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March 12, 2004 For more information contact: 404-817-6133 404-817-6247 404-817-6170 |
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March 12, 2004 Greetings from the Gold Dome! The House worked long and hard today. Meanwhile, the Senate made short work of its day and cleared out of the Capitol around noon. Day 32 is looming with the cross-over day of Day 33 just around the corner. Thus, Monday will be a long day in all likelihood as the FY 2005 budget is up. In Budget news, the House passed a House Appropriations Committee Budget for FY 2005 out of Committee around 2:00 p.m. today. The House Rules Committee has also agreed to place HB 1181, the FY 2005 Budget proposal, on its Rules Calendar for Monday. However, it has been rumored all day that the "deal" reached in Conference on HB 1180, the FY 2004 Supplemental Budget, has cratered. It is believed that the deal breaker is the bond package – apparently, Governor Perdue is insisting on his position and Conferees have disagreed. In any event, a Budget needs to be reached soon, especially for healthcare purposes. It is also rumored that the State's Medicaid program will be "broke" on March 23, 2004 and providers will be getting their last checks processed by the Dept. of Community Health next weekend. Senate Floor It was announced by Sen. Kasim Reed that House Member, Rep. Roger Bruce, had suffered a stroke and had been taken to Emory University Hospital. Prayers were requested for Rep. Bruce and his family. Sen. Crotts took the Well for a point of personal privilege on SR 595, the Constitutional Amendment which bans gay marriage. He asked his Senate Members to help urge House Leadership to bring the Resolution back to the Floor of the House for a vote. House Members had voted with a two-thirds majority in favor of reconsidering its prior action on the Resolution which opposed such ban. Sens. Seth Harp and Nadine Thomas had guests in the Senate and recognized the Georgia Chapter for USA Track and Field. Sen. Don Thomas moved that the Senate transfer and recommit HB 1138 which deals with smoking in motor vehicles with children in the car. The bill had previously been placed in the Senate Transportation Committee. Sen. Thomas requested that it be moved to the Senate Health and Human Services Committee. It is likely that he will amend this bill in an effort to place his ban on smoking, which is fairly broad, to this legislation. His bill, SB 577, has failed to move. The Senate approved its Local Consent Calendar without objection by a vote of 41 to zero. The first bill on its Rules Calendar was SB 458 which is the bill dealing with physician's assistants and redefines the job description for a physician's assistant, inactive licensure status, etc. The bill arrived on the Senate Floor by committee substitute. A delegation of authorities amendment was also proposed. Sen. Unterman presented her bill, which has been in the "works" since August. Sen. Unterman explained that SB 458 did not change the scope of practice for a physician's assistant and that they would still be overseen by a licensed, practicing physician. There are currently more than 2,000 physician's assistants in Georgia. Additionally, Sen. Unterman pointed out that a number of these physician's assistants work in free clinics giving of their time and talents which are critical in times when there are budgetary woes. Sen. Nadine Thomas rose to speak to the amendment which would allow advanced practice registered nurses ("APRNs") the ability to prescribe pharmaceuticals (either written or verbal). Sen. Unterman explained that she had not read the amendment which was offered. Sen. Thomas explained that nurses would be working under a collaborative practice agreement with a licensed physician. These APRNs are nurse practitioners, certified nurse anesthetists, and nurse midwives. Like physician's assistants, APRNs also perform work in free clinics around the State. Sen. Thomas suggested that a number of entities and persons supported this amendment such as the Georgia Commission on Women; many physicians; and the Georgia Nurses Association, among others. Sen. Thomas also pointed out that while the Medical Association of Georgia opposed this amendment, it was not truly representative of all physicians in the State as not all physicians are members of the Medical Association of Georgia. Sen. Butler also offered her support for Sen. Thomas' amendment stating that Georgia is the only state which will not allow advanced practice registered nurses the ability to prescribe. Sen. Butler also pointed out that 96 of Georgia's 159 counties have been designated as having a shortage of health professionals. Sen. Unterman asked for a ruling on germaneness for the amendment proposed. Lt. Governor Taylor ruled that it was germane to the underlying legislation. Sen. Unterman inquired if she could object to such ruling; Sen. Thomas referred Sen. Unterman to the Code Sections involved. Sen. Unterman then moved to table the bill. Her motion carried by a vote of 32 to 17. It is likely that Sen. Thomas may have had enough votes to pass her proposed amendment, which has long been fought by physicians. Sen. Tolleson spoke to SB 528, which is a bill dealing with firearms background checks. Currently, these are done by the Dept. of Public Safety but it does not have enough personnel to conduct such checks and oversee the licensing process for firearms. The Dept. of Revenue was asked if it could handle such licensing and reluctantly it agreed as it has more computer capability to track this licensing. This bill passed the Senate by a vote of 49 to zero. SB 554 was presented by Sen. Hall, which proposes the "Spread-the-Word Program." This would allow a used book program in an effort to get books to children who need them. The books would be reviewed for content and would apply for those children in kindergarten through fifth grade. The bill passed without objection by a vote of 52 to zero. SB 564 was the last bill on the calendar and was presented by Sen. Collins. This proposes not to allow the State to use a person's social security number as their driver's license number. Currently, there are approximately 25% of Georgia driver's licenses which use a person's social security number. This bill was offered in an effort to help stymie identity theft. There are more incidents of identity theft in the nation than any other category of white collar crime. Georgia also has victims of such crimes. So far in 2004, the Governor's Office of Consumer Affairs has received 170 identity theft complaints. The Federal Trade Commission has also received 1,500 identity fraud complaints from Georgia this year. Georgia ranks thirteenth nationally in the number of incidents of this crime (with the largest numbers in the Atlanta, Marietta, and Decatur areas). Sen. Crotts tried to amend the bill by adding that any driver's licenses of "non-citizens" be identified with a green transparent line on the license in order to identify those individuals. Sen. Zamarripa opposed the amendment as it has no bearing on a person's stature. Additionally, he argued that Sen. Crotts proposed that driver's licenses were a privilege when they are not. Sen. Clay also inquired about tracking a person's citizenship status and persons who were in the United States on a temporary basis or whether this was for persons who had applied for citizenship and were waiting out the time for the completion of such process. Sen. Zamarripa agreed that there were problems with immigration but this was not the answer as it would potentially set up an abusive practice by police officers. Sen. Fort also inquired what such amendment would do to Georgia's ability to participate in the Free Trade of Americas. Finally, Sen. Crotts withdrew his amendment; the Floor Amendment offered by Sen. Collins passed by a vote of 38 to zero and the bill as amendment was passed by a vote of 49 to zero. On the House side, it had 18 bills on its calendar. Here are a few on which action was taken: HB 656 – a bill which addresses consumer reporting agencies and amends notification requirements HB 984 – a bill which proposes income tax credits in certain tier 1 counties for telecommunications businesses HB 1304 – a bill which addresses the timely payments for goods and services by local boards of education and what happens when there is lack of compliance HB 1512 – a measure dealing with chiropractors and additional authority of the board of examiners HB 1528 – a sales tax exemption measure dealing with tangible personal property of corporate attractions HB 1410 – a bill dealing with income taxes and exemptions for organ donation expenses HB 1615 – a bill dealing with surface and ground water and regulation of inter-basin and intra-basin transfers regulation Committee News March 9, 2004 On March 9, 2004, the House Healthcare Facilities Subcommittee of the House Human Services Committee passed out HB 1704, a bill by Rep. Jay Shaw. HB 1704 proposes to require an annual report be provided to the General Assembly on the status of the State's Medicaid program. Additionally, it would require the General Assembly to act on moving forward with a managed care initiative for the State's Medicaid program. Also, on March 9, 2004, the House Health Professions Subcommittee of the House Human Services Committee met. It took up HB 1533, a bill by Rep. Austin Scott concerning the uninsured that are being charged more by hospitals than those persons who have some type of healthcare coverage. Rep. Scott presented his bill as well as recent news articles from USA Today and the Wall Street Journal on this issue. Monty Veazey with the Georgia Alliance of Community Hospitals opposed the bill as he was uncertain what Rep. Scott was trying to accomplish. Hospitals write off charity care. He also explained that not all uninsured lacked the ability to pay. Many choose not to have insurance even though they have insurance options available to them and can afford such. Additionally, if such a person is treated at a hospital, Mr. Veazey pointed out, fees are often discounted. If the State moves to an HMO program, this would change the Medicaid rates; currently, Medicaid does not cover the charges currently charged by hospitals. He urged the Subcommittee to look at the financial impact. He also asked that all providers, not just hospitals, be included, if the Subcommittee wished to move the legislation forward. Rep. Scott stated that he looked at hospitals' Medicaid cost reports. He found the average discount for Phoebe Putney Memorial Hospital to be 38%. Private insurers and the State's Medicaid program set these discount rates with the hospitals. He stated that hospitals cannot discount their rates below costs. Rep. Scott also argued that his bill would help those persons who are above the federal poverty level. The Subcommittee and the author also engaged in a discussion regarding the State's Indigent Care Trust Fund. Rep. Scott explained the he had been told by someone at Georgia State University that a person who qualifies for the Indigent Care Trust Fund has the hospital submit his or her bill to the Indigent Care Trust Fund which pays $.65 for each dollar charged. Rep. Scott made it appear that hospitals were making monies through the Indigent Care Trust Fund as he stated that the cost-to-charge ratio is approximately 45%. Holly Snow with the Georgia Hospital Association explained that hospitals also thought this bill needed to include other providers. She explained that hospitals already had a fragile system but that the Subcommittee needed to look at "who were the uninsured." Rep. Jeff Brown inquired if he could get information on the pricing structures involved – there were also discussions by Tish Towns regarding how hospitals are paid based on the DRG involved. Mr. Veazey explained that hospitals encouraged persons, not just those who are uninsured, to make financial arrangements. Hospitals prepare pro formas and have goals of making a 4% bottom line (which is the national average) so that they can purchase state-of-the-art equipment. Rep. Scott explained that this was not about insurance but was an attempt to get hospitals to charge the same price. He also explained that medical issues were the second reason for bankruptcies. After lengthy discussion, the Subcommittee voted to move the bill forward. However, Rep. Jackson, the chair of this Subcommittee, indicated that the bill might not be on the full Committee's agenda. This Subcommittee also moved out Rep. Manning's resolution, HR 1307, which urges the Departments of Community Health and Human Resources to address the waiting lists. March 10, 2004 The House Industrial Relations Subcommittee on Employment Security met and took up a number of issues. HB 112, by Rep. Black, was presented at the request of the Valdosta Chamber of Commerce. It proposes to require an employee to comply with a company's attendance policy. It would amend O.C.G.A. § 34-8-194(2)(B)(iii): "The discharge occurred because of absenteeism and the absences were caused by illness of the claimant or a family member, unless: (I) the claimant has without justification failed to notify the employer; or (II) the claimant's absenteeism violated the employer's attendance policies, orders, rules, or instructions; the claimant was made aware of such attendance policies, orders, rules, or instructions by the employer or through common knowledge; and such attendance policies, orders, rules, or instructions are lawful and reasonably related to the job environment and job performance." Elizabeth Appley, on behalf of the AFL-CIO, opposed the bill. Ensuring access to workers is critical; this bill does nothing to accommodate that. This would make it even easier to disqualify an individual from workers' compensation benefits. Ms. Appley also noted that only a small number of employees actually get employee manuals which outline their rights and benefits. Additionally, counsel to the Dept. of Labor opposed the bill, agreeing with Ms. Appley. He explained that the federal government requires an employee to have misconduct before benefits are denied. This proposal by Rep. Black would create a no fault policy. Policy cannot govern a person's behavior due to illness. He fears that if the General Assembly were to pass HB 112 it would be repealed as it conflicts with federal law. Earl Rogers, with the Georgia Chamber of Commerce, supported Rep. Black's initiative on behalf of the Valdosta Chamber of Commerce. He explained that employees were gaming the system by taking all their "sick" days and more. Rep. Williams moved for passage of the bill. The bill failed by a vote of 3 to 4. This Subcommittee also took up HB 1583 by Rep. Tommy Smith. This states that you cannot deny persons unemployment compensation due to circumstances that are no fault of their own or due to undue family hardships such as being a victim of domestic violence or if they are ill, must care for an elderly family member, etc. This would allow those persons to access the benefits as long as those persons seek employment and are available for work. Between 25 and 30 other states have adopted similar laws. Rep. Smith argued that Georgia's laws had not been keeping pace with societal problems. Rep. Williams asked why the General Assembly was not addressing laws which would impact the perpetrator of domestic violence rather than the victim. Elizabeth Appley also testified about this bill on behalf of the Coalition of Georgia's Working Families. She stated that passage of this bill would help to make Georgia prosperous and update the State's unemployment insurance laws. It would help working families. She cited that 1.5 million women are assaulted annually. 90% of domestic violence victims claim workers' compensation benefits are an issue for them for leaving their batterer. The bill states that an employer's experience rating account would not be impacted by the bill (Rep. Bannister asked who would pay.). Amy Fincher, with the Georgia Chamber of Commerce, testified against this legislation as it seeks to expand unemployment benefits to include a social issue. Additionally, unemployment is paid by employers at 100% with a 30% surcharge. Passage of this legislation might only cause the surcharge to be increased. Family violence, per Ms. Fincher, is a problem but should not be placed on the backs of employers. Roy Bowen, a lobbyist for the Georgia Textiles Manufacturing Association, also opposed the bill as did Harold Bevis, a lobbyist for Delta Air Lines. An organization known as 9 to 5 spoke in favor of the bill as it would be good for low income families. Rep. Orrock also spoke in favor of the legislation citing that Maine and Colorado had found six women who had availed themselves of the coverage provided by similar laws. She argued that this law would not negatively impact the workers' compensation program in a negative manner. She stated that one problem was that the workers' compensation fund had begun to get cuts in 1993 when taxes to employers were cut. There have been $2 billion in cuts since that time. Georgia previously had one of the healthiest funds. Rep. Teilhet moved to strike language in the bill "the individual knows or reasonably believes that" and his motion carried. However, the motion to move the bill as amended by Rep. Teilhet failed to carry. Thus, the bill did not pass out of Subcommittee. This Subcommittee also passed HB 1573, limiting a hospital's charges to the uninsured and other payors to the charges a hospital makes to its owned managed care entity (if it owns one). GHA opposed this bill, but it passed out of concern for overcharging uninsured persons. The House Industrial Relations Subcommittee on Workers Compensation met. This is a Subcommittee chaired by Rep. Bordeaux. HB 1574 was presented by Rep. Hill which proposes to amend the law governing law enforcement officers' benefits temporary and permanent disability benefits. Currently, there is a 30 day filing deadline for those benefits but persons are actually filing between 30 and 60 days. This bill proposes that such filing be done in 60 days from the date of the incident. There were concerns that language contained in the bill would allow the revival of dead claims (those filed since July 1, 2001). The bill was amended to reflect that this would address those claims filed after July 1, 2004. The bill passed. This Subcommittee also took up HB 1579 which is the bill dealing with the Subsequent Injury Trust Fund. Rep. Oliver explained that there had been extensive hearings on the issue and that she and Rep. Bannister had worked together on the legislation. A substitute was drawn in an effort to address some concerns raised. This substitute extends the ending date for new claims for eligible employers from July 1, 2005 to July 1, 2007. It also specifies injury and not claim which will supposedly help phase out claims. Rep. Oliver explained that this SITF is a secondary insurer or reinsurance for employers and insurers. It does not impact employees. It does require that the first 104 weeks of injury must be paid by the employer (or its insurers). There is no statute of limitations for an employer to file except that it is anytime during the 78 weeks that the employer is getting paid. The substitute also requires that the SITF must conduct an actuarial study by January 1, 2005. The SITF will also continue until 2020 when it will be discharged from its duties. There would be resolutions done to take action on this date certain. Rep. Oliver explained that this was intentionally a long phase out period. The General Assembly must deal with the policy question. 18 other states have repealed similar funds. Rep. Oliver explained that many employers win, but many also lose. The losers are often small employers. There were a number of questions raised such as the rationale behind the actuarial study and why the investigation prior to the dissolution. The actuarial study is to uncover the potential liabilities. If the liabilities change, the General Assembly may then address the proposal again. SITF assessments would decline over time. There were also concerns that workers compensation might actually rise. There were concerns too that private insurers might punish employers in regard to this. Currently, the SITF pays employers to take workers who have been injured on the job previously. Likewise, there were questions raised about ADA practices. Builders Insurance Group favors this legislation as do the Independent Insurance Association. Entities such as Children's Healthcare of Atlanta do not favor the bill as they manage to gain monies from the system. There were others who did not support the bill such as the Georgia Trial Lawyers Association; Georgia Hospital Association; ACCG; and others. Legislators questioned why there had not been any gubernatorial action by the last two governors on the Fund (such as placing persons on its Board of Trustees). Also, there were inquiries concerning why the Workers Compensation Advisory Committee had not been counseled more and why no Legislative Study Committee had been "staffed" even though legislation had passed last Session. In the end, a motion was made to table the bill. It failed by a vote of 4 to 5. The bill passed by a vote of 6 to 4. The House Health and Human Services Committee also met. It passed out HB 1204 which proposes to provide an exemption from liability to providers who provide healthcare in free clinics. There were amendments made to the bill in an effort to cover more professions. The bill passed as amended even though some Committee Members voted no to its passage. Rep. Bob Smith also brought HB 1653 which proposes the creation of a Commission on the Hard of Hearing. This Commission would be created subject to availability of monies. HB 1653 passed. Rep. Parsons' bill dealing with cosmetologists, HB 1024, passed by committee substitute. The bill lowers the age to 16 so that a person can seek licensing if he or she has been trained as a cosmetologist (currently, the law is 17). It also requires that those 16 must remain in school and have a B average if they have not completed school or obtained a GED. There were attempts by Rep. Henson to amend the grade average requirements in the bill. She withdrew her amendment prior to the vote on passage of the substitute. HR 1307 also cleared this Committee which urges the Departments of Community Health and Human Resources to address a plan for persons of developmental disabilities who are on the waiting list for services. HB 1711, Chairman Childers' bill on free clinics, was held as HB 1204 passed out of Committee. There was also a question on Rep. Scott's bill dealing with hospital's charges to uninsured patients and why that bill had not been placed on this Committee's agenda. Chairman Childers stated a similar bill had been introduced and it had been assigned to the House Industrial Relations Committee, which will address that subject. March 11, 2004 The Senate Insurance and Labor Committee met. It took up SB 584 which would allow state employees to make charitable donations through a payroll deduction (this is very similar to another bill offered by Sen. Faye Smith). The bill was before the Committee by Committee Substitute which adds some consumer protections so that the Secretary of State and the Dept. of Insurance may have the ability to investigate such charities. The charities must have a registered agent in Georgia for the donation to be made through payroll. Sen. Unterman presented this bill and explained that one organization which she was familiar with would be Doctors Without Borders. Stacey Freeman, an attorney with McKenna Long Aldridge, stated that this bill was brought about at the request of Global Impact which oversees international charities and helps them with their fundraising initiatives. The bill passed unanimously out of Committee. The next bill was SB 604, which amends last year's law on vaccination requirements. The bill amends O.C.G.A. § 45-9-108.1. It would address full-time employees and not part-time employees. The Dept. of Administrative Services raised concerns that the bill creates a presumption that a person was hurt or infected in the line of duty. This would require the Department to rebut that presumption. Sen. Harp argued that the General Assembly should give those first line defenders who are subject to hepatitis, tuberculosis, HIV/AIDS that presumption since they risk their lives daily and expose themselves to more risks. Lasa Joiner explained that the bill can require a pre-employment physical to check for diseases and can also require vaccination. If the employee refuses, then the employee cannot apply for benefits. There are also ways now to trace disease due to incident reports. This bill passed with added language to also cover HIV/AIDS. Kirk McGhee presented SB 350 which addresses the processing of health insurance claims. Currently, the law states that insurers must pay, deny or respond to claims submitted by providers within 15 working days. This bill would allow insurers to pay, deny or otherwise respond to electronic claims within 15 days and 30 days for paper claims. Initially, there was additional language in the bill addressing the ability of the Dept. of Insurance to oversee this process with a percentage requirement for health plans compliance or otherwise they would be subjected to penalties. That language was stripped from the bill. Sen. Lamutt explained that he would rather the bill follow federal requirements which is 14 days for electronic and 27 days for paper. The bill passed by substitute with the changes noted. The Senate Insurance and Labor Committee held SR 879, a Resolution by Sen. Squires, and did not call SB 608, a bill by Sen. Shafer. The Senate Finance Committee also met. It passed out a number of bills presented by Rep. Royal: HB 1103 – requires a 60 day notice on taxation issues relating to covenants HB 1238 – bill requested by Lockheed HB 1239 – the Dept. of Revenue's bill dealing with purchaser's exemptions HB 1457 – the Dept. of Revenue's bill amending the law governing vendor contracts of $100,000 or more HB 1461 – the Dept. of Revenue's bill amending the law governing what tax matters relating to legislators may be disclosed to the media HB 1437 – the Dept. of Revenue's bill updating the Code on Internal Revenue Code standards, etc. This Committee also passed out Rep. Buck's Resolution proposing a Constitutional Amendment concerning rent-restricted properties which receive tax credits. HR 1095 ran into some trouble concerning the use of low income language in the Resolution which might prejudice voters. Prior to getting the bill on the Senate Floor, efforts are to be made to address the language concern and yet not make the language run afoul of federal requirements which state "low income" for these qualified affordable housing projects to receive the tax credits. The problem that has arisen is that the credits are somehow placed back into the value of the property for taxation purposes. The House Industrial Relations Committee met. The first bill on the agenda was the SITF bill, HB 1579. Rep. Oliver explained that the quasi-state agency which oversees this fund has no legislative oversight and there are inequities in the fund. A substitute to the substitute was presented which would require actuarial services be obtained and performed prior to 2005. Rep. Orrock raised concerns over the legislation as the employee does not have a stake in this fund. Currently, the fund provides an incentive to employers to hire workers with special needs. Rep. Orrock tried to amend the bill to offer some protection to the employees but her amendment failed. The Committee passed the new substitute to HB 1579. Next it heard SB 485 which will attach the Georgia Medical Center Authority to a State agency for administrative purposes. This Authority would be attached to the Dept. of Community Affairs. This too passed out of Committee. HB 1574 was also before the Committee. Rep. Hill asked for Rep. Orrock to present the bill in his absence. This legislation dealing with filing deadlines to claim disabilities by firefighters passed out of the full Committee with an amendment taking the date back to July 1, 2001 rather than 2004. HB 1706 also cleared this Committee. HB 1708, which is Speaker Coleman's bill dealing with furloughs of state employees and hiring of new employees when others previously in those jobs were furloughed, also passed this Committee. No other bills were taken up even though Rep. Scott's bill dealing with managed care contracts was on the agenda. The Senate Agriculture and Consumer Affairs Committee also met regarding Sen. Adelman's bill SB 443. Sen. Adelman attempted to address gift cards' dormancy fees. There was a substitute presented which had been drawn by Sens. Kemp and Bulloch which basically gutted the original intent of Sen. Adelman's bill. Sen. Adelman expressed that it was not the substitute bill which he was supporting as it only prescribes disclosure which should be made and which should be on the front of the card rather than the back of the card. Lobbyists for the banking industry had apparently worked the nerves of Sens. Bulloch and Kemp to get them to redraw this bill taking out the language relating to dormancy fees. Sen. Adelman also noted that Sen. Unterman had authored a bill identical to his original bill, SB 443, with other Senate Leadership, so apparently the issue is one that they would support. In the end, the Committee voted to pass the Substitute with changes noted. The Senate Judiciary Committee was slated to meet but could not locate a quorum so the meeting was canceled. The Senate Health and Human Services Committee met. No vote was taken on SB 455 which is a bill offered by Sen. Nadine Thomas so as not to require physicians who work in hospitals to be covered by medical malpractice insurance. Sen. Kemp presented his bill on electronic medical records. He explained that these records would be password protected and would have to follow the federal privacy laws in HIPAA. It would allow any provider, facility or licensed professional to convert medical records to an electronic format. John Walraven with the Medical Association of Georgia expressed support to Georgia Electronic Commission's work on this bill. Martha Phillips with the Georgia Dental Association inquired if dentists and hygienists could be included as such electronic medical records was not mandatory. In the end, there was a discussion to work on the entire provider lists. The bill passed. Sen. Balfour inquired as to why the Committee would not take up SB 376, the nurse prescribing bill. In essence, Chairman Thomas stated the bill was not ready. SB 582 also cleared this Committee which deals with the Brain and Spinal Injury Trust Fund and allows for a central registry to be transferred from the Dept. of Labor to the Brain and Spinal Cord Commission for management. Apparently, there is some confusion over the contents of the registry and the fact that there are three such registries in place – hospitals have complained because the mandated one is not in electronic format. Thus, the Georgia Hospital Association will be working with this Commission to assure compliance with the law on discharge data on these types of cases. Finally, the Committee took action on SB 468, a bill by Sen. Levetan, which proposes a system to pay for indigent care patients who are treated in hospitals outside of their county of residence. SB 468 passed and is now on its way to the Senate Rules Committee. March 12, 2004 This Committee held a brief meeting on Friday morning to hear SB 608 and SR 879. SB 608 was explained by Sen. Shafer with assistance from Kirk McGhee. It proposes to allow health maintenance organizations which have met one of the national standards on quality, such as NCQA, not to be required to follow 1980 regulations currently in place within the Dept. of Human Resources. HMOs are also governed by the Dept. of Insurance. The 1980 regulations really dealt more with staff model HMOs. The newer national standards are more strict and a better check for health improvement of individuals. 30 other states are doing these "deeming" standards. The Medical Director for United Healthcare also supported SB 608. The bill passed without changes or discussion. SR 879 was presented by Sen. Squires but the quorum of the Committee was lost so her Resolution did not have any action taken. It proposes to allow employers to get $3,000 tax credits when they offer employees healthcare benefits. Sen. Squires did explain that this was merely the Constitutional Amendment but the House would need to offer enabling legislation on this issue if such were passed. The House Appropriations Committee voted out its version of the FY 2005 Budget proposal mid-afternoon. Here are a few highlights: Under Funds Available: Originally, the Governor had proposed a total of $16,125,208,162. The House came up with $16,215,522,162 by adding a million dollars from the Brain and Spinal Injury Trust Fund (it is now at $3 million) and raising the Indigent Care Trust Fund to $109,857,425 (versus the Governor's proposal of $20,543,425). Judicial Branch: The Governor had proposed $714,711 for salary adjustments equalizing District Attorneys' salaries to those of Superior Court Judges. The House zeroed that amount out. The House also eliminated the proposed $589,402 to provide administrative and technology funds for the Administrative Office of the Courts for services provided to the Georgia Public Defender Standards Council. Community Health: The House Appropriations Committee split in half the proposed cut to hospitals of $9.5 million to $4,750,000 million the proposal for the Department to implement a fixed fee reimbursement methodology for Ambulatory Surgical Services provided in an outpatient hospital setting (this would bring the total funds, with federal monies, to a cut of $12,185,839). The Committee also increased the cut of $9.3 million to more than $14.8 million the proposal to implement a supplemental drug rebate program for all drug classes and include the Texas Implementation of Medication Algorithms guidelines for treating schizophrenia. The Committee also lessened the cut to pharmacists by taking the proposed cut of $2.3 million to $999,162 by increasing the Average Wholesale Price discount from 10% to 11% (the Governor had proposed the 12% number). The total monies, with federal dollars attached to the new proposal would be a cut of $2,550,166. The Committee did not agree to implement premiums on families with children enrolled in the Katie Beckett Waiver Program and zeroed this item out. The Governor had proposed this would be a savings of $1,506,185 if these premiums were implemented. The Governor had proposed a savings of more than $5.6 million by eliminating coverage of the optional services for Adult Dental Services in the Medicaid program. The House did not agree to the elimination. The Governor had proposed a savings by eliminating Medicaid coverage for those with incomes exceeding 185% of the federal poverty level of more than $17.6 million. The House agreed that there should be some elimination but only for those over 200% of FPL. This lessens the cut to $12.8 million (with federal monies it would be more than $32 million). One of the most interesting items is that the Committee proposed to implement a targeted case management program for frequent users of emergency room services. This would be a savings of State monies of more than $1.8 million (with federal monies a cut of more than $4.5 million). This implementation of a preferred provider organization was proposed rather than a full-fledged HMO arrangement, which the Governor has been seeking. MRN/GA First has been working on this PPO arrangement. Another item the Committee included was to use existing SOURCE sites to provide disease case management to members with the highest Medicaid cost which would be a proposed savings of $985,946 (with federal funds a savings of more than $2.4 million). The Committee also proposed to increase the employer contribution to the State Health Benefit Plan for public schools and state employees to match prior employee premiums increases (this would bring in an additional $133,958). Department of Education: The Committee proposed not to eliminate the funding for Vocational Lab Supervisors. The Governor had proposed this elimination which would be a savings of more than $5.8 million. The Committee proposed to increase the Local Five Mill Share which would be a savings of more than $83 million. The Governor had also proposed this but arrived at a $21.9 million savings. The Committee also proposed to add $277,967,264 to continue QBE formula funding for more than 5,000 classroom teachers, counselors, psychologists, social workers and other support personnel and the related classroom materials in reduction number 3. Human Resources: Governor Perdue had proposed reducing funding for regional tertiary care centers by $450,000. The House Committee said no to this and reinstated that cut. The Governor had proposed cutting $66,562 from the Long Term Care Ombudsman Program's operating expenses. The Committee agreed to a cut but softened that cut to $23,281. The completion of closure of the Craig Nursing Home at Central State Hospital in Milledgeville did not sit well with the Committee. The Governor had proposed this item as it would be savings of more than $1 million. The House zeroed this out. Governor Perdue had proposed reducing the grant-in-aid to county health departments by 7%. The House placed this at 5% so the cut will be $3.5 million rather than $4.6 million. One of the biggest changes in this portion of the Budget deals with Child Protective Services. Governor Perdue had proposed $11 million to fund the initial development and implementation of the child welfare computer system (SACWIS). The House Committee said no to this and did not place any monies to fund this item. The House Committee also did not agree to transitioning 20 consumers with developmental disabilities from hospitals to community services (the House stated that these persons could remain in hospitals). The Governor had proposed an expenditure of $1.1 million to do this; the House zeroed these monies out as well. The Committee proposed a new addition of $218,035 to fund 10 Unlock the Waiting List developmental disability slots. Board of Regents: Governor Perdue had proposed a $15.5 million cut by reducing funding for Special Funding Initiatives. The House added back monies for these initiatives: Enhancing Access/Liberty Center/$188,000; Water Policy Center/$560,000; Georgia Southern IT program/$96,233; and the ICAPP programs/$1,777,296. This brings this cut to $12.8 million. The House Committee lessened the cut to Georgia Public Library Service and Public Libraries. The Governor had proposed a cut of $2,194,906; the Committee provided for a cut of $944,096. Governor Perdue had proposed an addition of $1,250,000 to provide funding to Georgia Public Library Service for PINES to maintain statewide materials-sharing operations. The House Committee zeroed those monies out. The House did make a couple of new additions: 1) more than $6.5 million to fund additional personal services to preclude further instructional reductions (research of $2,580,600; and instruction of $4,000,000); and 2) $2 million to provide funding for federal land grant match. If you have any questions regarding this Report, please contact Stanley S. Jones, Jr., Jeffrey C. Baxter, or Helen Sloat. |
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