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Travis suffered from a series of strokes when he was 11 years old that left him with several physical disabilities. He is one of the approximately 250,000 Georgians with disabilities to be covered by Medicaid.
Several years ago, Travis started volunteering with DisabilityLINK because he believes in the power of community and he likes being able to help others. Since then, he was hired as a Independent Living Specialist at the organization, where he connects people with disabilities to community-based resources and assists in coordinating various events at the DisabilityLINK office. He also works alongside other activists on issues such as housing, accessibility and self advocacy.
Travis recognizes that Medicaid is the reason he is able to financially support himself and work for an advocacy organization. Without the support Medicaid provides, Travis explains, he would not be able to help others the way he has been able to through his work at DisabilityLINK. When asked what he wanted others to know about him being able to receive affordable health insurance he replied, “With me working I am able to be a tax paying citizen.”
Medicaid is essential to ensuring that people with disabilities, like Travis, are able to lead fulfilling, independent lives as active participants in their communities. Georgia’s Medicaid program provides almost 2 million low-income children, people with disabilities, seniors, pregnant women, and very low-income parents with access to the health care services that they wouldn’t have otherwise.
Your story is powerful! Stories help to put a human face to health care issues in Georgia. When you share your story, you help others understand the issue, its impact on Georgia, and its importance. Your health care story is valuable because the reader may be your neighbor, friend, someone in your congregation, or your legislator. It may inspire others to share their stories or to become advocates. It is an opportunity for individuals who receive Medicaid or fall into the coverage gap, their family members, their physicians and concerned Georgia citizens to show that there are real people with real needs who will be impacted by the health policy decisions made by Congress and Georgia’s state leaders. Share your story here!
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.
New tool available to Georgia health care providers to address the opioid crisis
Laura Colbert, MPH, MCHES
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.
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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:
- To bolster economic activity across Georgia, especially in rural communities
- To move beyond a patchwork approach to health care by putting insurance cards in the wallets of more Georgians
- 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.
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.
A flurry of activity for Crossover Day
Last Wednesday was Crossover Day at the Capitol, meaning a bill must cross from its chamber of origin to the opposite chamber to remain viable for this legislative session. This week’s legislative update provides a rundown of consumer health legislation: which bills made it through and which did not. You can see a list of all the bills we’re tracking here, along with more information about the bills included here
Our priorities
Surprise billing & transparency legislation keeps moving
SB 359, the most comprehensive surprise billing legislation to be considered by the Georgia General Assembly this session, received approval by the full Senate on Wednesday and will be considered by the House Insurance Committee in the coming weeks. As previously reported, HB 678, a bill that increases provider network and billing transparency, passed the House several weeks ago. It has since been referred to the Senate Health & Human Services Committee. HB 799, which addressed out of network care in emergency situations, did not receive a vote by the House but much of the bill’s language is included in SB 359.
Legislation to close Georgia’s coverage gap did not receive legislative attention
HB 669, sponsored by House MInority Leader Bob Trammell, did not receive a committee hearing or a vote by the Crossover Day deadline. The legislation would expand Georgia’s Medicaid program to cover adults making less than $16,000 annually and parents making less than $21,000 for a family of three, as 32 other states have now done. The bill was assigned to the House Appropriations Committee and remains the most significant step the state could take towards addressing the opioid crisis, strengthening rural hospitals, and increasing access to care for thousands of hard-working Georgians.
Crossover Day Recap
HB 683: Amended FY2018 Budget | CROSSED OVER
HB 683 makes adjustments to the state budget for the current fiscal year which runs through June 30, 2018. The “little budget”, as it is known, has passed both chambers of the General Assembly but has not yet received “agrees” by both chambers, the final step before sending the budget to the Governor for his signature.
HB 684: FY 2019 Budget | REMAINS IN HOUSE
HB 684 is the budget document for the coming state fiscal year which will run from July 1, 2018 to June 30, 2019. 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.
HB 769: Recommendations from the House Rural Development Council | CROSSED OVER
HB 769 is the result of the 2017 House Rural Development Council’s work. The bill includes a number of provisions, most prominently of which is the creation of a Rural Center for Health Care Innovation and Sustainability within the existing State Office of Rural Health. The bill also increases the rural hospital tax credit to 100%, directs the Department of Community Health to streamline and create efficiencies within the state medical plan, allows for the establishment of micro-hospitals, sets up an incentive program for physicians practicing in rural areas, and redefines “rural county”.
HB 827: Rural hospitals tax credit increase | CROSSED OVER
HB 827, introduced by Rep. Trey Kelley, would expand the rural hospital tax credit program from a 90% credit to a 100% credit. The tax credit program went into effect last year and has resulted in the donation of about $10 million to rural hospitals thus far.
HB 872: Provider network transparency | DID NOT CROSS OVER
HB 872, sponsored by Rep. Knight, requires insurers to make a plain language description of their provider network standards publicly available on their website among other provisions. The bill also stipulates that if an insurer advertises a physician as being in a plan’s provider network when a consumer enrolls in an insurance plan, the insurer is required to cover the health care services received from that provider at an in-network rate during the entire contract year.
HB 873: Prescription drug formulary and prior authorization transparency | DID NOT CROSS OVER
This bill requires that insurers provide an easy-to-find, accurate, and updated drug formulary list on their website and requires the Insurance Commissioner to create rules about the format and information within the formulary so that consumers can more easily understand what prescriptions are covered under their insurance plan and the costs associated. The legislation also requires that a single, standard prior authorization form be developed that would apply to all insurers and pharmacy benefit managers regulated in Georgia.
HB 877: “Modified risk” tobacco | DID NOT CROSS OVER
HB 877 would have cut Georgia’s tobacco tax in half for so-called “modified risk” tobacco products. The bill lost decisively on the House floor by a vote of 109-59. Thank you to those of you who contacted your state representatives last week ahead of the House’s vote!
SB 325: Interstate Medical Licensure Compact Act | CROSSED OVER
SB 325 would allow Georgia to enter the “Interstate Medical Licensure Compact Act” which allows health care providers to more easily obtain licenses to practice in multiple states. It also grants states easier access to investigative and disciplinary information about providers.
SB 351: Changes for APRNs | CROSSED OVER
SB 351 would expand from four to eight the number of advanced practice registered nurses a physician is allowed to supervise and would allow APRNs to order radiographic imaging for patients if their supervising physician delegated the authority. The legislation is significantly diminished from the original proposal which would have granted APRNs a greater scope of practice.
SB 352: Legislation to establish Commission on Substance Abuse & Recovery | CROSSED OVER
SB 352 establishes a Commission on Substance Abuse & Recovery, headed by a director, which would be charged with coordinating data among relevant government entities; informing strategies to combat the opioid crisis within the Departments of Public Health and Education, the Attorney General’s Office, and other state entities; consulting with the Governor’s office on a potential Medicaid waiver related to opioid abuse; and developing and informing other efforts to expand access to prevention, treatment, and recovery support services across the state.
SB 357: Legislation to establish Health Coordination and Innovation Council | CROSSED OVER
SB 357 establishes the Health Coordination and Innovation Council, the Health System Innovation Center, and an advisory board to the Council. The Council would act as a permanent statewide coordinating platform, bringing together all of health care’s major stakeholders, and the Center is proposed as a research body that would collect and analyze data to support the work of the Council.
SB 418: FDA and USDA Preemption bill | DID NOT CROSS OVER
SB 418, sponsored by Rep. John Wilkinson, would preempt local governments from regulating any product currently under the jurisdiction of the FDA, USDA, or the Georgia Department of Agriculture, including tobacco and marijuana. The bill failed in the Senate by a 34-19 vote, but is expected to come back in an amended form.
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
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