgians for a Healthy Future’s eighth annual Health Care Unscrambled breakfast built on previous years’ successes with another standing room-only crowd. This year’s legislative panelists were:

Senator Elena Parent
Senator Renee Unterman
Representative Bob Trammell
Representative Mark Newton
Representative Sam Park

Each panelist provided updates on emerging health care trends impacting Georgia and took questions from the audience about what healthcare initiatives are likely to be taken up in the 2018 legislative session. Topics included Medicaid expansion, federal funding of PeachCare for Kids (CHIP), surprise out of network medical billing, access to mental health and substance use treatment services, network adequacy, hospital closures, scope of practice for non-physician providers, Certificate of Need reform, maternal and infant mortality, rural health care access, the Prescription Drug Monitoring Program (PDMP), federal health care reform, the opioid epidemic and homelessness.

Senator Unterman, Chairwoman of the Senate HHS Committee, led the conversation with updates of the findings and recommendations from the myriad study committees she chaired or established in the 2017 off-session including the Senate Study Committees on Homelessness, Georgians Barriers toAdequate Access to Healthcare, as well as her participation on Lt. Gov. Cagle’s Health Care Reform Task Force. New Minority Leader Bob Trammell, along with Representative Sam Park, announced their intention to introduce legislation to expand Medicaid in Georgia (which has now been filed as House Bill 669) and Rep. Mark Newton, an Augusta area ER physician and Senator Elena Parent, Deputy Whip in the Senate Minority Caucus both elaborated on the Medicaid expansion debate, mental health issues facing the state, the opioid epidemic and rural health care access.

This year’s key note speaker was Robin Rudowitz, Associate Director of the Kaiser Family Foundation’s Program on Medicaid and the Uninsured. Ms. Rudowitz provided some background information on the federal Medicaid program, as well as Georgia’s program specifically. She pointed out that children are the primary beneficiaries in Georgia’s Medicaid program followed by people with disabilities, pregnant women, and seniors respectively. Georgia’s Medicaid program does not cover adults making less than 138% of the federal poverty level (about $16,000 per year for an individual and $21,000 for a family of 3) because Georgia’s policymakers have thus far refused to extend health coverage to this population. There was an extended discussion by Ms. Rudowitz and audience members about the new flexibility offered by the U.S. Department of Health & Human Services to state Medicaid programs may impact children and other enrollees, as well as how it may change existing Medicaid expansion programs in other states, This information presented by Ms. Rudowitz and subsequent discussion are sure to inform the considerations around the future of Georgia’s Medicaid program. Ms. Rudowitz’s presentation can be accessed here.

To see photos, review materials, and get more information about this year’s Health Care Unscrambled event, please visit the event page.

The 2018 legislative session has begun

The Georgia General Assembly has convened at the state capitol for its annual 40-day legislative session. This year’s session is expected to be quick as legislators prepare for primary elections in May and this fall’s general election. While the legislature is only constitutionally required to pass a state budget, we expect that a number of critical consumer health care topics will be debated. GHF will be monitoring this activity and will keep you up-to-date with weekly legislative updates (like this one!), our legislation tracker, timely analysis of legislation, and more.

The State Budget

On Thursday, Governor Deal addressed the General Assembly in his annual State of the State address and, per tradition, used the opportunity to introduce his proposed budget. The Governor minimally mentioned health care in his address, only highlighting the Commission on Children’s Mental Health. The inclusion of $20.6 million to fund the Commission’s recommendations made up the most significant health care-related change in the Governor’s proposed budget. This money will go to fund behavioral health crisis services ($10.4 million), a school-based mental health initiative called Project Apex ($4.3 million), supported employment and education ($3 million), suicide prevention ($1.1 million), provider training and telehealth ($1 million), and opioid abuse prevention ($790,000). The budget will now go to the House for its consideration before passing to the Senate.

HB 669: Medicaid Expansion

New House Minority Leader (and Health Care Unscrambled panelist) Bob Trammell introduced HB 669 requiring Georgia to authorize state dollars to drawn down additional federal dollars to expand Medicaid. Closing Georgia’s coverage gap by expanding Medicaid (or through a tailored Georgia-specific 1115 Medicaid waiver) would be the most significant step Georgia’s law makers can take to strengthen the state’s weakening rural health care system, address the opioid and substance use epidemic, and provide all Georgians with an insurance card regardless of income. Contact your legislators and let them know that you support closing Georgia’s coverage gap and they should too. Save the date. February 15th is Cover Georgia Day at the Capitol. Make plans to attend! Stay tuned for an official event announcement and RSVP link soon.

The Legislative Calendar

The schedule for the first eleven days of the 2018 legislative session was set on Monday, January 8. The General Assembly has already worked four days of the constitutionally capped 40-day session (January 8 through January 11). Tuesday, January 16 and Wednesday, January 17 are slated for budget hearings, and the next seven legislative days are as follows:

• January 18: Legislative Day 5
• January 19: Legislative Day 6
• January 22: Legislative Day 7
• January 23: Legislative Day 8
• January 24: Legislative Day 9
• January 25: Legislative Day 10
• January 29: Legislative Day 11