Despite several missed opportunities to address consumer health concerns during this year’s state legislative session, the FY2019 budget includes several impactful investments. Last week, Governor Nathan Deal traveled through Georgia and held budget signing ceremonies in Atlanta, Acworth, Blue Ridge, Statesboro, and Tifton for the $26 billion spending plan which will begin on July 1 of this year through June 30, 2019. The infusion of dollars into children’s mental health is especially noteworthy and exciting because of the impact it is expected to have across the state.

Governor Deal has recently made children’s behavioral health one of his top health care priorities and this year included in his proposed budget $20.6 million to fund recommendations from the Governor’s Commission on Children’s Mental Health. During its consideration of the state budget, he legislature ultimately increased the funding dedicated to these recommendations to $21.4 million.

These funded recommendations include behavioral health crisis services, supported employment and education for young adults with behavioral health needs, provider training and telehealth, and opioid abuse prevention for youth. Funding for suicide prevention will in part go towards expanding the capacity of GCAL, the Georgia Crisis and Access Line, which provides 24/7 online and telephone support for people who are seeking services for developmental disabilities, mental health, or substance use issues. Some of the additional funding is also dedicated to the Georgia Apex Program, a school-based mental health program that improves early identification, access to and coordination of needed behavioral health (BH) services for children with BH needs..

In the coming months, we will break down the Commission’s funded priorities and their impact on young Georgians. Look for our Healthy Minds, Healthy Bodies blog mini-series.

Looking for more information on this topic? Georgians for a Healthy Future will be hosting an educational forum later this month during which we will explore the behavioral health needs of Georgia children and youth, Georgia’s publicly-supported behavioral health landscape, and successes and opportunities in the current system of care. Join us in person or via webcast for this exciting and important event!

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!

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.

With four open enrollment periods completed and a fifth one beginning in the coming weeks, the Health Insurance Marketplace has become established as the avenue for purchasing coverage for thousands of Georgians who do not have access to have insurance at work. The fourth open enrollment period differed from the first three in several important ways, and understanding these variations will be important in ensuring that the Marketplace continues to serve consumers who seek access to affordable comprehensive health insurance. This report examines the characteristics of the consumers enrolled in the Georgia Marketplace, compares open enrollment 4 to the previous three enrollment periods, and provides a preview for open enrollment 5.

Inside you’ll find:

– Key themes in consumer and assister experiences during the 2017 open enrollment period
– A look forward to open enrollment 5
– Policy opportunities to increase enrollment, ensure access to care, address affordability issues, and facilitate continued consumer education and supports

You can find the full report here. 

Georgians for a Healthy Future’s Executive Director Cindy Zeldin attended the Spring Meeting of the National Association of Insurance Commissioners (NAIC) in her role as a consumer representative to the NAIC. At the meeting, a group of health-focused consumer representatives presented an overview of a new report authored by a diverse group of patient and consumer advocates highlighting the need to ensure that any changes to the health care system do no harm to consumers, minimize market disruption, and maintain common-sense consumer protections. The report, The Need for Continued Consumer Protections and Stability in State Insurance Markets in a Climate of Federal Uncertainty, conveys the perspective of consumer advocates on the need for continued access to high-quality health insurance products—regardless of whether and how changes are made at the federal level—and the likely impact that some proposed Affordable Care Act replacement policies will have on consumers and state insurance markets. The report discusses:

• What consumers want when it comes to private health insurance;

• The progress that has been made in reducing the uninsured rate since 2010 and the risks of full or partial repeal of the Affordable Care Act;

• Key principles—such as insuring the same number of consumers with the same quality of coverage and minimizing market disruption—that we urge policymakers to apply when considering further changes to the market; and

• Concerns about the impact of potential changes on consumers and state markets, with an emphasis on high-risk pools, continuous coverage requirements, high-deductible health insurance products, association health plans, the sale of insurance across state lines, the loss of essential health benefits protections, and the need for continued nondiscrimination protections.

An overview of the report was provided to state insurance commissioners during the NAIC/Consumer Liaison Committee meeting on Monday, April 10th during the National Association of Insurance Commissioners (NAIC) Spring 2017 National Meeting in Denver, Colorado. The authors of the report serve as appointed consumer representatives to the NAIC and members come from national organizations such as the American Cancer Society Cancer Action Network, the American Heart Association, Consumers Union, and the National Alliance on Mental Illness; state-based advocacy organizations such as the Colorado Consumer Health Initiative, Georgians for a Healthy Future, and the North Carolina Justice Center; and academic centers such as Georgetown University and Washington & Lee School of Law.

The full report is available here.

As the health care debate ramped up in Washington, February’s Congressional recess presented opportunities for Georgia’s health care advocates to voice their concerns about plans to repeal and replace the Affordable Care Act. GHF participated in two events that highlighted the progress that has been made in Georgia under the ACA and the need to build on its successes rather than repeal it. 

The week began with a rally as the Save My Care bus tour stopped at Liberty Plaza across from the Georgia Capitol.  House Minority Leader Stacy Abrams energized the crowed and spoke of the importance of health care for every Georgian. GHF’s Executive Director Cindy Zeldin reminded the audience that because of the ACA the uninsured rate in the US is lower than it has ever been before and that new consumer protections provided to Georgians with pre-existing conditions, LGBT Georgians, and low-income families helped to narrow disparities in health care access. Georgia consumers Jan and Vicki shared their stories of how the ACA has helped them access the health care they needed when they needed it. You can watch the full rally here.

On Saturday, GHF marched at the Atlanta March for Healthcare organized by the Georgia Alliance for Social Justice. Marchers traveled down Peachtree Street from Midtown to downtown’s Woodruff Park where a rally was held. Along with partner organizations active on health care issues, Cindy reminded those at the rally of how much progress had resulted from the ACA and how interconnected health care is to other social justice issues like racial, gender, and economic equality.

GHF will continue to work to #ProtectOurCare as Congress attempts to pass the American Health Care Act, a proposal that attempts to cut and cap Medicaid and increase costs for low-income families and older Georgians. We hope you’ll join us to rally, march, call, and organize for affordable, accessible, high quality health care for all Georgians.

Hearing on surprise billing legislation scheduled for tomorrow 

SB 8, which seeks to protect consumers from surprise out-of-network medical bills, is scheduled to receive a hearing in the Senate Health & Human Services committee on Tuesday at 2 pm. SB 8 would establish a standard payment structure for physicians seeking reimbursement for surprise out-of-network services, and would hold consumers harmless in surprise billing situations. HB 71, the companion bill sponsored by Rep. Richard Smith, is expected to be assigned to a sub committee of the House Insurance committee on Tuesday at 8 am.

You can help!

If you have received a surprise out-of-network medical bill, share your story with our partners at Georgia Watch. Consumer stories help illustrate to legislators why legislation is needed to help protect consumers like you. Click here to share your story!

What Happened Last Week

Senate passes provider fee renewal

On Thursday the Senate passed SB 70 which renews the provider fee (also called the “bed tax”) for another three years in order to fund Georgia’s Medicaid program. This allows the Department of Community Health to collect the 1.45% tax on hospital revenues in order to draw down federal Medicaid dollars. These additional dollars are disproportionately used to support rural and safety net hospitals who serve high numbers of indigent patients. The bill will now move to the House where it expects an easy passage.

“Expand Medicaid NOW Act” reintroduced

House Minority Leader Stacey Abrams introduced HB 188, the Expand Medicaid NOW Act, last week. While we do not expect this bill to gain much traction because of the evolving health reform efforts at the federal level, it calls attention to the need to provide health care coverage to the 300,000 Georgians who are stuck in our state’s coverage gap because they do not currently qualify for Medicaid and cannot access health insurance through the Affordable Care Act’s Marketplace. The bill has been referred to the House Appropriations Committee.

Oral health legislation moves forward

Both HB 154 and SB 12, bills that allow dental hygienists to provide cleanings and other specified services in schools, safety net clinics, nursing homes, and private dentists’ practices under “general supervision”, received committee hearings and votes last week. Both bills will move to their Chambers’ respective Rules Committees to be approved for floor votes by the House and Senate.

Debate over opioid abuse prevention bill 

SB 81 received its first hearing in the Senate Health & Human Services committee last week. The bill seeks to address the growing opioid abuse epidemic in Georgia in a number of ways, including: 1) Extending the Prescription Drug Monitoring Program, a database of prescriptions written for certain narcotics and requiring physicians to consult this registry prior to prescribing under certain conditions; 2) Codifying the Governor’s emergency order increasing the availability of anti-overdose drug, Naloxone; 3) Requiring the tracking and reporting of Neonatal Abstinence Syndrome; and 4) Establishing penalties for providers who are not in compliance with drug prescription reporting requirements. While few dispute the need to address this issue, the scope of drug and drug classes that the bill covers, along with the severity of the penalty that physicians may be subject to for violating the law are currently points of contention. No vote was taken in Thursday’s committee hearing, but suggested changes were made and the bill is expected to be back before the same committee later this week.

Resources for you

Georgians for a Healthy Future has tools you can use to track and understand the Georgia legislative session. Stay up-to-date on the bills that matter to you with our legislation tracker and sign up for Georgia Health Action Network (GHAN) action alerts so you know when to engage.

Get Your 2017 Consumer Health Advocate’s Guide!

GHF’s annual Consumer Health Advocate’s Guide is your map for navigating the Georgia legislative session. The Guide provides information on the legislative process, and contact information for legislators, key agency officials, and health advocates. This year, we’ve added a glossary of terms to help you understand what is happening under the Gold Dome. This tool will help advocates, volunteers, and consumers navigate the 2017 Georgia General Assembly.  Download your copy here.

 Georgians for a Healthy Future’s Executive Director Cindy Zeldin participated as a featured guest at WABE’s A Nation Engaged community forum at the Carter Center in Atlanta on the evening of January 17th. The forum, an initiative of WABE’s A Closer Look radio show, featured a range of thought leaders, community activists, policy experts, and previous guests of the program. The conversation was wide-ranging and incorporated different views and perspectives. Georgians for a Healthy Future was honored to be invited and to be part of the lively event. You can see more details and listen to the entire special broadcast here.

Georgians for a Healthy Future will be at the Capitol throughout the forty-day session to monitor health-related legislation, serve as a voice for health care consumers, and keep you informed about opportunities to engage and take action. For the past four years, our top legislative priority had been closing Georgia’s coverage gap by expanding Medicaid. In the wake of the 2016 election, the national policy landscape has shifted considerably, knocking that off the table this year and placing existing coverage, care, and consumer protections at risk. Despite this backdrop of uncertainty and a critical need for federal advocacy, there will be important decisions made over the next three months at the state level that impact the health of individuals, families, and communities.

While it is early, here are the major health care issues we preliminarily expect legislators to tackle in 2017:

• Renewal of the provider fee commonly known as the “hospital tax” or “bed tax” to help fund Medicaid and keep hospital doors open
• Development of a set of reforms to improve mental health services based on the recommendations of a legislative study committee that has been meeting over the past several months
• Creation of a “repeal” task force to assess the impact of changes to or repeal of the Affordable Care Act on Georgia
• Addressing the practice of surprise medical billing, which can leave insured consumers with unexpected bills when a health care provider is out-of-network
• Increasing reimbursement rates for certain primary care services for health care providers participating in Medicaid
• Improving access to dental care for children, seniors, and people with disabilities

Georgians for a Healthy Future has several ways for you to stay up-to-date on what’s happening under the Gold Dome this year:

• Learn: Download our 2017 policy priorities, read up on how the legislative process works, and track health-related legislation
• Engage: Sign up for our Georgia Health Action Network (GHAN) action alerts
• Participate: Identify and contact your specific legislators on issues you care about

Stay tuned for updates throughout the session.