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January 30, 2004
It was a short day
today – Legislators concluded their business and headed for home.
Floor News
Not a great amount of activity took place today. The Senate again took moments
of personal privilege to discuss tort reform matters. Sen. Price again pointed
out problems in the medical community.
On the House side, its Members paid tribute to a visitor by welcoming home to
Georgia Sergeant Major Michael Henry Duke from the war in Iraq.
New Legislation
HB 1265 – Rep. Childers has proposed this change to practicing medicine without
a license. It changes the way in which an “intern” and “resident” can practice
medicine. It provides for temporary postgraduate training permits. This would be
added in O.C.G.A. § 43-34-47. “Temporary postgraduate training permit” means a
“permit issued by the board to a graduate of a board approved medical or
osteopathic school who is enrolled in a postgraduate training program deemed
acceptable by the board and who does not currently hold a full and unrestricted
license in this state.” An individual, who seeks to pursue postgraduate medical
training in Georgia who does not hold a license to practice medicine under this
chapter, must apply to the board for a temporary training permit. The applicant
must meet these requirements: 1) evidence satisfactory to the board that the
applicant has been accepted or appointed to participate at a training
institution in Georgia in one of the following: a) an internship or residency
program accredited by either the Accreditation Council for Graduate Medical
Education or the American Osteopathic Association; or b) a clinical fellowship
program at an institution with a residency program accredited either by the
Accreditation Council for Graduate Medical Education or the American Osteopathic
Association that is in a clinical field the same as or related to the clinical
field of the fellowship program. 2) Information satisfactory to the board that
identifies the beginning and ending dates of the period for which the applicant
has been accepted or appointed to participate in the internship, residency or
clinical fellowship program; and 3) Any other information that the board
requires.
HB 1266 – Rep. Childers has also authored this measure. It has a number of
provisions concerning the State Medical Education Board. One is concerning
staffing for the Board as found in O.C.G.A. § 20-3-511; it proposes that the
State Medical Education Board shall have the authority to employ administrative
staff to carry out the functions of the Board. Staff members would be employed
within the limits of the appropriations made to the State Medical Education
Board. (Now, the State Board of Medical Education, in concurrence with the
Department of Community Health, employs the staff.) It also proposes in O.C.G.A.
§ 20-3-516 that the funds necessary for loans or scholarships provided for and
to administer the terms of this shall come from funds made available to the
State Medical Education Board from appropriations made to the Board of Regents
(rather than the Department of Community Health); and that the State Medical
Education Board will be an independent state agency assigned to the Board of
Regents (rather than the Department of Community Health). In O.C.G.A. §
20-3-518, it provides the State Medical Education Board the sole responsibility
and authority for all state programs to assist Georgia communities with
recruitment and retention of physicians. In O.C.G.A. § 31-7-95, it provides that
the Georgia Board for Physician Workforce will be responsible for paying no more
than $10,000.00 per annum to the hospital authority or designated teaching
hospital for each resident receiving medical education and training. (Currently,
this is done through the Department of Community Health.) It also makes changes
to funding of service cancelable loans for physicians (money will would be paid
to the Board of Regents rather than to the Department of Community Health.)
There are some other changes to healthcare provisions:
• Changes
selection of the presiding officer for the Commission on Men’s Health
(currently, the Commission elects annually a presiding officer). This proposes
that the Commission shall elect one of its members as presiding officer who
shall serve as presiding officer concurrently with the term of office of such
member specified under O.C.G.A. § 31-43-7(a). A successor shall be elected
immediately prior to the expiration of the presiding officer’s term of office.
• It changes the
composition of the Renal Dialysis Advisory Council in O.C.G.A. § 31-44-3(b).
• Attaches the
Georgia Board for Physician Workforce to the Board of Regents of the University
System of Georgia for administrative purposes in O.C.G.A. § 49-10-1(a) and adds
that the Georgia Board for Physician Workforce shall have the authority employ
such administrative staff as is necessary to carry out the functions of the
board. Such staff members shall be employed within the limits of the
appropriations made to the board.
• Changes the
powers, duties and responsibilities for the Georgia Board for Physician
Workforce in O.C.G.A. § 49-10-3. (Such as, plan and coordinate statewide medical
education and physician workforce policy and issues; advise Governor, General
Assembly, and Board of Regents on short-term and long-range projected
requirements for physicians necessary to provide access to primary and specialty
medical care in Georgia; monitor and evaluate the supply and distribution of
physicians in Georgia; define areas of the state in which unmet needs for
physicians exist; etc.)
HB 1273 – Rep.
Boggs and others have proposed exemptions from jury duty to provide that primary
caregivers with children. It increases the age of children from under four years
of age to four years of age and under. It also reduces the age for removal from
the jury list from 70 years of age to 65 years of age.
HB 1275 – Rep. Day and colleagues have proposed changing the Governor’s powers
concerning appointments in O.C.G.A. § 45-12-50.1. Persons appointed to fill
positions of a head of a State department or agency which require the appointed
officer to be responsible for preparing or managing the budget of such
department or agency shall meet the following requirements:
• Be a citizen of
the United States
• Not have made a
campaign contribution to the Governor’s campaign committee after the period
commencing at three months prior to a published announcement of the person’s
intent to seek the Office of Governor, or the date of qualifying for that office
(whichever is first)
• Have
demonstrated to the Office of Planning and Budget and to the media that such
person is able to balance a checkbook by a) swearing or affirming that person
has balanced and reconciled a checkbook at least one time; and b) providing an
affidavit from a CPA that such person has performed the act of balancing and
reconciling a checkbook without assistance in the presence of such accountant
HB 1276 – Rep. Day
and others have proposed an amendment to Article 34 of Chapter 1 of Title 10. It
proposes to provide that a person who owns or operate a public accommodation may
not restrict an individual from access or admission to the accommodation or
otherwise prevent the individual from using the accommodation solely because the
individual operates a motorcycle, is a member of an organization or association
that operates motorcycles, or wears clothing that displays the names of such an
organization or association.
HB 1281 – Rep. Thompson and others have authored this change in O.C.G.A. §
50-4-8. “No contract between a state agency and a private provider or vendor for
the provision of all or part of any governmental services provided by the agency
or for the provision of any services to the agency shall be entered into if any
such services will be performed outside the boundaries of the United States. If
at any time during the performance of a contract the private contracting party
uses any services which are performed outside the boundaries of the United
States, such private contracting party shall be liable to the state agency for
damages in an amount equal to the contract value of such services. Each such
contract entered into on or after July 1, 2004, shall contain a provision
requiring compliance with the provision so this Code section and providing that
breach of such provision, at the election of the agency, shall constitute a
breach of the contract. In the event an agency brings an action in any court to
enforce such provisions, it shall be entitled to a reasonable attorney’s fee in
addition to any other damages.”
HB 1283 – Rep. Sims and others have proposed gradually eliminating the excise
tax on rental motor vehicles (business and occupation taxes) as found in O.C.G.A.
§ 48-13-93. The bill proposes a 3% on the rental charges for the period ending
December 31, 2004; 2% on rental charges beginning January 1, 2005 and ending
December 31, 2005; and 1% of the rental charges for the period beginning January
1, 2006 and ending December 31, 2006. Tax levied per this article would
terminate not later than December 31, 2006 (currently it is proposed to be
eliminated on December 31, 2038).
HB 1285 – Rep. Randall and others have proposed the creation of a new offense
relating to the use of a minor’s (someone under 17 years of age) social security
number to establish a utility or other credit account. This is proposed to be
added in O.C.G.A. § 16-9-7.
HR 1096 – Reps. Buckner and Harbin have proposed this Resolution to promote
health education and physical activity in Georgia schools. The Resolution states
that the American Heart Association and Surgeon General both suggest children
get physical activity. Not only does physical activity improve physical fitness,
studies indicate that it improves self esteem; improves school attendance;
improves school grades; reduces smoking; and reduces alcohol and drug use. The
Resolution urges that Georgia schools to provide age-appropriate and culturally
sensitive instruction in health education and to provide 30 minutes of physical
activity (moderate to vigorous) daily for children in grades K-12.
SB 458 – A proposed set of changes to Chapter 13 of Title 16 relating to
physicians, acupuncture, physician’s assistants, cancer and glaucoma treatment,
respiratory care, clinical perfusionists, and orthotics and prosthetics practice
so as to rewrite law governing physician assistants. One of the big changes is
that it changes the term “physician’s assistant” to “physician assistant.” It
also has changes to job descriptions, scope of practice, provisions for
prescribing drugs and devices, etc. Under the job description definition in
O.C.G.A. § 43-34-26.1, it changes that to have the same meaning as the term is
defined in O.C.G.A. § 43-34-102:
“[M]eans a document, signed by the primary supervising physician and the
physician assistant whom the primary supervising physician is supervising, which
consists of guidelines mutually developed by the primary supervising physician
and the physician assistant both to be based upon the physician’s delegatory
style and to be consistent with the primary supervising physician’s scope of
practice; and which document describes the professional background, scope of
practice, and specialty of the primary supervising physician; the
qualifications, including related experience of the physician assistant; a
general description of how the physician assistant will be utilized in the
practice; and how the physician assistant will be supervised. A job description
shall not be required to contain every activity the physician deems the
physician assistant qualified to perform but shall confine the activities of the
physician assistant to those in the scope of practice of the primary supervising
physician.”
A physician assistant is an individual licensed pursuant to this article. A
physician assistant is a skilled person who is qualified by academic and
practical training to provide patient services and who is a practitioner when
practicing with physician supervision and direction pursuant to the job
description required by this article. It defines “supervision” a “licensed
physician overseeing the activities of and accepting responsibility for the
medical services rendered by a physician assistant. The physical presence of the
supervising physician is not required when the services are rendered as long as
the supervising physician and physician assistant can be easily and immediately
in contact by telecommunications.” A physician may supervise as many as four
physician assistants at any one time while practicing in a group practice in
which other physician members of such group are primary supervising physicians.
A physician assistant is not permitted to prescribe drugs or devices except as
authorized in the physician assistant’s job description and in accordance with
this article. Further, this proposal states that a physician assistant delegated
as a prescriber of controlled substances is authorized to register with the
federal Drug Enforcement Administration. A physician assistant will be required
to complete a minimum of three hours of continuing education biennially in
practice specific pharmaceuticals in which the physician assistant has
prescriptive privileges. The bill also allows for the practice of physician
assistants in emergency or disaster instances and provides for exemption from
paying fees and temporary practice agreements under certain circumstances.
Committee News
There was light Committee activity today, primarily because folks wished to
return to their Districts. The House Health and Human Services Committee’s
Subcommittee on General Health met this morning to take up a bill relating to
licensure issues for clinical perfusionists (the persons who operate the
heart/lung machines during surgery). Rep. David Graves authored the bill which
passed out of the Subcommittee this morning. Thus, HB 617 will now move to the
full House Health and Human Services Committee for its consideration.
HB 594 by Rep. Teper was reported out of Committee. This relates to Community
Service Board employee health benefits for any person who retires as an employee
of a community service board with at least 10 years of actual service and after
attaining the age of 60 years or after 30 years of actual service to a community
service board regardless of age so that person will be eligible for the retiree
health plan. These changes would be added in a new Code Section, O.C.G.A. §
45-18-7.8. The fiscal note states that the bill is not expected to have a fiscal
impact on State funds. The CSBs would incur the expenses of the employer
contribution for the health plan, but they would not receive additional state
monies to cover these expenses. The fiscal impact on the CSBs would total from
approximately $185,185 to $457,774 per year.
The Senate Finance Committee has reported out a Substitute to SR 580 concerning
the proposed Constitutional Amendment to the sales and use tax for educational
purposes which may also be imposed in whole or in part for maintenance and
operation of public schools with an equivalent millage rate reduction. This
proposal would change Article VIII, Section VI, Paragraph IV. It outlines how
the board of education may impose such tax and provides for three options for
purposes.
Other News
Next week, the hospitals and physicians will again duke it out over the
ambulatory surgery center issues. Currently, there is a proposal by Rep. Porter
in HB 791 which would raise the cost threshold for limited purpose, single
specialty, physician-owned centers – currently, the cost threshold is $1.4
million; his proposal raises it to $1.9 million. Anything over that threshold
would be required to undergo a full certificate of need application and process.
Hospitals would prefer that these types of physician-owned surgery centers have
to submit data and have an indigent care commitment requirement and/or close the
loophole presently in the law and make them also undergo a certificate of need
application and process. Rep. Ron Dodson will host a Subcommittee hearing on
this issue on Monday at 11:00 a.m. in Room 514 of the Legislative Office
Building.
Tort reform is still bubbling and we have heard that some types of amendments
are “possible” such as changes to the law governing expert witnesses.
If you have any questions regarding this Report, please contact Stanley S.
Jones, Jr., Jeffrey C. Baxter, or Helen Sloat.
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